How to Treat Erectile Dysfunction After Prostate Surgery

If you’ve recently had prostate surgery such a simple prostatectomy or radical prostatectomy, it’s quite common to experience difficulties getting and maintaining an erection following surgery.

In fact, almost all men who have prostate surgery performed will experience sexual performance issues that can last from a few months to several years. 

Depending on the type of surgery you received, your ability to get an erection, as well as your general sexual performance, should improve over time. There are also several treatments that you can use to restore your sexual performance, both in the short and long term.

Below, we’ve explained how prostate surgery can affect your ability to get an erection, as well as what you can expect in the months after surgery. We’ve also listed the most effective options for treating erectile dysfunction (ED) after prostate surgery, from medications to other treatments. 

Why Does Prostate Surgery Cause Erectile Dysfunction?

While prostate cancer doesn’t directly cause erectile dysfunction, the treatments for this form of cancer can affect sexual performance. 

Currently, treating prostate cancer involves either surgically removing part or all of the prostate gland, androgen deprivation therapy (ADT, a type of hormone therapy) or the use of radiation to specifically target and damage the cancer cells. 

Performed properly, these treatments are effective at treating prostate cancer. Studies show that more than 90 percent of men who have a radical prostatectomy will not die from prostate cancer within the next 10 years, with similar survival rates for other treatments. 

However, it’s common to experience erectile dysfunction after prostate surgery. During the surgery to remove cancer-affected areas of the prostate, the nerves and blood vessels that play an essential role in helping you get an erection can become affected.

Even if the surgery is performed with minimal damage to the nerves, the trauma of surgery can make it harder for you to get an erection, even if you feel sexually aroused. 

It’s also relatively common to experience erectile dysfunction after other treatments for prostate cancer. According to John Hopkins Medicine, between 25 percent and 50 percent of men who undergo radiation therapy will experience some level of ED after treatment. ED is also common with androgen deprivation therapy. 

How Common is Erectile Dysfunction After Prostate Surgery?

It’s both extremely common and completely normal to experience difficulties getting an erection after prostate surgery. According to John Hopkins Medicine article linked above, nearly all men will experience some erectile dysfunction in the first few months after prostate cancer treatment. 

Most of the time, this is temporary. Within one year, almost all men with intact nerves following the surgery will experience a significant improvement in sexual performance. In short, if you’re finding it difficult to get an erection after surgery, it may only be a temporary issue.  

Within one year, between 40 and 50 percent of men who’ve had a nerve-sparing prostatectomy will return to their normal, pre-treatment sexual function. Within two years, about 60 percent will return to their pre-treatment function. 

Like with all surgical procedures, the speed and rate of recovery can vary between patients and surgeons. The more nerves your surgeon is able to spare during the procedure, the more likely you are to successfully maintain sexual function. 

How to Treat Erectile Dysfunction After Prostate Surgery

Luckily, even if you do find it more difficult to get an erection after prostate surgery, most cases of erectile dysfunction are treatable. Currently, several treatments are used to improve erections and sexual performance after prostate surgery. 

ED Medications

Most of the time, the most effective treatment for erectile dysfunction following prostate surgery is the use of oral medications. Drugs like Viagra (sildenafil), Cialis (tadalafil), Levitra (vardenafil) and Stendra (avanafil) can make it easier for you to get and maintain an erection.

These medications work by improving blood flow to the erectile tissue of your penis. According to the John Hopkins Medical article avoce, around 75 percent of men who’ve had a nerve-sparing prostatectomy report that they can successfully get an erection with the use of ED medications.

Each of the medications listed above is slightly different. For example, while Viagra lasts for a few hours, a single dose of Cialis can provide relief from erectile dysfunction for as long as two days. Our guide to the most common ED treatments compares them in more detail.

There’s no “best” ED medication for everyone. If you’ve recently had prostate surgery and want to treat ED, the best approach is to discuss your treatment options with your doctor, then opt for the medication they recommend. 

Often, you might need to try more than one medication, or adjust your dose, before you find the most effective treatment for you. Used correctly, these medications can provide lasting, effective relief from the symptoms of ED and allow you to enjoy a healthy, fulfilling sex life. 

Other Treatments

Although ED medications like Viagra, Cialis, Levitra and Stendra are effective for most men after prostate surgery, they don’t work for everyone. Alternative options for treating ED after prostate surgery include:

  • Injectable medications. These medications, such as Prostaglandin E1, are designed to treat ED in men who don’t respond to oral drugs. They’re either injected directly into the penis or inserted into the urethra in pellet form.
  • Vacuum constriction devices (VCD). These devices, or pumps, are designed to draw blood into the erectile tissue of the penis. VCDs are effective for about 80 percent of men who have had prostate surgery.
  • Penile implant surgery. For men with advanced ED who don’t respond to the treatment options listed above, penile implants are an option. Several different penile implants are available, each offering their own range of advantages and disadvantages.

So, What's the Deal?

Erectile dysfunction is a common side effect of prostate surgery. However, it’s usually temporary and can almost always be treated successfully using medications such as Viagra, Cialis, Levitra and Stendra. 

If these medications aren’t effective, other treatments can often help men who’ve had prostate surgery treat ED and improve their sexual performance. 

Learn More About Erectile Dysfunction Treatments

Dealing with erectile dysfunction can be a stressful process. However, almost all cases of ED are treatable. Our guide to the treatment options for ED covers the most effective options for improving your sexual performance, from medications to psychotherapy and more. 

The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of hims, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis or treatment, and should never be relied upon for specific medical advice.