Does prostate surgery cause impotence?

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Jun 28, 2016/ 0 Comments / in Male health / by

One of the most frequently asked questions when a patient faces surgery to resolve prostate problems is if he may suffer from erectile dysfunction in the aftermath. The answer depends on the type of surgery: since there are different surgical approaches for each prostatic pathology, let’s see what the answer is for each case.

Enlargement of the prostate

Over the years, the prostate starts to increase its volume and such process may be benign or malign. That’s why it is extremely important to book regular check-ups with an urologist in order to see what we are up against and what are our prevention and treatment options.

  • Benign prostatic hyperplasia (BPH)


If you are diagnosed with BPH, it means that the enlargement of your prostate is benign. The specialist will analyse each particular case in order to see what the treatment options are according to the prostate size and the specific conditions of each patient. The first line of treatment is the use of prescribed drugs, however, if this line fails, then we would have to go for the surgery option.

There are several possibilities to surgically treat the benign hyperplasia, depending on the prostatic characteristics of each patient as well as on the specialist’s recommendations. Thus, these are different available options: Urolift technique, photo-vaporization laser, laparoscopy and traditional open surgery.

Among these possible interventions, there is one that indeed causes an erectile dysfunction problem: the open surgery. Nevertheless, bet on health does not necessarily entails giving up your sexual life, because there is a solution for impotence cases caused by prostatic interventions: the penile prosthesis implantation. Such surgery allows the preservation of health and also keeps untouched the sexual life of the patient.

  • Prostate cancer or prostate malignant tumour


If the prostate enlargement is due to a malign lump, the doctor will prescribe the pharmacological treatment to follow and the different options you have regarding the degree of the cancer.

In this case, you can choose either cryosurgery or open surgery (total or partial), the second one entails the complete removal of the prostate gland. As in the previous case, open surgery inevitably leads to the secondary effect of an erectile dysfunction because the structures related to the sexual answer are damaged during the surgery. However, as well as in the cases of BPH, this situation may be corrected thanks to the implantation of a penile prosthesis, which re-establishes the erectile capacity of the patient.

Why do these surgeries cause erectile dysfunction?

In open surgeries (for BPH or cancer cases) there is a removal, total or partial, of the enlarged prostatic tissue. Since the neurovascular nerves in charge of making erection possible are attached to the prostatic capsule and to the seminal vesicles, when part or all the prostate is removed, these nerves are damaged thus leading to erectile dysfunction. The approximate percentage of impotence cases after an intervention of this kind ranges between 30% and 75%, depending on the surgical approach.

Even though the surgeon will endeavour to preserve the erectile functionality of the patient, it cannot be guaranteed that there will be a good quality of erection after the intervention.

If you are facing surgery and would like to have access to a second opinion, please contact us.

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