No erections after radical prostatectomy

A close friend of mine had a nerve sparing prostatectomy 5 months ago.
He is now undergoing radiation treatments. I am posting because he
doesn't go on newsgroups and I'd rather hear from people's actual
experience than websites.

He has tried Viagra and Cialis with no effect. He is able to have an
orgasm with masturbation and a soft penis which is better than nothing
but his hopes of ever having an erection are waning. What is the average
time it takes to regain function? Can it still happen? He is so
depressed, the thought of never being able to have a relationship again
is really bothering him. I am sorry I can't give you more information
such as PSA counts, scores, things I see on other posts but he is 58
years old and had no erection problems before the surgery. Has anyone
had this problem and it got better in time? Any suggestions? He also
heard that radiation can futher exacerbate the problem...is that true?
Thanks in advance, any feedback would be appreciated.

Hello, Frank:

I am sorry to hear about your friend's situation. Radiation following
surgery is an indication that there was some spread. I hope they can
contain it.

After surgery, the nerves going to the penis can take a year or more to
heal, and the healing of those nerves is crucial to the return of normal
erectile function. So, there is plenty of hope if it's been only five
months. I'm still waiting at 9.5 months, but have some hope that things
will return to normal -- it is getting firmer with every attempt.

I know little about whether radiation following surgery decreases the
likelihood of regaining erectile function -- I'd suppose it would have a
small impact if any, as (1) radiation targeting is pretty good these days,
and (2) I think the radiation is usually aimed at areas away from where the
nerves would be. But others who know a lot more about this than I do will
post here shortly with better answers.

--charlie

--
6/2006 PSA 5.2, DRE suspicious
7/2006 Biopsy: *2 of 10 positive, Gleason 7(3+4)
11/2006 LRP: *Clear margins
PSA < 0.01 on 1/2007, 3/2007, 6/2007
so far, so good ...

"Frank L" <frankieinpeace@webtv.net> wrote in message news:8762-46D8C8F1-681@storefull-3116.bay.webtv.net...
A close friend of mine had a nerve sparing prostatectomy 5 months ago.
He is now undergoing radiation treatments. I am posting because he
doesn't go on newsgroups and I'd rather hear from people's actual
experience than websites.



Without any other details I can tell you that yes, it can still happen in as long as 2-3 years, but he shoud continue to see his doc and ask questions.


--
JK Sinrod
www.SinrodStudios.com
www.MyConeyIslandMemories.com

On Fri, 31 Aug 2007 14:38:49 +0000, chasjac too
<chazjac@_takethisout_chazjac.com> wrote:

>Hello, Frank:
>
>I am sorry to hear about your friend's situation. Radiation following
>surgery is an indication that there was some spread. I hope they can
>contain it.
>
>After surgery, the nerves going to the penis can take a year or more to
>heal, and the healing of those nerves is crucial to the return of normal
>erectile function. So, there is plenty of hope if it's been only five
>months. I'm still waiting at 9.5 months, but have some hope that things
>will return to normal -- it is getting firmer with every attempt.
>
>I know little about whether radiation following surgery decreases the
>likelihood of regaining erectile function -- I'd suppose it would have a
>small impact if any, as (1) radiation targeting is pretty good these days,
>and (2) I think the radiation is usually aimed at areas away from where the
>nerves would be. But others who know a lot more about this than I do will
>post here shortly with better answers.
>
>--charlie


I had RP with salvage RT later on.

I had erection problems after RP and was advised that RT would
probably remove any likelywood of regaining erectile function (because
of the wide area approach of salvage RT).

In this scenario, injections seems the way to go. They can be quite
efective.

Just

On Sep 1, 5:00 am, Just <h...@there.com> wrote:
> On Fri, 31 Aug 2007 14:38:49 +0000, chasjac too
>
>
>
> <chazjac@_takethisout_chazjac.com> wrote:
> >Hello, Frank:
>
> >I am sorry to hear about your friend's situation. Radiation following
> >surgery is an indication that there was some spread. I hope they can
> >contain it.
>
> >After surgery, the nerves going to the penis can take a year or more to
> >heal, and the healing of those nerves is crucial to the return of normal
> >erectile function. So, there is plenty of hope if it's been only five
> >months. I'm still waiting at 9.5 months, but have some hope that things
> >will return to normal -- it is getting firmer with every attempt.
>
> >I know little about whether radiation following surgery decreases the
> >likelihood of regaining erectile function -- I'd suppose it would have a
> >small impact if any, as (1) radiation targeting is pretty good these days,
> >and (2) I think the radiation is usually aimed at areas away from where the
> >nerves would be. But others who know a lot more about this than I do will
> >post here shortly with better answers.
>
> >--charlie
>
> I had RP with salvage RT later on.
>
> I had erection problems after RP and was advised that RT would
> probably remove any likelywood of regaining erectile function (because
> of the wide area approach of salvage RT).
>
> In this scenario, injections seems the way to go. They can be quite
> efective.
>
> Just

My erections were back after two years just as my urologist predicted.
I did not have to go through salvage radiation, however.

