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nerve sparing success rates

VivianJC
Posts: 1
Joined: Oct 2009

Does anyone know the success rates for the nerve sparing prostatectomy. I have a friend that has put off getting help because of fear becoming impotent. I also have 2 other friends/coworkers with similar problems. Any advice/help will be appreciated.

Thanks,
Vivian

gkoper's picture
gkoper
Posts: 174
Joined: Apr 2009

Nothing strikes more fear in the heart of a sexually potent man then "losing it". I am one who had nerve sparing ( my surgeon said) & now am able to achieve only 60% erection w/o viagra. Don't like side effects of pills. I am 5 months post surgery & was told it can take up to a year for complete healing. Most men who have surgery will have some period of ED. For some, it comes quickly.

You should tell your friends that there are many other treatment options...radiation,seeds & others. Their Dr. can explain ALL the ways to treat prostate problems. To do nothing is risky.

As far as success rates for nerve sparing surgery, perhaps other recipients on this board could weigh-in??????? Good luck.
George

The Nev
Posts: 50
Joined: Sep 2009

Nerve sparing depends entirely on the size of the tumor. When I was diagnosed my PSA was 4.5 and the DRE was normal. After the biopsy my Gleason score was 3+3 +6 so things looked really good. Fast forward the tumor on the left side of my prostate was bulging out which could not be detected by the DRE. They had to take the nerves on the left side and were able to spare the nerves on the right. So if they wait, they really won’t know where the tumor is and just because they can’t feel it does not mean the tumor is not on the edge or even outside of the prostate. I did have an MRI before surgery which showed the bulge on the left side, so I knew before surgery that they would probably have to take the left side nerves. One thing is for sure the earlier the surgery is done the more likely to spare the nerves.
After reading this I realized you were asking about results and not whether they could spare them or not. Sparing depends on the development of the cancer, success according to my doctor was impossible to predict in an individual and he would only give what happened in most patients . Or success percents like over 80% regain erections with complete nerve sparing and somewhere around 50% with only one side spared and as already stated different doctors have different success rates.

lewvino's picture
lewvino
Posts: 1004
Joined: May 2009

Vivian,
I'm at two months post davinci Surgery. Age 55 so of course was very concerned about the sexual side of things like all men are (LOL)

Dr. said nerves were spared 100% on the one side and 50-70% on the other side.

I've been having success using Lavitra. I like it accept for the headaches. Doctor gave me some samples of Cialis which I'm going to try to see how they work and if the headaches are any better.

I just saw my Doc yesterday and he told me I was way ahead of the curve on the sexual and urinary control.

Fear is normal but what is worse the possibility of impotence or the cancer spreading?

There are several methods to fight impotence.

Larry

William Parkinson
Posts: 60
Joined: Oct 2009

There are many factors which come into play with nerve sparing prostatectomy and potency (e.g., skill of surgeon, age, prior potency, are both neurovascular bundles spared or just one, and medical state of the patient, such as does he have diabetes). First, not all surgeries are created equal. The radical retropubic approach has slightly higher rates of potency retention than the perineal approach. This is due to better visualization of the neurovascular bundles and also to the way the nerves are retracted. Also, age has a great influence, as does state of potency at the time of surgery. For example, if both NVB are spared in a younger man (40-55), who has excellent potency now, and the surgeon is a high volume surgeon (i.e., highly skilled) than the rates of potency retention can be as high as 80% (but at best 50% if only one NVB is saved). Mind you, even here, not all erections are created equal!! Even when potency returns, for most men, it is never quite like it was before. He will need so-called penile rehabilitation to expedite the process of healing. As for brachytherapy it is an untruth that it has better potency preservation. That reputation stems from the nature of prior studies. For radiation-induced impotency, usually it happens over time (although as many as 10% of men become impotent right after the implant). Most studies look at potency retention over the course of 24 months, both for surgery and radiation. Long term potency studies are now in for brachytherapy and it looks like the rate on impotency is 50%. For men under 50, with prior excellent potency, that rates go up to 75%. I hope this helps. Good luck to him!!
Cheers
Bill

gkoper's picture
gkoper
Posts: 174
Joined: Apr 2009

Got to say it larry....I can hardly see you in front of the window. Congrats...

lewvino's picture
lewvino
Posts: 1004
Joined: May 2009

Yep I vanished! That pic was taken about 3 weeks ago in Bermuda at my son's wedding.

Larry

NM
Posts: 214
Joined: Jul 2009

I am 52 had surgery Sept 3rd. I had the same concerns and my wife put it bluntly better ED and incontinence than death. I agreed and am half way home with no regrets. PSA after surgery .05

JR1949
Posts: 230
Joined: Jun 2009

I am 60. I had radical prostatectomy Mar. 2, 2009. My history was Gleason of 7, all 12 pin biopsy were positive for cancer, PSA of 22 prior and 3 months post surgery PSA of .007. I too had the same concerns. My wife also told me the same thing, better ED and incontinence than death. She also told me that we have been happily married 35 years and if we don't have sex again it will not be a problem.

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