Sexual function after radical prostatectomy

Prostate cancer and its treatment have been associated with decreased sexual desire and function.18 One important component of sexual function, orgasm, is often overlooked. Orgasmic pleasure is accompanied by contractions of muscles in the genital tract and pelvic floor, with stimuli reaching the brain via the somatic pudendal nerve.31 Orgasm is compromised after radical prostatectomy as there are no contractions of the prostate and seminal vesicles, and the ejaculate is decreased or absent.31 The orgasm experienced after surgery is often less intense and may be associated with an involuntary loss of urine. Decreased sexual desire, erection, orgasm and ejaculation are distressing factors affecting patients after radical surgery and must, therefore, be addressed early in the course of treatment.

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