Can ED be caused by surgery?

Impotence after prostate surgery

If you have recently undergone prostate surgery and are experiencing symptoms of ED for the first time, it’s important to note that this is completely normal. Practically all men will experience some degree of ED during the immediate few months of recovery following this type of surgery. However, the good news is that nearly all patients will see substantial improvement within one year of the operation.

What causes impotence after prostate surgery?

A radical prostatectomy involves the surgical removal of a prostate gland that has become cancerous. Although not the only treatment offered to those with prostate cancer, surgery is a common option if your doctor believes the cancer is contained solely to the prostate gland and has not spread to other areas of the body. 

The surgery involves removing the doughnut-shaped prostate gland, which surrounds the urethra located just below the bladder, as well as any cancerous cells that have developed around this area. The reason why this type of surgery carries a risk when it comes to ED relates to the fact that two small cavernous nerves run along the sides of the prostate. These nerves carry signals from the brain to the penis, controlling the flow of blood that leads to an erection. Even if these nerves don’t need to be removed fully as part of the operation, there is a chance they can become damaged during the procedure. If this happens, the trauma can cause both temporary or permanent ED. 

Although nerve sparing surgery can also be an option – which can prevent damage to the nerves that run alongside the prostate gland – not everyone is suitable for this type of surgery, making it less common than standard radical prostatectomies.

Treatment for erectile dysfunction after prostate surgery

If you are still experiencing substantial ED symptoms a year after your operation, it’s a good idea to talk to your doctor about different treatment options. Below we look into a number of the main treatment options you may want to consider.

• Medication

Your GP may suggest that prescription medication is the best treatment option for you. Drugs like sildenafil, vardenafil, or tadalafil can work to increase the blood flow to the penis, restoring your ability to achieve and maintain an erection.

• Further surgery

If both cavernous nerves are removed during prostate surgery, your best opportunity to overcome ED is likely further surgery. Various devices can now be surgically implanted into the penis to help you get an erection. This can include a small pump that can be surgically fitted under the skin of the scrotum that can be used to pump fluid to small cylinders that are implanted in the penis, creating an erection.

• Exercise

Pelvic floor exercises have been found to improve erectile function in men following prostate surgery. For this reason, your doctor may suggest that you follow a daily routine of simple exercises in the weeks and months after surgery to strengthen your pelvic floor muscles. This can help to restore sexual function, as well as improve urinary control.

Although many ED medications are only available on prescription and cannot be bought over the counter, you don’t have to fight to get a GP appointment when symptoms strike. If you want the convenience of ordering online, you can simply complete a consultation on our website. One of our independent General Pharmaceutical Council-registered prescribers can then review your situation and once it has been approved, we will deliver your medication straight to your door.