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Understanding Prostate Cancer

What You Should Know About Prostate Cancer Treatment: Erectile Dysfunction

(Read time: 5 minutes)

This article is not intended to replace professional medical care or advice. If you have any questions or need additional information, please talk with your doctor.

If you’ve been diagnosed with prostate cancer, you’re not alone. About 1 in 8 men are diagnosed with prostate cancer. The good news is, if detected early, localized prostate cancer is generally associated with a high survival rate.1

However, living with prostate cancer before, during, and after treatment can have some difficulties. Some prostate cancer patients may experience side effects as a result of prostate cancer treatment.

Erectile dysfunction — along with bowel dysfunction and urinary dysfunction — is one of the more common side effects of prostate cancer treatment.2

How can prostate cancer treatment lead to erectile dysfunction?

Some level of sexual dysfunction after prostate cancer treatment is common.2

To understand why, it’s important to understand how a man achieves an erection. There is a series of fragile nerves and blood vessels close to the prostate gland. These nerves stimulate muscles, allowing for increased blood flow. They also close tiny valves to keep blood in the penis at a high pressure, which maintains the erection. Any damage to the nerves can complicate this process.3

That’s why prostatectomies (surgeries to remove part or all of the prostate gland) are often referred to as “nerve-sparing” prostatectomies. Depending on the stage and grade of prostate cancer, it can be easier or more difficult for the surgeon to remove the prostate without affecting any adjacent nerves.4

Prostate cancer patients who undergo radiation treatment may be at risk for sexual dysfunction. Up to 70% of men who undergo brachytherapy or standard external beam radiation will eventually recover erectile function after therapy.5 There are also newer treatment therapies like vessel-sparing radiation therapy, which has an even lower rate of erectile dysfunction. One study found that as many as 78% of patients who had vessel-sparing radiation therapy maintain the same level of erectile function after treatment.6

How to manage erectile dysfunction during and after prostate cancer treatment

Your treatment plan should be unique to your situation. There are many factors for determining which treatment plan is right for you. You can talk to your doctor and healthcare team, including specialists like a urologist and radiation oncologist, about benefits and risks to determine the treatment options that are right for you.

Remember, the ultimate goal of either surgery or radiation therapy for prostate cancer is to treat the cancer while trying to maintain your quality of life.

It’s important to weigh treatment option benefits and risks with your doctor.

SpaceOAR™ Hydrogel is designed to help reduce prostate cancer radiation therapy side effects.7 Learn more.

There have been recent advances in prostate cancer treatment, such as radiation therapy techniques and dose planning strategies.8 And a rectal spacer such as SpaceOAR Hydrogel may lessen the radiation impact to the rectum by pushing the prostate farther from the rectum.9,10

Learn more about the side effects of prostate cancer treatment and how SpaceOAR Hydrogel can help reduce side effects from radiation and maintain your quality of life.9

If you want to learn more about potential treatment options for erectile dysfunction, or just have questions you’d like answered, find resources at

This material is for informational purposes only and not meant for medical diagnosis. This information does not constitute medical or legal advice, and Boston Scientific makes no representation regarding the medical benefits included in this information. Boston Scientific strongly recommends that you consult with your physician on all matters pertaining to your health.

  1. Key Statistics for Prostate Cancer—Prostate Cancer Facts. American Cancer Society. Accessed October 12, 2022.
  2. Erectile Dysfunction after Prostate Cancer. Johns Hopkins Medicine. Accessed January 6, 2023.
  3. Erection Ejaculation: How It Occurs. Cleveland Clinic. Accessed October 18, 2022.
  4. Nerve-Sparing Surgery for Prostate Cancer. Accessed October 18, 2022.
  5. Mahmood J, Shamah AA, Creed TM, et al. Radiation-induced erectile dysfunction: Recent advances and future directions. Adv Radiat Oncol. 2016 Jun 3;1(3):161-9[online] ScienceDirect. Available at: [Accessed 18 Oct. 2022].
  6. Spratt DE, Lee JY, Dess RT, et al. Vessel-sparing radiotherapy for localized prostate cancer to preserve erectile function: A single-arm phase 2 trial. Eur Urol. 2017 Oct;72(4):617–24.
  7. Data on file with Boston Scientific.
  8. Bowel Dysfunction after Prostate Cancer Treatment. Johns Hopkins Medicine. Accessed February 23, 2023.
  9. Mariados N, Sylvester J, Shah D, et al. Hydrogel spacer prospective multicenter randomized controlled pivotal trial: Dosimetric and clinical effects of perirectal spacer application in men undergoing prostate image guided intensity modulated radiation therapy. Int J Radiat Oncol Biol Phys. 2015 Aug 1;92(5):971–7.
  10. Hamstra DA, Mariados N, Sylvester J, et al. Continued benefit to rectal separation for prostate radiation therapy: Final results of a phase III trial. Int J Radiat Oncol Biol Phys. 2017 Apr 1;97(5):976–85.

Caution: U.S. Federal law restricts this device to sale by or on the order of a physician.

SpaceOAR Hydrogel is intended to temporarily move the rectal wall away from the prostate during the course of radiotherapy treatment for prostate cancer, and in creating this space it is the intent of SpaceOAR Hydrogel to reduce the radiation dose affecting the rectum.

SpaceOAR Hydrogel contains polyethylene glycol (PEG). As with any medical treatment, there are some risks involved with the use of SpaceOAR Hydrogel. Potential complications associated with SpaceOAR Hydrogel include, but are not limited to: pain associated with injection, pain or discomfort from the hydrogel, site inflammation, infection (including abscess), inability to urinate, urgent need to urinate, constipation, rectal muscle spasm, damage to lining of rectum, ulcers, fistula (a hole between rectum and bladder, urethra, or skin below the scrotum), perforation (hole in prostate, bladder, urethra, rectum), necrosis (dead tissue), allergic reaction (local reaction or more severe reaction, such as anaphylaxis), embolism (blood vessel blockage is possible and may happen outside of the pelvis, potentially impacting vital organs or legs), fainting, and bleeding. Please talk to your doctor about the risks and benefits related to using SpaceOAR Hydrogel. If one or more of these complications occur, you may need medical treatment or surgery. URO-1288805-AA

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