Can there be sexual desire or intercourse after penectomy?

Could one still have sexual desires after penectomy - the surgical removal of the penis? When the penis is gone, will the sexual desires go with it? This article answers these questions.

Penile surgery (penectomy)

Penectomy procedure usually asks the thorny question of "What is the fate of sexual intercourse afterwards?" Can a man have sexual urge sex after a penectomy? How is life after penectomy?

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

If you had a penectomy, your sexual abilities may likely 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 sex life after partial penectomy and fulfilling sex life is also possible after total penectomy.

Penile cancer and treatment

Penile cancer is the formation 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, penectomy, radiotherapy, and drugs. Your doctor will recommend the best treatment option for you. Treatment and prognosis will often depend on:

  • The cancer stage
  • The tumour 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. Sometimes penectomy depression too sets in.

Is penectomy depression real?

Photo by Alex Green on Pexels

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 remove surgically often affects their emotional and mental health.

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. Asides from penile cancer, there are rare cases where it might be recommended for severe penile trauma.

Penectomy surgery can be total or partial. With 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 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 alongside 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. If you experience any such problems after your surgery, you should reach out to your healthcare team.

There could be swellings 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 sex 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 go had 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 complete or total removal of the penis. Hence, It won't be possible for a person to have penetrative intercourse with 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.

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.