Q&A: Erectile Dysfunction

A Penile Problem

Question: My husband, in his early 40s, was diagnosed with bladder cancer nearly two years ago. His bladder was removed. Fortunately, the cancer hasn’t spread and he is now in remission. Things have mostly gone back to normal for us, except our sex life. He rarely wants to have sex; even when we do, he has trouble getting an erection. Is it safe for him to take medication for erectile dysfunction? More importantly, how can I help him feel good about his body again?

Answer: Men who have had their bladders removed due to bladder cancer would also have had their prostate and seminal vesicles removed. For proper clearance of cancer, the nerves in the pelvis that are responsible for initiating and maintaining a penile erection would have had to be sacrificed. As a result, most, if not all men, who had this surgical procedure are unable to have erections.

Oral medications that are prescribed for treatment of erectile dysfunction (i.e. PDE5 inhibitors) would not work for someone who has neurogenic erectile dysfunction i.e. ED resulting from nerve damage. These men (such as your husband) can try intracavernosal injections (an injection into the base of the penis to increase blood flow), or use vacuum erection devices. For the best outcome with guaranteed erections, your husband can consider a penile implant.

Do make an appointment and accompany him to an erectile dysfunction clinic for an examination and further advice.

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