On Aug 31, 10:05 pm, frankieinpe...@webtv.net (Frank L) wrote:
> A close friend of mine had a nerve sparing prostatectomy 5 months ago.
> He is now undergoing radiation treatments. I am posting because he
> doesn't go on newsgroups and I'd rather hear from people's actual
> experience than websites.
>
> He has tried Viagra and Cialis with no effect. He is able to have an
> orgasm with masturbation and a soft penis which is better than nothing
> but his hopes of ever having an erection are waning. What is the average
> time it takes to regain function? Can it still happen? He is so
> depressed, the thought of never being able to have a relationship again
> is really bothering him. I am sorry I can't give you more information
> such as PSA counts, scores, things I see on other posts but he is 58
> years old and had no erection problems before the surgery. Has anyone
> had this problem and it got better in time? Any suggestions? He also
> heard that radiation can futher exacerbate the problem...is that true?
> Thanks in advance, any feedback would be appreciated.
>
>

Just getting a few data points from others may give you some
rough benchmarks but in fact the factors affecting a particular
individual
can result in huge variation of results. In one study 80% of those
under
55 with nerve sparing ultimately regained functionality whereas none
who were over 55 and did not have nerve sparing. In another
study 37% of men regained functionality after 1 year and 62%
after 2 years with very few of the remaining regaining functionality.

There are many factors and in the case you cite nerve sparing
is positive, age is neutral and salvage radiation is negative.

Damaged nerves can take 1-2 years to heal which accounts for
the statistics above. If rehab after surgery to provide oxygenation
through exercise, drugs, injections or other means then the
possible consequent fibrosis may be irreversable.

More on the causes of ED after RP, preoperative, intraoperative and
postoperative
factors affecting it, mechanisms, pointers to the studies and
progression profiles
discussed above, fibrosis and oxygenation, treatments (exercise, PDE-5
inhibitors,
injections, VEDs) and selected online references are in the 2 part
article starting
here:

http://palpable-prostate.blogspot.co...my-part-1.html

---
The Palpable Prostate
http://palpable-prostate.blogspot.com

The line below that says "If rehab after surgery" should
read "If there is NO rehab treatment after surgery"

On Sep 1, 10:17 pm, "A. Black" <xuv...@gmail.com> wrote:
> On Aug 31, 10:05 pm, frankieinpe...@webtv.net (Frank L) wrote:
>
>
>
>
>
> > A close friend of mine had a nerve sparing prostatectomy 5 months ago.
> > He is now undergoing radiation treatments. I am posting because he
> > doesn't go on newsgroups and I'd rather hear from people's actual
> > experience than websites.
>
> > He has tried Viagra and Cialis with no effect. He is able to have an
> > orgasm with masturbation and a soft penis which is better than nothing
> > but his hopes of ever having an erection are waning. What is the average
> > time it takes to regain function? Can it still happen? He is so
> > depressed, the thought of never being able to have a relationship again
> > is really bothering him. I am sorry I can't give you more information
> > such as PSA counts, scores, things I see on other posts but he is 58
> > years old and had no erection problems before the surgery. Has anyone
> > had this problem and it got better in time? Any suggestions? He also
> > heard that radiation can futher exacerbate the problem...is that true?
> > Thanks in advance, any feedback would be appreciated.
>
> Just getting a few data points from others may give you some
> rough benchmarks but in fact the factors affecting a particular
> individual
> can result in huge variation of results. In one study 80% of those
> under
> 55 with nerve sparing ultimately regained functionality whereas none
> who were over 55 and did not have nerve sparing. In another
> study 37% of men regained functionality after 1 year and 62%
> after 2 years with very few of the remaining regaining functionality.
>
> There are many factors and in the case you cite nerve sparing
> is positive, age is neutral and salvage radiation is negative.
>
> Damaged nerves can take 1-2 years to heal which accounts for
> the statistics above. If rehab after surgery to provide oxygenation
> through exercise, drugs, injections or other means then the
> possible consequent fibrosis may be irreversable.
>
> More on the causes of ED after RP, preoperative, intraoperative and
> postoperative
> factors affecting it, mechanisms, pointers to the studies and
> progression profiles
> discussed above, fibrosis and oxygenation, treatments (exercise, PDE-5
> inhibitors,
> injections, VEDs) and selected online references are in the 2 part
> article starting
> here:
>
> http://palpable-prostate.blogspot.co...prostatectomy-...
>
> ---
> The Palpable Prostatehttp://palpable-prostate.blogspot.com- Hide quoted text -
>
> - Show quoted text -

