Cryosurgery, aka cryotherapy, involves inserting one or more ultrathin cryoneedles (or cryoprobes) into the prostate and circulating argon gas to freeze the cancer cells. Once the procedure is over, the frozen tissue thaws and is absorbed by the body. Men considering this procedure should ask their doctor about cryosurgery and erectile dysfunction.
How Are Cryosurgery and Erectile Function Related?
Erectile dysfunction is the most common side effect of cryosurgery; it is more common after cryosurgery than following radical prostatectomy, affecting as many as 80 to 90% of men who undergo the procedure. Several studies report erectile dysfunction was nearly 90% one year after the procedure was performed.
In a 2010 study published in Nature Reviews Urology, researchers compared the rate of erectile dysfunction following cryosurgery versus EBRT radiation. They found that of the 56 men in the cryosurgery group, 62% were capable of unassisted intercourse before the procedure, but only 22% were able to have either assisted or unassisted sexual intercourse at 36 months after cryosurgery. These figures were compared with those of the 57 men in the EBRT group: 55% were capable of unassisted intercourse before treatment, compared with 36% who could achieve assisted or unassisted intercourse at 36 months.
For men who are considering cryosurgery, those who are already experiencing erectile dysfunction and those who are not sexually active may not find the high risk of erectile dysfunction to be an important issue. However, it can be a highly significant factor for many men and needs to be explained before undergoing cryosurgery. An experimental procedure called focal cryoablation may be helpful in reducing the chances of erectile dysfunction, but it is not widely available.
Why Does Cryosurgery Affect Erectile Function?
Freezing often causes damage to the nerves that are near the prostate that are responsible for erections. In fact, erectile dysfunction is more likely to occur after cryosurgery than after undergoing radical prostatectomy. You are also more susceptible to erectile dysfunction if cryosurgery is done after you have already had radiation therapy rather than if it is your first line of treatment.
Roach M. Prostate cancer: worse sexual function after cryoablation. Nature Reviews Urology 2010 Mar; 7: 122-24