Prostate Cancer and Sexual Dysfunction

Lost in the desire to engage in sex commonly results during the treatment process when both partners become so preoccupied with otherwise more important matters that need immediate attention. Depression, anxiety and stress, which all ensue during the treatment, exacerbate the lost of interest in sex. Pain during ejaculation also adds up to this problem. However, more sexual problems arise as the treatment measures move forward.

The nerve that controls the penile erection lies close with the prostate gland. During Radical Prostactectomy or the complete removal of the prostate and the seminal vesicles, the nerve is usually removed together with the prostate gland resulting to complete impotence. This type of surgery, however, remains to be the typical surgical procedure done to cure prostate cancer. Trans-Urethral Resection of the Prostate (TURP) causes dry orgasms. TURP is done by removing a part of the prostate through the passageway of urine in the penis,  in doing so, the constricting valve at the bladder is opened causing the semen to flow to the bladder rather that through the penis. Orgasm occurs without the ejaculation of semen hence the term dry orgasm. Hormonal therapy, done either by orchiectomy (or removal of one or both testes) or through medication, aims to deprive the cancer cells of testosterone by creating a different hormonal balance in male. The deficiency in male hormone reduces sexual desire in men. The psychological effects of having one or both testes removed also heighten the problem. Other treatments like radiation and chemotherapy increase the pain during ejaculation. Decrease in amount of semen during ejaculation is also prevalent.

The chance of recovering penile erection after surgeries has become possible when the nerve is spared during radical prostatectomy. Viagra is found to be effective. Injection of Caverject (alprostadil) is used whenever erection is necessary and is very useful even without stimulation.  Effects of hormonal therapies are usually lessened by counseling of both partners. In the absence of social support referral to “self-help” groups might become necessary.