The operation may affect your sexual function in several ways, but it does not prevent you from enjoying a sex life after surgery. Usually men have some swelling and bruising in their scrotum and penis after surgery. This usually subsides within a couple of weeks. Some men prefer to wear briefs or a jock strap for support. Also, you can elevate your scrotum and testicles when lying down by placing a rolled washcloth or towel under them. It is not uncommon to feel occasional twinges or sharp pains in your penis or scrotum while the catheter is in place. You will be asked to put some Neosporin ointment at the tip of the penis where the catheter exits several times a day to help lubricate and protect this junction.
For men, sexual function involves erection, ejaculation, and orgasm. Ejaculation occurs when seminal fluid is expelled. This fluid is made and stored in the prostate and seminal vesicles so when these organs are removed, only a small amount of fluid, if any, will come out during ejaculation and orgasm. The operation should not affect your ability to experience a pleasurable orgasm, even if there is no fluid ejaculation. Erection occurs when the penis fills up with blood. This usually occurs in response to nerve signals. These nerve signals are carried in two nerve bundles that run along either side of the prostate. Attempts are made not to disturb these nerves during your surgery, but even preservation of these nerves does not guarantee the return of erections. The return of erections after surgery is usually slower than the return of urinary control. The average time until recovery of erections is 6 to 18 months, and it can improve for as long as 2 to 3 years after the operation. However, each patient is different.
It is well-known that some patients develop penile shortening and fibrosis after radical prostatectomy. One theory proposed for this frequent postoperative occurrence is the absence of sexual and nocturnal erections and the oxygenated blood that regular erections bring to erectile tissues. Efforts to re-establish erectile tissue oxygenation and prevent this phenomenon have been called by some penile rehabilitation. While patients are waiting for the return of erections that are spontaneously firm enough for vaginal penetration, several methods can be used to help induce and improve erections. These include oral drugs (Viagra, Levitra, or Cialis), penile injections, vacuum erection devices, and urethral suppositories (such as Muse). The more aggressive you are at your rehabilitation, our hope is the better chance you have at a quicker return of function.
Discussion of rehabilitation options and therapy will be initiated at catheter removal. You may attempt intercourse around four weeks after surgery.
Please note that after this operation, you will not be able to father children by way of sexual intercourse. Therefore, if there is a chance you may wish to have children after your prostate surgery, you may wish to consider storing your sperm before surgery (a process called cryopreservation).