Prostate Cancer and Erectile Dysfunction
How Effective Is Injection Therapy With Each Type of Treatment?
If oral erectile dysfunction drugs fail, injections into the penis can be an effective form of treatment for men who have undergone surgery or who have received radiation therapy (whether by external beam or seed implants) for prostate cancer.
Overall, 60% to 80% of men will regain erections with the use of injection treatments. Side effects include occasional pain due to one of the drugs used for injection therapy, and the development of scar tissue.
What About Other Treatments for Erectile Dysfunction?
If Viagra and injections fail (or if you are unwilling or unable to use either therapy), other treatments may be appropriate.
- Vacuum constriction device. A cylinder is placed over the penis. The air is pumped out of the cylinder, which draws blood into the penis and causes an erection. The erection is maintained by slipping a band off the base of the cylinder and onto the base of the penis. The band can stay in place for up to 30 minutes. Although these devices can be effective, they generally have been less desirable for patients who have been treated with surgery. Many patients dislike having to use the band at the base of the penis and find it uncomfortable.
- Penile suppositories. For this treatment, the patient places a suppository into the urinary tube (urethra) using a plastic applicator. The suppository contains the drug alprostadil, which travels to the erection chambers. Alprostadil relaxes the muscle in the erection chamber, allowing blood to flow into the penis. This treatment works in only about 30% of men.
- Penile implants. This option may be considered if the patient has had erectile dysfunction for about one year following cancer treatment and nonsurgical therapy has either failed or is unacceptable. An implant, or prosthesis, is an effective form of therapy in many men, but it does require an operation to place the implant into the penis. Surgery can cause problems, such as mechanical failure or infection, which may require removal of the prosthesis and re-operation. However, most men and their partners are very satisfied with these devices. The success rate is as high as 95%.