Cancer: Maintaining sexuality after prostatectomy

The prostate and seminal vesicles are responsible for sperm production. Removal of this organ therefore permanently prevents ejaculation. However, orgasm is still possible. Indeed, "since the mechanism of orgasm is independent of that of sperm production, feelings of pleasure and orgasm itself remain possible after prostatectomy and are even more intense for many patients," explains the French Federation of Sexology and Sexual Health (FF3S).

Maintaining an erection

Another consequence of the operation: erection problems, due to the neurovascular damage caused by the procedure. Even if the nerves are preserved, "the tissue contusion is responsible for local inflammatory reactions in the nerve tissue and blood vessels near the prostate," continues the FF3S. This is why no erection is possible in the immediate aftermath of the operation. However, this prolonged absence of erection can have long-term consequences. The corpora cavernosa (erectile tissue of the penis) may be less well oxygenated and fibrosis may develop, making erections difficult in the future.

There are several ways to maintain the tissues and mechanism of erection. In all cases, it involves rehabilitation aimed at maintaining the proper elasticity of the corpora cavernosa by allowing their regular oxygenation. To do this, it is advisable to induce erections regularly, for example by using a local medication. It is also possible to use intracavernous injections.

The last option is the vacuum. "This is a device that allows you to achieve an erection by means of a vacuum – by suction effect – thanks to a plastic cylinder equipped with a pump." This system can be used in conjunction with injections.

The recovery of neurological control of erections varies, but generally occurs between 6 months and 2 years. This is why it is important, in order to gradually regain a satisfying sexuality, to begin early to "reinvent intimacy and complicity in the couple."

"The role of the partner is fundamental in helping the patient find a good balance between all the components of sexuality and not make erection the center of all their sexual behavior," emphasizes the FF3S. "It is important to continue to maintain desire, dialogue, and eroticism within the couple."

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