Erectile Dysfunction Treatment Options After Oncology (Cancer) Treatment (The James)

Erectile Dysfunction Treatment Options After Oncology (Cancer) Treatment (The James)

 

Here is information about the different treatments used to help men with Erectile Dysfunction (ED) after any urological or surgery in the pelvic area. Patients receiving radiation therapy or hormonal therapy may need this as well.

Medicines: Viagra (Sildenafil), Levitra (Vardenafil), Cialis (Tadalafil), Stendra (Avanafil)

These medicines can be used each day to help with erectile rehabilitation. Patients who take nitrates (e.g., Isordil, Isomo, Imur, Sorbitrate, Isosorbide, Nitroglycerin) should not take Viagra, Levitra or Cialis. Talk to your doctor or pharmacist about other medicines that may have interactions with these medicines.

  • Viagra, also called Sildenafil, is a medicine that increases the blood flow to the penis so that when a man is sexually aroused, he can get and keep an erection. If he is not sexually aroused, an erection will not happen. For best results, this medicine should be taken 1 hour to 2 hours before any sexual activity. Take Viagra on an empty stomach. If you do eat, you should eat a low-fat meal. The medicine may take longer to work or may not work at all if taken with a high fat meal or with alcohol. Do not eat grapefruit, drink grapefruit juice or alcohol while taking Viagra.
  • Levitra, also called Vardenafil, is a medicine that works similar to Viagra. Levitra causes an erection within 1 hour or less. The erection may last up to 4 hours. You can take this medicine with or without food. Do not eat grapefruit, drink grapefruit juice or alcohol while taking Levitra.
  • Cialis, also called Tadalafil, is another medicine used to treat ED. After taking this medicine an erection usually occurs within 30 to 60 minutes and the effects can last for up to 36 hours. You can take Cialis with or without food. Do not eat grapefruit, drink grapefruit juice or alcohol while taking Cialis.
  • Stendra, also called Avanafil, is a medicine that works similiar to Viagra. For best results, this medicine should be taken 15 - 30 minutes before any sexual activity. You can take Stendra with or without food.

 

Manual Vacuum Erection Device (VED)

The vacuum (or suction) device can be used to help ED in two ways. First, the device helps to increase blood flow to your penis. It also helps to exercise the muscle within the penis. If you use the manual vacuum device for sexual activity you may need to use it with an oral medicine such as Cialis, Levitra, Viagra or Stendra. You will also need to use the constriction loop that came with the device.

 

Injection Therapy

This treatment is used to produce an erection for sexual activity and will help with rehabilitation. You will inject a medicine into your penis every time you want to have an erection. You will be
taught how to inject this medicine. The response to the medicine is different for each person. Your doctor will determine the amount of medicine you will need. If the injections work for you, the erection will be close to normal. Your erection will happen quickly after the injection and can last up to 90 minutes. You can only give yourself this injection every 24 - 48 hours.

The benefits of this treatment vary from person to person. The cost varies with the amount of medicine you are taking. Men can have fairly normal short-lasting erections with this treatment. Rare side effects are: slight bleeding or bruising at the injection area, or priapism (an erection that does not go away).

 

Penile Implants

A penile implant is an artificial device surgically placed in the penis to help a man have an erection. Implants can be made of silicone or other synthetic materials. The three basic types are:

  • Malleable Implant

Two semi rigid rods are put inside the penis and it is always ready to be used. The malleable implant can be bent, so it is easier to hide when you do not want to use it.

 

  • Two Piece Inflatable

This implant has inflatable cylinders that have a fluid reservoir (container). The cylinders are placed within the penis and a pump is placed next to the testicles. The implant can be inflated and deflated whenever you want. This allows for more control over your erection.

 

  • Three-Piece Inflatable

This inflatable implant is a fluid-filled system with three parts: two cylinders, a fluid reservoir and a pump with a deflation valve. This implant gives the most natural result, because it expands fully to fill the penis and can be totally deflated so the penis is soft.

 

Penile implant surgery takes about 30 minutes to 2 hours. Most patients go home the same day of their surgery. At times, some patients may stay in the hospital overnight after their surgery. You will need time to heal from the surgery and your doctor will let you know when you can begin using your implant. Most men will be able to use their implant about six weeks after surgery. Your erection will depend on the type of implant that you choose.

The cost of the implant depends on the type used. Most insurance companies, including Medicare, cover surgery for erectile dysfunction. Check with your insurance company about your benefits.

Problems can happen with an implant. Sometimes the implant can become infected or cause problems with the skin. Your implant is a mechanical device and it can stop working. If you have any of these problems or any questions about your implant call your doctor’s office.

 

 

© October 12, 2022. The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care.