Orgasm Problems Common After Prostate Surgery

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The quality of a man’s orgasm often decreases after prostate cancer surgery, according to a new study presented at a meeting of men’s health specialists. But the good news is that orgasm quality improves over time.

Although prostate cancer surgery is known to cause sexual function problems, the emphasis has been placed on erection problems, says lead researcher Andrew R. McCullough, MD, at the annual meeting of the American Urological Association in San Francisco. He is director of the Sexual Health and Male Infertility and Microsurgery Programs at New York University School of Medicine in New York.

McCullough says no long-term studies had been done on orgasm quality after prostate cancer surgery, so he and his team performed a study on 228 men. In order to rate orgasm quality, the men, average age of 59, completed questionnaires before prostate cancer surgery and several times during the following 24 months.

Before prostate cancer surgery, 76% of the men described their orgasm quality as either good or very good. But after surgery, some men in the very good category said their orgasm quality had fallen.

There are many factors at play, says McCullough, including the effect of surgery on sexual function and the psychological stress of a cancer diagnosis.

Approximately 15% of men with poor to fair orgasms had an improvement and described their orgasms as good or very good two years after surgery. Younger men, men who were able to get an erection, and men with more sexual desire were all more likely to report an improvement in orgasm quality.

But the good news is that orgasm quality continued to improve in the months after prostate cancer surgery. Treatment with medications to improve erectile function, such as Viagra, also improved orgasm quality, says McCullough. Erectile dysfunction treatments also helped speed return of both erectile function and orgasm quality.

“These findings are consistent with what I see in my practice,” Anthony Y. Smith, MD, tells WebMD. “Around the time of surgery, men experience stress and other factors that probably do carry forward for some time, but in a significant percentage of men, orgasmic quality gets better over time, and it gets better with erectile dysfunction treatments.” He is a professor of urology at the University of New Mexico in Albuquerque.

“The findings are good news,” he says, noting that many men dread prostate cancer surgery because they fear permanent impairment of sexual function. “Certainly age is always a factor for recovery of sexual function. Older men have less success after surgery, but some of the other things are probably related to stress of diagnosis. Recovery is not something that may happen overnight; the recovery may take a couple of years.”

Even with erectile dysfunction treatments, recovery is gradual, he says. “What we tell patients is not to expect anything early on, but that treatment will keep the [nerves] functioning so that eventually sexual function will recover. Patience is the key.”

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