Various forms of male sexual dysfunction may occur following prostate cancer surgery and/or radiation therapy.
These issues include erectile dysfunction, penile curvature (Peyronie’s disease), loss of penile length, lack of ejaculation and/or orgasm, and loss of urine during sexual intercourse.
Penile rehabilitation is a term used to describe the use of a specific therapy to improve and facilitate an earlier return of penile erection, and prevent the development of cancer treatment-related male sexual dysfunction. Studies have confirmed that the earlier the erectile dysfunction is treated, the better the chance of a return of erection and preservation of penile size and shape.
Professor Chung holds numerous distinguished posts in various organisations including the Chair of the Prostate Cancer Survivorship for Sexual Health, Function and Rehabilitation committee at the International Consultation on Sexual Medicine, the peak authority body for the International Society of Sexual Medicine; the Secretary-General for the Asia Pacific Society of Sexual Medicine; and past Chair of the Andrology section in the Urological Society of Australia and New Zealand. He has published several clinical guidelines on penile rehabilitation (see below) and is considered the leading authority in his field in Australia and around the world. He has been invited to speak on sexual health and rehabilitation strategies at numerous major international and national meetings as well as consultative role in governmental bodies.
Here is one of the algorithms for penile rehabilitation in the context of prostate cancer survivorship (landmark publication by Professor Chung in the Medical Journal of Australia)
What is your option?
Oral tablets such as Viagra®, Levitra®, Cialis® and Spedra® are only effective if the underlying erectile nerves are normal (not traumatized by surgery or affected by radiotherapy). Injection of erectile agents into the penis and/or the use of vacuum penile pump device can assist your erection too. Penile prosthesis implant should be considered when it is apparent that there will be no return of natural erection and you achieve unsatisfactory erection with medical treatment. The role of regenerative medicine such as shockwave technology, stem cells and platelet-rich plasma as well as nerve transfer, is considered largely experimental with questionable outcomes in the setting of men with erectile dysfunction related to prostate cancer treatment.
Some of the key articles published by Professor Chung
- Chung E. Regenerative technology to restore and preserve erectile function in men following prostate cancer treatment: evidence for penile rehabilitation in the context of prostate cancer survivorship. Ther Adv Urol. 2021
- Chung E and Rhee H. Impact of physical exercise program interventions on erectile function and cardiovascular health in males with prostate cancer. World J Men Health. 2021;39:e31
- Chung E. Male sexual dysfunction and rehabilitation strategies in the settings of salvage prostate cancer treatment. Int J Impot Research 2021;32(4):457-63
- Hyde MK, Opozda M, Laurie K, Vincent AD, Oliffe JL, Nelson CJ, Dunn J, Chung E, Gillman M, Manecksha RP, Wittert G, Chambers SK. Men’s sexual help-seeking and care needs after radical prostatectomy or other non-hormonal, active prostate cancer treatments. Support Care Cancer. 2021;29(5):2699-2711
- Chung E, Bang-Ping J, Koichi N et al. Provision of sexual medicine services during the coronavirus disease-2019 pandemic: An Asia Pacific Society of Sexual Medicine position statement. Sex Med. 2020;8:325-26
- Chung E. Sexuality in ageing male: Review of pathophysiology and treatment strategies for various male sexual dysfunctions. Med Sci (Basel). 2019;7(10). pii:E98
- Chung E. Penile reconstructive surgery in Peyronie’s disease: Challenges in restoring normal penis size, shape and function. World J Mens Health. 2018; 36:e10-17
- Chung E. Management of treatment-related sexual complications in cancer care: Evidence for erectile function recovery and penile rehabilitation after radical prostatectomy in prostate cancer survivorship. Expert Rev Qual of Life Cancer Care. 2017;2(6):279-86
- Chambers SK, Chung E, Wittert G, Hyde MK. Erectile dysfunction, masculinity, and psychosocial outcomes: a review of the experiences of men after prostate cancer treatment. Transl Androl Urol. 2017;6(1):60-68
- Rhee H, Vela I and Chung E. Metabolic syndrome and prostate cancer: A review of complex interplay amongst various endocrine factors in the pathophysiology and progression of prostate cancer. Hormones Cancer. 2016;7(2):75-83
- Chung E and Gillman M. Prostate cancer survivorship: A review of current literature in erectile dysfunction and the concept of penile rehabilitation following prostate cancer therapy. Med J Aust. 2014;200(10):582-5
- Chung E and Brock G. Sexual rehabilitation and cancer survivorship: a state of art review of current literature and management strategies in male sexual dysfunction among prostate cancer survivors. J Sex Med. 2013;10(Suppl.1):102-11