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Non Nerve Sparing

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User
Posted 08 May 2023 at 12:02

Hi

(Apologies if this has been asked before)

I had a non nerve sparing radical prostatectomy in November 2022. I was Gleason 8 before and Gleason 7 afterward with first blood test PSA 0. I was prescribed Sildenafil 50 then 100 and now a pump with very little effect. I have two questions. Is it likely I will ever get a “hard erection’ again? And is the pump the way ahead?

Thanks in advance

User
Posted 08 May 2023 at 19:23

Hi Markie1r,

Firstly, it''s great news about your Gleason Score being downgraded after surgery and your PSA score remaining at 0.

Don't be afraid of asking a question that might have been asked before.  People return to the same themes again and again, because these are our current reality.

I'm sure that people on this site who are more knowledgeable than me will be able to answer your question more fully. 

I was a Gleason 7 (4+3) and supposedly had nerve-sparing surgery.  However,  I'm now 11 months post-op. and have no natural erections whatsoever.  I've been taking 5mg. Cialis daily.  After taking it, there is a slight thickening of the penis and a very slight lengthening, but nothing that could remotely be called an erection.  I also have been prescribed a pump, which can give me a kind of 'erection' , so that I experience lengthening and a wider girth, but my penis points towards the floor :-((.  Even when I use a tension ring, my penis is not capable of standing upright.

So, you can probably see that the difference between non-nerve-sparing and (supposed) nerve-sparing may not be that great.

My understanding is that both the Cialis and the pump are provided for penile rehabilitation (i.e. to reduce the risk of the penis getting any smaller through lack of erections) but I'm happy to be corrected on this point.   

I hope you can make good progress with the Sildenafil and/or the pump.

Best wishes,

JedSee.

Edited by member 08 May 2023 at 19:25  | Reason: Not specified

User
Posted 08 May 2023 at 21:11

Markie, in theory if you are non nerve oral medication will not help get an erection. I was supposedly non nerve sparring but a few weeks after surgery got some movement and was put on daily 100mg of sildenafil. The sildenafil is sometimes mentioned as being beneficial to continence recovery. I have never fully recovered but we had fun along the way finding what worked for us. Even nine years after surgery I get an odd surprise.

You will hear it said that if you haven't recovered erections within two years you never will, there are plenty on here who have or are still recovering long after two years. 

Use the pump to get blood into the penis and get some expert tuition if you can. Never give up and have fun.

Get to understand PSA values but don't get hung up on minute changes. PSA results are either given as a figure or a less than value. 

Hope all goes well with your recovery.

Thanks Chris 

 

User
Posted 08 May 2023 at 21:16

Markie,
the pump is the way ahead in terms of maintaining penile health and preventing (or at least reducing) penile atrophy - which means permanent shrinkage. If you do not exercise / stretch the spongy material of the penis regularly, it dies (actually, it becomes hard and inflexible and will no longer be able to expand).

The sildenafil is probably not going to make any difference to you - I wonder if the person who prescribed it realised that you had no nerves spared? By now, I would have expected you to have been referred to an ED nurse / andrology clinic so that you can start trying the various options that can work without nerves - injections and pessaries, for example. But keep going with the pump in the meantime to ensure that if / when you do find an ED treatment that works, you have still got enough healthy penile tissue to be able to have intercourse.

Edited by member 04 Jun 2023 at 21:36  | Reason: Not specified

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

User
Posted 08 May 2023 at 22:52
As above pump pump pump !! Still at it 8 years on and you won’t regret it. I’m incurable now and on injectable HT but with 20mg Cialis each week I can still get him up even though I should no longer have a libido ( which I definitely have ). But yes if you non nerve then the pills may not help except Tadalafil which keeps some blood down there. Injections may be the way forward but don’t mix with pills or the pump at the same time on the same day.
User
Posted 04 Jun 2023 at 21:12
I had a non nerve sparing RALP last September and have not experienced any erection since or will likely to in the future .I would recommend using a Bathmate for rehabilitation most days and a Soma erect pump with gel and rings for penetrative sex. After pumping I always apply moisturising cream to prevent dryness.
User
Posted 04 Jun 2023 at 22:51

You have a number of options. We chose the pump and have been using it for over 12 years. Have a look at the link:

https://community.prostatecanceruk.org/posts/t28948-Re-establishing-Sex-Life

 

 

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

User
Posted 25 Oct 2023 at 13:02

Bathmate is a make of pump, I think it’s designed to be used in the bath or shower…if you Google it you should find it. You should be able to get a Vacuum Pump on prescription from the NHS. See your GP or CNS to get referred to the ED Clnic. It seems the most commonly prescribed one is the Somarect from iMedicare. It is really good but you do need to practice and also make sure you get the correct sized cylinder. If you look at the iMedicare web side you can find all about them. It has definitely made a difference for me, I didn’t have surgery but need it to correct my Peyronie’s disease.

You can buy it privately but it’s NOT  cheap!

Happy Pumping😊

Derek

Show Most Thanked Posts
User
Posted 08 May 2023 at 19:23

Hi Markie1r,

Firstly, it''s great news about your Gleason Score being downgraded after surgery and your PSA score remaining at 0.

Don't be afraid of asking a question that might have been asked before.  People return to the same themes again and again, because these are our current reality.

I'm sure that people on this site who are more knowledgeable than me will be able to answer your question more fully. 

