For many men, a prostate cancer diagnosis is just the start of a complex journey. Even after successful treatment, some face an unexpected challenge: erectile dysfunction (ED). According to Dr. Phillip Westbrook, trauma and reconstructive urologist at Lexington Urology, this is one of the most common concerns men raise after surgery or radiation.
"Prostate cancer treatments — whether surgery, radiation, or thermal ablation — can affect the delicate nerves and blood vessels responsible for erections," Dr. Westbrook explains. "Even when we use nerve-sparing techniques, healing takes time, and some men will experience long-term changes in erectile function."
Conservative Treatment Options
Before considering surgery, men can try less invasive therapies. Dr. Westbrook often recommends starting with:
- Oral medications like Viagra®, Cialis®, or Levitra®
- Vacuum erection devices with penile tension rings ("penis pumps")
- Penile injection therapy, where medication is injected into the penis before sex
- Urethral suppositories, small medicated pellets placed into the urethra
"These therapies can be very effective," says Dr. Westbook. "But their success depends on how much the nerves controlling erections were affected by treatment."
Do Pills Like Viagra Still Work?
The answer is "yes — but it depends."
"If the nerves that control erections are intact, oral medications may work quite well. But when those nerves are damaged, pills might not be enough," Dr. Westbrook notes. "That's when we look at other options, including surgery."
Surgical Options: Penile Implants
For men who don't respond to conservative treatments, Dr. Westbrook offers penile implants — a highly effective, permanent solution.
"The penile implant is a device placed inside the penis that allows a man to have an erection whenever he chooses," he says. "There are two main types: inflatable implants, which can be pumped up for a natural look and feel, and malleable rods, which are always firm but can be positioned as needed."
Who's a Candidate?
Men are typically considered for penile implants if they:
- Have tried and not benefited from pills, injections, or vacuum devices
- Are healthy enough for surgery
- Want a permanent, reliable solution for ED
"This is often life-changing for couples," Dr. Westbrook emphasizes. "Over 90% of men and their partners report satisfaction with penile implants. Devices last many years and restore spontaneity."
Recovery and Results
The surgery is usually performed on an outpatient basis or involves an overnight stay. Most men return to light activities within one to two weeks, and sexual activity typically resumes after four to six weeks.
"Our goal is to restore not just function but confidence and quality of life," says Dr. Westbrook.
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