Sexual impotence after Prostate Cancer Surgery

It is common for the majority of men to experience incontinence after surgery and have occasional dribbling when coughing or exerting themselves. A few will lose all urinary permanently. Some men are candidates for an artificial urinary sphincter which is implanted surgically or narrowing the bladder opening with injections of collagen.

Stool or fecal incontinence (loss of normal muscle control of the bowels) may affect some men after their prostatectomy. This is caused by muscle damage during rectal surgery and stool incontinence is also caused because of a reduction of the elasticity of the rectum. What this does is shorten the time period between the sensation of the stool and the need to have a bowel movement. The rectum can be scarred and stiffened by surgery or radiation.

Historically, a prostatectomy always resulted in sexual impotence. Advances in surgical procedures called “nerve-sparing surgery” may reduce the risk of impotence. The nerve sparing technique avoids cutting the two bundles of nerves and vessels that run along the surface of the prostate gland that are needed for an erection.

Unfortunately, this procedure is not viable for everyone, if the cancer is too large or if it is located too close to the nerves. Under these circumstances, even with this technique many men (especially older men) will become impotent.

The fact is that most men will lose a degree of sexual function and if a man has a problem with erections before treatment, the nerve-sparing surgery is not indicated.

The chances of impotence run the gamut from 20 to 90% depending on age, stage of the disease and the type of surgery.