If you’ve undergone prostate removal, you know recovery can be challenging both physically and emotionally. Adding to the trauma are the sexual side effects that typically accompany prostatectomies.




One of those side effects is erectile dysfunction, which can make thoughts of having sex after prostate removal a distant dream. But returning to an active and satisfying sex life is possible, and understanding what your body is going through and what you can expect in terms of arousal and performance can play in a large part in your journey to recovery.

This comprehensive guide can help you regain strength, rebuild confidence, and return to sex after prostatectomy.

Prostate Cancer and Your Body

First, know that erectile dysfunction is expected. But achieving strong erections again is possible. Having an understanding of the role of the prostate and what your body is going through is a good first step.

Understanding the prostate.

The prostate is an important part of reproduction. According to the Prostate Cancer Foundation, the prostate helps facilitate fertilization and sperm transit and survival. The prostate also helps make zinc, citrate, and fructose, which give sperm energy to travel to the egg for reproduction.

Trauma in the pelvic area can make ED after prostate cancer common. The various treatments for prostate cancer, including prostatectomy, nerve-sparing prostatectomy, and radiation, can also cause ED and can interfere with erection health. This is because, according to UCLA Health, many prostate cancer treatments affect the nerves, blood vessels, and muscles surrounding the prostate that are needed to have an erection.

The recovery time to regain control of the erection may be a few days, to a few months, to years, depending on the treatment. Sources indicate your ability to regain control is also based on your age, and the strength of your erections before surgery.

Other side effects of prostate cancer treatment include incontinence, partial or complete loss of orgasm, pain with orgasm, infertility, and loss of penis length.

Understanding expectations.

During this process, as you prepare to return to sex after prostate removal or sex after prostate cancer, it’s important to set expectations. Even with nerve-sparing procedures, the nerves involved in creating erections can be damaged. Experiencing ED after prostate cancer is normal. It’s important to relax, be patient, and understand that it may take several months to regain function.



Understanding orgasms.

In the meantime, another way to prepare for sex after prostatectomy is to have a better understanding of what sex and orgasm will look like. While your penis heals and erections are more challenging, keep in mind that you do not need an erection to have intimate and satisfying sex, or to even achieve orgasm. Use this time to explore how to pleasure you and your partner using hands, mouth, and vibrators.

Also remember: prostate-cancer treatment or radical prostatectomy can damage or destroy erection nerves, but it leaves intact the nerves that govern orgasm. Experts advise that it can be an adjustment to orgasm with a flaccid penis, but it is entirely possible.

According to experts at Harvard Medical, the orgasm has three parts:

  • The secretion of fluids from the testicles, prostate, and seminal vesicles that creates the feeling of “fullness” and “inevitability.”
  • The ejaculation, which is accompanied by contractions of the pelvic floor muscles.
  • The mental experience from the incoming sensory signs from the penis.

A full removal of the prostate affects the first two parts of the orgasm as there is no longer any fluid build-up and release. However, the mental component can still be strong and just as intense. This makes it possible to have an orgasm even with a flaccid penis.

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Strategies for Sex after Prostate Removal

Now that you know the impact prostate cancer can have on your body, you can start taking steps to reclaim your sex life. This involves having a more holistic view of sex, making lifestyle choices that can reduce erectile dysfunction; and exploring ways to return to solid, satisfying erections.

Make love in other ways.

As your body recovers, remember that sex is not just about penetration. When it comes to having sex after prostatectomy, there are ways to have options and intimacy.

You can use the time to reconnect with your partner, plan a trip, or return to good old-fashion making out and cuddling. Going through this experience together can draw you both closer, and make you find new ways to establish and maintain a connection.

Eliminate ED roadblocks.

Another strategy to take after going through prostate cancer treatment is to make sure you’re not doing things that can contribute to erectile dysfunction and put further stressors on your ability to achieve erections.

Sources indicate erectile dysfunction can be caused by several health-related issues things, in addition to prostate cancer treatment. These include:

  • Low testosterone
  • Chronic illness
  • Kidney disorders
  • Nerve damage from diabetes
  • Stroke

Other causes include taking medications that affect the hormones, nerves or circulation, including:

  • Antidepressants
  • Anti-inflammatory medicines
  • High blood pressure medications
  • Drugs for an irregular heartbeat
  • Muscle relaxers
  • Hormone therapy

Erectile dysfunction can also be triggered by non-medical issues, including:

  • Disinterest
  • Stress, depression, and anxiety
  • Smoking
  • Too much alcohol
  • Drug use

Getting out in front of any of these issues can help reduce the incidence of ED. Your doctor can help you address the health-related factors, while you have the power to focus on lifestyle changes that can enhance your sexual performance:

  • If you’re experiencing disinterest in sex, try to get to the root cause. Examine your relationship or seek counseling.
  • Take active steps to control stress through exercise, meditation or recreation.
  • If you smoke, stop. Talk to your doctor about smoking cessation treatment options.
  • Limit alcohol.
  • Avoid drugs.


