Bladder cancer and its treatments may cause sexual side effects, including erectile dysfunction (ED). How long this side effect lasts varies considerably, but ED treatments can help manage it.

Erectile dysfunction (ED) is the inability to get or keep an erection. It’s not uncommon to experience ED after having bladder cancer or treatments for bladder cancer, such as a bladder removal surgery.

Read on to learn more about why bladder cancer and its treatments can cause ED, what you can do about it, and how long you may be able to expect ED to last.

Bladder cancer can spread to nearby nerves or organs that are part of your sexual function, including your prostate, testicles, and penis.

Bladder cancer treatments can also affect these organs and the nerves involved in helping you get hard, ejaculate, and feel aroused.

Bladder cancer and its treatments don’t always cause ED. But when they do, the causes may be both physical and psychological.

Physical causes

Cancer treatments that affect nerves and organs around the bladder are most clearly linked to ED.

A 2020 article reviewed 17 studies of several thousand people who underwent treatments for bladder cancer and other related cancers.

The researchers found that cancer treatments such as radical cystectomy (removal of the whole bladder) were significantly associated with shorter penis length and sexual dysfunction, which is when you’re facing significant challenges related to your ability to experience pleasure or respond sexually.

The reviewers mention that nerve cell damage plays a part in ED after bladder cancer treatment. Radiation therapy and chemotherapy can also change how your body uses nitric oxide, a major component involved in getting an erection when you’re aroused.

A 2022 survey of nearly 1,800 people with bladder cancer revealed that treatment had a noticeable effect on sexual function. Up to 60% of males who completed the survey had ED and trouble ejaculating after invasive treatments such as transurethral resection of a bladder tumor or open surgery to remove the bladder.

Psychological causes

A 2020 review examined 37 studies investigating the sexual effects of bladder cancer in males and females.

The findings suggested that many males don’t feel they get the medical help they need to manage sexual side effects after bladder cancer treatment. This results in a lower quality of life and mental well-being that can cause changes in the ability to get erections, ejaculate, and feel sexual desire.

The other 2020 review mentioned earlier notes that stress and negative body image can play a part in ED after bladder cancer treatment.

Other sexual health effects of bladder cancer

Some of the sexual health effects of bladder cancer can include:

  • changes in sensation in your penis or testicles
  • less firm erections
  • lowered feelings of arousal
  • having trouble staying hard
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Here are some treatments that can help you manage ED after bladder cancer.

PDE-5 inhibitor

Phosphodiesterase-5 (PDE-5) inhibitors reduce a substance called PDE-5 that may stop muscles in your penis from helping you get hard. PDE-5 inhibitors such as sildenafil (Viagra) are widely available by getting a prescription from a healthcare professional or through telehealth platforms that specialize in sexual health.

PGE1 suppository

You can insert prostaglandin E1 (PGE1) suppositories into your urethra to relax penis muscles and dilate penis blood vessels. This helps your penis fill up with blood during an erection.

Penis pump

Penis pumps help bring blood into your penis using a vacuum suction device and keep blood there with a ring placed around the base of your penis.

Penis pumps can help you get erect when the organs and nerves around your bladder aren’t working well and keep you from getting an erection on your own.

Penile implant

A penile implant is a surgically inserted device that allows you to inflate your penis with fluid to get an erection. You can also have rigid implants inserted that stay hard all the time.


Changes in your quality of life and sex life can make you anxious, depressed, or feel bad about how long your erection can last or how your partner feels about your sexual actions.

Working with a sex therapist can help you navigate changes in your life after bladder cancer that affect your sex life or self-image.

There’s no simple answer to how long difficulties with getting or keeping an erection after bladder cancer lasts.

A 2023 study found that the type of treatment you get makes a difference.

Some people in the study who got a radical cystectomy never experienced any improvement in their sexual function up to 5 years after treatment.

But people who were younger or who got less invasive bladder removal surgeries eventually saw improvements in their sexual function.

Here are some of the most frequently asked questions about ED after bladder cancer.

How common is erectile dysfunction after cystectomy?

ED is common after a cystectomy, especially a radical cystectomy that removes your whole bladder. A 2014 study suggests that up to 80% of people who get a cystectomy have some difficulty with getting or keeping an erection afterward.

Which bladder cancer treatments are less likely to cause sexual dysfunction?

Bladder cancer treatments such as nerve-sparing surgery and sexual-preserving cystectomy are much less likely to cause ED or difficulties with getting or keeping an erection than radical cystectomy, radiation therapy, or chemotherapy.

What cancers cause erectile dysfunction?

Prostate cancer and bladder cancer are most likely to cause ED. But many cancer treatments have links to ED, such as:

Can you get erectile dysfunction after cystoscopy?

A cystoscopy is part of the diagnostic process for bladder cancer. Doctors also use the technique to monitor your condition, so you may have several cystoscopies.

An older study linked cystoscopy to erectile dysfunction, especially within the 2 weeks after the procedure. But a 2017 study suggests that the type of cystoscopy (rigid versus flexible) may have an effect.

ED is a common side effect of bladder cancer or its treatments. Talk with a healthcare professional about what treatments may help you lower your risk of ED after bladder cancer or what you can do to lower its effect on your sex life.