"Frank L" <frankieinpeace@webtv.net> wrote in message news:8762-46D8C8F1-681@storefull-3116.bay.webtv.net...
A close friend of mine had a nerve sparing prostatectomy 5 months ago.
He is now undergoing radiation treatments. I am posting because he
doesn't go on newsgroups and I'd rather hear from people's actual
experience than websites.

He has tried Viagra and Cialis with no effect. He is able to have an
orgasm with masturbation and a soft penis which is better than nothing
but his hopes of ever having an erection are waning. What is the average
time it takes to regain function? Can it still happen? He is so
depressed, the thought of never being able to have a relationship again
is really bothering him. I am sorry I can't give you more information
such as PSA counts, scores, things I see on other posts but he is 58
years old and had no erection problems before the surgery. Has anyone
had this problem and it got better in time? Any suggestions? He also
heard that radiation can futher exacerbate the problem...is that true?
Thanks in advance, any feedback would be appreciated.




------------------------------------------------------------------------------


My RRP (lost both nerve bundles) was December 2000. Radiation was July 2002. First unassisted erection was May 2003.

But, first ADT was July 2003. Mr. Happy had a brief respite.





--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05, <0.04 (06/12/2007)
Non Illegitimi Carborundum

Having tried the V stuff, the next step is typically a VED. I tried it and
although it would give me a raging, red erection, it didn't work, ie I
couldn't have an orgasm with one.

I then tried injections and life has been better ever since. They aren't
really painful and I soon got over the distaste of shooting up. Sexual
spontaneity is a bit lacking, but it really works.

Implants are the last resort, one I am not going to try.

David

Dear Frank,

On Aug 31, 10:05?pm, frankieinpe...@webtv.net (Frank L) wrote:

> A close friend of mine had a nerve sparing prostatectomy 5 months ago.
> He is now undergoing radiation treatments.

> but his hopes of ever having an erection are waning. What is the average
> time it takes to regain function? Can it still happen?

> He is so depressed, the thought of never being able to have a relationship again
> is really bothering him. Any suggestions? He also heard that radiation can futher >exacerbate the problem...is that true?

Re your questions: My husband had RP in 10/05 and has just completed
salvage radiation. He had almost no sexual function after the RP, but
I noticed improvement after a year. He was able to get an erection on
his own then. Too bad that that was right before the radiation. I do
know for a fact that erectile function can return later -- I think the
average is 2 years. First thing is, look up "penile rehab". See a
specialist.

Yes, the radiation can exacerbate the problem. But its side effects
take time to kick in. I asked husb's rad oncologist about sex after
RT (including with injections), and I actually saw him squirm! (Was
just thinking about "the squirm" today: it really humanized the
doctor.)

We have had a good sex life with injections after my husband's RP, as
have many others. It is possible to get over the initial repulsion to
the idea. But you also have to be sure to inject correctly and follow
up with a doctor if you see any curvature.

*However, all this is secondary.* You MUST:

(1) Have your friend evaluated and treated for depression
immediately. This is a life-threatening illness. I wish I could say
your friend was getting himself worked up over nothing, but I can't.
He has been through an awful lot in a short time. The failed surgery
and the erectile failure. But there is help. It might be a could
idea for your friend see a psychologist or even a sex therapist. *As
well as a psychopharmacologist.* Recently some men posted here how
much they have been helped by such treatment. At MSK, where my
husband was treated, there is an expert in "sexual medicine" available
on staff, as well as psychological and other supportive services
available to patients. You might check with the hospital. For a
referral, you could ask your surgeon or family doctor. I know of a
psychologist who specializes in the tx of men with PC, but he's out in
Toronto (Dr. Ross). Maybe we can induce him to move here.

(2) Have your friend see an excellent erectile dysfunction (ED)
specialist. The sooner the better. (Not right now, with the rad in
progress! He needs a break.) He should not just rely on the advice
of just any urologist. A specialist can answer his questions better
than any layperson.

