Are there treatments for ED after bladder cancer?
Yes, options include oral ED medications, penile injections, vacuum erection devices, or penile implants, depending on individual needs and recovery progress.
Bladder Cancer and Erectile Dysfunction: Understanding the Link
By Dr. Sharon Kumar
With a strong academic background in dentistry and clinical exposure, Dr. Sharon who has studied at PDM Dental College, brings a valuable blend of medical knowledge and communication skills to health content writing. She is passionate about creating clear, compassionate, and evidence-based content on topics such as general wellness, sexual health, oral care, and patient education. Her goal is to make complex medical information easy to understand, relatable, and genuinely helpful for readers seeking clarity on their health concerns. Dr. Sharon believes in the power of well-researched, empathetic content to educate and empower people to make better health decisions. Whether it’s writing about preventive care or breaking down myths in sexual wellness, her content always balances science with sensitivity.
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• 12th November 2025
Why This Was Updated?
Our experts continually monitor the health and wellness space, and we update our articles when new information became available.
Updated on 12th November 2025
- Article was updated as part of our commitment to diversity, equity, and inclusion.
INErectile Dysfunction
Quick Read
Yes, bladder cancer can cause erectile dysfunction (ED), but usually as a side effect of treatment rather than the cancer itself. During procedures like radical cystectomy or radiation therapy, the delicate nerves and blood vessels in the pelvic area that control erections can be damaged. Chemotherapy and hormonal changes may also contribute. As a result, many men experience erectile dysfunction after bladder cancer treatment. However, with modern nerve-sparing surgeries, medications like sildenafil, penile rehabilitation programs, and emotional support, recovery is often possible. Early discussion with your doctor can help manage both bladder cancer and erectile dysfunction effectively.
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When faced with a diagnosis like bladder cancer, most people focus on treatment and survival, and not realizing that sexual health can also be affected. Many men later ask,
“Can bladder cancer cause erectile dysfunction?” The answer: yes, but usually not directly. Erectile dysfunction after bladder cancer often develops due to the effects of surgery, radiation, or chemotherapy on the delicate nerves and blood vessels in the pelvic area that control erections. The good news? With modern treatments, nerve-sparing surgeries, and penile rehabilitation programs, recovery of sexual function is possible. Understanding how and why ED occurs after bladder cancer is the first step toward getting help and reclaiming confidence.
Allo asks
After cancer treatment, what aspect of recovery worries you most?
Understanding the Connection Between Bladder Cancer and Erectile Dysfunction
Erectile dysfunction (ED) is when a man has trouble getting or keeping an erection firm enough for sexual activity. This condition can happen for many reasons, such as nerve damage, problems with blood flow, hormone imbalances, or emotional stress. For men with bladder cancer, ED often happens as a side effect of the cancer treatment or, in some cases, due to the disease itself.
According to Allo Health, nearly 1 in 2 men experience erectile dysfunction, which is based on our internal clinical data of more than 2.5 lakh patients who have visited our clinics.
Getting an erection involves several parts of the body working together. The brain sends signals to the nerves in the pelvic area (lower part of your abdomen), which helps blood flow into the penis. If something harms these nerves or blood vessels, particularly in the pelvic region, it can affect a man’s ability to get or keep an erection.
Bladder cancer doesn’t usually directly cause ED. But the situation is more complicated. Most people diagnosed with bladder cancer are older and may already have health conditions like diabetes or high blood pressure, which can also affect sexual health. Moreover, if the cancer is near the prostate or pelvic nerves, it could cause physical issues that interfere with getting an erection.
How Bladder Cancer Treatments Impact Sexual Function
1. Radical Cystectomy
Radical cystectomy is a surgical procedure to remove the bladder and is the main treatment for muscle-invasive bladder cancer.
Muscle-invasive bladder cancer (MIBC) [1] refers to a type of bladder cancer where the tumor (abnormal growth of cells) has spread into the muscle layer of the bladder wall. In men, this surgery usually involves removing the bladder, prostate [2] (prostate is a small gland that sits below the bladder in men), and seminal vesicles [3] ( two small, paired glands located behind the bladder in men), which can damage the nerves needed for erections. Here’s what you need to know:-
- Nerve-sparing [4] techniques try to protect sexual function, but the success depends on where the tumor is, the surgeon’s skill, and the patient’s age.
- Robot-assisted radical cystectomy can give doctors better visibility and precision, which may help reduce nerve damage.
- Prostate-sparing cystectomy is an option for some patients, but it doesn’t work for everyone.
- Even with advanced techniques, many men still experience erectile dysfunction after the surgery.
2. Urinary Diversion
After a radical cystectomy, patients need urinary diversion to collect urine.
Urinary diversion [5] refers to surgical procedures that redirect the flow of urine when the bladder is no longer able to function normally due to disease, injury, or surgical removal.
The most common types are:
- Ileal conduit [6], which involves creating an opening (stoma) on the abdomen to connect to a bag that collects urine.
- Orthotopic bladder substitution, where a new bladder is made from part of the intestine. This significant change in the body can impact how someone perceives their appearance, leading to emotional and psychological challenges.
3. Radiation Therapy’s
Radiation therapy is used to treat bladder cancer, but it can damage healthy tissue around the bladder. Over time, this damage can worsen sexual dysfunction. Here’s what you should know:
- External beam radiotherapy [7] uses high-energy X-rays (or other radiation beams) directed from outside the body to target and destroy cancer cells. It targets the bladder and surrounding muscles, but it also affects nearby nerves and blood vessels.
