Post-Surgery Erectile Dysfunction: Is It Linked to Cyst Removal?

Impotence due to surgery?

For the past three years, I have had two hard nodules the size of rice grains on the dorsal side of my penis, slightly to the left.
They are painless and do not cause any discomfort, and my sexual function has been normal, but they are aesthetically unpleasing.
A urologist diagnosed them as sebaceous cysts and referred me to a dermatologist.
In July of this year, I underwent surgical removal in dermatology, which involved over ten stitches and left a 2.5 cm vertical scar.
However, after the scabs fell off, I noticed significant changes during sexual activity.
Currently, my penis requires constant stimulation to maintain an erection, and its rigidity is somewhat diminished compared to before.
Once stimulation ceases for a few seconds, the erection fades, making vaginal penetration difficult.
These symptoms have never occurred before, and I recently attributed them to possible vascular damage to the corpora cavernosa due to the surgery.
Is this a possibility? Additionally, I have been applying Hirudoid daily after the scabs fell off to minimize scarring; could this also have an effect?

Liu, 20~29 year old female. Ask Date: 2000/10/01

Dr. Liu Jianting reply Urology

A simple excision of a sebaceous cyst on the skin should not cause any damage to the penile corpora cavernosa.
However, postoperative pain and scarring may lead to psychological stress that affects sexual function.
I recommend that you visit a urology clinic for evaluation and assessment.
How does that sound?

Reply Date: 2000/10/01

More Info

Post-surgery erectile dysfunction (ED) can indeed be a concerning issue, especially when it arises after a procedure that may not seem directly related to sexual function, such as cyst removal. In your case, the surgery to remove sebaceous cysts from the penis may have inadvertently affected the surrounding tissues, including the blood vessels and nerves that are crucial for achieving and maintaining an erection.

Firstly, it is important to understand that the penis is a highly vascular organ, meaning that its ability to achieve an erection is largely dependent on the proper functioning of blood vessels. Any surgical procedure in the area, particularly one that involves incisions and sutures, has the potential to cause trauma to these blood vessels. If the surgery resulted in any damage to the blood supply or the nerves that control erectile function, this could lead to the symptoms you are experiencing, such as difficulty maintaining an erection and reduced hardness.

Additionally, the presence of scar tissue from the surgery can also play a role in erectile dysfunction. Scar tissue can affect the elasticity and blood flow within the penis, making it more difficult to achieve a full erection. The fact that you have a 2.5 cm vertical scar may suggest that there was significant tissue manipulation during the procedure, which could contribute to the changes in erectile function.

Regarding your use of Hirudoid (a topical treatment often used to reduce bruising and swelling), it is unlikely that this medication would directly cause erectile dysfunction. However, if the application of the cream leads to irritation or an allergic reaction in the sensitive skin of the penis, it could potentially contribute to discomfort during sexual activity, which might indirectly affect your ability to maintain an erection.

It is also worth noting that psychological factors can play a significant role in erectile dysfunction, particularly after surgery. Anxiety about sexual performance, fear of pain, or concerns about the appearance of the scar can all contribute to difficulties in achieving or maintaining an erection.
In terms of management, it is advisable to consult with a urologist or a sexual health specialist who can evaluate your specific situation. They may recommend a variety of treatments, including:
1. Counseling or Therapy: If psychological factors are contributing to your ED, speaking with a therapist who specializes in sexual health may be beneficial.

2. Medications: There are several medications available that can help improve erectile function by enhancing blood flow to the penis.

3. Physical Therapy: In some cases, pelvic floor exercises or physical therapy may help improve erectile function.

4. Follow-up on Scar Management: Discuss with your healthcare provider about the best ways to manage your scar and whether additional treatments, such as silicone gel sheets or laser therapy, might help reduce scar tissue and improve function.

5. Monitoring and Evaluation: Regular follow-ups with your healthcare provider can help monitor your recovery and any ongoing issues related to erectile function.

In conclusion, while it is possible that the surgery has affected your erectile function due to vascular or nerve damage, it is essential to have a thorough evaluation to determine the exact cause and appropriate treatment. Don't hesitate to reach out to a specialist who can provide tailored advice and support for your situation.

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