Can Bowel Surgery Cause Erectile Dysfunction?

It is a fact that men are more likely to develop colon cancer than women. Young, healthy, and active men can develop this cancer, although it is more common in people over 50 years of age. As studies prove that colon cancer is no longer "an older man's disease", concerns of infertility in younger men with cancer emerge. Specifically, a concern of developing erectile dysfunction (ED) following bowel surgery is prevalent in many men.

Although there are exceptions, it is rare that the bowel surgery alone causes ED. More likely, there might be many different causes -- both physical and emotional -- causing a temporary sexual dysfunction.

Non-Cancer Related Causes of ED

Sexual dysfunction is not always permanent. Frequently, it can be transient, perhaps due to emotional causes like stress, a new diagnosis of cancer, or relationship issues. Non-cancer related causes of ED include:

  • Complications of existing medical conditions (diabetes, heart disease)
  • Taking certain prescription medications 
  • A physical injury such as a trauma to the male sex organs
  • Drinking excessive alcohol
  • Smoking
  • Advancing age 
  • Stress 

Likewise, there are many different degrees of dysfunction ranging from difficulty maintaining an erection long enough or firm enough to have sex to the complete inability to become erect at all. 

What the Research Shows

Large studies have shown variances in the timing and emergence of ED following bowel surgery -- and there are potentially many men who do not even report it due to embarrassment or the assumption that it is transient or stress related.

These factors pose quite a challenge for the researchers as it can be difficult to pinpoint the exact cause of ED in a man who has received multiple therapies for cancer treatment.

The primary treatment for colorectal cancer is surgical removal of the cancer -- whether through a colonoscopy (when caught early) or through the more extensive bowel surgery. There is no known risk for ED following a colonoscopy, however.

The types of bowel surgery that may impact your ability to have an erection include:

  • Left hemi colectomy (removal of the left portion of your colon)
  • Abdominoperineal resection (removal of your rectum and anus)
  • Proctectomy (removal of your rectum)

There are many different types of bowel surgery. If you are not scheduled for an emergency surgery, make sure you sit down with your doctor and specifically ask if the type of operation offered to you can result in ED. In some surgeries, such as partial colectomies with a temporary colostomy, it is possible to suffer temporary ED, which usually resolves on its own.

Get Informed Before You Start Treatment

Prior to bowel surgery or any treatment for colon cancer, your doctor will discuss all of the risks and benefits with you. If he or she informs you that the potential for erectile dysfunction following chemotherapy, radiation or bowel surgery is present -- especially if you are considering family planning -- you want to have a lengthy discussion with your doctor and your partner.

If there is a chance of infertility you may want to consider sperm banking before you begin treatment. It is not advisable to begin sperm banking once you have begun chemotherapy or radiation therapy for cancer.

The Risk

The overall risk of permanent ED in a cancer patient following bowel surgery is generally quite low. Do not let the concern overshadow the more pressing issue -- treating the cancer and saving your life. Most commonly, ED following bowel surgery occurs due to psychological impacts, such as a new colostomy, depression, or anxiety.

ED is a potential complication that can cause many men concern. Have an open discussion with your doctor and know the risks of your treatment up front. Studies on ED and colon cancer showed that even though some men were not aware of the risk of ED, they still would not have altered their choice in choosing life-saving bowel surgery to treat the cancer.

Sources:

Dietz, D. (2011). Complications in Colorectal Surgery. American Society of Colon and Rectal Surgeons (ASCRS). Accessed online January 22, 2014.

Doswell, G., Ismail, T.,et al. (2011). Men's Experience of Erectile Dysfunction After Treatment for Colorectal Cancer: Qualitative Interview Study. Boston Medical Journal. Accessed online January 19, 2014.

PubMed. (2010). The Prevalence of Erectile Dysfunction in Post-Treatment Colorectal Cancer Patients and Their Interests in Seeking Treatment: A Cross-Sectional Survey in the West-Midlands. The Journal of Sexual Medicine. Accessed online January 20, 2014.

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