Sexual impotence and prostate cancer: understand the relationship


Sexual impotence and prostate cancer: understand the relationship


Prostate cancer is the most common malignancy in men worldwide when we exclude the cancers originate in the skin. It is estimated that approximately 1,300,000 new cases are diagnosed each year worldwide.

In industrialized countries, most cases are diagnosed at an early stage. In developing countries, on the other hand, the disease is usually discovered in more advanced stages.

The sexual impotence is a major concern for men with prostate cancer, and the doctors responsible for prostate cancer treatment. In the medical literature shows a wide variation in the occurrence of this side effect, going 7-90% of cases treated with surgery or radiotherapy.

This wide variation in results occurs due to several factors that hinder the comparison between groups of patients. The amount of information collected in each study differs greatly from one to the other, as do the characteristics of each man, the disease and the degree of experience of the medical team with a particular type of prostate cancer treatment.

It is clear that the occurrence of sexual impotence (erectile dysfunction) is a multifactorial event and that the risk of its occurrence must be discussed individually in each case. In infrequent situations, sexual impotence can be the initial symptom of prostate cancer, says sexologist in Pitampura. This occurs when the disease breaks through the boundaries of the prostatic capsule and infiltrates the nerves that pass around the prostate gland and drive the erection stimulus to the penis.

The decrease in sexual performance can occur naturally with the male ageing process and most of the time it is not related to the presence of prostate cancer.

Since the nerves that drive the erection are either compromised by the infiltration of the disease or destroyed during prostate cancer treatment, naturally driving the stimulus to the penis is no longer possible. In this situation, the use of oral medications does not produce the desired effects. Treatments such as injectable vasodilators in the penile tissue, or even the use of artificial prostheses, appear as treatment alternatives.

Erection performance can also be influenced by decreased libido or sexual desire. This is a relatively common effect and can occur at any point of treatment or even before it. Libido can be influenced by psychological issues related to the diagnosis of prostate cancer itself, as well as being a direct consequence of the use of medications that decrease testosterone levels in order to slow the growth of prostate cancer cells, explains sexologist in Rohini.

These medications are usually used only in cases of advanced prostate cancer or metastases. Soon after the treatment of prostate cancer with surgery, radiation therapy or other methods, the medical team will start a protocol for rehabilitation of sexual function. This involves psychological monitoring of the couple, as well as the use of oral medications that facilitate the arrival of blood flow directly into the penis. This protocol is called first-line rehabilitation for erectile dysfunction treatment in Delhi.

When first-line measures are not effective, treatments considered second-line, such as the injection of vasodilator medications into the penis and even the use of vacuum devices can be useful tools in the rehabilitation of erectile function. Finally, when the two initial measurements do not show satisfactory results, there is the possibility of implanting an artificial device known as a penile prosthesis, suggests sexologist in Delhi.

There is a wide variety of penile prosthesis models, as well as the possibility of implanting malleable or inflatable devices. The procedure is considered definitive and requires surgical intervention. To better understand the risk of sexual impotence occurring after prostate cancer treatment, it is important to keep in mind 5 fundamental factors in the evaluation:

  • Age
  • Other associated health problems
  • Stage at which prostate cancer was diagnosed
  • Treatment modality used
  • Medical staff experience level

There is a group of men who fall into a high-risk category for the occurrence of permanent sexual impotence after treatment for prostate cancer. This group includes men over 65 years of age, with diabetes, obese, smokers, with heart problems, who use antidepressants and in which the disease has been found to have an advanced stage of nerve involvement that drive erection stimuli.

Men who do not have any of the aforementioned characteristics are those at the lowest risk of presenting with permanent sexual impotence. Another variable that must be taken into account is the experience of the attending medical team.

In the case of surgery for the removal of the prostate, there are studies in the medical literature indicating an equivalence in the probability of cure of cancer, regardless of the method of surgery used (open laparoscopic or robotic). However, the results of a recently published meta-analysis indicate that the robotic surgery technique showed better results in terms of faster recovery of urinary continence and erection, less blood loss during surgery, less pain in the postoperative period and fewer days of hospital stay.

But it is important to keep in mind that most comparative studies between surgical techniques come up against methodological problems that prevent an effective comparison. This is because there is great variability in the degree of experience of the urologist in Rohini involved, as well as their stage in the procedure’s learning curve.

What seems clear is that regardless of the method, the more experienced and familiar with the technique, the surgeon achieves better functional results. Treatment modalities such as radiotherapy and other focal therapy methods also have their results influenced by the team’s level of experience urologist in Pitampura. It is clear that maintaining the quality of sexual function involves psychological aspects, health conditions prior to cancer treatment, type of treatment employed, the stage at which the disease was discovered, the treatment modality used and the degree of experience of the medical team.

In order for you and your urologist in Delhi to have an open and enlightening conversation about your risks of presenting this or other sequelae after treatment, it is important to keep in mind all aspects that involve the prostate cancer treatment and its rehabilitation.