Erection problems after prostate cancer
This is the story of Peter* (70), who suffered from erectile dysfunction after his prostate removal. He talks candidly about what happened to him and how he dealt with it.
About 10 years ago, Peter went to the doctor with a complaint: he had to urinate very often, and only in small quantities. He had no other problems. The doctor told him that men in their 60s sometimes suffer from an enlarged prostate. But that was not the case with Peter. The doctor ordered a blood test to measure his PSA (Prostate Specific Antigen) level. At 4.6, this was too high. So Peter went to the urologist, who made an ultrasound. She saw something, but could not identify it. The biopsy she took just to be sure did not reveal anything.
Bad news: prostate cancer
Peter was sent home and had to come back six months later. He continued to urinate frequently, without any further problems. When his blood was retested at the next appointment, the PSA value was found to be 6.4. A new examination and a new biopsy followed. And then it turned out it wasn't good at all: There was a tumour, and it was malignant too.
"The only option was to remove the entire prostate," says Peter. "But I had to agree to that beforehand. Because when the prostate is removed, nerve fibres could be hit or interrupted. There was only one alternative to this operation: to die. And I knew some people who had died from it. So the decision was easy. I agreed to the operation."
Operation successful, patient left with erectile dysfunction
Peter was lucky to be fit and healthy. The operation was finished an hour earlier than planned. Radiation was not necessary, as the urologist had successfully removed everything. However, Peter continued to have regular check-ups: his blood was tested every year.
Two years after the surgery, his PSA value was slightly higher again. Could part of the tumour have been left behind? Examination showed that there was indeed something there. New treatment was started, during which Peter was irradiated 35 times. He did not suffer at all. He just drove himself to the treatment centre every time and felt physically fine. Years have gone by since and Peter is still feeling great. The only thing he suffers from is erectile dysfunction. He is unable to get an erection spontaneously.
Coping with erectile dysfunction
"In the beginning I just wanted to get better. I wanted to survive. But later, when all is well, you would like everything to go back to 'normal', and for your body to cooperate again. You get used to the fact that you are still alive and want to return to the way things were.
I struggled with the fact that this was not the case; I did not want to accept it outright. The relationship with my wife has been excellent for more than 40 years, and intimacy is just part of it. So I took every opportunity to improve the situation. I did a lot of pelvic floor therapy. I had already started doing that in preparation for the surgery and picked it up again immediately afterwards. The physiotherapist assisted me and gave me exercises I could do at home. I also did relaxation exercises. Unfortunately, none of this helped.
The erectile dysfunction was difficult for me. No matter what I did, nothing changed. I could be very grumpy and irritable at times, lose my temper. All caused by frustration. And I felt bad for my wife."
Discuss erectile dysfunction with urologist
"When the urologist asked how I was doing, I mentioned the erection problem. I told them how miserable it made me feel. And you know what? There was a solution. There was a remedy that could perform a kind of miracle - that's how I see it. I had to give myself an injection, directly into the penis. The urologist taught me how to do it, gave me a prescription and I could pick it up at the pharmacy. It worked really well!
I am still using the injections and am now also going back to physiotherapy. These regular injections create scar tissue in the penis over time. I also have to give the injection alternately to the left and right side. All this pricking disturbs the blood circulation. The physiotherapist massages my penis very gently to stimulate blood circulation and prevent scar tissue from forming."
Other people's opinion
"There are also people who say: 'You don't need all that stuff at our age, do you?' But I do! I can see them thinking, and I wouldn't mind trading places with them. Theirs is still working and they don't want it anymore, and mine is not working and I want it. Intimacy is something that my wife and I have certainly not left behind. That remains part of our relationship."
Erectile dysfunction and relationship
"I have no problem talking about it. In the first place, of course, with my wife. Because this whole process is something we have to do together. Right after the operation we were just happy that I was still alive, but for her my erectile dysfunction was also difficult. That is one of the reasons why I started those injections. Of course, sometimes I find it sad and difficult that things are not like they used to be. And I also understand that I am getting older. But I continue to do everything I can to enjoy intimacy with my wife. Things are a little different now, that's all. We're going for it!"
''Erectile dysfunction? You are depressed. It is between your ears.''
Erection problems due to a mental cause.
* Real name known to the editors