I was a Gleason 7 (4+3) and supposedly had nerve-sparing surgery.  However,  I'm now 11 months post-op. and have no natural erections whatsoever.  I've been taking 5mg. Cialis daily.  After taking it, there is a slight thickening of the penis and a very slight lengthening, but nothing that could remotely be called an erection.  I also have been prescribed a pump, which can give me a kind of 'erection' , so that I experience lengthening and a wider girth, but my penis points towards the floor :-((.  Even when I use a tension ring, my penis is not capable of standing upright.

So, you can probably see that the difference between non-nerve-sparing and (supposed) nerve-sparing may not be that great.

My understanding is that both the Cialis and the pump are provided for penile rehabilitation (i.e. to reduce the risk of the penis getting any smaller through lack of erections) but I'm happy to be corrected on this point.   

I hope you can make good progress with the Sildenafil and/or the pump.

Best wishes,

JedSee.

Edited by member 08 May 2023 at 19:25  | Reason: Not specified

User
Posted 08 May 2023 at 21:11

Markie, in theory if you are non nerve oral medication will not help get an erection. I was supposedly non nerve sparring but a few weeks after surgery got some movement and was put on daily 100mg of sildenafil. The sildenafil is sometimes mentioned as being beneficial to continence recovery. I have never fully recovered but we had fun along the way finding what worked for us. Even nine years after surgery I get an odd surprise.

You will hear it said that if you haven't recovered erections within two years you never will, there are plenty on here who have or are still recovering long after two years. 

Use the pump to get blood into the penis and get some expert tuition if you can. Never give up and have fun.

Get to understand PSA values but don't get hung up on minute changes. PSA results are either given as a figure or a less than value. 

Hope all goes well with your recovery.

Thanks Chris 

 

User
Posted 08 May 2023 at 21:16

Markie,
the pump is the way ahead in terms of maintaining penile health and preventing (or at least reducing) penile atrophy - which means permanent shrinkage. If you do not exercise / stretch the spongy material of the penis regularly, it dies (actually, it becomes hard and inflexible and will no longer be able to expand).

The sildenafil is probably not going to make any difference to you - I wonder if the person who prescribed it realised that you had no nerves spared? By now, I would have expected you to have been referred to an ED nurse / andrology clinic so that you can start trying the various options that can work without nerves - injections and pessaries, for example. But keep going with the pump in the meantime to ensure that if / when you do find an ED treatment that works, you have still got enough healthy penile tissue to be able to have intercourse.

Edited by member 04 Jun 2023 at 21:36  | Reason: Not specified

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

User
Posted 08 May 2023 at 22:52
As above pump pump pump !! Still at it 8 years on and you won’t regret it. I’m incurable now and on injectable HT but with 20mg Cialis each week I can still get him up even though I should no longer have a libido ( which I definitely have ). But yes if you non nerve then the pills may not help except Tadalafil which keeps some blood down there. Injections may be the way forward but don’t mix with pills or the pump at the same time on the same day.
User
Posted 09 May 2023 at 12:14

Thank-you all for your replies. 

Mark

 

User
Posted 04 Jun 2023 at 21:12
I had a non nerve sparing RALP last September and have not experienced any erection since or will likely to in the future .I would recommend using a Bathmate for rehabilitation most days and a Soma erect pump with gel and rings for penetrative sex. After pumping I always apply moisturising cream to prevent dryness.
User
Posted 04 Jun 2023 at 22:51

You have a number of options. We chose the pump and have been using it for over 12 years. Have a look at the link:

https://community.prostatecanceruk.org/posts/t28948-Re-establishing-Sex-Life

 

 

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

User
Posted 25 Oct 2023 at 12:41

Hi. Excuse my ignorance what is bathmate? Like you I had non nerve sparing surgery so I'm looking for advice on solving the ED issues for which I clearly have. 

Dave

User
Posted 25 Oct 2023 at 13:02

Bathmate is a make of pump, I think it’s designed to be used in the bath or shower…if you Google it you should find it. You should be able to get a Vacuum Pump on prescription from the NHS. See your GP or CNS to get referred to the ED Clnic. It seems the most commonly prescribed one is the Somarect from iMedicare. It is really good but you do need to practice and also make sure you get the correct sized cylinder. If you look at the iMedicare web side you can find all about them. It has definitely made a difference for me, I didn’t have surgery but need it to correct my Peyronie’s disease.

You can buy it privately but it’s NOT  cheap!

Happy Pumping😊

Derek

User
Posted 25 Oct 2023 at 15:02

 

Bathmate is a cheap pump, quite adequate for habilitation purpose after prostatectomy, but for more serious use the NHS prescribed SOMAerect is excellent. I have used both the manual and the battery operated version in the past for many years but now I use battery operated PRIMUS (German) because SOMAerect could not supply me with a battery operated version. There is a pump called Vacurect (South African) which is heavily advertised expensive and not medical grade and not for serious users. If you want more information about how to use pumps please send me a private message.

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

User
Posted 25 Oct 2023 at 16:00

Good afternoon,

Please view my post #3. https://community.prostatecanceruk.org/posts/t29865-Got-a-ED-appointment-with-my-consultant

It'll save me typing all that, all again. 😀

Edited by member 25 Oct 2023 at 16:03  | Reason: Not specified

 
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