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What to Know About Prostate Cancer Treatment: Erectile Dysfunction

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.

In our previous articles (What to Know About Prostate Treatment: Bowel Dysfunction and What to Know about Prostate Cancer Treatment: Urinary Dysfunction), we talked about the generally high survival rate with treatment options including radiation therapy and surgery if prostate cancer is detected early enough. In many cases, new medical devices and advanced technology are helping to limit some of the treatment burden men have experienced in the past. There will always be room for improvement, and discussing potential treatment complications is essential to fully understand the road ahead. As we continue to review prostate cancer treatment side effects, it’s important to consider one of the most common post-surgery complications – erectile dysfunction.

According to the Prostate Cancer Foundation, some level of impotence following surgery is almost inevitable. The blood vessels and nerves responsible for an erection are extremely fragile and may be damaged during surgery because they are located in close proximity to the prostate gland. Those nerves need to be able to stimulate muscles to relax and allow increased blood flow, while at the same time  close tiny valves to maintain an erection. Any damage to the nerves can complicate this process.

While patients who undergo radiation treatment are at a lower risk for impotence¹, those who do experience ED symptoms do not tend to improve over time, as radiation can take longer to have effects on the surrounding nerves. Up to about half of men who undergo brachytherapy or standard external beam radiation will experience erectile dysfunction, and some of them will not experience symptoms until six months or more after their therapy.

The ultimate goal of radiation therapy is to amplify radiation to the prostate while avoiding damage to surrounding tissues and organs. There is an FDA-cleared hydrogel spacer that has been clinically proven to reduce radiation side effects during therapy. The hydrogel spacer has the potential to allow doctors to increase the radiation dose and more accurately target the cancer. In one studypatients who had erections sufficient for intercourse at baseline were  76  percent more likely to retain sexual function at 3 years when this new technology was implemented.

This is only one example where innovations are having a direct impact on the prostate cancer patient experience. In the years and decades ahead, our hope is that more technological advances will complement improved treatment options. Men who are diagnosed with prostate cancer have a brighter outlook now than ever before. We encourage anyone impacted by a diagnosis to do your homework, talk to your medical team, and try to fully understand the implications of each treatment option before making a decision.


1)    Mahmood J et al. Radiation-induced erectile dysfunction: Recent advances and future directions. Advances in Radiation Oncology July-September, 2016