Sexual function after prostate removal

I am frequently asked about the changes to fluid that comes out of the penis during sexual activity and about the ability to have children.

Many years ago I described the changes for men to expect after prostatectomy for cancer.

Normally the testicles make sperm that travels through the vas deferens to reach the prostate where it mixes with most of the fluid from the prostate to make the ejaculate.

male reproductive picture

If you have a vasectomy, the vas defers is clipped so that sperm can not enter the prostate area and you become sterile.  The amount of ejaculate during sexual activity remains the same.

With prostate removal, the ejaculate which is made from fluid from the prostate and seminal vesicles is also missing.  Men can have an orgasm, but there will be no fluid that comes out with the orgasm as normal.

There may be a small amount of fluid that is thick that comes out during the excitement phase as before.

Some men also experience leakage of urine that comes from the bladder during the excitement or orgasm stage of sexual activity.





6 responses to “Sexual function after prostate removal”

  1. Vincent Avatar

    Hi Dr. Savatta,
    I had Robotic Surgery August 23rd, 2016 for prostate cancer, up till this moment that I’m communicating with you I’ve no erection, no sexual intercourse, no ejaculation and I’m still being incontinent using about 3- to- 4 diapers on a daily basis. It keeps me very uncomfortable to look for jobs, depressed most time have nothing to do for a daily bread lost my job, begging from family on how to feed. Just turned 50 years December 24th, 2017. QUESTION: I’m I going to continue with this for the rest of my life or is there any thing to do for a healing. Please help.

    1. Dr. Savatta Avatar
      Dr. Savatta

      The worst side effects of prostate cancer surgery are loss of erections and loss of urinary control. There are treatment options for these conditions and speaking to your urologist about them would be the place to start.

  2. Paul Reid Avatar
    Paul Reid

    I had Robotic surgery and the doctor in Birmingham, AL convinced me that he should be allowed to “go wide” during surgery. He never told me of the issues I would have by allowing him to do so. What i found out later is that by going wide he was not concerned with preserving any of the nerves and blood vessels connected to the penis. Of course this allowed him to complete the operation quicker but it also contributed to the decrease in penis size and eliminated any possibility of ever getting an errection again.

  3. Maurice Avatar

    I had robotic prostatechtomy 31 Jul 18, reading all these comments is very helpful however, one question remains. If I never regain the ability to produce an erection will I continue to climax indefinitely?

  4. John Avatar

    I had prostate surgery September 13 2016,I have not had an erection since. Is this normal?

  5. Pierre Avatar

    In 2018 I had a radical prostatectomy for localized prostate cancer. As planned, the surgeon removed my prostate, my 2 seminal vesicles and cut my vas deferens, which made me completely sterile. Before the surgery I had no erectile dysfunction and my ejaculation was very good. My erections returned quickly after the catheter was removed and as it had been explained to me before, I am no longer able to ejaculate. It’s very weird at first, I feel orgasm and muscle spasms but I really don’t have any semen squirting out of my penis. Everything stays clean even if I have an orgasm, it’s convenient for that