Last Updated on October 31, 2025 by

Men facing prostate cancer treatment often worry about sex. The truth is, prostate removal changes how you feel during sex. But it doesn’t mean you can’t enjoy sex anymore. A comprehensive guide to sexuality after prostate removal, covering erectile function recovery, intimacy, and managing side effects.

Prostatectomy, the surgery to remove the prostate gland, can impact your sex life. Yet, with the right treatment and support, many men can get erections again.

At Liv Hospital, our skilled urologists and teams help you recover from surgery. We focus on your sexual health with care and knowledge. We aim to help you keep your quality of life, even with changes in sex function.

Key Takeaways

• Prostate removal surgery can affect sexual function, but it doesn’t necessarily end sexual satisfaction.
• Most men can achieve erections with the right treatment and support.
• Liv Hospital offers complete care for men’s sexual health after prostatectomy.
• Expert urologists and teams provide care based on evidence.
• Compassionate care is available to help men with sexual function changes.

The Reality of Sex After Prostate Surgery

Sex after prostate surgery is complex, with both physical and emotional changes. Prostate removal, or prostatectomy, is a big surgery that can change a man’s sex life. Knowing how it affects sex is key for managing hopes and finding ways to help.

What Changes and What Stays the Same

Men often face changes in their sex life after surgery. One big worry is getting an erection without a prostate gland. Studies show many men struggle, but some can get erections, though it might be harder.

Some men might have dry orgasm after surgery. This happens because the prostate and seminal vesicles, which help with ejaculation, are changed or removed. Knowing this helps set realistic hopes for sex after surgery.

Setting Realistic Expectations

It’s key to have realistic hopes for men having prostate surgery. Some men might get back to normal sex quickly, but others might need more time or help. Remember, post radical prostatectomy sex can be different, and patience is needed.

Knowing these changes and treatments helps men prepare for life after surgery. It’s also vital to talk to a healthcare provider for personalized advice and support.

Understanding Prostate Removal Surgery

For men with prostate cancer, knowing about prostate removal surgery is key. This surgery, or prostatectomy, removes the prostate gland. It’s often used to treat prostate cancer.

Types of Prostatectomy Procedures

There are several prostatectomy procedures, each with its own benefits. The main types include:

• Radical Prostatectomy: This removes the whole prostate gland and its capsule. It’s usually done when cancer is found.
• Nerve-Sparing Prostatectomy: A version of radical prostatectomy that tries to keep nerves around the prostate. This might help keep erectile function better.
• Simple Prostatectomy: This removes only the affected part of the prostate. It’s often used for benign prostatic hyperplasia (BPH).

Thanks to nerve-sparing surgical techniques, more men can keep their sexual function after prostatectomy.

Why Prostate Removal Is Performed

Prostate removal is mainly for treating prostate cancer. The choice to have prostatectomy depends on several things. These include the cancer’s stage and grade, the patient’s health, and personal choices.

Radical prostatectomy removes the prostate and its capsule because of cancer. It’s often suggested for men with localized prostate cancer that hasn’t spread.

The main reasons for prostate removal are:

1. To take out cancerous cells from the prostate gland.
2. To stop cancer from spreading to other parts of the body.
3. To ease symptoms from an enlarged prostate.

Knowing why prostate removal surgery is done and the different procedures can help men choose their treatment wisely.

Physical Changes to Expect After Prostatectomy

After prostatectomy, men face changes in both urination and sex life. Knowing these changes helps men prepare and recover better.

Anatomical Alterations

Prostatectomy removes the prostate gland. It might also take out nearby tissues like the seminal vesicles. This means men can’t ejaculate as they used to because the seminal vesicles are gone.

The surgery also changes the pelvic area. It can affect nerves and muscles that control bodily functions. These changes can impact a man’s sex and urinary health a lot.

Impact on Urinary Function

Prostate surgery can make it hard to control urination. Men might leak urine when they cough or sneeze. But, this usually gets better with time and exercises.

Urinary function can change in many ways after prostate surgery. Some men might feel the need to urinate often or have trouble emptying their bladder. There are treatments to help manage these issues.

How These Changes Affect Sexual Activity

The changes after prostatectomy can affect sex life a lot. Men can’t ejaculate the same way anymore. This might change how couples have sex.

Erectile dysfunction is also common after prostate surgery. How much it affects a man depends on the surgery and his health. It’s important for men to know about treatments for erectile dysfunction.

There are many ways to treat erectile dysfunction, like pills, injections, and devices. Talking to a doctor is key to finding the right treatment.

Sexuality After Prostate Removal: The Complete Picture

Sexuality after prostate surgery is complex, involving physical and emotional changes. It’s key for men to grasp these changes to manage their sexual health post-surgery well.

Immediate Post-Surgery Sexual Function

Right after prostate surgery, many men face big changes in their sex life. Up to 85% of men experience temporary erectile dysfunction after radical prostatectomy. This is mainly because of the damage to nerves and tissues around the prostate during surgery.

