Treating Sexual Dysfunction After Prostatectomy

Overview

Prostate cancer is one of the most common cancers affecting men, and radical prostatectomy remains a frequently chosen treatment, but surgery is rarely the end of the story. In the months and years that follow, many men experience significant changes to urinary control and sexual function, along with the emotional weight of navigating a shifted sense of identity and intimacy. As a pelvic health practitioner, you're often the clinician best positioned to address these changes, yet the rehabilitation literature specific to this population remains under-utilized in clinical practice.

This on-demand course with Dr. Susie Gronski offers a thorough clinical grounding in what actually happens — anatomically, physiologically, and psychosocially — after a radical prostatectomy. You'll move well beyond the basics, exploring why recovery timelines vary so widely, how the nervous system drives penile rehabilitation, and what practical tools (from vacuum erection devices to vibration therapy) can be integrated into your treatment plans. Whether you're new to men's pelvic health or deepening an existing clinical focus, this course connects the anatomical dots in ways that directly improve how you explain, treat, and support this often-underserved population.

Learning Objectives

By the end of this on-demand course, participants will be able to:

1. Describe the anatomical and physiological changes that occur following a radical prostatectomy, including the impact on the tunica albuginea, corpora cavernosa, and neurovascular bundles.
   
   
2. Identify common pelvic and sexual health concerns in prostate cancer survivors — including urinary incontinence, erectile dysfunction, and dry orgasm — and explain their underlying mechanisms to patients.
   
   
3. Explain why surgical approach alone (open, laparoscopic, or robotic) does not reliably predict functional outcomes, and identify the patient-specific factors that are more clinically predictive of recovery.
   
   
4. List at least three evidence-informed biopsychosocial strategies to support prostate cancer survivors in reconnecting with sexual function, intimacy, and emotional well-being.
   
   
5. Describe the role of penile rehabilitation tools — including vacuum erection devices, penile clamps, vibration therapy, and phosphodiesterase inhibitors — and outline how to guide patients in their appropriate use.
   
   
6. Recognize the psychosocial dimensions of post-prostatectomy recovery, including grief, anxiety, depression, and relational dynamics, and identify when and how to integrate sexual counseling into your care approach.

Audience

This on-demand course is designed for pelvic health physiotherapists, physical therapists, and occupational therapists who work with or are expanding into men's health. It is also relevant for sexual health educators, mental health providers working with oncology populations, and members of multidisciplinary cancer rehabilitation teams. A foundational understanding of pelvic floor anatomy is helpful but not required — Dr. Gronski builds from first principles throughout the course. Practitioners at any stage of their men's health journey will find both clinical depth and immediately applicable tools here.

Why This Course Matters

Men's pelvic health is one of the most underserved areas in rehabilitation, and post-prostatectomy care is a clear example of the gap between what patients need and what they typically receive. Despite affecting roughly 1 in 8 men, prostate cancer treatment is rarely followed by coordinated rehabilitative support for urinary or sexual function — and many practitioners feel underprepared to address these concerns confidently in the clinic.

This course challenges common assumptions head-on: contrary to popular belief, there is no conclusive evidence that robotic prostatectomy produces superior functional outcomes compared to open surgery. What actually matters — nerve-sparing extent, patient age, co-morbidities, and surgeon experience — is rarely discussed with patients before or after surgery, leaving them without realistic expectations or a clear recovery path. Neurovascular healing can take up to two years, and urinary continence may take up to a year to stabilize, yet most patients receive little guidance on what to do in the interim.

Beyond the physical, the emotional toll is significant and frequently overlooked. Concepts like dry orgasm — orgasm without ejaculation — are poorly understood by patients and often inadequately explained by care teams, contributing to unnecessary distress. Anxiety, depression, grief, and relationship strain all influence physiological recovery in ways that purely exercise-focused rehab cannot address. Dr. Gronski integrates psychosocial care as a clinical necessity, not an add-on, making this course an important step toward truly comprehensive men's pelvic health practice.

Related Learning

You can find additional resources on this topic below:

• Men Have Pelvic Floors Too! How PTs Can Help Before and After a Prostatectomy
• Pelvic Health Resources on Embodia
• The Nuts and Bolts of Men's Pelvic Health with Pelvic Health Solutions