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No erections 8weeks after robotic prostatectomy

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Posted 4/3/2018 8:43 PM (GMT 0)
Good afternoon all. I had a Davinci robotic prostatectomy 8weeks ago and both nerve bundles were spared. Pathology was good, organ confined. As of 3 weeks ago I have been taking viagra (100ml) once a week, however I’m becoming concern because I still have no erection. With Viagra my friend below does get some swelling and enlargement, but no erection and the swelling is week and does not last. I’m starting to get worried that I will not regain erections and wanted to see if you all that have gone through this could please advise me as to what to expect. Like I said, it’s been 2months since my surgery and I don’t know if I should be starting to get some erections by now, specially with the Viagra.

Also, I have my first PSA test since surgery in one week and I’m super nervous that it will be anything other than 0.0. Im so nervous that i can’t sleep just thinking about it. I’m 41, and my PSA at diagnosis was 3.5, pathology was stage PT2, 3+4. Don’t know what to expect. Any advice is greatly appreciated.

Thank you.
Posted 4/3/2018 9:00 PM (GMT 0)
Hang in there, you never know what might come up.

8 weeks is early and your body still has a lot of healing to do. Some guys take a year or more to recover. If you're getting some effect, well take it as good news and be patient - where there's life there's hope.

Worry is natural at this point and also counterproductive. Worry won't change anything. Best thing is to just start living. Go do something fun and something that will distract your mind from your problem.

Hang in there and let us know what the PSA test is.
Andrew
Posted 4/3/2018 9:04 PM (GMT 0)
What Andrew said!! Saved me a lot of typing smilewinkgrin

There is a lot still to heal in the prostate bed, so confer with your urologist, and see what suggestions he has.
Posted 4/3/2018 9:14 PM (GMT 0)
8 weeks is way early. Give it some time. You should regain full use.
Posted 4/3/2018 10:06 PM (GMT 0)
Ask your surgeon what his usual practice is for penile rehabilitation after RP. Many doctors have a series of things they try at particular times in particular orders. The idea is to prevent atrophy of the erectile tissues that comes from poor oxygenation and to minimize shrinking. A man needs to have several erections a week to maintain proper oxygenation of his member. Usually this is no problem since his body takes care of that automatically while he sleeps. During REM sleep a normal man will get something like half a dozen erections every night. Unfortunately, the irritation of the erectile nerves that prevent erections during sex after prostate surgery also prevents nocturnal erections. Since you had full nerve sparing the chances are excellent that you will recover spontaneous erections in a few more months. But it's worth asking your doctor about things you can do in the meanwhile to keep your hydraulics in good working order.

Things you might ask about are increasing the number of times a week you take the Viagra, switching to generic sildenafil if the cost of Viagra is a problem, where he stands on Vacuum Erection Devices (VEDs), and when he thinks men who don't respond to pills should think about injections.
Posted 4/3/2018 10:50 PM (GMT 0)
I haven’t had a spontaneous erection since robotic prostatectomy 10years ago, of course there’s all trimix
Posted 4/4/2018 12:01 AM (GMT 0)
The earlier you start on a penile rehab program, the better your chance of mitigating ED and size loss. Ask your Uro for a scrip for a VED or get one from a sex shop. Use it every day. Master bate frequently. The goal is to get more blood flowing down there. If the ED meds aren't getting you hard, ask your Uro for a scrip for trimix injections. As soon as you regain continence, switch to nightly ED meds.
Posted 4/4/2018 12:08 AM (GMT 0)
I'll echo what others have said. It's way too early to be concerned (but do take Tall Allens advice above). I had a pretty quick recovery in that department, but still I am 3 years past surgery and I noticed this past 6 months it's improved more.

Ask about switching to daily cialis, 5mg. Along with the rehab that Allen mentions. Don't know if it willl help more than Viagra, but it's worth a try
Posted 4/4/2018 3:17 AM (GMT 0)
Thank you all so very much. I just did t know what to expect and didn’t know if two months is too soon to expect signs of an erection.
Posted 4/4/2018 4:45 AM (GMT 0)
Ivic,

Yes, two months is early. The nerves tend to sulk after the irritation of the surgery -- ED gets worse before it gets better and at two months it is often still on the downward slope. So, not to despair, it's early days for you.

But... That doesn't mean it's a good idea to wait to start rehabilitative activities. You need to get going on that now.
Posted 4/4/2018 4:54 AM (GMT 0)
I think at 8 weeks I could have an erection, but it was extremely painful. The more hard, the more hurt. As I recall, it was over a year before I was pain free. YMMV.
Posted 4/4/2018 11:32 AM (GMT 0)
DJBearGuy, your signature has PSA at .5. Are you starting salvage radiation or anything? Also used City of Hope
Posted 4/4/2018 1:47 PM (GMT 0)
oldbeek, yes, i expect to talk about salvage radiation at my next appointment. Which I made as soon as I learned the latest PSA result, but isn't for two weeks.
Posted 4/4/2018 2:31 PM (GMT 0)
At 8 weeks I was still too sore down there to even think about erections or self stimulation.

You may be ready for a penile rehab program. Check with your urologist. As others have said it is important to get increased blood flow to the penis. That will help keep it healthy until your nerves recover from the trauma of surgery.

I'm 18 months past my surgery and have had success using sildenafil for rehab purposes. I just experienced my first erection hard enough for penetration. So it can take time.

I recommend you get the book, "Saving your Sex Life" by John Mulhall. He is a urologist specializing in penile rehab at Sloan Kettering.

Good luck.
Posted 4/4/2018 2:58 PM (GMT 0)
Thanks for the book suggestion “tennisplayer”
Posted 4/6/2018 1:27 AM (GMT 0)
I think it will get better. I had surgery January 18 and am 65. You are young and I think things will come back. You have heard this many times but everyone is different. I could erections and last week, for no reason, nothing. I mean totally limp. A real let down if you know what I mean. Sometimes I get a heavy feeling around 3am, sometimes not. This weekend nothing, then Tuesday I was back again. I had nerve sparring on one side so I thought I would have nothing ever again so this is a nice surprise. I read of things getting better 18-36 months out. Try and relax. Easier said than done I know. Things have happened just about like the doctor said they would. Try to remember back when you were having blood in your urine and that went away. And how about when you went through clothes and you felt like you were going to be "soggy pants" forever. I'll bet that is getting better to. I think all will start working. It takes time. Try to relax and let yourself heal. That's some major stuff they did down there. One other thing, try not to expect it to be like it was before the surgery. It probably won't be. Remember, dead men don't have sex.

Post Edited (dmv1990) : 4/6/2018 2:16:34 PM (GMT-6)

Posted 4/10/2018 1:51 AM (GMT 0)
DMV1990, thank you so much for you words. Much appreciated.
Posted 4/11/2018 4:19 AM (GMT 0)
Ivic anyway you could get your signature up there...its like dancing in the dark to offer pertainent advice not a scold..thanks
Posted 4/11/2018 5:53 AM (GMT 0)

tennisplayer said...
At 8 weeks I was still too sore down there to even think about erections or self stimulation.

You may be ready for a penile rehab program. Check with your urologist. As others have said it is important to get increased blood flow to the penis. That will help keep it healthy until your nerves recover from the trauma of surgery.

I'm 18 months past my surgery and have had success using sildenafil for rehab purposes. I just experienced my first erection hard enough for penetration. So it can take time.

I recommend you get the book, "Saving your Sex Life" by John Mulhall. He is a urologist specializing in penile rehab at Sloan Kettering.
Tennis Player,, Congratulations on getting some success down below.
Good luck.

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