Sex After Prostatectomy: What To Expect

A health problem, especially something like prostate cancer or BPH, can take a huge toll on a couple and their sex life. 

It leads to stress, emotional pain, anxiety, debt, and more. 

If you’ve had a prostatectomy, you may wonder what you can expect after prostate surgery.

Can you have sex after treatment? 

How will the entire prostate surgery experience impact your sex life? 

If you want to learn more about sex after prostatectomy, you are in the right place. Here, we will answer all your queries. 

Note: The goal of this post isn’t to encourage readers to get a prostatectomy. This guideline is for educational purposes only. If anyone struggles with prostate complications, it’s best to contact a specialist.

Can you have sex after prostate removal?

Nerve-sparing procedures, like prostatectomy, have a better chance of recovering or preserving erectile function in men. 

Many patients with normal sexual function who treat prostate cancer in the early stages can have a satisfying sex life after prostate removal. (2)

According to experts, there is a reasonable chance patients regain their erectile function. Although men can’t ejaculate, they can still enjoy intercourse. 

However, healing from the surgical procedure takes a while – sometimes up to 1 year. 

Can a man live without a prostate?

Yes, you absolutely can live without a prostate. However, there are two major problems that will affect your quality of life. These are the inability to keep or maintain an erection and loss of urinary control.

How can a prostatectomy affect your sex life?

Life after prostate removal can get hectic. The entire treatment will cause a drastic shift in erectile and sexual function. The degree to which a patient experiences these problems post-prostatectomy will vary. 

What happens when the prostate is removed? The disadvantage is that this is a major operation with the chance to cause problems. 

Such as:

  • Incontinence (less than 5%-30%)
  • Ejaculatory dysfunction (100%)
  • Impotence (over 50%)
  • Orgasmic dysfunction (50%)

Sexual dysfunction starts right after treatment, with almost every patient experiencing ED. Morning, nighttime, and psychogenic erections (when an erection happens for psychological reasons) disappear immediately. Although some men can get an erect penis, this is a rare occurrence. (3)

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How long does erectile dysfunction last after prostate surgery?

Studies show that roughly 25–90% of patients who get a radical prostatectomy experience ED after prostate surgery. 

So, how long does erectile dysfunction recovery take? In patients who do recover, the typical recovery process for getting erections adequate for penetration is 6-12 months. Some patients need more time than that. To restore sexual potency, men should also do Kegels regularly. (4)

Think of the impaired erection process as an injury. Just like any other injury, it needs time to heal. 

Remember that this is an ongoing battle. Recovery can take months to even years. Proper medical treatment and conditioning might help you heal faster, but there is no guarantee. 

When can I start having any sexual activity? 

Let the body heal for at least 3 to 4 weeks before you try anything. Some patients might return to sexual activity after a robotic prostatectomy in a month. If you see the fullness in your erections months after treatment, then this is a good sign.

Does viagra work after prostate removal?

Erectile dysfunction after prostate surgery can be difficult to treat. Viagra after prostate removal can be a viable option for managing impotence. 

When the nerves have been spared, Viagra can improve the odds of getting an erection by roughly 60%. However, if the patient doesn’t have any nerves spared, then the efficiency of Viagra plummets to 20%. 

So, the success of the drug will vary based on the prostate nerves spared. Talk to a healthcare expert if the prostate and erectile dysfunction are causing you problems. Men who don’t feel any effect from Viagra can use a mechanical device for erectile dysfunction and injections.

How soon after surgery can I take Viagra? 

Consult with your doctor. Most patients can turn to Viagra soon after healing from the procedure. This can be as early as 4 weeks after treatment. For best effects, men take a pill 1-2 hours before sexual activity.  

What about using Viagra after prostate radiation? Does it work? Radiation can hinder normal erectile function. 

In 40% to 50% of patients, a complete loss of erections after prostate radiation can happen. Viagra (sildenafil) can help get erections back on track in about 70% of these patients. (5)

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Can you get hard after prostate removal?

Many people are worried about the quality of life after prostate removal. Especially when it comes to erection problems and restoring normal erection function. Can you get an erection without a prostate? 

Surgical removal of the prostate gland can change your sex life. And the odds of restoring full erections to have sex after prostatectomy will vary based on the patient’s age and nerve damage

Sex after prostatectomy

Although it is often technically possible to spare the nerves, some are cancerous and must be removed. If the carcinoma is not affecting the nerves in charge of erection, then robotic prostatectomy can have the precision needed to spare these nerves. 

At 60 years or younger, patients with both spared nerves have the highest odds of getting full erections two years after surgery. But, the older the patient and the bigger the nerve damage, the harder it is to regain full erections. Some patients don’t regain their erection after prostatectomy surgery.

If you are bleeding while erect or the side effects of surgery are decreasing your quality of life, talk to a urologist. 

Can a man function sexually without a prostate?

