Sexual function—If the erectile nerves are damaged during prostatectomy, which was standard during this type of surgery up until the mid-1980s, the ability to achieve erection is lost, though sexual desire is not affected. Erectile dysfunction can also result from damage to these nerves by radiation therapy, though this process usually occurs more slowly over time.

Modern techniques in surgery (nerve-sparing), radiation (intensity modulated radiation therapy, positioning devices, 3-D conformal technologies), and seed placement (brachytherapy) have been developed to try to minimize these side effects, and this process continues to improve.

Fertility—About 10% of men with prostate cancer have what is known as seminal vesicle invasion. This means the cancer has either spread into the seminal vesicles or has spread around them. If that occurs, seminal vesicles are typically removed during prostatectomy and targeted during radiation therapy. The loss of the prostate and the seminal vesicles renders men infertile. After surgical removal, ejaculation is dry, but orgasms may still occur.

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