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Prostate size correlates to return of erections? A Survey

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Posted 8/27/2010 10:22 PM (GMT 0)
In another thread, there's been some discussion and wondering if the size of the gland removed or radiated had any effect on the length of time to recover erections.

Common thinking was that the larger the gland the longer it may take to regain erections. Or does it? Who knows. So, lets open up the discussion with a survey of guys who have been there, got their ticket punched and are living it. What was the size of your prostate, in grams if possible, at surgery removal or when seeds were implanted? Also, what was your initial ED stage, say, 6 weeks after procedure. When, if ever, did you regain what could be considered 'full' erectile function, either with or without using the ED drugs? We won't consider the injections or pump, as these are more 'mechanical' methods. It'd help if you could tell us what your erections were or weren't both when natural and when using an ED drug. Another factor is did you get both nerves spared or just one or a partial. No nerve bundles spared probably wouldn't fit into this survey.
Posted 8/27/2010 10:24 PM (GMT 0)
I'll start. 110 grams gland removed, nerve bundles spared, no response of any type, at any time, natural or using the pills, now 3 years after.
Posted 8/27/2010 10:37 PM (GMT 0)
I'll join you. 42 grams, gland removed, SRT, right side nerve  left intact, no ED at any point

Post Edited (Purgatory) : 8/27/2010 4:47:50 PM (GMT-6)

Posted 8/27/2010 10:41 PM (GMT 0)
Husband 60yrs. old, no aids necessary pre-surg, 95 gram prostate removed by open manual radical prostatectomy 53 days ago, both nerve bundles spared, now has ED with very slight tumescence at tip only with stimulation, still orgasmic, no mechanical/chemical aids used to date but Viagra scrip filled today.
Posted 8/28/2010 12:00 AM (GMT 0)
prostate 61 grams at robotic surgery.
no ED at 8 weeks - but ED bounce came along and was back at square one...total ED. Steady slow progress, two years later can have normal natural erections. oral meds make it much easier... oral meds even produce spontaeous erections with just mental stim.
Posted 8/28/2010 1:17 AM (GMT 0)
56 grams, One nerve (supposedly) partially spared. One year out. I got nothing - unless I fill 'im with Trimix.
Posted 8/28/2010 3:10 AM (GMT 0)
Prostate and seminal vesicles combined were 43 grams, both nerves spared, one "beat up a bit".

6 weeks after surgery mild "plumpness" gradually increasing function to the point of a usable erection a bit less than 4 months after surgery. At best it's 90% of what it was and getting there is nothing like it was pre surgery, today it takes 100mg of Viagra, vibrating ring and stimulation but I'll take it.

Haven't noticed any nocturnal stirrings, usually take 10mg Levitra (generic from adc) every other night, 50 to 100mg Viagra (also adc) for play time.
Posted 8/28/2010 3:27 AM (GMT 0)
Good idea on the survey James.

My stats so far:

Prostate 110 gm @ surgery (open RP, both nerves spared).
(Added to counter Proscapt argument about larger prostate may mean MORE PCa)
1 of 10 cores with 5% 3+3 gleason.
And hey, we're never going to do a scientific survey here -- we only WANT anecdotals!!!
(also yes I would think younger patients would be self-deselected (<50) -- seldom having large prostates or much BPH).

Some ED prior to RP and meds did help at that time.

1.5 years along and still no erections (drugs or au natural).

Some nocturnal tumescence (using full dose Viagra @ bedtime) lately but nothing really useful.

Post Edited (JimStars) : 8/28/2010 9:16:54 AM (GMT-6)

Posted 8/28/2010 5:38 AM (GMT 0)
My experience

63 grams, bilateral nerve sparing, robotic-assisted
with viagra at 6 weeks I had a partial response
at 6 months, half the time its good enough for sex with viagra; without viagra I get partial response, sometimes good enough for sex.

More broadly speaking, I think to James C's original question, there may be a spurious correlation. The bigger the gland, likely either the more advanced the cancer or the more BPH going on. More BPH is likely to mean an older patient which means not as good a recovery, and not as good a baseline performance status. The more advanced the cancer the more likely that bilateral nerve sparing was not possible. So their could be a correlation between size and ED, but the correlation may not be causal; it could be coincidence. You'd need to do a regression type analysis (nomogram?) to figure out impact of the different factors.
Posted 8/28/2010 10:20 AM (GMT 0)
70 gram prostate. Nerve bundles spared. ED stage 6 weeks after - 1 out of 10 (no drugs); 15 months - 9 out of 10 (with levitra).
Posted 8/28/2010 1:40 PM (GMT 0)
35 grams, robotic rrp on 4/27/2009, no erections to date, but trying
Posted 8/28/2010 5:01 PM (GMT 0)
I probably shouldn't put my stats here since I had both nerve bundles removed but I'll do anyway. Prostate 57 grams, I can get 70% erection with stimulation. 100% with trimix.
Posted 8/28/2010 5:57 PM (GMT 0)
I couldn't find the weight on my path report. I do remember my surgeon said my prostate was about 20% larger than normal for my age/mass. I'll edit this post later if I do find it.