Here are some resources from my blog (prostatecancerblog.net):

1. I just posted, "FYI: If you should every feel desperate". Not
exactly on point, but it will tell you how to find your local mental
health association. Or any of those helplines should have this info.

2. See "Sexy Secrets for Finding ED Specialists." Silly title, but
substantial. (Also, "How to Find a Good Doctor.")

3. "How I became the Trimix lady." You *can* have great sex with
shots.

4. "Penile Mechanics 101". On second thought: read Curtis' posts.
He is the expert on hydraulics and mechanics, and guys seem to like
those analogies.
..
Finally, if you can handle it, there is a lot of humor about *PC* on
my blog. I just posted something called "Deliveries to the Rear".
Gave Ted a chuckle.

My very best to you and your friend.

Leah

prostatecancerblog.net

On Aug 31, 9:05 pm, frankieinpe...@webtv.net (Frank L) wrote:
> A close friend of mine had a nerve sparing prostatectomy 5 months ago.
> He is now undergoing radiation treatments. I am posting because he
> doesn't go on newsgroups and I'd rather hear from people's actual
> experience than websites.
>
> He has tried Viagra and Cialis with no effect. He is able to have an
> orgasm with masturbation and a soft penis which is better than nothing
> but his hopes of ever having an erection are waning. What is the average
> time it takes to regain function? Can it still happen?

Dear Frank,
I am a wife who has been dealing with these problems since July 18,
2002, the date of his RPx. I know this is a physical
problem, but it is also a mind over matter. I think I can , I think I
can, I will not use the pills, the pills I can always fall back on.
We finally got to the, OH it is shorter, but what the heck , who cares
as long as she (me) doesn't seem to care. It is softer than it use to
be, whoo, push it in, figure it out, and it will work it out. I am
not sure of the time table, but it didn't matter, it will happen and
by gosh, by golly if it didn't. He took a pill, but it never had
time to work, the thought gave him confidence in himself.
We never bought a prescription and never used many of the samples. I
wish I remembered the date it happened, but I don't.
I think it was far less than a year after, but it seemed an eternity
to him. He wishes it was harder, but it still works from the way he
reacts!!!!!!!!

We then had a set back 4 years later, PSA started a slow rise. I was
frantic, he thought after his 38 radiation treatments (me too) that
was it, the Doctor said, he was shocked Ike could, after having
RPx, , this was his radiation oncologist, I said no, we were fine. He
was a jerk to say the least. Ike was upset by me talking to him, he
just wanted to live (normal) but I wanted him to have quality of life
too. ( I am not a sex maniac by the way , I just know my husband.) I
wasn't allowed back, Ike didn't want me to come. I wanted to kill my
husband at this point because he doesn't ever want to know anything
till after everything is done. I don't know what I would have done
without this support group, Steve, Curtis off the top of my head. It
is almost 3 months later, we went through the treatments having
relations and we still are. It is once a week to a little over that,
and believe me he does get his climax. Ike was 70 yesterday and I am
67 and not a sexy looking 67 year old. I say a glass is half full,
and a penis doesn't have to be a rock hard object to get the
satisfaction you want. He did have nerve sparing on the cancer free
side. We don't use porno, or anything else except he does use
vaseline. (Sorry Curtis, still haven't got the slick stuff, I can't
remember.)
I am sorry I write long and probably a lot of unnecessary info. We
find out soon if he has a PSA or not. Good luck to all of us in this
little country club.

He is so depressed, the thought of never being able to have a
relationship again
> is really bothering him. I am sorry I can't give you more information
> such as PSA counts, scores, things I see on other posts but he is 58
> years old and had no erection problems before the surgery. Has anyone
> had this problem and it got better in time? Any suggestions? He also
> heard that radiation can futher exacerbate the problem...is that true?
> Thanks in advance, any feedback would be appreciated.
>
>

On September 6, "orchids58" wrote:

(snip)

>> He is so depressed, the thought of never being able to have a
>> relationship again
>> is really bothering him. I am sorry I can't give you more information
>> such as PSA counts, scores, things I see on other posts but he is 58
>> years old and had no erection problems before the surgery. Has anyone
>> had this problem and it got better in time? Any suggestions? He also
>> heard that radiation can futher exacerbate the problem...is that true?
>> Thanks in advance, any feedback would be appreciated.

Check http://www.renewintimacy.org/index.asp

and

Prostate Cancer and Intimacy at
http://www.prostatepointers.org/mailman/listinfo/pcai

Intercourse is far from the only means of exchanging pleasure.

