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Can there be sexual desire or intercourse after penectomy?

A penectomy procedure usually asks the thorny questions, "What is the fate of sexual intercourse afterward?" Can a man have sexual urges after a penectomy? How is life after a penectomy? Read on for answers to these questions.

Penile surgery (penectomy)

Key takeaway

  • Penectomy is a surgical procedure doctors carry out to remove all or part of the penis. It is a typical treatment for people with penile cancer.
  • Sexual desire may reduce after a penectomy procedure, but some people may be able to have sexual intercourse after the procedure. How much sexual activity will be affected will depend on whether the surgery is a partial or total penectomy.
  • Penectomy can increase the risk of mental health issues like depression.

The impact of conditions such as penile cancer (cancer of the penis) will vary depending on factors such as the stage of the condition at the time of diagnosis, how sexually active the man is, and the treatment approach.

If you had a penectomy, your sexual abilities may not be affected, and you may be able to have sex whenever you want. According to Cancer Research UK, people are usually able to continue their sexual lives after a partial penectomy, and a fulfilling sexual life is also possible after a total penectomy.

Penile cancer and treatment

Penile cancer is the development of cancerous or malignant cells on the surface or inside the penis tissue. Like every other cancer, penile cancer has a high risk of mortality, especially when diagnosed late.

There are different treatment options for penile cancer, such as chemotherapy, radiotherapy, and surgery. Your doctor will recommend the best treatment option for you. Treatment and prognosis will often depend on the following:

  • The cancer stage
  • The tumor size and location
  • Whether the cancer has been recently diagnosed or it is a recurring cancer.

Treatment of penile cancer raises much fear and anxiety for people with penises and their partners, and penectomy seems to be the height of this treatment. Penectomy depression can occur too.

What is penectomy?

Penectomy is a surgical procedure that might be recommended by the doctor when the situation demands it. It is an effective treatment method for penile cancer. Aside from penile cancer, there are rare cases where this procedure might be recommended for severe penile trauma.

Penectomy surgery can be total or partial. With a total penectomy, the whole penis is removed.

However, to enable the patient to urinate, surgeons typically create another urinary opening in the perineum (the area between the scrotum and the anus). The person will have to squat to urinate.

The procedure of creating a new urinary opening is known as a perineal urethrostomy.

In partial penectomy, only the end of the penis is removed, leaving out the shaft. In more advanced cases, the testicles and surrounding lymph nodes might also be removed along with the penis.

Also, a portion of skin might be taken from another part of the body to replace some of the tissue that has been removed (a procedure known as a skin graft).

Surgery to the penis, in some cases, causes complications like urinary problems. There could be swelling and inflammation of the penis, which exerts pressure on the urethra, thus causing the urinary system to spray when urinating. However, this is expected to improve as the body heals.

The sexual after-effects of partial penectomy

Removing all or part of the penis (total penectomy) can greatly impact a person's self-esteem. It can throw one into a state of depression. It can also reduce a person's sexual drive.

If you had a penectomy, you may feel less desirable and this can affect your sex drive. However, you should know that sex is possible after a penectomy. Some men can still attain sexual arousal and can even have satisfying sex after undergoing a partial penectomy.

According to an older 2005 study, 55.6% of people that had partial penectomy reported that the erection of their penis also allowed vaginal penetration.

This means there can be sex after penectomy. Penectomy is meant to treat a health condition -penile cancer. Living a quality life shouldn't end after it. You can reach out to a support group in your area or check online. It often helps to talk to a group of people who are willing to listen and offer support.

Photo by Alex Green on Pexels

It may not be a walk in the park, but many people who undergo a penectomy procedure often benefit from therapy sessions and having their partners work with them to overcome their challenges.

Since partial penectomy involves removing the end of the penis, the shaft would still be intact and become erect when aroused. So, even though the penile glans, or 'head', which is the most sensitive area of the penis, has been removed, orgasm and ejaculation can still be reached.

The sexual after-effects of total penectomy

Total penectomy involves the complete or total removal of the penis. Hence, It won't be possible for a person to have penetrative intercourse with a total penectomy.

However, it is still possible to feel or have sexual pleasure when certain sensitive areas such as the area around the surgical scars, the scrotum, and the skin behind the scrotum are caressed, according to the American Cancer Society.

There might also be a possibility of reconstructing the penis after having a total penectomy surgery. You will have to consult expert physicians or speak with your healthcare team about this option.

Is penectomy depression real?

While penectomy might be the last resort to saving the life of one diagnosed with penile cancer, much may change in terms of the man's sexual life.

After undergoing surgeries to remove part of their penis, some men will be unable to satisfy their partners sexually. This can cause them to start experiencing penectomy depression.

Penectomy depression is when a man is thrown into a state of depression and anxiety after penectomy surgery. This is common in many men that have undergone the procedure. Having a significant anatomical feature of their body removed surgically often affects their emotional and mental health.

References

  1. American Cancer Association. (2016). Long-term side effects of penile cancer treatment.
  2. Cancer Research UK. (2021). Sex and relationships with penile cancer.
  3. Romero, Frederico Ramalho et al. (2005). Sexual function after partial penectomy for penile cancer.