Impotence, also known as erectile dysfunction (ED), refers to the inability to have an erection for sexual intercourse. Several prostate cancer treatments have been shown to cause ED. These include:
- Radical Prostatectomy (RP): This surgery involves the removal of the prostate gland and tissues that surround it. A retropubic approach is the most common way to perform radical prostatectomy; it involves the removal of the prostate gland and lymph nodes through an abdominal incision above the pubis. Other radical prostatectomy approaches include a “nerve-sparing” radical prostatectomy in which a surgeon removes the prostate gland but tries to save the nerves/tissues that closely surround the prostate gland and are responsible for erections. RP is also commonly done through a robotic (laparoscopic) approach that involves the use of small cuts and a long, thin video camera and small instruments that enables a surgeon to see with greater detail and magnification and use delicate instruments to operate inside the body. Learn more about robotic-assisted surgery, including the da Vinci surgical system, here.
- Radiation Therapy: This treatment requires no anesthesia and is commonly administered to older men or men who are dealing with heart problems or other health issues. Two types of radiation therapy treatments are used to address prostate cancer: external beam radiation, or brachytherapy (internal radiation). External beam radiation therapy (EBRT) involves the use of a machine to emit radiation beams on the prostate gland; it generally is utilized to cure early-stage prostate cancer. Brachytherapy involves small radioactive pellets, or “seeds,” that are placed directly into the prostate; like EBRT, brachytherapy is used to treat early-stage prostate cancer.
- Hormone Therapy: Commonly referred to as androgen suppression therapy, hormone therapy for prostate cancer blocks the production and use of androgens, hormones that are responsible for the development and maintenance of male characteristics. Dihydrotestosterone (DHT) and testosterone are two of the most abundant androgens in men, and both promote prostate cancer growth. Suppressing their production can result in sexual dysfunction and potentially ED.
The above prostate cancer treatment options have been shown to help cure the disease or prolong the life of individuals affected by it. However, if an individual experiences erectile dysfunction after undergoing one of these prostate cancer treatments, options are available to resolve this problem.
What Causes Erectile Dysfunction?
To find the right treatment for erectile dysfunction, an individual must first identify the root cause of the issue. In many instances, ED is linked to physical causes, and these include:
- Obesity: Obese men have lower levels of testosterone than others; a lack of testosterone makes it difficult to produce nitric oxide, a blood vessel dilator in penile tissue that is essential to have an erection during sex.
- Diabetes: ED is common in men who are dealing with type 2 diabetes, as this condition causes damage to nerves and blood vessels due to poor long-term blood sugar management.
- Atherosclerosis: Atherosclerosis refers to the formation of fatty deposits that clog arteries. It increases a person’s risk of obesity and may eventually lead to ED.
- High Blood Pressure: High blood pressure causes the arteries to become thicker than ever before or burst. It may also restrict blood flow to the penis, resulting in ED.
- High Cholesterol: High cholesterol often causes reduced blood flow that leads to ED and other sexual disorders.
- Smoking Cigarettes: Smoking cigarettes damages the blood vessels, including those in the penis that are critical to have an erection during sex.
- Heart Disease: ED frequently precludes heart problems and occurs due to plaque build-up in the arteries that limits blood flow to the penis.
- Thyroid Issues: Studies indicate there is a strong connection between ED and hypothyroidism, hyperthyroidism, and other thyroid problems.
- Alcoholism: Alcohol is a depressant that reduces a man’s sexual desire and hinders his ability to have an erection or achieve orgasm during sex.
- Parkinson’s Disease: ED is one of the most common sexual problems for Parkinson’s disease patients, and anxiety, sleep problems, and other non-motor issues sometimes make it tough for these patients to achieve or maintain an erection.
- Multiple Sclerosis (MS): ED is one of many sexual problems that may affect MS patients; in fact, the National Multiple Sclerosis Society notes a recent study indicated 63% of MS patients reported a decline in sexual activity following their diagnosis.
