Sex After Surgery

Dear Dr. Melanie,

I need prostate surgery to treat my cancer, and I’m afraid my partner will leave me because we can’t have sex any more. Is there anything I can do to keep our sex life going after surgery? — Concerned Partner


Dear Concerned Partner,

You are right to be concerned about loss of erectile function, and I hope your partner will love you enough to stick by you regardless of your ability to have erections later. There are two types of surgery, one of which is geared toward sparing erectile nerves. It works in many cases, but not all. Factors affecting post-surgical erectile function include:

  •  Age at surgery. Men in their 40s have better outcomes than men in their 70s or older.
  • Pre-surgery erection quality. If you had erectile difficulty prior to surgery, you’re less likely to have firm erections after.
  • Extent of your cancer. The severity of your cancer will affect the extent of surgery and its impact on your erectile function.
  • Your communication with your surgeon. You must emphasize to your surgeon that your sex life is important to you, and to ensure that every step is taken to maintain your ability to have erections.
  • Your surgeon’s experience. Doctors who do nerve-sparing surgery on a regular basis have better patient outcomes, even though there are no guarantees.

Be sure to do everything possible to rehabilitate your erectile nerves immediately following surgery. Before surgery, ask your surgeon about any prescriptions you might need afterward. Typically, men are told to use a drug like Cialis immediately after surgery and to masturbate frequently. This gets blood flowing and stimulates healing.

Second, redefine what “have sex” means. Men can have orgasms without erections, so even if you can’t become erect, you and your partner can enjoy sex play to orgasm using hands, mouths, and toys. If you’re not already competent in bringing your partner to orgasm with your hands, mouth, or toys, now’s the time to work on your skills. No doubt, your partner will be very happy to help you practice!