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Sex and relationships after Focal Therapy

Whatever your age, we know that having sex is an important part of many peoples’ relationships, and that the prospect of losing this due to impotence can be distressing. Although you are having the treatment, any kind of procedure can affect your partner and friends. We advise all our potential patients to discuss their options with someone they trust.

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Dr Christos Mikropoulos: Sex and prostate cancer​

Learn more about sex and relationships after Focal Therapy

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Dr Christos Mikropoulos Can I have sex after prostate cancer treatment
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SUMMARY
Dr. Christos Mikropoulos (Oncologist, The Focal Therapy Clinic): After radical treatment, men can still have sex, but erectile function may be affected, often requiring medication or additional therapies. Ejaculation will be dry due to prostate removal or radiotherapy, but sexual sensation and orgasm can still be preserved.

TRANSCRIPT
Dr. Christos Mikropoulos: After **radical treatment** for prostate cancer, men can still have **sexual intercourse**. However, the treatment may affect **erectile function**, and some men may require **medication** or other support to maintain erections. Additionally, **ejaculation will be dry**, as the **prostate gland** and **seminal vesicles** are either **removed (surgery)** or **damaged by radiotherapy**. This change can impact what men perceive as **normal intercourse**, but sexual activity remains possible with appropriate support.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.
Can you have children after having prostate cancer?
00:58
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SUMMARY
Mr. Raj Nigam (Consultant Urologist, The Focal Therapy Clinic): Focal therapy preserves ejaculation and sperm production, unlike radical prostatectomy or radiotherapy. Some men treated with focal therapy have successfully fathered children, making it a strong option for those concerned about fertility.

TRANSCRIPT
Mr. Raj Nigam: ### **Focal Therapy & Fertility Preservation** One of the key advantages of **focal therapy** is that it **does not damage other structures within the prostate**, allowing men to maintain **ejaculation and sperm production**. ### **How Focal Therapy Compares to Other Treatments** - In **radical prostatectomy and radiotherapy**, ejaculation function is **almost always lost**. - Men undergoing these treatments can still have children if they **freeze their sperm beforehand**, but this requires **assisted conception**. ### **Fertility After Focal Therapy** - **Focal therapy allows men to continue producing semen and sperm naturally**. - Unlike whole-gland treatments, **the prostate remains functional**, supporting fertility. - I have personally treated **at least three men with focal therapy who have gone on to father children naturally**. For men concerned about **fertility and maintaining natural function**, **focal therapy offers a significant advantage** while effectively treating prostate cancer.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Read more.

How does prostate treatment impact sex and relationships?

Impotence

97% of the men we’ve treated are able to get and maintain erections normally, or with the help of pills or other medication. Research from Prostate UK shows that 76% of men who receive whole gland treatment for prostate cancer experience erectile dysfunction.

Fertility

After focal therapy, you’ll still be able to produce sperm and semen, although you may find you produce less than you did before. We are delighted that some of our patients have gone on to have children after treatment.

Libido

After focal therapy, most men keep their erections and sexual desire, although some notice small changes. The large majority of our patients continue to enjoy a normal sex life after treatment. We are pleased that men often report confidence in their intimacy returning quickly.

Erectile dysfunction

After focal therapy,  men recover their erections within a few weeks. Around 20% find that tadalafil helps during recovery. At one year after treatment, over 95% of our patients report normal erectile function.

Anejaculation

Anejaculation means not producing semen during orgasm, (Dry Orgasm) and occurs after surgery for prostate cancer. After focal therapy, this side effect is very rare, and most men continue to ejaculate, although sometimes with less volume.

Prostate cancer’s impact on partners and relationships

Communication challenges: Couples may struggle to talk openly about changes in intimacy

Partner’s emotional response: Partners may feel confused, rejected, or unsure how to help.

Need for adaptation: Couples often need to redefine what intimacy looks like, exploring new ways to connect physically and emotionally.

Strain vs. growth: While some relationships experience strain, others grow stronger through shared coping and emotional closeness.

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Questions to ask your doctor or nurse

Am I a good candidate for HIFU prostate cancer treatment?

Are You a Good Candidate for HIFU (High-Intensity Focused Ultrasound)?

  • Your cancer is intermediate risk (usually Gleason 3+4 or 4+3).
  • The cancer is localised (hasn’t spread outside the prostate).
  • Your PSA is under 15–20 ng/mL.
  • You are expected to live at least 8–10 more years.
  • The cancer is in one main spot and small enough to target.

Note: HIFU is not usually used for very low-risk or very high-risk cancer. It aims to treat the cancer while keeping side effects like incontinence or erection problems low.

"I had the HIFU procedure with Tim Dudderidge and was very happy with the results... I have absolutely no incontinence and I'm fully sexually active without any side effects."

– Graham Pipe, HIFU patient

“Focal HIFU treats cancer with lower side effects.”

– Mr. Tim Dudderidge, Consultant Urologist

Is HIFU available at your clinic, and how experienced is the team?

HIFU is available at the Focal Therapy Clinic in the UK. It is one of the leading centres for focal therapy, including HIFU, NanoKnife, and Cryotherapy. The team includes top urologists like Mr. Tim Dudderidge, Mr Marc Laniado, Mr Raj Nigam and Mr Alan Doherty who have treated over 2,000 patients successfully.

Patient quote: "I had the HIFU procedure with Tim Dudderidge and was very happy with the results." – Graham Pipe, FTC HIFU patient.
How does HIFU compare to other treatments like NanoKnife, surgery or radiotherapy?

HIFU targets only the cancer, not the whole prostate. This means fewer side effects like leaking or erection problems compared to surgery or radiotherapy. NanoKnife is also precise and may preserve erections slightly better, especially in tricky cancer locations.

