two pair of feet in a bed

Erectile Dysfunction, So Now What?

In this article, I will begin to discuss some ways to proactively recover erections after you have had surgery to remove your prostate due to prostate cancer. I have to warn you, some of these treatment options may seem a bit overwhelming. As you read through this and any other information regarding this topic, remember that these treatments may seem scary at first but usually become more normal as you dive into care. Think of a person diagnosed with diabetes who may have a needle phobia but will now be giving themselves insulin injections daily. It soon becomes your “new normal”. I encourage you to seek out compassionate caregivers who will guide you through this process.

Key facts for active treatment

There are some keys facts that you should know as you begin the process of active treatment.

Fact 1: Most men will have some period of erectile dysfunction. The nerves will be stretched and injured even with a nerve sparing procedure and a highly skilled surgeon. The prostate is surrounded by these nerves and it is a function of the anatomy that the nerves will be injured.

Fact 2: Nerves take a long time to heal. Recovery of erectile function may take as long as 1-3 years.

Fact 3: We know that men who use the current treatments available will regain function more often than those who choose to do nothing. And it is always your choice!

Fact 4: If you had good erections and sexual function prior to surgery, you are more likely to recover more fully and more rapidly post operatively than someone with diminished sexual function.

Fact 5: The old adage of “use it or lose it” applies here. What does that mean if you can’t get an erection, how can I use it? We will talk more about this for sure!

Discussing your medical care

In terms of medical care, there are several options available and you will want to discuss each of these with your doctor to determine which one or combination of these treatments would be best for you.

  • Medications - Doctors are prescribing with more regularity nightly low dose medications such as Viagra and Cialis. These medications are called PDE-5 inhibitors. There are choices based on insurance coverage, nightly versus “on demand” usage. These medications do have some side effects but are overall safe for most men when prescribed and followed by a physician. Many men are able to achieve an erection firm enough for penetration using these medications, following a recovery period. The recovery period can vary from person to person so it is important to be patient.
  • Penile injections - Patients work with their doctor’s office to find a dosage of medication for self-injections. Basically, you use a small needle and inject some medicine that will relax the vessels in the penis to allow blood flow and create an erection that is suitable for intercourse. This is called Intracavernosal injection (ICI) therapy.
  • Penile suppository - This involves the patient inserting the medication into the tip of the penis. The medication helps to bring blood flow into the penis to achieve an erection. You would work with your doctor’s office to find the right dosage. There may be side effects including some discomfort for some men.
  • Vacuum Erection pump - This involves using a small pump to pull blood into the shaft of the penis and using a ring to help hold the blood in the penis. This can be done to achieve an erection for intercourse and also used for penile rehab. You have to be very careful amount removing the ring after the recommended time frame to avoid cutting off blood flow to the penis.
  • Penile prosthesis - This is a surgery that involves placing an inflatable penile prosthesis that consists of two attached cylinders -- a reservoir and a pump. This can be a very effective form of treatment but does involve another surgery.

Talk to your doctor for guidance

I hope this introduces some of the medical options available for post-op recovery of erectile dysfunction. All of the above options will require your physician input and guidance. I will continue the conversation with some behavioral interventions -- like diet and exercise in future articles.

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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