The effect penile cancer has on your sex life and sexuality depends on which treatment you have. Most treatments for cancer of the penis don’t affect being able to have sex.
Doctors will always try to give you the treatment that preserves as much of your penis as possible. This will allow you to use it as normally as possible.
Having sex after radiotherapy or chemotherapy
It can take time to recover from the side effects of radiotherapy or chemotherapy before you feel ready to have sex.
Radiotherapy to your penis might temporarily affect your ability to have an erection. This is sometimes because of tiredness caused by the radiotherapy and worry about your diagnosis. Radiotherapy might also affect the nerves in and around the penis in the short term.
The tissue in the penis might become thickened from radiotherapy. This might make it more difficult and painful to have an erection. You may also have less sensation.
Most of these side effects improve once you have finished treatment. Many men are able to carry on their sex life as before.
Having sex after surgery
After treatment for early stage cancer
Your sex life is unlikely to be affected. Some men worry about their sex lives after a circumcision. There is no proof that men are less sensitive or have more difficulty getting an erection after a circumcision.
After removal of the area of the cancer (wide local excision)
Most men are usually able to have an erection and carry on with their sex life.
After removal of the head of the penis (glansectomy) with reconstruction
You are usually able to continue your sex life. You might have less sensation but it is likely you are able to have erections.
After removal of part of the penis (partial penectomy)
You are also usually able to have a fulfilling sex life. You might be able to have an erection and orgasm without the sensitive head of the penis. You can still penetrate your partner with the remaining shaft of the penis (glans). A study on men who had a partial penectomy found that over half of them could have an erection and intercourse.
After removal of the whole penis (total penectomy)
After a penectomy you might need to adapt the way you express your sexuality. It is still possible to have a fulfilling sex life. Talk to your partner and share the ways you would like to be sexually satisfied. But it is still possible to find different ways of being sexual with your partner. This may help you to overcome the changes in your body.
After a penis reconstruction
You may have a penis reconstruction after your penile surgery if you had part, or all, of your penis removed. This is also called a phalloplasty. This will be another operation after a period of time and once there is no sign of penile cancer.
Specialist plastic surgeons and urologists use skin and muscle from other areas of the body to reconstruct a new penis. You might have some sensation if your surgeon is able to reconnect some of the nerves. You usually have a penile implant so that you can have an erection.
This is major surgery with a high risk of complications and is not suitable for everyone. Before you have the surgery, talk to your doctor about what you should expect afterwards.
All these changes to your sex life take time to adjust to. Working as a couple on the changes and sharing your feelings can make it easier.