Sexual health after prostate cancer

Over the last several decades, doctors and researchers have made major advances in understanding and treating prostate cancer. Today, many patients are living longer, healthier lives thanks to earlier detection, more personalized treatment and improved support throughout recovery, making consideration of life after prostate cancer more important than ever.

For many patients, sexual and urinary side effects are one of the key considerations when reviewing treatment options. Often, bringing up the topic of sex with their doctor isn’t exactly their idea of comfortable. However, according to Dr. Carter Mikesell, a board-certified urologist with Sharp Community Medical Group and affiliated with Sharp Chula Vista Medical Center and Sharp Grossmont Hospital, it's a conversation he welcomes.

“I want my patients to feel comfortable discussing sexual health concerns with me at any stage, but ideally, we’ll have these conversations early so we can make a shared decision about the right treatment plan,” says Dr. Mikesell. “My priorities are to help patients find solutions and improve their quality of life — open and honest communication is key to that.”

Managing sexual side effects

Treatment for prostate cancer can affect sexual function in various ways. Surgical treatments, such as removal of the prostate, and radiation therapy can damage the nerves responsible for erections, leading to erectile dysfunction (ED). The degree of impact depends on the treatment type, but sexual side effects are common.

According to Dr. Mikesell, some treatments are designed to minimize sexual side effects. Nerve-sparing robotic prostatectomy preserves erectile function by avoiding damage to the erectile nerves. At Sharp Chula Vista Medical Center, Dr. Mikesell regularly operates on patients using the latest innovation in robotic-assisted surgery, the da Vinci 5 Robotic Surgery System, which he says helps him make more precise incisions and reduce side effects.

“Compared to traditional open surgery, robotic-assisted procedures allow for greater precision, smaller incisions and a clearer view of delicate anatomy,” Dr. Mikesell says. “This means patients often experience less pain, less blood loss and a quicker recovery. Robotic technology also helps us better preserve urinary continence and sexual function after surgery — two aspects of recovery that are especially meaningful for patients with prostate cancer.”

Multiple therapy options

According to Dr. Mikesell, several therapies can help restore sexual function after treatment for prostate cancer. Medications like sildenafil (Viagra) or tadalafil (Cialis) are commonly used to improve erectile function. Penile pumps, injections and penile implants can be options for more severe cases of ED. Counseling or sex therapy can help address the emotional and psychological aspects of sexual health, as many patients struggle with intimacy and self-esteem post-treatment.

“Treatment for prostate cancer can be an emotional experience, and side effects can compound those feelings,” Dr. Mikesell says. “Support groups offer an opportunity for men to share experiences with others going through similar challenges. I also encourage patients to explore additional resources, such as the Prostate Cancer Foundation, and reach out to sexual health professionals for specialized help addressing post-treatment sexual health concerns.”

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