During this time, men should know their sex life will be affected. But, it doesn’t mean they can’t have sex at all. Many can have orgasms even without being able to ejaculate.

Long-Term Sexual Changes

As men get better from prostate surgery, their sex life can change in different ways. Some might get their erectile function back, while others might not. How well a man can get an erection after surgery varies a lot.

Long-term, men might experience “dry orgasms,” where they can orgasm without ejaculating. This happens because the prostate and seminal vesicles, key in ejaculation, are removed or changed during surgery.

What Research Shows About Recovery Rates

Studies on recovery after prostate surgery offer insights into what men can expect. The rate of getting erectile function back varies a lot. It depends on age, how well a man could get an erection before surgery, and the surgery method used.

Knowing these factors and the full picture of sex life after prostate removal helps men and their partners. It helps them manage their expectations and make informed choices about their sex life after surgery.

Erection After Prostate Removal: What to Expect

Men facing prostatectomy need to know how it affects their erections. New surgical methods aim to keep erectile function intact.

Impact on Erectile Function

Prostate removal surgery can change how men get erections. The surgery type greatly influences this change. Nerve-sparing prostatectomy tries to keep erectile function, but results vary.

Loss of Nocturnal Erections

Nocturnal erections happen during sleep and are normal. After surgery, some men might see a decrease or loss in these erections. It’s a common part of healing.

Timeline for Erectile Recovery

Recovery time for erections after prostate removal varies. Some men regain function in months, while others take up to 1-2 years.

Factors Influencing Recovery

Many things can affect how fast a man recovers from prostate removal. These include:

• The type of prostatectomy performed (e.g., nerve-sparing vs. non-nerve-sparing)
• The patient’s age and overall health
• Pre-existing erectile function
• Post-surgery rehabilitation and treatment

Knowing these factors and talking to a doctor can help men understand their recovery. It also helps find the right treatments for erectile issues after surgery.

Can You Have an Orgasm Without a Prostate?

Many men wonder if they can have an orgasm without a prostate. The answer is complex, involving changes after prostate removal.

During a prostatectomy, the prostate gland and seminal vesicles are removed. This surgery affects ejaculation, as the seminal fluid is produced by these areas. But, the impact on orgasm is more complex.

The Difference Between Orgasm and Ejaculation

It’s important to know the difference between orgasm and ejaculation. Orgasm is the climax of sexual excitement, bringing intense pleasure. Ejaculation is the release of semen from the penis. These two processes are related but controlled by different pathways.

After prostate removal, men can’t ejaculate in the traditional sense. This is because the seminal vesicles and prostate, which contribute to seminal fluid, are removed. Yet, many men can achieve orgasm.

“The ability to experience orgasm is not solely dependent on the presence of the prostate gland.”

What Happens to Ejaculation After Prostate Removal

Ejaculation changes after prostatectomy. With the prostate and seminal vesicles removed, there’s little to no seminal fluid. This leads to a “dry orgasm.”

How Orgasms Feel Post-Surgery

Men’s experiences of orgasm after prostate removal vary. Some say their orgasms feel different or less intense. Others describe a similar sensation to before surgery.

It’s key for men to know that while orgasm may feel different, many can experience sexual pleasure.

Adapting to Dry Orgasms

Adjusting to changes in sexual function after prostate removal can be tough. Men may need to find new ways to experience sexual pleasure and intimacy with their partners.

Understanding that dry orgasms are a normal outcome can help men adjust. It’s also helpful to talk about these changes with healthcare providers and partners. This way, men can maintain a fulfilling sexual life.

Nerve-Sparing Surgical Techniques and Sexual Outcomes

Nerve-sparing prostatectomy is key to keeping sexual function after prostate surgery. New surgical methods have greatly helped men keep their erectile function and sexual health after prostate removal.

Preserving Sexual Function Through Nerve-Sparing Surgery

Nerve-sparing surgery carefully keeps the nerves around the prostate gland. These nerves are vital for erections. By saving these nerves, surgeons boost the chance of keeping sexual function after surgery. The success of nerve-sparing prostatectomy depends on the surgeon’s skill and the patient’s health.

The method involves finding and saving the neurovascular bundles near the prostate. These bundles have nerves for erections. Keeping these nerves can improve erections and sexual happiness after surgery.

Eligibility for Nerve-Sparing Procedures

Not every man can have nerve-sparing prostatectomy. The choice to do this surgery depends on several things:

• The stage and aggressiveness of the prostate cancer
• The patient’s overall health and age
• Any existing erectile dysfunction
• The surgeon’s view of the cancer’s closeness to the nerves

Men with early prostate cancer and good erections before surgery are best for nerve-sparing surgery.

Success Rates and Expectations

The success of nerve-sparing prostatectomy varies. Men who have this surgery often recover better than those without it. But, it’s important to have realistic hopes:

1. Recovering erections can take up to 2 years or more.
2. How much recovery happens can differ, with some men getting full recovery and others partial.
3. More treatments, like pills or penile programs, might be needed to help recovery.

