Erectile dysfunction after prostate surgery: What you can do now

Have you undergone radical prostate surgery, or are you about to? Then you have probably asked yourself: “When will erections actually start working again?” And if so, you are not alone. After a prostatectomy, many men initially find that things in the bedroom no longer work as they did before. That is completely normal. Far more importantly, there are ways for you to take active steps. MyPelvi explains the role the pelvic floor plays – and how you can target it specifically.

If your entire prostate was removed during the operation, this can affect erections. The reason is that extremely fine nerve pathways responsible for erections run directly alongside the prostate. And although surgeons now use highly precise techniques, these nerves can still be affected – simply because they are so close to the surgical site.

The procedure itself, wound healing, your physical recovery and the emotional stress surrounding diagnosis and treatment also influence how quickly (and how well) your erectile function returns.

Experts report very different figures depending on the surgical method, age, state of health and whether the nerves could be “spared”. Some studies state that around 85 % of men experience erectile problems after the operation. Importantly, this is not a personal weakness, but a common consequence of a serious, life-changing operation.

Think of it this way: your body has worked with the same nerve pathways for years – rather like a stable cable system. After the operation, some lines have been severed, moved or placed into a kind of sleep mode. It takes time, training and sometimes support before the signal gets through again and your body learns to deal with the new situation.

The short answer: no, not as before. But that does not mean you can no longer experience an orgasm. If your entire prostate was removed during a radical prostatectomy, the seminal vesicles and the section of the urethra responsible for ejaculation are also severed. This means:

There is no longer any visible ejaculation, even if you have an orgasm.

In many cases, orgasm itself remains possible, but it may feel different: less intense, shorter or simply “dry”.

This is also known as a “dry orgasm”. Desire and climax are not necessarily linked to the release of semen. Your brain, nerves and pelvic floor are still involved – even though there is no longer a route outwards.

What many people do not know is that some men continue to experience desire and arousal after surgery – even if they are unable to have an erection.

The pelvic floor is involved here too. It plays a role in the experience of orgasm and can be trained in a targeted way – for example, through electromagnetically assisted training on the MyPelvi chair.

In very rare cases, what is known as retrograde ejaculation occurs, in which semen is released into the bladder rather than out of the body. This is more relevant to other surgical procedures, not the complete removal of the prostate.

You will no longer be able to conceive a child naturally after a radical prostatectomy. If family planning is still relevant to you, you should seek advice about sperm preservation before surgery.

A number of things change after prostate surgery – including your sexuality. You will no longer ejaculate, but that does not mean your sex life is over. Desire, intimacy, arousal and even orgasms are still possible – often in new ways. And targeted pelvic floor training can help reactivate awareness and control.

After a radical prostatectomy, it is completely normal for erectile function to decline considerably at first or be absent altogether. This is due to the sensitive nerve pathways, which are often affected too. The extent to which potency recovers can vary depending on whether these nerves were spared, your general state of health and how actively you approach your recovery.

Important to know: training the pelvic floor can also provide valuable support here. This is because it is actively involved in erections – both in terms of blood flow and muscular support.

With its chair, MyPelvi offers a targeted training option in which electromagnetic impulses stimulate the pelvic floor muscles – even if you find it difficult to perceive or consciously control the muscle yourself. This can be a useful complement to medical rehabilitation measures.

Important: The MyPelvi chair is not a medical device and does not replace medical therapy. However, it may be an option for providing targeted support for your pelvic floor training – depending on your individual situation and in consultation with your healthcare professional.

Learn the right technique with guidance — free of charge at your MyPelvi studio.