Sexual Health Q&A

Erectile Dysfunction Prostate Cancer
Would shockwave therapy be helpful for erectile dysfunction related to prostate cancer treatment?

Many men develop erectile dysfunction (ED) after prostate cancer treatment because of damage to nerves or blood vessels. Unfortunately, shockwave therapy is probably not a viable solution at this time.

Typically, when a man has an erection, some important processes occur. First, sexual stimulation triggers a message that travels from the brain to the penis through a complex network of nerves. Some of these nerves are located very close to the prostate gland.

Once the message is “received,” smooth muscle tissue in the penis relaxes and blood vessels expand. This allows more blood to flow in so that a firm erection can form. Once the man ejaculates, the blood flows back into the body.

Prostate cancer treatment can disrupt both of these processes.

Because of their close proximity, nerves can be injured during prostatectomy (surgical removal of the prostate gland). Surgeons try their best to preserve as many nerves as possible, but some nerve damage is inevitable. As a result, the nerves may not get the message from the brain to start an erection.

Radiation therapy can damage nerves, too. But it can also affect blood vessels in the penis. Sometimes, arteries become more narrow or completely blocked. Scar tissue may prevent them from expanding fully in response to sexual stimulation.

Shockwave therapy uses acoustic waves to prompt the formation of new blood vessels. It is sometimes used to treat patients with kidney stones, fractures, and heart problems.

But it is still considered an experimental treatment for erectile dysfunction and more research is needed before it can become routine. And because it works on blood vessels, it would not be effective for men who have ED due to nerve damage.

There are still a number of treatment options for men with ED, such as oral medications, injections, and vacuum devices. Men should ask their doctor which options are best for them.

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