After prostate removal, some men may need a penile prosthesis. Learn which patients are eligible for implantation.
Surgical removal of the prostate (prostatectomy) may, in some cases, lead to the development of erectile dysfunction. When this occurs, a penile prosthesis may be considered one of the treatment alternatives, provided it is indicated after an individualized medical evaluation.
Prostate removal, a procedure known as radical prostatectomy, is one of the approaches used in the treatment of prostate cancer and involves removal of the prostate gland and the seminal vesicles. Although it is an effective treatment for oncological disease, this surgery may impact erectile function.
Pelvic surgeries, such as radical prostatectomy, may affect the nerves responsible for erection, either partially or completely. As a result, some patients develop erectile dysfunction to varying degrees and, in some cases, may also experience urinary changes.
The severity of erectile dysfunction varies according to factors such as surgical technique, nerve preservation, age, preexisting clinical conditions, and individual physiological response.
Men who have undergone prostate removal surgery may indeed be candidates for a penile prosthesis. However, the indication depends on a thorough medical evaluation.
When erectile dysfunction is mild or moderate, clinical treatments such as oral medications or intracavernosal injections may be considered before a surgical approach. Penile prosthesis implantation is usually indicated mainly in cases where erectile dysfunction is more severe or when clinical treatments do not provide satisfactory results.
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The penile prosthesis acts as an internal mechanical support and may provide sufficient penile rigidity for penetration during sexual intercourse. Its function is independent of the natural mechanisms of erection, which may be relevant in patients with nerve injury after prostate surgery.
It is important to clarify that, due to removal of the seminal vesicles, men do not ejaculate after radical prostatectomy, even with prosthesis implantation. However, the ability to experience orgasm tends to be preserved and varies according to individual characteristics.
In selected cases, a penile prosthesis may contribute to:
achieving sufficient penile rigidity for penetration, independently of natural erection mechanisms;
greater predictability of erectile response, as activation is controlled by the patient;
preservation of penile sensitivity, since the prosthesis does not act directly on the nerves responsible for sensation;
maintenance of the ability to experience orgasm, which may occur even after prostatectomy, depending on individual factors;
a positive impact on emotional well-being and the couple’s relationship, in a subjective and individual manner.
It is important to emphasize that results vary according to the clinical condition, surgical history, health status, and patient expectations. Indication and potential benefits should always be discussed during an individualized medical evaluation.
Undergoing treatment for prostate cancer is not easy, just as developing erectile dysfunction and seeing your sex life being affected.
For over 28 years, Dr. Paulo Egydio has been helping patients in this situation to regain their sexual health. In addition to erectile dysfunction, he also treats cases of penile curvature, which can be associated with this condition.
To find out if you need a penile prosthesis after prostate removal, get in touch. Dr. Paulo Egydio will use his experience for a personalized analysis and will help you take this step.
