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Partial nerve sparing expectations

User
Posted 27 Jun 2022 at 22:29

Any comments from those who have had experience of partial nerve sparing?All the stats and info seem to be about 100% nerve sparing.

User
Posted 28 Jun 2022 at 00:31

I haven't had prostatectomy, or looked up statistics on the matter. From posts on this forum I get the impression 100% nerve sparing isn't really possible. The nerves run around the prostate and some will get damaged the surgeon can try and do as little damage as possible and if the cancer is only on one side she might be able to spare all the nerves on the other side.

Hopefully others who have had prostatectomy will post and say what percent of nerves were spared.

Dave

User
Posted 28 Jun 2022 at 01:11
You may find more data by searching for uni-lateral nerve sparing v bi-lateral nerve sparing. More men have partial / uni-lateral than bi-lateral RP.

If you are asking about sexual function - it makes little difference whether he has retained all or just some of the nerve bundles. Men can have total nerve sparing and never get a natural erection again, or partial nerve sparing and make a full recovery. It is a bit of a lucky dip :-/

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

User
Posted 28 Jun 2022 at 06:32

I think the stats show that almost all men after prostatectomy who can still get erections have less effective erections, which probably backs up Dave's point that some nerves get damaged even in claimed full nerve sparing. Often this doesn't prevent intercourse if you go from rock solid grade 4 erections down to still usable grade 3 erections, although there are circumstances where it might, e.g. if you have anal intercourse where a more solid erection is required than for vaginal intercourse. Known partial nerve sparing is going to make this a little worse, and it's going to take longer to recover to the point of having usable erections. Some men find this still improving years after prostatectomy (improvements after 3 years are probably due to nerves regrowing, which can happen in a few cases).

However, there are some simple things you can do to improve erections if you're getting them but they aren't as strong as you'd wish. The PDE5 inhibitor drugs (Viagra, Cialis, etc) have the effect of amplifying the nerve signals arriving at the penis, and can often make up for fewer nerves. A cock ring (not a pump constriction ring, but something more gentle such as a Durex Pleasure Ring) can also do this by holding more blood in the penis.

 
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