Looking for thoughts after prostectomy

PeterDisAbelard. said...
Mark,
The "trifecta" for prostate surgery is to achieve 1) disease control, 2) urinary continence, and 3) erectile function. While you are not totally out of the woods with number one there's not a lot you can do except to remain vigilant and encourage your doctor(s) to stay on top of it. You will do yourself a lot more good if you spend your time working on the other two.
Other commenters have mentioned that continence takes time but most men will get there in three months to a year. If they do their kegel exercises and keep their expectations realistic most men regain social continence. That's most - not all (*sigh*) - but you'll probably do ok.
Where you can actually do yourself the most good is to work on erectile function. It's not good for a man's equipment to go more than a few weeks without an erection. The extra blood supply is needed to keep the tissues oxygenated and to keep the stretchy bits from shrinking. A normal man will get several erections a night while he sleeps. These nocturnal erections are plenty to keep the hydraulics working. But if the erectile nerves are damaged sometimes these nocturnal erections don't happen and things can start to shrink.
I think you mentioned that pills aren't working for you. Other commenters mentioned using a pump. Pumps are sorta-kinda helpful but they are only so helpful for oxygenating the tissues since they draw arterial blood mixed with oxygen-poor venous blood.
I believe you said that your doctor had mentioned injections. Many guys shy away from the idea of poking needles in their willies. This is understandable but unfortunate. It's easier than you think and it's the best way to prevent penile atrophy while you wait for your nerves to recover.
Sloan Kettering has a good sexual medicine program. You are fairly young for our company here and it's worth a bit of extra effort to retain/regain your secular function.

halbert said...
Mark, you're about 10 weeks out since surgery, so it sounds like you're well on track. Night dryness is a key development on the continence front--it means that your muscles are working, and that you have a functional sphincter. The rest will come with time.

I'll share my definition of continence--and it's probably similar to Peter's "social continence": Before RALP I had some leaks and dribbles due to BPH. It was never severe enough to worry me or for me to seek treatment. In today, I drip occasionally at random times. I kind of view it as, hey if I was continent THEN with an occasional drip, then I am NOW with a similar volume and randomness.

As far as ED goes, I'll just say that if you get a little swelling in the area, then do what you can to encourage more of the same. It's even better if you have a willing partner to help things along. If you're having some stirrings, then for sure get that scrip for daily cialis or viagra.