Erectile dysfunction after prostate cancer
After cancer, sexual desire vanishes, so does an erection and orgasm. As survivors of prostate cancer in Kenya increase, many men who have gone through surgery or radiation therapy are suffering in silence, not knowing when their sexuality will return. And for most couples, erectile dysfunction remains the elephant in the room.
“It is a secret that nobody wants to talk about, including the wives, and because they don’t want to embarrass their husbands, they turn to religion and other ways of coping,” said Daniela Wittmann, a sex therapist and assistant professor at University of Michigan’s Department of Urology.
She said because many men do not know how to manage the problem well, they lose their confidence and some avoid sex all together.
“The penis has to be rehabilitated to start functioning. Most men use pills but they experience headaches. Injections also work well. The advantage with an implant which may cost from $1,500 to $10,000 (Sh150,000 to Sh1 million) is that it is a one-time cost compared to others. It has higher satisfaction and also gives a longer erection,” he said.
“Try having sex immediately the soreness has eased. You can also use sexual aids. We encourage couples to engage in all types of sex to stimulate and reawaken the nerves,” he said, adding that according to research African men fail to report their sexual problems while wives feel left out of the treatment decisions.
The side effects of surgery happen faster than for radiotherapy. The operation causes a temporary nerve damage and it may take five years to recover. However, quick recovery is determined by how good a man’s erection was before the disease.
“If erections were good before surgery, a man is likely to almost go back to normal even though the penis will not fully function as it used to,” said Dr Pastuszak, who is also an assistant professor at University of Utah’s Department of Surgery.
After diagnosis of prostate cancer, the urologist says a patient ought to start taking oral pills every night for one week so as to preserve their erectile function after treatment. Three days after surgery, resume taking the pills daily and three months later consider injections if the oral drugs are not working.
In the Kenyan market, the high cost of the pills has driven some people to herbalists. Viagra costs Sh1,000 a tablet while Cialis goes for Sh1,200. A packet of four ranges from Sh3,260 to Sh7,500. However, generic drugs are cheaper and cost Sh100 or Sh50 per tablet. There is also the gel option with a sachet costing Sh100.
All these drugs are used 30 minutes before intercourse. For most people, one method may not necessarily work and the urologist says combining oral pills and injections could be more effective.