- As time goes on, erectile dysfunction can become worse, and the risk is higher with larger doses of radiation or a wider treatment area.
- This damage usually develops gradually, often becoming noticeable months or even years after treatment.
“Radiation and surgery can affect blood flow and nerves in the pelvic region. Talking about it early with your doctor allows us to start treatments that can protect or restore your sexual health.”
4. Chemotherapy and Immunotherapy
Chemotherapy [8] and immunotherapy [9] are used to treat bladder cancer, but they can affect sexual health as well.
Chemotherapy is a cancer treatment that uses powerful drugs to kill fast-growing cells, including cancer cells, and immunotherapy is a type of cancer treatment that helps your own immune system recognize and destroy cancer cells more effectively.
- Intravesical chemotherapy, a type of chemotherapy (used for nonmuscle-invasive bladder cancer), usually doesn’t cause systemic side effects, so it’s less likely to cause ED.
- Systemic chemotherapy (used for muscle-invasive cancer) can damage nerves. Cisplatin, a common chemotherapy drug, is particularly known for affecting erectile function.
- Immunotherapy, like the BCG vaccine, may change hormone levels, which can lower sexual interest and affect testosterone levels.
5. Less Invasive Approaches
- For people with nonmuscle-invasive bladder cancer, treatments like transurethral resection of a bladder tumor (TURBT) [10] have a lower risk of causing erectile dysfunction than more invasive options like radical cystectomy.
- It involves the removal of tumors from the bladder using a thin, flexible tube called a resectoscope, which is inserted through the urethra (the opening where urine can pass).
- Repeated TURBT procedures or complications, such as urinary tract infections, can still affect sexual activity and quality of life.
Psychological Impact
- A diagnosis of bladder cancer (or related cancers like prostate or testicular cancer) can be emotionally overwhelming.
- Younger patients, in particular, often find it hard to cope with the changes, as sexual health is a big part of overall well-being and relationship happiness.
- Sexual problems can put a strain on relationships if couples aren’t ready for the challenges after treatment.
- Talking to a therapist or joining a support group can help couples find new ways to connect and communicate.
- It’s important to openly discuss issues like changes in sexual desire, problems with ejaculation, and body image concerns, so both partners can understand and support each other.
How to manage Erectile Dysfunction After Bladder Cancer Treatment
Before undergoing treatments like radical cystectomy or radiation therapy, patients should receive counseling on potential sexual health outcomes. Doctors should use tools like the International Index of Erectile Function to measure baseline function and track changes after treatment.
1. PDE-5 Inhibitors (e.g., Sildenafil)
First-line treatment for erectile dysfunction after cancer treatment. These medications improve blood flow to the penis, making it easier to get an erection.
2. Intracavernous Injections
If pills don’t work, injections directly into the penis can help achieve an erection.
3. Vacuum Erection Devices (Penis Pumps)
Vacuum Erection Device is a non-invasive option where a pump draws blood into the penis.
Good for those with cardiovascular/heart concerns and no side effects.
4. Penile Prosthesis (Implant Surgery)
For those who don’t respond to other treatments, penile implants offer a permanent solution.
High satisfaction rates for selected patients.
5. Penile Rehabilitation Programs
Starting rehab early after treatments like radical cystectomy can help improve long-term sexual function.
Includes medication, pumps, and sometimes hormone therapy to prevent tissue damage and improve recovery.
Sexual Health Concerns
Sexual problems go beyond just trouble with erections. Men may also experience:
- Reduced sexual interest.
- Difficulty reaching orgasm.
- Ejaculation issues.
To better understand these changes, doctors use tools such as the International Index of Erectile Function-5 or the Bladder Cancer Index, which help assess all these aspects.
Sexual health is now recognized as a key part of cancer recovery. Multidisciplinary teams should include specialists for sexual health and offer access to support groups. They should also use reliable quality-of-life tools like the EORTC QLQ-NMIBC24 to understand and monitor sexual well-being after treatment fully.
What Patients Can Do?
Patients need to speak up about sexual health issues with their healthcare provider. Often, doctors may not bring it up, but discussing concerns early can help avoid problems later and reduce emotional stress.
Smoking, being overweight, and poor heart health can make sexual problems worse after treatment. Staying active, eating well, and avoiding harmful chemicals can help maintain healthy testosterone levels, which support better recovery.
As more people survive bladder cancer, many want to focus on improving their quality of life, including sexual health. With the right treatment, emotional support, and clear expectations, many survivors can have fulfilling intimate relationships again.
Conclusion
Bladder cancer and erectile dysfunction share a complex, multifaceted relationship. The disease rarely causes sexual dysfunction directly. However, treatments like radical cystectomy, urinary diversion, and radiation therapy often harm sexual function. Understanding these risks empowers patients to make informed decisions, pursue timely interventions, and maintain realistic expectations. Many bladder cancer survivors face sexual health challenges. They use drugs, mechanical devices, penile rehabilitation, and psychological support to manage these issues. These methods help them keep a good quality of life during survivorship.
Disclaimer
"The following blog article provides general information and insights on various topics. However, it is important to note that the information presented is not intended as professional advice in any specific field or area. The content of this blog is for general educational and informational purposes only.
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The content should not be interpreted as endorsement, recommendation, or guarantee of any product, service, or information mentioned. Readers are solely responsible for the decisions and actions they take based on the information provided in this blog. It is essential to exercise individual judgment, critical thinking, and personal responsibility when applying or implementing any information or suggestions discussed in the blog."
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