Effect of total cystectomy on sexual function in patients with bladder cancer

In patients with bladder cancer, radical cystectomy involves removing the prostate and seminal vesicles in addition to the bladder. This is similar to the process of removing the prostate and seminal vesicles during radical prostatectomy. Therefore, the risk of erectile dysfunction in patients who have undergone radical cystectomy is the same as that in patients who have undergone prostate cancer surgery.

In the past few years, a technique has been developed to preserve the sex nerves that run on both sides of the prostate. If your doctor uses this technique during surgery, the chances of restoring erectile function after surgery will increase. The prostate and seminal vesicles produce fluid that is expelled from the body through ejaculation during orgasm, so it is impossible to restore ejaculation function after removing the prostate and seminal vesicles. In addition, since the vas deferens are removed during surgery, sperm cannot be expelled after surgery. Therefore, even if erectile function and orgasm are restored, it is impossible to make your partner pregnant. However, the testicles can still produce normal sperm, and in vitro fertilization can still be fertilized. Using modern technology, sperm can be extracted from the testicles or epididymis (attached to the testicles, which can store and mature sperm and connect the testicles to the vas deferens) and fertilized in vitro with eggs removed from the woman's body. The eggs are then implanted in the woman's uterus and the normal pregnancy process can then begin.

Erectile dysfunction is a common problem even for men who have not undergone bladder or prostate surgery. About 50% of men aged 40-70 have some degree of impaired sexual function. Men who already have erectile dysfunction before surgery should discuss this with their doctor. Fortunately, there are a variety of treatments available to treat erectile dysfunction, including oral medications, intraurethral therapy, injectable medications, vacuum devices, and implant surgery.