Life without a prostate can be different. While regaining an erection after prostate removal may not be possible for every patient, an erection is not the only way to have a satisfying sex life. 

Other areas remain intact after surgery. You can still achieve these feelings without an erect penis. These are: 

  • Sexual fulfillment 
  • Sexual feelings 
  • Climax 
  • Orgasm sensations

People also ask, does prostate removal cause impotence? What is the chance of impotence after prostate surgery? 

Research institutions studied sexual and urinary function 1 or more years after radical prostatectomy. Findings suggest that incontinence rates ranged from 4% to 40%. And the odds of impotence were as high as 29% to 75%. (6)

Can a man produce sperm after prostate surgery?

After taking out the prostate, men can’t produce semen. Without the seminal vesicles and prostate, there is no ejaculate after prostatectomy. 

So, where does sperm go after prostatectomy? The testicles are still there and capable of making sperm cells. However, the body will just reabsorb them.

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Sex after prostatectomy

How does prostate surgery affect you sexually? Even if the prostate removal surgery destroys or damages the erection nerves, nerves that affect other sexual feelings still work. 

With adequate stimulation by vibrator, hand, or mouth, sex after prostatectomy can still feel pleasurable. Many couples see a sex therapist to work on their intimacy and improve their sex lives

So, can a man with prostate cancer affect a woman? Technically, prostate cancer treatment doesn’t directly affect your sexual function. But, having a cancer diagnosis can have a significant emotional or psychological impact. 

It’s normal to feel anxious, worried, stressed, or depressed – this will affect your desire to have sex and cause performance issues. To top it all off, penile rehabilitation takes a very long time. Therefore, it is normal to feel overwhelmed with sexual dysfunction and not in the mood for sex.

Orgasm after prostatectomy

Men can have an orgasm after prostate cancer surgery, even without an erection. That’s because sexual pleasure doesn’t depend solely on penetration. There is also mental stimulation, physical penis stimulation, and sex toys that can help. 

But, men should expect a drastic change when it comes to having an orgasm after prostatectomy surgery – orgasm without ejaculating. It feels different, but it is still pleasurable. 

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How to improve your sex life after prostatectomy 

Post-operative penile rehab often starts a couple of weeks after treatment. Oral medications, such as Viagra and Cialis after prostate surgery, are a popular choice. 

When this kind of erection treatment is not enough, patients opt for vacuum pumps or penile implants. Injections for erectile dysfunction after prostate surgery can also help.

Studies indicate that penile injection can be one of the efficient treatment options. Limited trials show that medications like papaverine, Bimix, and Trimix can improve sexual confidence and self-esteem. Including satisfaction and erectile function. (7)

Physical therapy for ED can be another option. Targeted penile rehabilitation exercises can engage and strengthen the ischiocavernosus muscle. 

This muscle is capable of maintaining penile rigidity. But, neither of these treatments is completely effective. And they can have side effects. Talk to a doctor to choose the best option.

Experts can also suggest lifestyle changes as a key component of every erectile dysfunction treatment. It’s important to eat healthy after prostate removal and supply the body with the necessary nutrients. 

Sticking to low-fat dairy, lean protein, and plant-based consumables can benefit the body in the long haul. Aphrodisiac foods like oysters, dark chocolate, and maca root powder can help. 


Sex after prostatectomy does feel like an uphill battle. Although the treatment can damage or completely destroy the nerves that control erections, men can still have an orgasm and pleasurable sexual experience. It is important to let the body recover first and then experiment in the bedroom.

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  1. Miyao N, Adachi H, Sato Y, Horita H, Takahashi A, Masumori N, Kitamura H, Tsukamoto T. Recovery of sexual function after nerve-sparing radical prostatectomy or cystectomy. Int J Urol. 2001.
  2. Graefen M, Schlomm T. Is radical prostatectomy a useful therapeutic option for high-risk prostate cancer in older men? Oncologist. 2012.
  3. McCullough AR. Sexual dysfunction after radical prostatectomy. Rev Urol. 2005.
  4. Tutolo M, Briganti A, Suardi N, Gallina A, Abdollah F, Capitanio U, Bianchi M, Passoni N, Nini A, Fossati N, Rigatti P, Montorsi F. Optimizing postoperative sexual function after radical prostatectomy. Ther Adv Urol. 2012.
  5. Study of Sildenafil Citrate During and After Radiotherapy/Hormone Therapy for Erectile Function Versus Radiotherapy/Hormone Therapy for Prostate Cancer. 2017.
  6. Stanford JL, Feng Z, Hamilton AS, et al. Urinary and Sexual Function After Radical Prostatectomy for Clinically Localized Prostate Cancer: The Prostate Cancer Outcomes Study. JAMA. 2000.
  7. Albaugh JA, Ferrans CE. Impact of penile injections on men with erectile dysfunction after prostatectomy. Urol Nurs. 2010.

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