Urology

Sex after Prostate Surgery

Most men who have normal sexual function and receive treatment for early prostate cancer regain erectile function and can have satisfying sex lives after robotic prostatectomy. However, it is a gradual process and may take up to a year. Very few of our patients experience erectile dysfunction, but we work closely with those who do.

Penile rehabilitation can help you resume sexual functioning. Studies show that going for too long without blood flow to the penis can damage the muscle and tissue, which can affect your ability to have erections on your own. The goal of penile rehabilitation is to keep the penile tissue and muscles oxygenated and stretched to preserve erectile function while the nerves in the penis fully recover. We encourage our patients to start working on penile rehabilitation even before surgery.

Pre-operative visits could include early evaluation, penile Doppler studies (a test of blood flow into and out of the penis), and testosterone level estimations, if our experts feel that your particular case could benefit from these evaluations. Occasionally, we start penile rehabilitation using medications a few weeks before surgery in order to enhance the blood supply to the penis and “jump start” sexual rehabilitation.   

Post-operative rehabilitation usually starts a few weeks later and may include the following treatment options to maximize your chances of recovery.    

  • Intra-urethral suppository (also known as MUSE®): MUSE (alprostadil) is a medication that can encourage erections anywhere from two weeks to three months after surgery. MUSE consists of a medicated pellet that you place in the urinary opening using a disposable plastic applicator. MUSE works by opening the blood vessels to increase blood flow to the penis.  
  • Oral medications are ones that you take by mouth to improve blood flow to the penis. Theycan include such as Cialis® (tadalafil), Levitra® (vardenafil), and Viagra® (sildenafil citrate).
  • Vacuum device therapies (or vacuum pumps) are mechanical devices that draw blood into the penis to achieve an erection. The device is a plastic cylinder that you place over the penis and activate using a manual or battery-operated pump.
  • Penile implants are permanent devices that we surgically place inside the penis. Penile implants can be a satisfying option for you and your partners, if drug treatments and other therapies do not resolve erectile dysfunction. A very small proportion of patients may benefit from a penile implant or other surgical treatments.