Oral ED drugs did nothing until recently. Used trimix from about 8 mo to 13 mo post-surgery. 13 months after surgery 10 mG of levitra was giving something usable...not consistent. That dose is giving pretty consistent results now at about 16 months. Both nerves were spared. I did have a pretty high cancer content in biopsy cores, so maybe the surgeon made the margins a bit wider resulting in more trauma to the nerves, etc. Nothing natural that's usable at this point but, staying optimistic.

Post Edited (mikey1955) : 8/28/2010 12:11:21 PM (GMT-6)

Posted 8/28/2010 10:30 PM (GMT 0)
Interesting topic - 43 gram prostate, RRP (nerve sparing) on 12/1509, no ED problems before surgery, now 8 months after surgery require either 50 mg Viagra or 20 mg Levitra to get an erection which is functional about half the time - but has been slowly improving with time. No spontaneous erections, no nocturnal erections (that I am aware of). I still look at it as a long haul, and still use pump therapeutically three to four times a week.
Posted 8/29/2010 9:32 AM (GMT 0)
hi good idea this .mine was 62g and there is no sign of action on the ed front.no probs prior to op .have taken cialis and viagra but nothing.do use the pump and  can have sex but its painfull.i think i may try the jabs
Posted 8/29/2010 8:42 PM (GMT 0)
Husband had RRP 12/22/09. Prostate was 110 grams. He has total ED, but can have orgasm with stimulation. We are just thankful that the cancer is out. PSA 0.001.
Posted 8/29/2010 9:00 PM (GMT 0)
52.7 gms.

Surgery 1/26/10

ED --yes. Cannot get anything usable. Orgasmic after lots of stimulation.

No big deal as far as we are concerned.

Major concern remains the cancer. Fortunately, 100% continent.

Mel

Posted 8/29/2010 11:36 PM (GMT 0)
50 Grams..... No problems at all before Davinci.... both nerves sprared... 7 weeks post op... still ED, even with a trial pack of Cialis. shakehead
Posted 8/30/2010 12:30 AM (GMT 0)
77 gms. ED immediately after RP. Viagra/Cialis gave side effects so did not use. Incontinence dominated last two years so did not work on ED. No natura erections. Can use pump but to painful so stopped trying intercourse after one time. Can have orgasms with pump and stimulations. Libido is way down following RP.
Posted 8/30/2010 5:19 PM (GMT 0)
58g and I was having erections before the catheter was removed.
Posted 8/31/2010 2:10 AM (GMT 0)
Dr Patrick Walsh makes this point:

"We believe that the operation is also more successful because these men [younger men] have smaller prostates. There is more tissue surrounding the prostate, and the margins of resection (the surgical border between healthy tissue and cancer) are wider. Finally, in younger men, the neurovascular bundles are located farther from the prostate and are easier to preserve."

Many of you know who Dr Patrick Walsh is, but for those who might not he is the father of nerve sparing RP technique, and is considered by some to be the world's foremost authority on prostate cancer.
Posted 8/31/2010 5:22 PM (GMT 0)
I haven't had my surgery yet, I have to wait until January. But geez, I hope what you are guessing is true. My prostate is only 19, that's tiny compared to some of yours!
Posted 9/1/2010 2:10 AM (GMT 0)
95 grams. Both nerve bundles spared. 50% erection only with Trimix combined with VED. On top of that, now have Peyronnies
Posted 9/26/2010 9:04 PM (GMT 0)
Doing double duty here both bumping this thread back up for additional contribs and also to update my status.

We had liftoff this morning -- with a good solid and lasting what-are-we-gonna-do-with-all-this erection. Took 20 months to get there but finally did. And this was not one of those fleeting middle of the night ones that disappear as soon as you wake up. It stayed around for about an hour (with help from the missus).

Yes I am using Ceebis regularly, but it was long after (8+ hrs) taking 20mg (I don't think the 36 hr thing applies in any way to RRP patients really).

So the stats once again were 110 gram prostate size, first real erection at 20 months.

Note to NeIrish: I also try Viagra and Levitra at times -- no real difference from Cialis. I do use MUSE once or twice a week now and that lasts for up to 4 hours (softening up by the 4th hour). Overall the 20 months I think Willie just has had a mind of his own and does what he wants no matter what I want (and my wife ruefully agrees). No real side effects for me from any of the Big 3. I have aches here and there -- but that's from Volleyball not the pills.

Post Edited (JimStars) : 9/27/2010 2:42:57 PM (GMT-6)

Posted 9/27/2010 1:08 AM (GMT 0)
JimStars: Congrats on reaching the stars. Did Viagra ever do the job for you? We're still trying it and the improvement in the ED is barely noticeable. Not usable, anyway. Any side effects from the Cialis (that's what ceebis is, right?)?
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