Regards,

Steve J

On Sep 6, 9:45 pm, Steve Jordan <mycrofts...@cox.net> wrote:
> On September 6, "orchids58" wrote:
>
> (snip)
>
> >> He is so depressed, the thought of never being able to have a
> >> relationship again
> >> is really bothering him. I am sorry I can't give you more information
> >> such as PSA counts, scores, things I see on other posts but he is 58
> >> years old and had no erection problems before the surgery. Has anyone
> >> had this problem and it got better in time? Any suggestions? He also
> >> heard that radiation can futher exacerbate the problem...is that true?
> >> Thanks in advance, any feedback would be appreciated.
>
> Checkhttp://www.renewintimacy.org/index.asp
>
> and
>
> Prostate Cancer and Intimacy athttp://www.prostatepointers.org/mailman/listinfo/pcai
>
> Intercourse is far from the only means of exchanging pleasure.
>
> Regards,
>
> Steve J

"" Orchids58 is an idiot, she does not write things right, the
following was from Frank about his friend.

"" September 6, "orchids58" wrote:
>
> (snip)
>
> >> He is so depressed, the thought of never being able to have a
> >> relationship again
> >> is really bothering him. I am sorry I can't give you more information
> >> such as PSA counts, scores, things I see on other posts but he is 58
> >> years old and had no erection problems before the surgery. Has anyone
> >> had this problem and it got better in time? Any suggestions? He also
> >> heard that radiation can futher exacerbate the problem...is that true?
> >> Thanks in advance, any feedback would be appreciated.""

(snip)

This is Orchids58 again, I agree with what you said Steve, I just
know I am a terrible writer, no snip here, no snip there,
but I promise to learn about quotes and snips and all of it ( please
don't hold me to getting it straight too soon. I agree with you
>

(snip)
Intercourse is far from the only means of exchanging pleasure.
>
> Regards,
>
> Steve J (snip)

Steve , thank you for letting me correct this, I will try harder after
seeing how you misunderstood me by my writing it wrong.
Steve K and Curtis , where are you when I need you. I bet you have a
smile on, that Orchids58( Charlotte) and her ditzy writing.

Well, Good Morning all, and may Wall Street make up for my incorrect
way today. Steve J. thanks again, you are an angel. I know there is
more to life than just sex, someone forgot to tell my hubby though.
Thats the Kentucky in him, I am just an old
Louisiana girl with my man in Texas .
Charlotte (Orchids58) Adams

On Aug 31, 9:05 pm, frankieinpe...@webtv.net (Frank L) wrote:
> A close friend of mine had a nerve sparing prostatectomy 5 months ago.
> He is now undergoing radiation treatments. I am posting because he
> doesn't go on newsgroups and I'd rather hear from people's actual
> experience than websites.
>
> He has tried Viagra and Cialis with no effect. He is able to have an
> orgasm with masturbation and a soft penis which is better than nothing
> but his hopes of ever having an erection are waning. What is the average
> time it takes to regain function? Can it still happen? He is so
> depressed, the thought of never being able to have a relationship again
> is really bothering him. I am sorry I can't give you more information
> such as PSA counts, scores, things I see on other posts but he is 58
> years old and had no erection problems before the surgery. Has anyone
> had this problem and it got better in time? Any suggestions? He also
> heard that radiation can futher exacerbate the problem...is that true?
> Thanks in advance, any feedback would be appreciated.
>
>

" from Steve Jordan via me: http://www.renewintimacy.org/articles/LovingPie.asp
"

On September 7, Charlotte (orchids58) wrote:

(snip)

> "" Orchids58 is an idiot, she does not write things right....

(snip)

> This is Orchids58 again, I agree with what you said Steve, I just
> know I am a terrible writer, no snip here, no snip there,
> but I promise to learn about quotes and snips and all of it ( please
> don't hold me to getting it straight too soon. I agree with you

I am not the author of that rather nasty comment. So no apology is
necessary.

Good luck!

Regards,

Steve J

"orchids58" <orchids58@yahoo.com> wrote in message
news:1189165763.400446.237520@57g2000hsv.googlegro ups.com...

> Steve , thank you for letting me correct this, I will try harder after
> seeing how you misunderstood me by my writing it wrong.
> Steve K and Curtis , where are you when I need you. I bet you have a
> smile on, that Orchids58( Charlotte) and her ditzy writing.

You right good 'nuff for me, Charlotte!