Time, exercise, and a shift in expectations all help. You can also do additional natural things to treat ED and help strengthen your erection – check out these ways to spice up your sex life as well as these foods men should avoid to improve their sexual health. There are also many natural supplements and dietary choices you can incorporate that can strengthen erections.

Work toward returning to erections.

As you work toward other ways of finding intimacy and treating ED, there are things you can do to regain your ability to get an erection. In fact, to facilitate sex after prostatectomy, it’s important to do these things to maintain the health of the penile tissue. This means actively trying to create and maintain erections.

Oral medications such as Viagra, Cialis, and Levitra can help with this, as they relax the muscles of the penis and promote blood flow. But while they are effective in many situations, it’s important to understand that medications may not be advised for men who are taking nitrates. And oftentimes, medications simply just don’t work.

The Prostate Cancer Foundation also describes a medicated pellet that can be used to promote erections. The tiny pellet is inserted at the tip of the penis using a disposable plastic applicator and stimulates blood flow to the penis.

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Exploring Vacuum Therapy to Build Penile Strength

Another strategy that can help create erections is vacuum therapy, ultimately making it an answer to how to have great sex after prostate cancer.

What is vacuum therapy?

A vacuum therapy device or penis pump can be used with your partner or on your own. It can be part of the rehab process to draw blood into the penis, promoting circulation, strengthening the penile tissues, engorging the penis, and then letting the blood subside. It can also be used with the accompanying penis ring to sustain the erection by constricting the blood in the penis.

Here is how it works: A vacuum therapy device or penis pump consists of an acrylic tube that is placed over the penis. One end of the tube is attached to a pump that creates a vacuum suction to create an erection. Once the erection is achieved, a tension band is placed around the base of the penis, holding the erection in place. Learn more about how they work here.

What are the parts of a penis pump?

The pump consists of several components:

  • The vacuum pump, which can be manual or battery-powered
  • An acrylic penile tube
  • A loading cone
  • An elastic support ring

When the parts come together, they use the laws of physics to draw blood into the penis creating an erection. See a demonstration of how it works here.

What are the benefits of a penis pump?

The penis pump is an increasingly popular tool because:

  • It is natural and medication-free.
  • There are no medical side effects.
  • There is no wait time for the medication to kick in.
  • And, the pump can be used before sex or on its own in the rehabilitation process to start strengthening the penile tissue.

Studies have found that over 55% of men who used a vacuum therapy device daily as part of a recovery program after radical prostatectomy were able to achieve natural erections after nine months. Of those, more than half were able to achieve erections sufficient for vaginal penetration.




Other studies have found that over 80% of men who underwent prostate cancer surgery and who used a vacuum device had successful intercourse, and 60% had improvement in spontaneous erections. Additionally, these studies have found that using vacuum therapy also preserved the penile length, which can be compromised after surgery because of loss of blood flow to the area and reduced tissue elasticity.

How to purchase a penis pump.

Once you decide you want to try vacuum therapy, you may have questions about where to buy a penis pump and just what to look for. Penis pumps are indeed used for the treatment of ED, but they’re also used as novelty adult “toys” for adult entertainment. As you’re looking for a tool for rehabilitation after prostate cancer, it’s essential to have an eye for quality.

All pumps are not created equal. One should look for one that is:

  • From a quality, respected source. There should be client testimonials, a money-back guarantee, prompt and caring customer service, and a discrete shipping policy.
  • Safe. Quality pumps, like those sold through Rejoyn Medical, are FDA-certified. In addition, they have an external safety release and an internal release that automatically activates if the vacuum creates too much pressure.
  • Right for you. Pumps come with different features, styles of penis rings, and types of pumps, both manually-operated and battery-operated. Check out the product specifications and reviews and make an informed decision.

A Positive Future



With time, a healthy lifestyle, and rehabilitation, the outlook for sex after prostate removal is positive. Researchers find that 40% to 50% of men who undergo nerve-sparing prostatectomy will return to their pre-treatment function within one year. After two years, 30% to 60% will return to previous levels.

Here are three things you can do moving forward.

  • Be patient. Remember that ED is a common and expected outcome of prostate cancer treatment. Prostatectomy recovery and rehabilitation of your penile strength will take time. Focus on your overall health, along with communication and intimacy of your relationship. Trust that you will recover, but it will take time. Relax!
  • Focus on recovery. As you heal from the treatment, work toward getting an erection two to three times a week. This will help improve penile blood flow, which protects the sensitive tissues and promotes recovery of penile function.
  • Experiment. Use the time to reacquaint yourself with your body and how it responds. Sensations, erections, and orgasms may feel different after treatment. Practice on your own for a while to get used to the feelings of arousal again. Again, experiment with vacuum therapy, either with the pump or with the penis ring alone to practice drawing blood into the penis and holding the erection in place.

Sex after prostate removal can happen. More details about returning to a healthy and active sex life after prostate removal and cancer are outlined in the free ebook, Prostate Cancer and ED: What You Need to Know. And for more information about Rejoyn Medical’s full line of FDA-approved, safe, and medical grade vacuum therapy systems, browse our secure online store.