Will prostate cancer treatment affect my ability to orgasm and ejaculate?

If you have had a radical prostatectomy you will not be able to ejaculate after surgery. This is because the prostate gland and seminal vesicles, which store and transport semen, are removed during the operation. Instead you may experience what is sometimes called a ‘dry ejaculation’ where you feel the sensations of orgasm but do not release any semen from the tip of the penis.

This may feel different to the orgasms you were used to. Occasionally, some men will find that a small amount of liquid comes out from the tip of the penis during orgasm, which may be fluid from glands lining the urethra.

If you have had radiotherapy or brachytherapy you may notice that you produce less semen after your treatment is completed. You should still be able to have an orgasm but you may find that it feels different to before treatment. Some men have also found that they have less intense orgasms when they are having hormone therapy.

Will prostate cancer treatment affect the appearance of my penis?

Some studies have shown that around five out of ten men (50 per cent) will find that their penis is shorter after treatment with radical prostatectomy. This happens because of the way surgery is conducted. You and your doctor should discuss this in advance of your surgery. You should also consider taking a photograph of your erect penis before surgery, next to a ruler or some other measurement. That way, you’ll be able to determine what if any changes occurred to your length and girth.

Some studies have shown that encouraging blood flow to the penis after surgery may help you get erections and prevent your penis becoming smaller. In particular using a vacuum pump might be helpful. In some cases other types of prostate cancer treatment such as radiotherapy and hormone therapy may also cause changes to the size of your penis. There is not as much research into
this but it may be less common than changes in size after surgery.