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Non-nerve sparing RP

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User
Posted 22 Apr 2025 at 19:51

Muy husband is due to have his RP in a week. He saw the doctors today and they explained that it will be non-nerve sparing. 


He is concerned about greater risks re erection and continence. 


How was it for those of you who have already had non-nerve-sparing RPs?


Obviously I want to support him in a sensitive manner. 


We realise recovery may take a while. He is still in his 50s so maybe that will help?


 


(He still won't tell the kids, which concerns me. The younger ones know nothing yet)

User
Posted 22 Apr 2025 at 22:30

Hi Fragen.


I had a non nerve sparing robotic prostatectomy two years ago. I was told I would never be able to have a natural erection again. Unfortunately, to date, this is the case. However, I can get erections with Invicorp injections.


I believe that non nerve sparing surgery has no extra effect on incontinence issues. I was in full control after about six months.

Edited by member 22 Apr 2025 at 22:52  | Reason: Additional text

User
Posted 23 Apr 2025 at 15:15

I was diagnosed at age 48 (T3bN0M0), I was given the choice of RALP or Radiotherapy. In fact I was recommended RALP by one surgeon, then Radiotherapy by another. It made choosing rather hard!


In the end I went for Radiotherapy after being told surgery would be non-nerve sparing and I would most likely need salvage radiotherapy. I think the salvage radiotherapy dose would have been less than have radiotherapy as the primary treatment. Worth checking this if you do ask about it as an option


Finished Radiotherapy 3rd December 2024 with a session of HDR brachytherapy on 19th December. Not enjoying the hormone therapy that goes with it so much, but it bearable. (15 month to go!) Though it can be quite unpleasant for some.


So. So far so good, no issues with incontinence, erections achievable, though the HT make it more of an effort! Hopefully will go back to normal once off it.


However it's the long term effects of radiotherapy that have to be considered going this route. ED can become a problem as can bowel issues. I thought it was worth the gamble for quality of life now.


All the best


John

User
Posted 23 Apr 2025 at 01:02

Fragen, I was supposedly non nerve sparing, I was 99 percent dry within 4 days of catheter removal. I did show some signs of erection recovery but I never regained the ability to get a natural erection. You don't need an erection for vaginal intercourse, my advice on that issue is, try everything that is offered, never give up, think outside the box and have fun finding a solution.


Don't forget to pack a packet of his favourite biscuits in his hospital bag for a midnight snack after his surgery.


Thanks Chris 

User
Posted 23 Apr 2025 at 12:10

Has he considered radiotherapy instead? At 50, he's a bit young for that, but if they think radiotherapy might be required too and the prostatectomy will be non-nerve-sparing, I would want to find out what radical radiotherapy options there might be available instead. For this, he needs to speak with a radiation oncologist.

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User
Posted 22 Apr 2025 at 22:30

Hi Fragen.


I had a non nerve sparing robotic prostatectomy two years ago. I was told I would never be able to have a natural erection again. Unfortunately, to date, this is the case. However, I can get erections with Invicorp injections.


I believe that non nerve sparing surgery has no extra effect on incontinence issues. I was in full control after about six months.

Edited by member 22 Apr 2025 at 22:52  | Reason: Additional text

User
Posted 23 Apr 2025 at 01:02

Fragen, I was supposedly non nerve sparing, I was 99 percent dry within 4 days of catheter removal. I did show some signs of erection recovery but I never regained the ability to get a natural erection. You don't need an erection for vaginal intercourse, my advice on that issue is, try everything that is offered, never give up, think outside the box and have fun finding a solution.


Don't forget to pack a packet of his favourite biscuits in his hospital bag for a midnight snack after his surgery.


Thanks Chris 

User
Posted 23 Apr 2025 at 12:10

Has he considered radiotherapy instead? At 50, he's a bit young for that, but if they think radiotherapy might be required too and the prostatectomy will be non-nerve-sparing, I would want to find out what radical radiotherapy options there might be available instead. For this, he needs to speak with a radiation oncologist.

User
Posted 23 Apr 2025 at 15:15

I was diagnosed at age 48 (T3bN0M0), I was given the choice of RALP or Radiotherapy. In fact I was recommended RALP by one surgeon, then Radiotherapy by another. It made choosing rather hard!


In the end I went for Radiotherapy after being told surgery would be non-nerve sparing and I would most likely need salvage radiotherapy. I think the salvage radiotherapy dose would have been less than have radiotherapy as the primary treatment. Worth checking this if you do ask about it as an option


Finished Radiotherapy 3rd December 2024 with a session of HDR brachytherapy on 19th December. Not enjoying the hormone therapy that goes with it so much, but it bearable. (15 month to go!) Though it can be quite unpleasant for some.


So. So far so good, no issues with incontinence, erections achievable, though the HT make it more of an effort! Hopefully will go back to normal once off it.


However it's the long term effects of radiotherapy that have to be considered going this route. ED can become a problem as can bowel issues. I thought it was worth the gamble for quality of life now.


All the best


John

 
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