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What happens to our previously attached sex nerves after radical prostetectomy?

SV
Posts: 56
Joined: Sep 2010

Assuming the gap where the prostate existed pre-surgery eventually has other organs that squish in to fill the empty space, what happens to any nerves that were hopefully spared? That is, do they just float around? Or does the surgeon tuck them away?

I am fully fucntional and still pulling zeros 3.4 years past DaVinci except that the need to awake and pee throughout the night is as intense if not more so, than when I had a prostate. How can this be?

Occaisonally due to sports related joint pain, I take an 800mg Motrin which makes the urges subside dramatically. But due to my urologist's warning about kidney damage from Motrin I don't take them nightly like I used to--just when the joint pain is unbearable.

Trew
Posts: 892
Joined: Jan 2010

Unrelated, but why not....

when I was on Eligard (hormone therapy) I looked at all the stuff the Eligard turned off and yet I still had to shave every day.  I thought that was really like getting kicked twice- should have had at least one benefit from the Eligard.  There are some mysteries about the afterlife of PC that are just......!!

 

 

 

 

SV
Posts: 56
Joined: Sep 2010

i thought for sure that Vasco de Gamma would have an answer to this. Am I the first guy to wonder about those remainging nerves?

Swingshiftworker
Posts: 634
Joined: Mar 2010

Not sure what you mean.

When a surgeon attempts nerve sparing, he leaves the one of the erectile nerve bundles and the surrounding tissue alone.  Nothing changes.  When the prostate (and any nerve tissue) is removed, the remainder of the urethra at the neck of the bladder is attached to the top of the urinary sphincter.  What usually happens then is the the penis retracts into the body cavity to "fill" the space created after the prostate is removed, which often results in the apparent shortening of the penis.  As for the nerve tissue that is NOT removed in order to attempt "nerve sparing," I can only assume that other surrounding tissue simply moves in to fill the void, just as the penis tissue does when the prostate is removed.  Nothing "floats" around or needs to be "tucked in."

FWIW, the possible shortening of my penis is one of many reasons that I chose NOT to persue the surgical option.  When I asked a prospective surgeon about this potential "problem" (which I read about in on the Net), he flatly denied that this happens.  Technically, he was "right" in that the penis itself does not actually get shorter BUT the length of the penis "looks" shorter because a part of it retracts into the body cavity to fill the space afte the prostate is removed.  However, his flat denial and unwillingness to discuss the matter left me very unimpressed about his candor and, if nothing else, demonstated a decided lack of empathy for a concern that I (and any man) would have in this regard.

Fortunately, I found another way to treat my cance that did not result in this or other problems commonly caused by the surgical removal of the prostate.

 

 

 

VascodaGama's picture
VascodaGama
Posts: 1563
Joined: Nov 2010

SV

Why should you expect me “for sure” to answer your doubt? You could well investigate the matter and share the details you found with all of us.

What I was told by one doctor in my team of surgeons (year 2000) is that, after dissecting, the loosed “parts” (nerves, portion of lymph’s, vas deferens, etc) are left as cut, and the voids will be filled with viscous connective tissue such as fat. This tissue will be purposely “manufactured” conveniently to support the organs. Sperm will continue to flow into the void and then is drained together with the “little bits” not needed, out of the body through the lymphatic system. Here you got descriptions about tissues;
http://quizlet.com/4455488/tissues-of-the-body-flash-cards/

 

Swing’s opinion may be a justified explanation but it deviates from your main theme and disguises the benefits of the Nerve-sparing Technique (NsT) you have chosen. My experience from the radical prostatectomy is not very rosy. I got a shorter penis plus erectile dysfunction and continued progression of the disease, but I am continent since the day they withdrawn the catheter. The penis retracts into its “capsule” for being shorter (the cross-section length of dissected prostate) but it can be pulled out to a certain extent. These outcomes are common whenever the surgery includes or not the so called “nerve spare technique” (NsT).

The naming of this RP method also has a commercial content to revel Dr. Patrick Walsh superiority (claimed to be the “inventor” at Johns’ Hopkins) among other fellow urologists. However, the real scope of the NsT obscures the meaning making the radical as permanence.
In fact the outcome of prostatectomies is similar. The difference in “with” or “without” NsT is the length of the period it takes to reach the best performance in erection levels. NsT has a shorter period but not exactly a better erection. In the long run the radical method (no sparing technique) will achieve the same level. Here is a link to the "begining" of NsT and its conclusive trials;
http://www.harvardprostateknowledge.org/can-nerve-grafts-restore-erectile-function

The human body, even without a wireless capability (Wi-Fi), got its nerve system prepared to find substitute routes to accomplish the original signalling pathway. This will interfere to certain extent with other localized functions such as the ones that control urination. Some guys may feel the need to void more frequently, or we disgustedly may urinate at the climax when having sex.  Embarassed

The autonomic nerve bundle in organs that command the visceral muscle tissue (part of the ones saved at NsT) controls the muscle for erections that is located next to the prostate. Another provides the stimulus that will unchain a series of events such as the “flush” of blood supply to the zone. If this muscle is dissected by the surgeon, then one may lose the capability or will take longer to return to the original status (never to the 100% mark). I manage to have "low standards" erections and am enjoying sex as before. Sometimes I wonder if my wife feels the same.

Radical radiation therapy also got its pitfalls. It also may cause ED and Incontinence but not “shorter penis” or voids to fill up. The typical prevalent side effects are bladder cystitis, urethra scares, proctitis and colitis. Nasty cases from RT are usually in cases of treatment done in patients that have not been previously checked or diagnosed with existing ulcerative colitis. These group should never be recommended RT.  Cry

I am glad to know about your continuing ZEROS and Good Performance.  Tongue Out  Best wishes in your future journey.

Let’s get drunk. Where is the bottle?

VGama  Wink

SV
Posts: 56
Joined: Sep 2010

Thanks Vasco. If we ever meet I'll buy dinner and wine.

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