How important was maintaining erectile function in your primary treatment decision?

It was VERY important to me. In fact, as was said a little earlier, the SE's were my number one concern at the time of diagnoses. I was and am very concerned about the "quality" of my life and not just the "quantity". Sex is a big part of my life and I didn't want to lose it. The chances of SE's had a major role in my decision to use SBRT. There are no guarentees in life, but I liked what I read and went in that direction.

Both the local Uro who dx'd me and the RALP surgeon discussed ED with us (they asked me to bring my wife to the consultations). The discussion started with asking if there were current issues. Neither one quoted statistics exactly. The RALP surgeon was very clear with his language however: He said that with my biopsy pattern and G scores, he had no concerns about being able to spare both nerves. And, given that I had no issues with ED going in, he didn't see any reason why I shouldn't have a full recovery.

As I wrote earlier, it's important, but with life as it is, if it doesn't work out there are alternatives. To be blunt, I may be unusual in that at least half of the pleasure I get from sex is my ability to please my partner. If she is satisfied at the end, then I'm good.

It was important to me. I picked DaVinci surgery thinking it would take care of PCa and leave me functioning. I truly think I was sold a bill of goods. I was in good shape, not overweight, active, and had an active, healthy sex life. All comments I read on the subject indicated that men with ED before surgery had it after. Since I did not have that issue I figured I was golden. Wrong. Now I see that the ED rates are much higher. I also see how surgeons docs talk around it and leave out the bad bits. The statements did not include how many men without ED end up with it.
20-20 hindsight has shown that surgery worked out well for me. I just wish they had been more forthcoming and honest about the odds.

Now that I think about it, they had to lie. Like a dog going to the vet, had they had told me the truth I would never have gotten in the car.

Jeff

I was already experiencing ED going in. In fact when I talked with the Uro about my rising PSA, I also mentioned ED to him and there was even the suggestion of checking my testosterone but he wanted to do the biopsy first. Of course all is history now. The last thing on my mind was solving my ED problem and the Uro didn't offer much hope since I was suffering ED prior to treatment. Do I miss it? Yes there are times but I have to admit I think all of this has affected my libido in some ways as well because I am not "in the mood" like I used to be. But incontinence comes into play as well. Even though my wife says it doesn't matter, it does bother me when I know any amount of foreplay is going to result (how can I say this delicately) in my peeing all over her and me.

TA - I voted when I posted in this thread, but do not see the results of this survey in the header?

I did not separate out the erectile function overwhelmingly from other side effects.  My response here was, therefore, "Somewhat."   I was quite a bit younger than the median age of men diagnosed with prostate cancer, so I was very aware of the many years of life I should expect to have.   As a result, I wanted to put the blip-in-the-road of “prostate cancer” far behind in the rear view mirror and avoid the constant lingering “late-term” effects from radiation therapies which have some tendency to occur in some men.   Erectile dysfunction was one of those late-term effects, but not the only one.  I didn't want to have to look for additional secondary treatments 10-years down the road as a result of my decisions...I wanted it to be DONE, and to have moved on.   The urologist who diagnosed me in my suburban community setting offered to recommend a colleague who was experienced at robotic surgery, but I choose to look further to the nearby (40 miles) Comprehensive Cancer Center at a major academic institution for a practitioner who was a pioneer in developing the procedures in the US.       My own theory on why “ patients seldom bring it up and don't seem to be very concerned about it ” is that they are still scared crapless about the big “C” word and have not yet learned enough about the disease to understand that for many men (not all) they may not need to take a tank to kill an ant. Post Edited (JackH) : 3/2/2015 9:06:55 AM (GMT-7)

At diagnosis, ED was never brought up. Uro didn't mention it and we didn't know enough about it to bring it up. After some reading, at the next visit, we asked and were told that nerve sparing surgery wasn't an option, so ED would be a permanent part of our lives. Second opinion doc told us that he could possibly save the nerves (game day call) so we went with him for the surgery. He did save the nerves but our post-op pathology changed everything. Husband is now on Lupron and is awaiting radiation therapy. He's currently taking Cialis and using Vac device to try to "rehab", so that after therapy, hopefully, things can go back closer to "normal".

EF is/was very important to us. However, if we hadn't done our own research, we would have been completely in the dark.

I had ED problems long before PCa came along so it wasn't an issue. I probably would have gone with an implant had I been in my 60's rather than 70's.

My husband of almost 40 years is 72, I'm almost 65. We have sex weekly, at least. I think he was unwilling to have any therapy, at first, because he didn't want to experience side effects. (He's a doc and knew what they were.)

The doctors at the treatment meeting clapped him on the back, and said, "Way to go, Pal, you're above average for your age!" Our son was there and was a tad embarrassed.

His choosing not to treat was my biggest worry. I wanted him alive. The rest we could figure out.

When we were presented with the treatment options at the meeting, the thought of putting off SE for a year or two made more sense for someone his age.

He's just started Lupron and Bicalutamide. Six months of these drugs with radiation in the middle. He's got a pretty nasty case, rated intermediate with high risk features. He still cannot tolerate the thought of surgery. His choice. And we think this will be a long time deal for him.

On a lighter note, we tried to have as much sex as possible leading up to hormonal therapy. Then /I got a urinary tract infection, and we both caught our grandson's stomach bug. Not a lot of sex going down!

You can't friggin' win.

Not at all important, to leave any functionality to Mr Willy would have left some cancer.

To live or to boink that was the question.

Allen,

Uhhh .... I think you missed the point of my last post. That or you are referring back to my first post. Either way no big deal. Have a good day.

not that important. I was too freaked out about the cancer and the thought that I could die. my treatment decision was made solely on beating the cancer.

ed

Halbert, I would think the discrepancy is from the difference sources - i.e. published issue that could be across a very wide spread population of practitioners, and skill sets - compared to individual practitioner results. Gets back into the whole point of being seen by "the best" in terms of results.