Sex and Men With Cancer: Overview

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Surgery and sex

Surgery in the lower belly and pelvis area can affect a man’s sex life in different ways. Some operations cause more sex problems than others. For instance, a man will not be able to get full erections if most of the organs in his pelvis (bladder, prostate, rectum, and more) are removed. We also know that men who had good erections before cancer surgery are far more likely to have them again than men who had problems with erections before surgery.

How pelvic surgery can affect a man’s erections

  • It can cut down blood flow to the penis so that the penis may not get firm enough to enter his partner. He should still be able to feel pleasure from touch and have an orgasm.
  • It can damage nerves that control blood flow to the penis so that the signal to start an erection is either weak or lost.

Some men can still get full erections after pelvic surgery, but it could take up to 2 years. Injured nerves may heal. And the healing and growth of new blood vessels may help more blood get to the penis. All of this takes time, which could explain part of the delay in getting back full erections. It’s not always clear why some men get back full erections and others do not.

Studies have looked at ways to help men get erections just weeks after pelvic surgery. The results suggest that treatment to get back erections, called penile rehabilitation or erectile rehabilitation, should be started shortly after surgery. This can be done by using drugs, injections, or vacuum devices. Talk to your doctor to find out if this could be a good choice for you.

How surgery can affect a man’s ejaculation

  • It can damage the nerves that control the prostate and other parts needed for normal ejaculation, which can block or change the way ejaculation happens. A man can still feel the pleasure of an orgasm. The difference is that little or no semen comes out.
  • Removal of any part of the path that sperm and semen need to go through to get out of the body does not cause problems with orgasm, but the man will not ejaculate semen.
  • Damage to the nerves that come from the spine can make semen shoot backward into the bladder instead of coming out the penis. This backward ejaculation does not cause pain or harm to the man. When a man passes urine after this, it looks cloudy because semen gets into it during the orgasm.

Surgery for cancer of the penis

When a man has cancer in his penis, the best treatment may be removing part or all of the penis. This surgery is rare, but it can have a huge impact on a man’s self-image and his sex life.

The surgeons try to save as much of the penis as they can, but all of the cancer must be removed. If the shaft and head of the penis cannot be saved, the man must have the whole penis removed, even the base that extends into the body. The surgeon makes a new opening for urine to come out behind the man’s scrotum.

If a man is willing to put some effort into his sex life, pleasure is possible even after a total removal. He can learn to reach orgasm when other sensitive areas are stroked. He can help his partner reach orgasm by stroking with the fingers, oral sex, or using a vibrator.


Last Medical Review: 08/28/2014
Last Revised: 09/23/2014