Intimacy after prostate surgery

Several readers have posted and emailed me about sex and intimacy after prostate surgery. I asked Anne Katz , RN PhD, author of Breaking the Silence on Cancer and Sexuality: A Handbook for Health Care Providers and sexuality counselor at CancerCare Manitoba in Winnipeg, Manitoba, to respond to a common question:

Ever since my husband had his prostate removed because of prostate cancer, he has been reluctant to touch me. This is so upsetting. I love him very much and don’t know what to do.

It is common for men to be unable to have an erection after this surgery. Depending on the type of surgery (nerve sparing or not), his ability to have erections may or may not return. Many men are deeply distressed by this and may avoid all physical contact with their partner so as not to “lead them on” or disappoint them. This leads to a very unhappy partner who wants to express his/her love and support but feels cut off and cut out.

What is important is for the couple to TALK. It is often really difficult to talk about a sensitive topic when emotions are running high. But talking goes a long way to healing and connecting. Start with an “I” statement: “I miss touching you and being touched by you. How can we reconnect again?” Or perhaps: “I love you so much and want our relationship to be the way it was before the surgery. What can WE do to help this happen?”

While there are medications and treatments that may help, further treatment should be a couple’s decision and the man should always include his partner in medical appointments so that both people can express themselves and have their questions answered. Because communication is so important, the couple may need professional help to start the communication flowing. But seeking help is the first step.

For more posts about cancer and sexuality, please click “cancer” in the “labels” list in the right-hand column.

Is this helpful? Let me know what questions you’d like me to explore as we age and encounter physical and emotional challenges to our sexuality.



  1. Anonymous on June 16, 2009 at 9:23 pm

    My gosh. My husband and I have been together for almost 10 years. He has not had Prostate surgery, but because of medication, getting an erection is one of the side effects. We learned to have wonderful lovemaking sessions with lots of kissing caressing and using different parst of our bodies besides penetrative sex. We still love being together, it is all learning to look outside the box.

  2. john on July 28, 2008 at 6:26 pm

    Also speaking from my own experience, yes.

    It must be that the nerves involved in the feeling aren’t routed through the prostate as are the ones that control erections.

    And, yes, sexual stimulation and orgasm become different without a prostate and erections. Not the least of which is that there is no more semen and from earliest experiences that expulsion of semen has been central to the overall sensation.

    Actually, I have found it to be stronger, but more diffuse (if that makes any sense.)

    An encouraging and active partner helps a lot as reaching a climax requires a much more shared, cooperative interaction.

  3. Anonymous on June 18, 2008 at 6:02 am

    Yes C4bl3Fl4m3 speaking from my own experience a man can get aroused and even have an orgasam without having an erection. I am speaking from my own experience as I had my prostate removed about 7 weeks ago and allthough I havn’t been able to acheive an erection yet I have been able to experience an orgasm, allthough its not the same as before surgery.


  4. C4bl3Fl4m3 on December 27, 2007 at 11:02 pm

    What I’m curious about is if I man still will get aroused (irregardless of an erection) and/or have an orgasm from prostate stimulation after having prostate surgery. I’d think it would depend on the surgery, but I’m not sure. I am curious, though.

  5. gratitude on September 9, 2007 at 4:11 am

    My late father was a urologist and a very good surgeon, so I must comment.

    I didn’t realize until much later in life that part of what my dad did was prostate surgery. I thought he just took out kidney stones and cured UTI’s. We just didn’t talk about this stuff at home. I had to figure this out from putting the pieces together.

    Back in the 60’s and 70’s when this was a smaller town, my dad had these “grateful patients” all over the place who would do about anything for him at no charge. They were almost always men. I remember one visit here when my car had broken down and two men who had been Daddy’s patients spent most of their day towing me around and trying to fix my car. (Unfortunately it was a SAAB and I ended up asking the guy with the tow truck to take me over to the foreign car place.)

    Having grown up around doctors I just took this grateful patient thing for granted and didn’t think much about it. Until years later when I realized that urologists often did prostate surgery. There was a huge bunch of happy men who were his former patients. They all adored my dad. I thought, dang! He must have been good!

    My dad loved to do about anything with his hands. He made all kinds of things and built the house I grew up in mostly by himself. Once he even made a violin and played it with the local symphony.

    The moral of this story is that it is possible to perform prostate surgery without severing the nerves that are responsible for erections in men.

    I hope that anyone needing this kind of surgery will choose their surgeon very carefully. This procedure need not result in impotency in every case.

    I also know of at least one medically documented case where nerve tissue has regenerated. It was a leg injury, but the principle is the same. The person in question worked extensively with a healer after being told that he would have to lose his leg. (This story is about a man named Mitchell May, and you can read the details on his Synergy Company website, and order some of the best whole food supplements around while you’re at it. And I’m not getting compensated in any way for saying that.)

    So even if you’re post surgery and having problems, there is still hope. Don’t give up. Don’t just assume your situation is permanent.

    I know getting an erection is so so important to men, but it bears repeating anyway, and echoing what Joan says over and over, that for women sex is about much more than just male erections. It would seem to me that the nerve and other tissue involved would be more likely to heal itself if the man in question were engaging in some kind of sexual activity.

    I make my living as a massage therapist and natural health educator, and have a good knowledge of natural therapies. I think, without having dealt specifically with prostate problems, that acupuncture and/or energy based healing might have promise for those suffering from what might be temporary impotence after prostate surgery.

    Medicine is an inexact science, and there are no promises that can be made about outcomes, but it’s always worth a try.

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