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A little surprise

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User
Posted 12 May 2025 at 00:07

My OH is not much for forums so I am asking for him. He had a Robotic op in Dec last year. Non nerve sparing.

He has not been on any medication for ED but has noticed some movement.

He had quite a surprise the other day where it was sitting at half mast while he was standing. We were told that he would have significant ED after the op. The urologist was quite surprised and we are not sure he believed us.

Has anyone had the same experience and did it improve over time? Thanks

User
Posted 12 May 2025 at 08:31

Hi Casey

Following my prostatectomy, 13 years ago, I suffered from complete erectile dysfunction. So my wife and I know how you guys must be feeling.

The bad news is that your husband is unlikely to return to his pre-prostatectomy level of  erectile function. But  very good news is that you don't have to give up on your sex life. There are many options to help him.

Initially he should start rehabilitating his penis by exercising it: Use a penis pump, massage penis/scrotum/pelvic area and masturbate which can give him orgasms. This will remind him, his penis and his brain/mind how life was before surgery. 

Have a look at the following link which you will find encouraging:

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

Happy to help him if he would like to get in touch with me.

 '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 12 May 2025 at 09:21

The erection nerves are in the form of a cobweb which isn't very visible during the op, and there's quite some variation in exactly where they are between different men. So occasionally when the surgeon thinks they were taken, they weren't all.

Given this, he should be doing rehab as for nerve sparing surgery, i.e. on regular Tadalafil to help with nerve healing. Sometimes this is done with 5mg daily low dose Tadalafil, or sometimes 2 x 20mg/week Tadalafil. The latter option gives you a couple of extra boosts a week to try for erections, as the daily low dose is more for healing and usually not sufficient for erections, whereas the 2 x 20mg/week will also give the continuous low dose because the drug is quite long acting, but also gives you a couple of boosted periods.

If that doesn't enable him to get regular good quality erections, he should ask for a pump too, to ensure he is getting regular erections to reduce damage to the penis (which requires regular erections).

User
Posted 12 May 2025 at 09:34

Hi Casey.

I had non nerve sparing surgery over two years ago. I was told that I would never have a natural erection again, unfortunately that has been the case. However. I've found that Invicorp injections work well. They are good enough for penetrative sex. I'd say my stiffies are about 80% as good as they were pre-op.

I get Invicorp on prescription and would certainly recommend giving it a go if all else fails. I've found that it works best when I'm stood up. I think it's probably got something to do with better blood flow?

I've never used a pump. I researched them, and they do appear to help a little, but to me, the benefits weren't worth the palaver of using one. 

I hope your hubby's natural recovery continues. Onwards and upwards!👍

 

User
Posted 12 May 2025 at 09:46

I would see if you get Tadalafil or variant prescribed. I had nerve sparring RP and take 20mg once a week for maintenance. However I had to go through a few hoops to get this prescribed, my trust did not offer this sort of therapy automatically as other seem to do. 

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User
Posted 12 May 2025 at 08:31

Hi Casey

Following my prostatectomy, 13 years ago, I suffered from complete erectile dysfunction. So my wife and I know how you guys must be feeling.

The bad news is that your husband is unlikely to return to his pre-prostatectomy level of  erectile function. But  very good news is that you don't have to give up on your sex life. There are many options to help him.

Initially he should start rehabilitating his penis by exercising it: Use a penis pump, massage penis/scrotum/pelvic area and masturbate which can give him orgasms. This will remind him, his penis and his brain/mind how life was before surgery. 

Have a look at the following link which you will find encouraging:

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

Happy to help him if he would like to get in touch with me.

 '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 12 May 2025 at 09:21

The erection nerves are in the form of a cobweb which isn't very visible during the op, and there's quite some variation in exactly where they are between different men. So occasionally when the surgeon thinks they were taken, they weren't all.

Given this, he should be doing rehab as for nerve sparing surgery, i.e. on regular Tadalafil to help with nerve healing. Sometimes this is done with 5mg daily low dose Tadalafil, or sometimes 2 x 20mg/week Tadalafil. The latter option gives you a couple of extra boosts a week to try for erections, as the daily low dose is more for healing and usually not sufficient for erections, whereas the 2 x 20mg/week will also give the continuous low dose because the drug is quite long acting, but also gives you a couple of boosted periods.

If that doesn't enable him to get regular good quality erections, he should ask for a pump too, to ensure he is getting regular erections to reduce damage to the penis (which requires regular erections).

User
Posted 12 May 2025 at 09:34

Hi Casey.

I had non nerve sparing surgery over two years ago. I was told that I would never have a natural erection again, unfortunately that has been the case. However. I've found that Invicorp injections work well. They are good enough for penetrative sex. I'd say my stiffies are about 80% as good as they were pre-op.

I get Invicorp on prescription and would certainly recommend giving it a go if all else fails. I've found that it works best when I'm stood up. I think it's probably got something to do with better blood flow?

I've never used a pump. I researched them, and they do appear to help a little, but to me, the benefits weren't worth the palaver of using one. 

I hope your hubby's natural recovery continues. Onwards and upwards!👍

 

User
Posted 12 May 2025 at 09:46

I would see if you get Tadalafil or variant prescribed. I had nerve sparring RP and take 20mg once a week for maintenance. However I had to go through a few hoops to get this prescribed, my trust did not offer this sort of therapy automatically as other seem to do. 

User
Posted 12 May 2025 at 10:30
Thanks so much for your replies and good wishes, the urologist has started him on 5mg Tadalafil daily after the appt.

I am glad to hear it is possible that some nerves have been left behind and will wait to see how things go in the next few months.

We were investigating Sural nerve grafting in Melbourne Australia but will leave that for the moment. I think that restores erections in around 70% of men after a prostatectomy.

User
Posted 12 May 2025 at 20:55
Andy's advice is good. People think the penile nerves are like power cables, but the description of them as like the fibres of a spider's web is much more accurate. They are not anything that can be visualised during the operation, the surgeon just knows where they are located in general terms relative to some rather more visible blood vessels.

Because of that web-like nature I hadn't imagined that nerve grafts might be possible, that development is interesting.

User
Posted 13 May 2025 at 00:33

Casey13, I was in the same situation after supposedly non nerve sparing, my surgeon put me on daily 100 mg sildenafil, unfortunately it didn't have much effect. I got the occasional 70 percent swelling. I am now 11 years post op and never got a 100 percent full erection but boy did we have fun and enjoyment. I resisted the injections for a long time, that was a mistake. The sight of my almost full size penis over rules the reluctance to stick a needle in the penis. 

We mastered the technique after flaccid insertion and the moaning and groaning got quite loud, the wife was quite noisy as well. 

Naver give up, take everything that is offered, think outside the norm, experiment and have fun.

Thanks Chris 

 

 
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