Almost all men will experience a normal enlargement of the prostate gland if they live long enough (see Chapter 5). Prostate cancer is one of the most common cancers in men over 50. When prostate cancer is diagnosed or if the normal enlargement of the prostate progresses to the point at which it affects urination, a prostatectomy (pross-tuh-TECK – toe-mee; sometimes along with a cystectomy) must be performed. In the past, a prostatectomy involved cutting the nerves necessary for erection, resulting in erectile dysfunction. Newer techniques, however, allow more careful surgery, and fewer men suffer ED as a result.
One result of prostatectomy may be incontinence, sometimes necessitating an indwelling catheter. Many couples fear that this means the end of their sex life because removing and reinserting the catheter can lead to infection. However, the catheter can be folded alongside the penis during intercourse or held in place with a condom (Sandowski,
1989) . For men who experience erectile dysfunction from the surgery, penile prostheses or intracavenous injections are possible. As in all surgeries of this kind, the man must also cope with the fear of disease, concern about his masculinity and body image, concern about the reactions of his sexual partner, and the new sensations or sexual functioning that can accompany prostate surgery.
It is well documented that sexual dysfunctions can occur as a result of any type of cancer or cancer treatment (Sheppard & Wylie, 2001). Men with prostate cancer report higher levels of sexual problems than men from the general population (Jakobsson et al.,
2001) . However, because prostate cancer treatment is often aimed at a cure, many of these sexual problems remain after treatment. It’s important that sexual functioning be evaluated after treatment for prostate cancer.