Knowing the good and bad of nerve-sparing surgery is key for men to make smart choices. Talking with their doctor helps them understand what to expect and how to improve their sexual health after surgery.

Treatment Options for Erectile Dysfunction After Prostatectomy

Prostate removal can cause erectile dysfunction. But, there are many effective treatments to help regain sexual function. This condition affects many men, impacting their life quality and relationships. Luckily, there are several ways to manage it.

Oral Medications (PDE5 Inhibitors)

Oral medications, like PDE5 inhibitors, are often the first choice. They help by boosting nitric oxide, a natural chemical that relaxes penis muscles, improving blood flow. Sildenafil (Viagra), Tadalafil (Cialis), and Vardenafil (Levitra) are common options. They are usually well-tolerated and effective.

Injection Therapies

Injection therapies are an alternative for those not responding to pills or preferring not to use them. Alprostadil is injected into the penis to cause an erection. It relaxes penis muscles, allowing blood flow. These treatments can be effective but may need adjustments.

Vacuum Erection Devices

Vacuum erection devices (VEDs) are another option. They create a vacuum around the penis, drawing blood, and then use a ring to keep the erection. VEDs are non-invasive and can be used with other treatments. They may need practice to use correctly.

Penile Implants and Prosthetics

For a more permanent solution, penile implants and prosthetics are available. These are surgically implanted and can provide a reliable erection. There are inflatable and semi-rigid models. Surgery is needed, but they can greatly improve satisfaction.

Men with erectile dysfunction after prostatectomy should talk to their doctor about treatment. Understanding the options and their benefits and risks helps make informed decisions. This way, men can improve their sexual function and overall well-being.

Timeline for Sexual Recovery After Prostate Surgery

The time it takes to regain sexual function after prostate surgery varies. Most men see improvements in the first year. Knowing this timeline helps men plan and make informed choices about their treatment.

First 3 Months: Initial Healing

The first three months are key for healing. Men often see a big drop in sexual function right after surgery. Following post-operative instructions closely is vital to avoid complications. While some men might start to feel better, it’s too soon to know the full recovery.

3-12 Months: Progressive Improvement

Between three to twelve months, many men see slow but steady improvements. This time is about nerve healing and getting erectile function back. Being patient is important during this period. Some men might start to have erections on their own or respond to treatments.

1-2 Years: Maximum Recovery Period

For many, the best recovery happens in the first two years after surgery. This is when erectile function keeps getting better, but at a slower pace after the first year. Staying healthy and following doctor’s advice helps recovery. It’s also a time to explore new treatments for erectile dysfunction.

What to Do If Recovery Plateaus

If recovery stalls, talking to a healthcare provider is essential. They can suggest new treatments or therapies. Keeping in touch with doctors is key for better recovery. Also, counseling can help with the emotional side of sexual changes after surgery.

Psychological Impact and Coping Strategies

Prostate cancer treatment affects more than just the body. Men facing prostate removal surgery deal with a mix of feelings. They might feel relieved the cancer is being treated but also worried about the future.

Managing Expectations and Anxiety

One big challenge is managing worries about sex after surgery. It’s common to face some erectile dysfunction. Talking openly with doctors can help set realistic hopes and ease worries.

Talking to your healthcare team about the mental side of treatment is key. They can guide you on what to expect and how to handle it.

Dealing with Changes in Sexual Self-Image

Prostate removal can change how men see themselves sexually. This can affect their sense of masculinity and confidence. Therapy or counseling can help men adjust and keep a positive view of themselves.

Support groups, online or in-person, are great for sharing experiences. They let men learn from others facing similar issues.

When to Seek Professional Mental Health Support

While many men handle the mental side well, some need extra help. Knowing when to seek help is important. Look for signs like ongoing anxiety or depression, big changes in how you see yourself sexually, or trouble adjusting after surgery.

If you’re struggling, don’t hesitate to seek help. Mental health experts in men’s health or oncology can offer the support you need.

By focusing on the mental side of prostate removal, we can help men cope better. Providing the right tools and support is key to navigating this tough time.

Conclusion: Embracing a New Sexual Normal

It’s important for men to find a new sexual normal after prostate removal. With the right care, many can get back to a fulfilling sex life. Today’s treatments for prostate cancer offer many options to help with erectile dysfunction and other issues.

Men can try different treatments like pills, injections, or implants to find what works. Keeping a positive attitude and getting help when needed is key. This way, men can adjust to changes and enjoy intimacy with their partners.

Understanding sexual health after prostate removal and prostate cancer is key. We urge men to stay informed, talk openly with their doctors, and seek support. This ensures a healthy and fulfilling sex life.

FAQ

References

1. Cocuzza, M., Alvarenga, C., & Athayde, K. (2009). Steps in the investigation and management of low semen volume in the infertile man. Canadian Urological Association Journal, 3(4 Suppl 2), S101–S112. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2792416/