Erectile Dysfunction After Prostate Cancer, Prostatitis, or BPH Diagnosis, Surgery & Treatment

Being diagnosed with prostate cancer, prostatitis, or BPH is fairly common. According to the American Society of Clinical Oncology, over 174,650 men in the United States will be diagnosed with prostate cancer this year. (1) More commonly a quick Google search will display, an estimated 3 million annual cases occur for enlarged prostates due to BPH, and prostatitis is diagnosed in well over 200,000 men each year. (3,4)

If any of these diagnoses are new for you, it makes sense to have questions about what prostate issues mean, how it affects the body, treatment options, and how it will affect your sexual activity. Understanding the effects of these diagnoses and their treatment options helps protect our sexual health provides us a feeling of being more in control of our bodies and sexual satisfaction.

Is the condition prostate cancer, prostatitis or BPH – what’s the difference?

Before we can dive into the different effects and treatments of these prostate conditions, it is helpful to first understand their differences. We will explain further about how each of these conditions affects sexual activity in relation to erectile dysfunction but first here are the general definitions and causes that we will reference.

Prostate cancer: A cancer in which occurs in the prostate. This prostate is a small gland in men that produces seminal fluid for sperm production. It is the among the most common type of cancer in men. (10)

Prostatitis: This condition is the result of an infection or inflammation of the prostate gland and can cause issues with urination and discomfort. (9)

Benign Prostatic Hyperplasia (BPH): Common in older men, this enlarged or swollen prostate condition can cause urinary discomfort by blocking the flow of urine from the bladder or urinary tract. It can also cause kidney problems. Benign prostatic hyperplasia is noncancerous and unlike prostatitis, is not caused by infection or generalized inflammation.

When a man is diagnosed with any of these conditions it is important to note, that these conditions are typically diagnosed individually. It is possible that an individual may have none, one, or a combination of these conditions. Additionally, erectile dysfunction is a symptom that may manifest with any of these conditions. While a man may develop ED for a variety of reasons, it is a common symptom and side effect for those suffering from BPH, prostate cancer, and prostatitis.

What causes Erectile Dysfunction?

The inability to maintain an erection suitable for sexual activity is known as erectile dysfunction (ED). (8) There are several factors that can lead to erectile dysfunction, among them prostate cancer, prostatitis, and an enlarged prostate.

Regardless of the cause of the erectile dysfunction, according to Dr. Carson from the University of North Carolina School of Medicine Urology Division, the most common physical symptoms are poor nerve input to penis, poor blood flow, hardening of penile tissue, and the inability of the vessels within the penis to fill with blood and hold it suitably enough for an erection. (5)

Can prostate cancer cause erectile dysfunction?

Yes, prostate cancer can lead to erectile dysfunction. According to the organization About Prostate Cancer (6), prostate cancer can not only affect erectile dysfunction but also, ejaculation, libido (sex drive), and orgasms.

The good news is, for men who have intact nerves, there is a substantial chance of improvement with treatment. (6)

Can prostatitis cause permanent erectile dysfunction?

In most cases prostatitis is reversible through antibiotic treatment or it can self-resolve. While discomfort and pain may take several weeks to disperse, erections should return to normal. (9)

If prostatitis has been an ongoing condition without treatment, it is more likely the effect of inflammation to the surrounding this tissue.

Is ED directly linked to prostate cancer or can a swollen prostate also cause erectile dysfunction?

The symptoms of an enlarged prostate can be completely different than the effects of prostate cancer or prostatitis.

An enlarged prostate can affect a man’s ability to urinate and may make him feel like his bladder is not empty after urination leading to the lingering feeling of needing to urinate.

According to the National Institute of Diabetes and Digestive and Kidney Disease for the US Department of Health and Human Services (NIDDK)(2) these are the common types of medication prescribed for an enlarged prostate.

  • Alpha blockers
  • Phosphodiesterase-5 inhibitors
  • 5-alpha reductase inhibitors
  • A combination of these medications

The purpose of BPH medication is to stop the growth or shrink the prostate’s enlarged cells. Some sexual side effects that have been linked to BPH medication are painful erections, problems with ejaculation, and erectile dysfunction.

What are some treatment options for prostate cancer and their effects for erectile dysfunction?

Today, there are multiple treatment options when it comes to prostate cancer including GAINSWave’s innovative shockwave therapy treatment. It is important to know treatment options and the possible risks affiliated with surgery or radiation treatment. Therefore, it is important to consult with your physician.

Nerve-Sparing Radical Prostatectomy (Surgery)

According to About Prostate Cancer, a surgery called nerve-sparing radical prostatectomy has been an option since the 1980s. (7) This surgery requires the removal of the prostate and seminal vesicles, while leaving the surrounding nerve tissue intact. Having surgery can be high risk and not every male is eligible for surgery.

