Prostate cancer is often treated with a radical prostatectomy - a procedure wherein cancerous tissue of the prostate is removed. Approximately 85% of men who undergo the surgery complain of erectile dysfunction (ED) after the procedure. Erectile dysfunction is defined as the inability to achieve and maintain an erection for satisfactory sexual performance. Around 6-8% of men report urinary incontinence after radical prostatectomy.
Other commonly reported symptoms of sexual dysfunction in male survivors of pelvic cancer include problems with ejaculation, low levels of sexual desire, urinary incontinence and orgasmic dysfunction.
A 2019 literature review by Twitchell et al. shows that sexual dysfunction in male survivors of cancer can have negative psychological effects, including low self-esteem, body image, and mental health.
Though issues stemming from nerve damage and tissue damage cannot be healed with physical therapy, studies show that pelvic floor physical therapy delivered by a trained physical therapist can help improve function of the pelvic floor, resulting in improved symptoms including improved urinary continence and erectile function resulting from prostate cancer treatment (Laurienzo, 2018; Sighinolfi, 2008).
Pelvic floor issues can be multi-layered and complex and often times there are several factors that can be contributing to your pelvic floor and sexual dysfunction. Therapists at our clinic utilize a 90-minute evaluation to understand all the things that could possibly be contributing to your condition: tight muscles and restricted tissues, scar tissue, poor movement patterns, musculoskeletal problems like incoordination or strength, nerve impingement, dietary factors, among others.
Twitchell et al.’s study (2019) underscored the importance of getting psychological supports and referrals for mental health providers if you are experiencing depression, anxiety, or low self worth following cancer treatment. If you are experiencing thoughts of hopelessness, suicidal ideation, or other signs of depression, notify your doctor to talk about getting the support you need.
If you have recently had a radical prostatecomy and are experiencing issues with erectile dysfunction post prostatectomy and/or urinary incontinence, schedule a visit with Fusion Wellness and Physical Therapy today!
Twitchell, D. K., Wittmann, D. A., Hotaling, J. M., & Pastuszak, A. W. (2019). Psychological Impacts of Male Sexual Dysfunction in Pelvic Cancer Survivorship. Sexual Medicine Reviews. doi:10.1016/j.sxmr.2019.02.003
Littlejohn, N., Cohn, J. A., Kowalik, C. G., Kaufman, M. R., Dmochowski, R. R., & Reynolds, W. S. (2017). Treatment of Pelvic Floor Disorders Following Neobladder. Current Urology Reports, 18(1). doi:10.1007/s11934-017-0652-4
Hobbs, J. (2020). Physical Therapy Restores Some Control Lost To Prostate Cancer Treatment
USC News. Accessed at: https://news.usc.edu/164230/prostate-cancer-physical-therapy-pelvic-floor-muscles/
Laurienzo, C. E., Magnabosco, W. J., Jabur, F., Faria, E. F., Gameiro, M. O., Sarri, A. J., Kawano, P. R., Yamamoto, H. A., Reis, L. O., & Amaro, J. L. (2018). Pelvic floor muscle training and electrical stimulation as rehabilitation after radical prostatectomy: a randomized controlled trial. Journal of physical therapy science, 30(6), 825–831. https://doi.org/10.1589/jpts.30.825
Sighinolfi, M. C., Rivalta, M., Mofferdin, A., Micali, S., De Stefani, S., & Bianchi, G. (2009). Potential Effectiveness of Pelvic Floor Rehabilitation Treatment for Postradical Prostatectomy Incontinence, Climacturia, and Erectile Dysfunction: A Case Series. The Journal of Sexual Medicine, 6(12), 3496–3499. doi:10.1111/j.1743-6109.2009.01493.x