Actual Levels of nerve sparing during RP surgery - in percentage terms ? - Localised cancer

User

Posted 08 Jul 2021 at 22:48

On your post RP surgery letter/review from your consultant , has anyone had the actual levels of nerve sparing that was achieved laid out in numbers or percentage terms ?

Just had my 3 month follow up and have been told that the surgeon managed 3½ /5 on both sides ? but have no idea if this is good/bad or just ok? Rightly or wrongly I’m reading it as 70% ?

Before the op I’d got it in my mind I that it was a case of non nerve sparing, left side only, right side only or if you were very lucky both sides. Thinking about this now, its probably a very foolish and oversimplistic view and now knowing what they’ve done during the operation it would be stupid to assume no collateral damage at all.

70% is way better than 50 but no where near as good as 95!!

It’s been 18 weeks now since the op and nothing not even a twinge. Using the pump 3/4 times a week and taking Tadalifil 5ml daily.

I guess it’s just a waiting game ?

Thanks

User

Posted 08 Jul 2021 at 23:07

Yep it is !!! Sounds good on the nerve sparing front indeed. You are doing exactly the right thing. The pump should be your best friend and daily Cialis is great. I have excellent EF now at 6 yrs post op even though I’m incurable. If I’m honest it took 2 to 2 1/2 yrs before I got spontaneous useable erections back. I still use the pump ( habit ) and still use daily Cialis but all good except the prognosis. Way too early to be expecting miracles honestly

Good luck

User

Posted 09 Jul 2021 at 01:19

Whether or not you regain natural erections is not always directly related to the amount of nerves spared. Some men can have full nerve sparing but never achieve an erection again; my husband had only one side saved but did regain natural erections some 3 years post-op. In theory, a man who has had non nerve sparing RP will be left with permanent ED but we have two members here who have gone on to recover - the thinking is that tiny fragments of nerve bundles can sometimes repair themselves.

Certainly, 70% nerve sparing improves your chances of recovering EF at some point but it is also affected by how much bruising or heat damage is done to the nerve bundles - some, bashed about a bit, basically go on permanent strike even though they are intact. For some men, the emotional impact of diagnosis and then radical treatment leads to ED not through a physical cause but emotional / psychological (that's where my husband has been for much of the last 12 years). It is possible to have full nerve sparing but be left with such a shrunken penis that although an erection is achievable, penetration is difficult if not impossible.

General view is that 90% of men can get an erection at 12 months either naturally or using chemical / mechanical assistance and that if you haven't achieved an erection by 2 years post op, it is unlikely to happen although as I said, my husband and a few others on here (like Chris above) have seen significant progress between years 2 and 3. Too early for you to worry yet.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 09 Jul 2021 at 13:25

Seem to be achieving good results with the pump, with not too much time and effort I can get back to my full pre-op size (length and girth) I understand the vacuum is stretching it and filling it out way more than it would do naturally, but thankfully I don’t appear to have lost much

thanks

User

Posted 09 Jul 2021 at 13:45

I was the same for a long time. Even bigger if the truth be known. But don’t over do it ok. In time over the years things inside you settle into a new place and loss of length is inevitable. I lost 1 1/2 inches or more. Girth still good.

User

Posted 13 Jul 2021 at 10:29

Hi Philip,

I'll be interested in what you find out re. 3.5/5 etc.

Never heard of this, I had no report.

See my profile. Do as you are doing, patience and keep on regular rehabilitation. See Chris wealth of posts, he helped me enormously. Never give up.

Oddly nocturnal erections initially returned for me after about 2 years, which suggests a nerve pathway was active. In my opinion much more research needed. Obviously huge collateral damage during op.

Regards Gordon

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Actual Levels of nerve sparing during RP surgery - in percentage terms ?

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