Prostate Cancer Community

Hi Sanford, - da Vinci, robotically aided Prostatectomy is still radical surgery, involving the separation of the sensitive nerve bundles necessary for erection. They are almost always at least bruised, if not otherwise damaged during treatment intervention and recovery is necessary. Five weeks is awfully early to be worried about the return of natural erections.

Even in the most favorable Study results, it is usually 3 to 6 months before potency returns. It is not unusual for it to take over a year and sometimes 2, before suitable erections occur. Like most things involving PCa, the rapidity of return and the quality of erections are very much age related, with younger men (40's and 50's) doing measurably better than those in their 60's and 70's+, as you would expect.

Since nearly a third of men over 55 report at least some transient erectile dysfunction without the PCa factor involved, recovery varies widely by individual patient. Of course, some never fully recover this function, but again, statistically increasing with advancing maturity. Reportedly, the first encouraging sign of the advancing healing in natural mechanics, is often initially realized with nocturnal erections.

The medicinal assistance rendered by the oral pills, penile injections and other mechanical aids work effectively for a large percentage of men, during the transitional period, in stimulating recovery. All of this assumes that bi-lateral nerve-sparing surgery was performed with success. The loss of one of the two nerve bundles can hamper, but not preclude an effective recovery process

It should also be remembered however, that sexual encounters, even when alone, usually begin in the brain and too much anxiety about POSSIBLE impotence or erectal failure due to unrealistic, premature attempts to have sex, only tend to exacerbate such concerns.

I know that it is easy to say and much harder to accomplish (no pun intended), but open communication, mutual cooperation, a good sense of humor and empathetic patience, all tend to contribute to a more relaxed (not less passionate) sexual atmosphere. If an erection lasts as long as the last sentence, you are on your way. -(;-{)) Good luck! - John@newPCa (aka) az4peaks

Thanks AZ.....seems like U know your STUFF....I'm curious....R U a physician?? Have or did U have pca and use the DaVinci method?? What was your experience and how R U progressing along?? Thanks for the informative info. Bruising does sound correct..Guess I'm just anxious. I'm 50 with removal at stage 1 with no further followup other than psa tests. My erection capability was very good prior to the removal. The meds ..Viagra... are of no help at present. My surgeon wanted me to take them before surgery as well as continue after... until further notice. Everything is progressing nicely less the erection thing... with my daily comment to friends and family ...better everyday!!! It's great to be cancer free... my Dad waited to treat too late and it took him quickly:{ Not for me..my brother is 3 years older ..still low psa...but very nervous. We both feel it's only a matter of time before he develops pca. We have been watching and waiting as the result of my Dad.

Hello sanford! azspeaks is a tremendous wealth of information and was extremely helpful as I navigated the field of treatment options and the expected results of my surgery. I agree, 5 weeks post-op is being very optomistic when it comes to regaining the ability to achieve and maintain and erection. As my doctor indicated, my erections will never be what they once were. I am almost 4 weeks post-op and am now on daily doses of 5mg Cialis and am pleased with the results so far. I realize this is going to take time, but it may be an option you want to discuss with your doctor. I was on Viagra for ED prior to my surgery and have found the daily Cialis to be more effective for me personally.

Hi again Sanford, - To answer your questions:

Although I consider myself a well informed layman, I am NOT a physician. I did have 30 years of daily experience working with Physicians in multiple specialties, in Hospital and Group Practice settings. I have been educating and counseling men with Prostate Cancer (PCa) for 11 years.

No, I did not have the da Vinci robotically aided surgery (RALP), but rather the traditional "open" Retropubic Radical Prostatectomy (RRP). This was over 11 years ago and I have CONSISTANTLY had an "undetectable" PSA (LESS THAN 0.1 ng/ml) since that surgery.

I am a triple Cancer survivor (so far), but I do have T4 Renal Cell Carcinoma (RCC=Kidney Cancer) due to a metastatic recurrence in 2007, found in the contra-lateral (opposite side) right Adrenal Gland. A Radical Laparoscopic (manual) Adrealectomy was performed.

Originally, I lost my left Kidney to RCC (unrelated to the PCa in 1998) in December, 2000 which was also performed Laparoscopically (manual). All 3 surgeries have been performed by the same Mayo Clinic Urologist, here in Mayo Clinic Hospital in Scottsdale/Phoenix, AZ.

I have also had 3 heart Pacemakers in the last 18 years, with the latest beiing inserted, along with a new Atrial Lead in March, 2007, the month following my Adrenalectomy. Complications, caused by heart perforation with resulting painful Pericarditis, required a complete re-insertion surgery the following day.

Hopefully, your Brother escape PCa but his chance of eventually acquiring it is four-fold with 2 immediate relatives having had it, so he should remain vigilant. Don't hesitate to contact me with any questions with which you feelI can help! Good luck on a rapid and complete recovery of all your functions and a Cancer-free future for both of you. - John@newPCa.org (aka) az4peaks

Thanks Steve for the info. Is there some kind of different chemical mixture between Cialis and Viagra?? Aren't they both intended to do the same thing?? I will ask my Dr. next psa followup about possibly changing over and see what happens.

Thanks John for your guidance....Sorry to hear about ALL U have going on ;{ My little problem is nothing compared to your numerous conditions..My prayers go out to you!!! Hang in there.

Sanford, there are some minor chemical differences and yes, all these medications are to accomplish the same thing. Cialis however, does remain in your system up to 36 hours compared with Viagra, which lasts approxmiately 5 hours in the system. You may need to try each of them to find out what works best for you. Hang in there!

Stanford,

I am almost 59 years old, 4 years post open RP. Both nerve bundles were spared and I regained 99% continence in 2 to 3 months. I tried the big 3 pills (V, C, L) for several months with no results except headaches and a flushed feeling. I started using a pump at about 6 weeks which worked in giving me an erection with 2 constrictions rings but it was very uncomfortable for me. My doctor prescribed Trimix injections for me at about 6 months out, and after a few tries to get the dosage right (0.12ml works for me) I have been enjoying a very happy love life with my wife of 37 years. I still use the pump without the rings to keep the blood supply going for Mr. Happy on the days I don't use injections. My reason for this info is because many men never regain natural erections after PCa treatments but there are ways to continue an active love life if you are motivated. I hope you have a complete recovery and regain natural wood, but if not, don't dispair. Many of us use Trimix or Bimix with great results and life is good and continues on.

Best of luck to you,

Allan

Allan, I too found the side effect to Viagra you mentioned and actually suffered horrible headaches afterward and the erections weren't great either. However, so far on Cialis I am getting better erections than prior to my surgery and I had my follow up with the doctor today and we talked about future treatments. Based upon the preliminary results, I am going to continue on the daily 5mg Cialis. So far, my incontenience is much better and am down to 2-3 pads per day and the doctor said this too should improve over the next few weeks. I am hopeful I can avoid the injections....sorry, I just can't imagine myself putting a needle in my penis....lol

Steve

Hi, I'm into my 3rd week after having the Da vinci surgery. I'm taking 1 cialis pill (5mg) daily. I able to have a erection but no ejection so far. That is my concern now.

what about incontinence after surgury.how long after

what about incontinence after surgury.how long after

That can vary a lot depending on the specifics of the operation, the person overall fitness, how much they do their kegal exercises, etc.

It is reported that it can improve for up to 2 years.

In my case I was basically dry in 8 days. But it was another 3 months making sure and finding all of the special cases where I needed to be careful.

Walking and other aerobic exercises will help along with the kegals.