Male Orgasmic Dysfunction Post-Radical Pelvic Surgery

Background Pelvic surgeries are recognized to cause dysfunction of the male sexual response, which consists of erection, emission, expulsion, and orgasm. However, the least attention has been paid to male orgasmic dysfunction after invasive pelvic surgery. Aim To describe the available literature on post-pelvic surgery orgasmic dysfunction disorders. Methods A literature search was performed on PubMed using the search strings related to dysfunction of the male sexual cycle and orgasm after pelvic surgery. Outcomes Orgasmic dysfunction after pelvic procedures in urologic, colorectal, and vascular surgeries was assessed. Results Radical prostatectomy was the most common procedure where orgasmic dysfunction was quantified. Anorgasmia post-operatively occurred in patients in a range of 5–70%. Dysorgasmia occurred less frequently from 7–14%. The prevalence of climacturia was highly variable occurring in 20–93% of patients. Radical cystectomy resulted in anorgasmia 33–62% of the time and climacturia ranged from 6–45%. Studies involving colorectal surgeries were less likely to assess for dysorgasmia and climacturia, but anorgasmia rates ranged from 0–52%. Most current studies do not differentiate between ejaculatory and orgasmic dysfunction. However, more recent studies have started to distinguish between the 2 disorders and publish more specific data on what components of the male sexual response has been affected by the specific surgery. Conclusions The male sexual response, specifically the male orgasm, is difficult to quantify in a non-obtrusive setting and can exhibit variability between patients and between sexual encounters in the same patient. Data involving the outcome of male orgasmic dysfunction after pelvic surgery are sparse, limiting health professionals’ ability to appropriately counsel patients. Future work needs to standardize outcome assessment for orgasmic disorders, which, in turn, can be used across all surgical specialties. Haney NM, Alzweri LM, Hellstrom WJG. Male Orgasmic Dysfunction Post-Radical Pelvic Surgery. Sex Med Rev 2018;6:429–437.