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Many men worry about whether surgery for BPH will affect their ability to
enjoy sex. Some sources state that sexual function is rarely affected, while others claim
that it can cause problems in up to 30 percent of all cases. However, most doctors say
that even though it takes awhile for sexual function to return fully, with time, most men
are able to enjoy sex again.
Complete recovery of sexual function may take up to 1 year, lagging behind a person's
general recovery. The exact length of time depends on how long BPH surgery was postponed
despite symptoms and on the type of surgery that was done. Here is a summary of how
surgery is likely to affect the following aspects of sexual function.
Erections
Most doctors agree that if you were potent (able to maintain an erection) shortly
before surgery, you will probably be able to have erections afterward. Surgery rarely
causes a loss of potency. However, surgery cannot usually restore potency that was lost
before the operation.
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Ejaculation
Although most men are able to continue having erections after surgery, a prostatectomy
frequently makes them sterile (unable to father children) by causing a condition called
"retrograde ejaculation" or "dry climax."
During sexual activity, sperm from the testicles enters the urethra near the opening of
the bladder. Normally, a muscle blocks off the entrance to the bladder, and the semen is
expelled through the penis. However, the coring action of prostate surgery cuts this
muscle as it widens the neck of the bladder. Following surgery, the semen takes the path
of least resistance and enters the wider opening to the bladder rather than being expelled
through the penis. Later it is harmlessly flushed out with urine.
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Orgasm
Most men find little or no difference in the sensation of orgasm, or sexual climax,
before and after surgery. Although it may take some time to get used to retrograde
ejaculation, you should eventually find sex as pleasurable after surgery as before.
Many people have found that concerns about sexual function can interfere with sex as much
as the operation itself. Understanding the surgical procedure and talking over any worries
with the doctor before surgery often help men regain sexual function earlier. Many men
also find it helpful to talk to a counselor during the adjustment period after surgery
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