ED Question

I'm currently 7 weeks post davinci surgery (nerves spared) with full ED, which is not unexpected.

My question is - reading on here and other sources say that in order to get an erection physical stimulus is required and mental stimulation doesn't work (that worked well enough before surgery). If that's true, what's the cause for the change in how obtaining an erection occurs? It seems like all the components (penis, nerves, imagination, testosterone, etc.) are all still available and functioning. So what's different now?

"nerve sparing" surgery does not mean your nerves will necessarily remain functional. Nerves don't like being handled. Sometimes they recover, sometimes not. In addition, penile atrophy begins almost immediately. That may lead to fibrosis and the loss of ability to retain blood in those tissues.You can do your part by stimulating nerves as much as possible, and maintaining blood flow.

- Allen

Seven weeks is too soon to start worrying about ED.

Your nerve sparing surgery saved the nerves associated with erections. But you must know that these nerves are traumatized from the surgery and can require months to regain functionality. And there is the possibility that even with the saved nerves ED can raise its ugly head.

But first thing you should do is start taking Viagra or daily Cialis to get the blood flowing again.

OK: As someone who had 100% ED 3 years ago and now can get "mental erections"; please let me give you my experience:

It may take over 1 & 1/2 years for things to start working again. It took me that long to get my first erection sutible for intercourse. As I have said here many times, our doctors don't stress that the period to ED resolution is generally over a year and more depending on your age.
If you get nocturnal erections; that may be a good indication that natural erections will return.
Take Cialis daily, use a VED, and even do injections to jumpstart things.
In my case, I was 58 years old at the time of my surgery and had no ED issues prior to surgery.

I believe that mental erections are always the most difficult type to achieve at any age in a man's life. When you are younger and "firing on all cylinders" we take them for granted and get them all the time. Physical stimulus will nearly always work if there are no underlying issues and that is why when we get older this is the way we get erections. The process of haveing a RP basically "knocks your ability down a notch" and that is the reason why they (mental erectons) become difficult. Taking Cialis will still require physical stimuli. But don't get discouraged, after 2 years, I can get mental erections, although they are not as dramatic as before surgery. But I am more than happy for that.

In my case, everything is as before. Orgasms are good. But the diagnoses of PCa has a stressful effect on your mental state and the phyical trauma to that area require quite some major time to resolve. I had immediate urinary control and therefore was expecting immediate erections. It was a long road and I got very depressed when things were not improving quickly. AND I blame that depression for adding to my ED!

Try to relax and heal.

Bill K from NJ

Thanks for the replies. I guess I didn't ask my question too clearly originally. I'm up to speed on the probability of having ED and how long it might last (including forever) and what therapy to use to increase probability of getting an erection.

My question was (and Z06dude came closest to answering) if and when you can get erections it seems (from reading on here) that the only way is through physical stimulation and that the mental ability (from fantasy or **** or whatever) no longer works and why that is if all of the physical parts are still functioning. What changed from pre to post surgery?

It was just a curiosity question.

I am 7 years post op from robotic surgery and I was having rock solid erections the day the catheter was removed, but only with manual stimulation.  The mental stimulation just didn't seem to work anymore after the surgery. 

To this day I  still get rock solid erections without drugs, but only with the manual stimulacion.  I can look at naked women and think about sex 24/7 ,,,,but I just don't feel anything done there, no tingling, no movement, nothing.  But the second the manual stimulation starts, in a matter of a  30 to a minuite ,  I  am rock solid and will stay that way for as long as the stimulation continues.  If I stop the manaul stimulation , I will loose the erection in seconds.

My nerves were spared during surgery so said the doc , but something else must have got disconnected during surgery.  I remember the specifically the day before the surgery, I remember how I saw my wife naked and I had an rock solid erection almost immediately without any stimulation other then thoughts of sex.   Two weeks after surgery, I looked at my wife in the same way and had thoughts of sex , but this time,  I couldn't get an erection from thought alone like I did before.  Not until the manual stimulation started did the erection come.