Radical prostatectomy – surgical removal of the prostate gland – can be an effective way to treat prostate cancer. Unfortunately, the prostate is surrounded by nerves necessary for rigid erections. Surgeons may try to preserve as many of the nerves as possible, but erectile dysfunction (ED) is still a frequent result.
It can take up to two years for a man’s erectile function to recover. Many men feel frustrated or depressed during this time. ED can put stress on relationships, and men might have sex less often than they used to. The situation can interfere with a man’s quality of life.
Some men undergo penile rehabilitation after prostatectomy. This protocol may require men to inject their penis with medication that induces an erection. In this way, the penis can “practice” getting erections while nerves heal. A man’s urologist teaches him how to inject his penis at home safely and properly.
Still, the idea of injecting one’s penis with medicine can be difficult to accept. Patients may feel squeamish and decide not to continue with the therapy, especially if they don’t see results quickly.
Quitting injection therapy can lead to more frustration and might lower a man’s chances of successful rehabilitation.
In a July 2019 Journal of Sexual Medicine paper, researchers discussed a four-month program that might help men stick with their rehabilitation plan.
Called the Acceptance and Commitment Therapy for erectile dysfunction (ACT-ED), the program helped the men better understand injection therapy and accept it as part of the process needed for better erections in the future.
During ACT-ED sessions, men learned more about the goals of injection therapy and the importance of persistence and commitment. They also considered the obstacles that could impede their progress and worked on coping with negative feelings.
Researchers compared two groups of men for a pilot study. Some men underwent ACT-ED, while others received standard penile rehabilitation without ACT-ED.
Overall, men in the ACT-ED group were more likely to stick with their injection program and used more penile injections each week. They also tended to be more satisfied with their treatment and developed more sexual confidence.
Links to learn more:
International Society for Sexual Medicine
“What is a penile rehabilitation program (PRP)?”
The Journal of Sexual Medicine
Nelson, Christian J., PhD, et al.
“Acceptance and Commitment Therapy to Increase Adherence to Penile Injection Therapy-Based Rehabilitation After Radical Prostatectomy: Pilot Randomized Controlled Trial”
(Full-text. Published online: July 2, 2019)