It should be noted that men with cancer around the nerves are not typically able to have this type of surgery- limiting candidacy. (11)

While men with ED will have difficulties achieving erections in the weeks following surgery, men who experienced moderate to severe erectile dysfunction before and leading up to surgery might regain function, although it may take up to two years for full a recovery. The most important factor contributing to whether or not a man develops ED during a prostatectomy comes down to whether or not the nerves responsible for sexual function have been damaged during surgery. (6)

It is also important to note that other contributing factors affecting the return of erectile function include, but are not limited to factors such as age, weight, and lifestyle

Some of the side effects of a prostatectomy include:

  • Erectile Dysfunction
  • Reduced Semen in Ejaculation
  • Infertility
  • Loss of Orgasm Sensation
  • Urination during sexual activity

Thankfully, GAINSWave is noninvasive and non-surgical, making it a great option for those who have undergone surgery and are trying to alleviate erectile dysfunction.

Radiation Therapy

There are two types of radiation therapy for prostate cancer, external beam and brachytherapy.

Brachytherapy: The direct input of the insertion of radioactive implants into the tissue. This is the type of radiation currently used for prostate cancer treatment.

External Beam: The method of using a direct radiation beam at the tumor for treatment. Unlike brachytherapy, it is not common to treat prostate cancer through radiation therapy.

Similar to surgery, radiation damage to surrounding nerves and blood vessels can impair erectile function. The primary difference between surgery and radiation therapy for treating prostate conditions is time. (8,11)

With surgery, the manifestation of sexual dysfunction is immediate with a typically slow resolution. Conversely, with radiation treatment, these effects tend to worsen slowly over time.

Further complicating matters, with radiation treatment it may be hard to distinguish if the side effects, including erectile dysfunction is a result of the treatment or the natural aging process.

As with surgery it is important that nerve and blood vessel damage is minimized so as not to affect the erectile tissue in the surrounding area.

GAINSWave does not introduce surgery or radiation into their treatment program alleviating the stress of erectile dysfunction.

Cryotherapy

The American Cancer Society explains Cryotherapy (also called cryosurgery or cryoablation) is a type of treatment for prostate cancer which involves the use of very cold temperatures to freeze and destroy cancerous prostate cells. (7)

This treatment exposes the neurovascular bundle to extremely cold temperatures for a prolonged duration. This can cause severe nerve damage which is why this method of treatment is not generally recommended for younger men as there is high risk it can cause ED. (7)

How effective is medication for treating patients with prostate conditions?

Depending on the type and severity of the condition, prescription medications range in efficacy from dissolution of the condition to simple symptom management. With Prostatitis for example, antibiotics over a course of several weeks can reverse these problems.

Several men prefer not or simply cannot take antibiotics for prostate conditions. Allergies, limited swallowing ability, and other previous conditions may limit the ability to consume medication. As a result, men have turned to GAINSWave for treatment.

What is GAINSWave® and how can it benefit men who have been treated for BPH or have had a prostatectomy?

GAINSWave is a safe, non-invasive therapy that was developed to help men seeking an ED treatment that has no side effects or downtime and is backed by clinical research for its efficacy in treating ED.

GAINSWave works to improve blood flow to the penis by using high-frequency, low intensity acoustic waves to dissolve vascular plaque build-up which promotes new nerve and blood vessel growth. These sound waves also induce healing by triggering the release of nitric oxide and encouraging penile growth factors to help restore and improve healthy erectile function.

Men with penile implants or elevated prostate-specific antigens (PSAs) must consult with their physician prior to beginning any GAINSWave treatment.

This article was created for informational purposes only. It is not meant to be used as medical advice or in medical decisions. We recommend reaching out to a physician for decisions in erectile dysfunction cause and treatment.

References:

  1. American Society of Clinical Oncology. Prostate Cancer Statistics. 2019.
  2. “Prostate Enlargement (Benign Prostatic Hyperplasia).” National Institute of Diabetes and Digestive and Kidney Disease, 2017.
  3. Prostatitis Google. Mayo Clinic & Others, 2019.
  4. Benign Prostatic Hyperplasia Google. Mayo Clinic & Others, 2019.
  5. Carson CC (ed). Erectile Dysfunction. Urol 2000: S25-S31.
  6. “Can Prostate Cancer Cause Erectile Dysfunction? | PCF”. Prostate Cancer Foundation, 2019.
  7. “Cryotherapy for Prostate Cancer”. Cancer.Org, 2019, https://www.cancer.org/cancer/prostate-cancer/treating/cryosurgery.html.
  8. https://www.webmd.com/erectile-dysfunction/guide/erectile-dysfunction-basics#1
  9. https://www.mayoclinic.org/diseases-conditions/prostatitis/symptoms-causes/syc-20355766
  10. https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/erectile-dysfunction-after-prostate-cancer
  11. https://www.healthline.com/health/enlarged-prostate/sexual-function#bph-surgery
  12. https://www.webmd.com/prostate-cancer/guide/impotence-prostate-cancer#1

Judson Brandeis M.D.

Dr. Judson Brandeis is a board-certified Urologist and the GAINSWave® Director of Excellence. He received his medical degree from Vanderbilt University. His professional experience for 18 years includes practice at Pacific Urology in Walnut Creek, California, where he pioneered the use of many innovative technologies and procedures. Dr. Brandeis has also been the Chief of Urology at John Muri Medical Center for 8 years and Hill Physicians for 7 years.