Patient quote: "I have absolutely no incontinence and I'm fully sexually active without any side effects." – Graham Pipe, HIFU patient
Surgeon quote: "Focal HIFU kills cancer with minimal side effects. It preserves sexual function reliably." – Mr. Alan Doherty
How many times can HIFU be repeated if cancer comes back?

HIFU can be safely repeated if the cancer comes back in the treated area. Studies show about 15 to 20% of men may need a second round, and it usually works well. Follow-up scans and biopsies help decide if another treatment is needed.

Urologist quote: “Focal HIFU lets us hit the cancer without harming the rest of the prostate.” – Mr. Raj Nigam
What are the success rate and potential side effects for my specific case?

For men with intermediate-risk, localized prostate cancer, HIFU has a success rate of about 88% at 5 years—meaning no need for surgery, radiation, or further treatment. Side effects are usually mild: 2% need a pad for leaks for a short time, and 90%+ men keep erections, especially if function was good before treatment.

Urologist quote: “HIFU preserves sexual function reliably.” – Mr. Alan Doherty
Patient quote: “I have no incontinence and full sexual function after HIFU.” – Nigel Harris, FTC patient
What follow-up schedule should I expect?
After HIFU, follow-up usually includes:
  • PSA tests every 3 months for the first year
  • MRI scan at 12 months
  • Biopsy only if the MRI scan indicates an area of concern
  • Regular checks for urinary or sexual function

This helps catch any signs of cancer coming back early.

Urologist quote: “Monitoring side effects and recurrence rates is a key part of our research” – Mr. Marc Lanaido

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    Frequently asked questions

    Am I a good candidate for HIFU prostate cancer treatment?
    You may be a good candidate for HIFU (High-Intensity Focused Ultrasound) if your cancer is intermediate risk (usually Gleason 3+4 or 4+3), localised, your PSA is under 15–20 ng/mL, you are expected to live at least 8–10 more years, and the cancer is in one main spot and small enough to target. HIFU is not usually used for very low-risk or very high-risk cancer. It aims to treat the cancer while keeping side effects like incontinence or erection problems low. Patient quote: "I had the HIFU procedure with Tim Dudderidge and was very happy with the results... I have absolutely no incontinence and I'm fully sexually active without any side effects." – Graham Pipe, HIFU patient. Surgeon quote: "Focal HIFU treats cancer with lower side effects." – Mr. Tim Dudderidge, Consultant Urologist.
    Is HIFU available at your clinic, and how experienced is the team?
    HIFU is available at the Focal Therapy Clinic in the UK. It is one of the leading centres for focal therapy, including HIFU, NanoKnife, and Cryotherapy. The team includes top urologists like Mr. Tim Dudderidge, Mr Marc Laniado, Mr Raj Nigam, and Mr Alan Doherty who have treated over 2,000 patients successfully. Patient quote: "I had the HIFU procedure with Tim Dudderidge and was very happy with the results." – Graham Pipe, FTC HIFU patient.
    How does HIFU compare to other treatments like NanoKnife, surgery or radiotherapy?
    HIFU targets only the cancer, not the whole prostate, resulting in fewer side effects like leaking or erection problems compared to surgery or radiotherapy. NanoKnife is also precise and may preserve erections slightly better, especially in tricky cancer locations. Patient quote: "I have absolutely no incontinence and I'm fully sexually active without any side effects." – Graham Pipe, HIFU patient. Surgeon quote: "Focal HIFU kills cancer with minimal side effects. It preserves sexual function reliably." – Mr. Alan Doherty.
    How many times can HIFU be repeated if cancer comes back?
    HIFU can be safely repeated if the cancer returns in the treated area. Studies show about 15–20% of men may need a second round, and it usually works well. Follow-up scans and biopsies help decide if another treatment is needed. Urologist quote: "Focal HIFU lets us hit the cancer without harming the rest of the prostate." – Mr. Raj Nigam.
    What are the success rate and potential side effects for my specific case?
    For men with intermediate-risk, localised prostate cancer, HIFU has a success rate of about 88% at 5 years—meaning no need for surgery, radiation, or further treatment. Side effects are usually mild: 2% need a pad for leaks for a short time, and 90%+ men keep erections, especially if function was good before treatment. Urologist quote: "HIFU preserves sexual function reliably." – Mr. Alan Doherty. Patient quote: "I have no incontinence and full sexual function after HIFU." – Nigel Harris, FTC patient.
    What follow-up schedule should I expect?
    After HIFU, follow-up usually includes PSA tests every 3 months for the first year, MRI scan at 12 months, biopsy only if the MRI scan indicates an area of concern, and regular checks for urinary or sexual function. This helps catch any signs of cancer returning early. Urologist quote: "Monitoring side effects and recurrence rates is a key part of our research." – Mr. Marc Laniado.
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    Any questions?

    If you’ve got any questions about your prostate cancer diagnosis or want to know more about HIFU or NanoKnife, don’t hesitate to get in touch with our friendly, knowledgeable team.

    0207 036 8870

    info@thefocaltherapyclinic.co.uk

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      Reference List

      Ahmed HU et al. (2015). Focal therapy for localized prostate cancer: a systematic review of the literature. Nature Reviews Urology.

      Ganzer R, Fritsche HM, Brandtner A, et al. (2017). Five-year outcome of HIFU treatment for localized prostate cancer. Urologia Internationalis.

      The Focal Therapy Clinic – Prostate Cancer Treatments (Internal Resource).

      NHS Resources on Prostate Cancer (Internal/External Resource).

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