- Peyronie’s Disease: Men with Peyronie’s disease experience hardened scar tissue around the penis. Peyronie’s disease makes the penis less flexible and causes it to bend, and in some instances, may lead to ED.
- Pelvic Trauma: Research shows ED and other types of sexual dysfunction are more common in men who experience pelvic trauma.
- Long-Distance Cycling: Sitting on a bicycle for an extended period of time puts pressure on the perineum, an area that runs between the penis and anus. Long-distance cycling may cause numbness of the perineum that makes it difficult for men to have an erection.
A urologist possesses the skills and expertise to help ED patients address any of the following physical problems. Together, a urologist and patient can determine the best way to treat ED.
Erectile Dysfunction Treatments: Here’s What You Need to Know
Erectile dysfunction treatment varies based on the patient. Fortunately, a urologist allocates time and resources to learn about a patient prior to administering treatment. A urologist takes a comprehensive approach to ED diagnosis to ensure each patient receives a personalized treatment designed to help this individual achieve the optimal results.
To treat ED, a urologist first meets with a patient. The urologist then performs a physical examination and requests information about a patient’s medical history. Furthermore, a urologist may order non-invasive and invasive medical tests for proper ED diagnosis. These tests include:
- Blood and Urine Tests: Used to identify diabetes, heart disease, low testosterone, and other physical conditions.
- Ultrasound or MRI: Used to determine if vascular or blood flow issues are causing ED; an ultrasound or MRI may be used in combination with an injection of medicine that stimulates blood flow and make the penis erect.
- Nocturnal Erection Monitoring: Requires the use of a device that is placed around the penis while a patient sleeps; the device tracks the strength or number of erections that a patient experiences overnight.
- Psychological Tests: Involves screening a patient for anxiety, depression, and other psychological conditions.
In some cases, patients can treat ED through a series of dietary and lifestyle changes, such as:
- Losing weight
- Maintaining a balanced, healthy diet
- Quitting smoking
- Staying physically active
- Limiting alcohol consumption
- Reducing stress
- Getting at least seven hours of sleep each night
If dietary and lifestyle changes are insufficient, oral and injectable medications are available to treat erectile dysfunction. Oral medication is administered as a pill, but it does not automatically trigger an erection. Instead, oral medication helps a patient gradually improve the nerve signals and chemical reactions that are involved in the process of achieving an erection. Comparatively, injectable medications may be used that are administered into the side of the penis via a small needle. These medications may trigger an erection that lasts between 30 and 60 minutes; conversely, the injections have been linked to bleeding, pain, and other unwanted side effects in some cases.
A penis pump is another option to treat erectile dysfunction. This vacuum pump pulls blood into the penis, and a tension ring is placed around the base of the penis to stop blood from leaving the penis. Or, penile implants may be surgically placed on either side of the penis. These devices are typically a final resort to treat ED after all other methods have failed and help control when and how long a man can have an erection.
Visiting a counselor to address emotional or psychological factors that cause ED may prove helpful, too. Men can often work through emotional or psychological issues with a counselor. Then, they can alleviate the emotional or psychological tension that otherwise causes ED.
Lastly, a penile prosthesis (mechanical pump) placement surgery may be used to give men back their potency, providing erection on demand. This surgery is commonly performed and involves the use of mechanical devices that replace the erectile mechanism of the penis and are implanted inside the penis with them pump inside the scrotum, nothing being visible from outside.
Contact Comprehensive Urology in Los Angeles to Address Erectile Dysfunction After Prostate Cancer Treatment
Erectile dysfunction is a problem that can affect men of all ages, but the issue frequently goes unaddressed. Sometimes, men are embarrassed about ED and choose to ignore the condition. In other instances, men receive improper ED diagnosis and treatment, both of which may do more harm than good.
At Comprehensive Urology in Los Angeles, our team of expert urologists is committed to helping men address the underlying causes of ED. We provide in-depth ED consultations and treatments to help men achieve long-term ED relief. To find out more, please contact us today at (310) 499-2756 to schedule an initial treatment consultation.