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ED after RP

PayneOrtho61
Posts: 13
Joined: Jul 2020

I thought I might get some advice after my RP on the 17th of December of last year.  I am now almost 2 1/2 months post-surgery and I have gained almost complete urinary continence.  I am wearing a pad to work but just for back up.  I am going without a pad on weekends just to "test the waters" (pun intended).  I have gotten a clean bill of health from my surgeon based on the pathology report on my prostate and the ultra-sensative PSA test: < 0.014ng/ml.  I am grateful for all of this, however I am impotent with little or no improvement even with sildenofil.  I have seen no improvement over the last two months and was wondering if this is normal or should I start looking towards other meds/treatments.  My surgeon was very confident that both nerve bundles were spared and that I would soon gain erectile function. but I'm no so sure.  My wife and I have not been initmate because I just don't feel comfortable in the state I'm in.  I am starting to get frustrated taking sildenofil and getting little to no response and the inability to have a physical relationship with my wife.  I would be grateful for any advice.

Clevelandguy
Posts: 658
Joined: Jun 2015

Hi Payne,

Been there done, that give it more time.  Nerves take a long time to heal when they have been traumatized by surgery. It took me several months after surgery before I had even a partial errection.  It took me about a good solid year before I had a usable errection but at about the two year mark I was back to a round 90%.  At 2.5 months you need to be patient and give it a chance.  Everyone heals differently so I doubt if anyone could give you a date on when or how firm you will become.  I am a firm believer in use it or loose it so keep on stimulating that area until the old dude starts to respond.  I used Silendiful for a while and it did help me.  I think the presuure of being able to respond actually hindered my responce, but that was on me.  You know sex is more than just penetration, get creative with your wife and explore.  Glad to hear your Urine leakage is doing great at 2.5 months..........

Dave 3+4

MK1965
Posts: 215
Joined: Jun 2016

Payne,

if you get any little response at 2.5 months post op while using sildenafill, that is already good sign you will recover it.

Keep working on it and rehab it daily. As for continence, you are doing great. 
I was diagnosed and had RP at 51 y/o. Had nerve sparing RP according to my surgeon but I had big doubt from day 1. At 6 weeks visit, he asked me me if I already popped one (erection) which was most insulting moment with him in our 2 year long ( doc - patient) relationship.

Stopped seeing him after that. As time was passing by; 6 months, year, year and a half, 20 months, I never felt any sign of life in my penis, never had any response to Cialis, Viagra etc. VED pump never worked for me even while using the smalles rubber band.

I all this RP aftermath, I lost 2+ inches of length, some girth and rest of my penis disappeared in my body. Never regain orgasam, total anorgasmia. Very few times it was just very smal hint of orgasm coming, just blitz moment and back to starting point.

Never recovered erectile function. I lost trust in any medical specialties despite being a RN myself and working with them.

MK

Old Salt
Posts: 788
Joined: Aug 2014

Cases like the one described by MK1965 do happen, but the much more common scenario is presented by Clevelandguy.

Let's hope you will see some progress soon.

Georges Calvez
Posts: 503
Joined: Sep 2018

Hi there,

This is a tricky one.
Surgeons are pretty safe when they say hopefully that you will not be incontinent after surgery, about 95% of men will end up dry to the point where they will only lose an odd drop or two after eighteen months, most are adequately dry long before that.
So that is the cake out of the way, on to the icing :-)
The tricky ones are penile length, some men find that they lose some length, others less so, erectile ability will be affected in many cases even in patients under sixty with good erectile function before hand and they are the group with the most favourable results, orgasms are hard to predict; painful, non events through OK to not bad.
A prostatectomy removes a major part of the male sexual and urinary plumbing while hoping to preserve most of the normal functions except ejaculation so it is not surprising that it has some side effects in many cases.
Like all us you have to keep on struggling back and living in hope. Maybe one day your penis will start to perk up again.

Best wishes,

Georges

PayneOrtho61
Posts: 13
Joined: Jul 2020

Thank you all for your prespective on ED after RP.  I am going to meet with one of the (UCSF) urology departments PA's that specializes in the area of ED to see if there is any more I can do to help the process along.  I figure getting more advice can't hurt.  My surgery was pretty text book, with only the gland and seminal vesicles removed, everything else was saved and the surgical time was about 3 1/2 hours.  My surgeon is supposed to be one of the best in the area and I am sure he does these surgeries by the hundreds, so I am hopeful that the nerve bundles were left in the best condition as possible.  That being said, I still am concerned and hate the feeling of being nearly celibate.

scoop317
Posts: 7
Joined: Oct 2020

I had my RP in Dec also, still suffer INcontinence but ED is getting better, I use edex injections which was painful 3 weeks after RP but now 3 months after no pain and can penetrate. Gets firmer every month. incontinence getting better but I use at least 6 pads/diapers per day

hewhositsoncushions
Posts: 381
Joined: Mar 2017

I just don't feel comfortable in the state I'm in.  I am starting to get frustrated t - this here may be part ofthe problem. My ED counsellor explained me that our emotions have a huge impact. If you are not getting EDc counselling, I recommend it. Also, see if you can get a pump to help keep blood flow to the penis.

 

Good luck

Clevelandguy
Posts: 658
Joined: Jun 2015

Hi,

 The mental aspect of not being able to perform with no pressure from my wife effected me.  As I recovered over several months the mental thing went away.

Dave 3+4

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