This is all to do with some very sensitive nerves surrounding the prostate.

During prostate removal surgery, cavernous (‘erection’) nerves surrounding the prostate may be damaged, removed, or traumatised during surgery. These nerves are responsible for spontaneous erectile function (both nocturnal and arousal-induced). Remaining cavernous nerves are usually in an ‘offline’ state post surgery for some time in order to recover.

This recovery process is called neuropraxia and can take two years or longer. You can learn more about ED recovery timelines post-Prostatectomy here.

The earlier the better!

Start as early as your medical specialist recommends. There’s evidence that the structural integrity of the penile tissue changes within the first 2 months after Prostatectomy, so bring the conversation of Penile Rehabilitation up with your medical team early after surgery, or even better, before surgery.

Check out our Penile Rehab Guide for further questions such as when it’s safe to start using a vacuum erection device (penis pump).

It’s not that black and white…

In an interview with Professor Declan Murphy (a urologist who has completed over 1000 Prostatectomies) he said that in fact, it’s not rare that a patient will come back to him two years later post non-nerve sparing and say, "My erections have come back. I had no expectations. How is that possible?" It’s not just the physical preservation of the bundles, but small subtleties.

Read more about non-nerve sparing Prostatectomy here.

Yes! You can have a fulfilling sex life after prostate cancer treatment of any kind.

A Touchy Subject exists to offer practical ideas and options to help men and couples not only optimise their sexual function recovery, but thrive sexually no matter what the physical outcome is. Start here with this inspirational story from one of the guys who completed our free rehab course.

Sexual function can change after all forms of Prostate Cancer Treatment

Our mission is to help facilitate good conversation, education, and outcomes no matter what type of prostate cancer treatment you’ve gone through (or combination of treatments).

This year (2024) we are striving to add more resource guides for all types of prostate cancer treatment. At this point, our resources mostly focus on sexual rehabilitation following Prostate Surgery (prostatectomy). This is because this website was born out of Victoria’s PhD research, which at the time focused on the post prostate surgery journey.

We’ve realised from men reaching out to us, that there’s an enormous need to also provide specific options and stories for treatments such as hormone therapy, radiation therapy, and brachytherapy.

We’re aware that not seeing your situation represented on this website and others can feel demoralising. Please bear with us, we are constantly updating our resources, and feel free to reach out with any suggestions or to share your story or resource needs with us (hello@atouchysubject.com).

In the meantime, we have a video interview covering why and how sexual function can change after radiation therapy here. We also recommend this fascinating study that investigates the characteristics and strategies of couples who maintained a sex life on hormone therapy.

Keep in mind that the interventions suggested for maintaining erection health through our Free Rehab Program apply for men experiencing ED post any type of prostate cancer treatment. This program is side effect focused, therefore it’s the best place to start no matter what type of treatment has impacted your sex life.