Could prostate surgen paly a role on outcome and Eriction

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samadabad
New Member


Date Joined Nov 2007
Total Posts : 10
   Posted 2/6/2008 11:01 AM (GMT -7)   
Like to hear back from Friends with similar situation
 
There are reports on people that have Eriction within a short time after Devinchi Prostate Sergury with both Nerves spared.  I am woundering if it is possible for the surgen to have done somthing different that has better outcome or it is purly depend on the patient.
 
I had my surgery on Oct 29th 2007, the surgen worked for 6 hours and said it was due to my previous hernia that he had to work around it.
 
I am 54 and was fine before the surgery, no problem what so ever, blood test lead to PSA at 5.0 and then biopsy with 30% of 1 out of 10 sample showed cancer. Now my PSA is undetectable.
 
Since the surgery I have tried Lavitra, Viagra and tried pump and non seem to help my eriction. Although I have desire and can get dry ejaculation without eriction. Woundering if it is normal and expected until some time passed or I should expect nothing more.
 
Appriciate any response,
Thanks
 
 
 

lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 664
   Posted 2/6/2008 10:05 PM (GMT -7)   

Yes, the skill of the doctor can effect how well you recover your erection capability.

However, a lot has to do with you.  Your age, physical condition and pre-surgery erection problems or lack of problems all factor in to how well you recover.

Keep asking your doctor questions.  Many of us have had some success with cavernosal injections.

good luck


 
Biopsy 10/16/06
T2A,  PSA 4.7
Gleason 4+4=8 right side
adrenocarcinoma of prostate
DaVinci Surgery 01/16/07
Post op report,confirms Gleason4+4=8 , no extra extension or invasion
No continence problems
PSA results 90 day (-.01) 6 months (-.01) 9 months (+.02)
PSA one year (+.02)
Using Caverject/viagra for continuing ED problems (one year)
 
 
 
 
 
 
 
 
 


puget
Regular Member


Date Joined Mar 2007
Total Posts : 237
   Posted 2/6/2008 10:05 PM (GMT -7)   
I had little response from Viagra for the first 3 months. After that, things improved very gradually. I'm 8 months post-op and 100 mg of Viagra results in about an 80% erection. (No spontaneous erections yet, however.) I wouldn't despair. You're only 3 months out, and I bet you'll begin to see some improvement soon. Stay on the meds and keep trying!! Good luck!
Puget
60 years old
Dx March 2007
Pre-Surgery Gleason 3+3 = 6
Clinical Stage: T1c
Biopsy: 1 in 10 positive
Da Vinci: June 7, 2007 
Post-Surgery Gleason 3+3 = 6
   Clear at margins
First Post-PSA Sept 07 = <.01 (Hooray!!)


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4461
   Posted 2/7/2008 8:12 AM (GMT -7)   
I am 4 1/2 months post-op and have a case of full blown ED.... :-)    I began Viagra nightly at catheter removal, a pump twice daily after 6 weeks, and first Caverject, now Bimix injections twice weekly after 3 months.  I have been told and believe that recovery of ED takes daily work and attention to rehab tissue and blood vessels and stimulate regrowth of nerves that provide that function.  Any surgery can cause damage to those nerves, no matter how slight.  Continence seems to be better regained by surgeons skill, ED seems to be more a matter of variables beyond that skill.  At least that seems to be what I read here.  People seem to have more problems regaining ED than continece, no matter the procedure or skill/experience of the surgeon.  If, like me, you are at the 3 months mark and no response, then it seems that we both require more healing of the nerves to get back somewhat or all of what is missing now.  Sadly, it sometimes takes up to 18 to 24 months to complete the process, and some few never do regain it.  Don't get discouraged, we are both early in the stage of recovery for ed.   
James C. 
 
Help support the forums so they can support you:  http://www.healingwell.com/donate 
 
Age 60 
4/19/07   PSA 7.6, referred to Urologist, recheck 6.7 06/05/07
7/11/07   Biopsy- 16 core samples, size of gland around 76 cc. Staging pT2c
7/17/07   Path report:  3 of 16 PCa, 5% involved, left lobe , GS 3/3:6. 
9/24/07   (Open) Retropubic Radical Prostatectomy performed 
9/26/07   Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
10/15/07  ED- begin 25mg Viagra nightly, Fully continent
11/15/07  ED-continue 25mg Viagra, no response, begin Vacurect pump-
11/15/07  1st Post-surgery PSA-0.01
12/17/07  ED- 3 mts.-continue Viagra and pump-no change-no response
01/14/08  Caverject started/stopped, aching and pain , Bimix started
02/04/08  Bimix X 6 tries, .1mL, .15mL, .2mL, .3mL, .4mL, .5mL, success at .5mL


wd40
Regular Member


Date Joined Jan 2008
Total Posts : 218
   Posted 2/7/2008 8:13 AM (GMT -7)   
We talk about nerve sparing as if it were the only ingredient in an erection. Keep in mind the old testosterone generators have been disconnected and they too must reconfigure. Testosterone levels dictate your drive to breed, therefore sex. So you may have the desire to have an erection but how strong is your desire to breed which is a deep primeval spirt we were born with.

In a way, we are like a person that recently lost an appendage. We still feel that it is there but we know it isn't. I think our task is to open our mind up, and let everything began to work without the prostate.
12/06/07 DaVinci and open prostate surgery after difficulties in breathing stopped the davinci.
Walked a lot
90% control the day the catherter removed.
pad only for a sneeze before the week was out
No pads most of the second week.


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4461
   Posted 2/7/2008 8:32 AM (GMT -7)   

wd40- good point.....

I found that after surgery I was much more emotional and given to tears at the least little thing. Accompaning that was hot flashes.  Both have now slowed down, especially the hot flashes, but the emotions are still on a roller coaster.  I never knew what my T level was before surgery, but am curious as to what it is now.   Maybe I can squeeze that test into my next PSA sample test...lol  I'm in the process of getting a new doctor/surgeon, the one who did such a good job of surgery and who I really trusted and was working with so well on fighting the after effects of my surgery is leaving the group practice and going back to Texas, so I got to start all over learning to like and trust his replacement.  Anyway, I'm sure half the battle is in the mind and in the chemistry, like you said...


creed_three
Veteran Member


Date Joined Jan 2007
Total Posts : 762
   Posted 2/7/2008 1:43 PM (GMT -7)   
This is "long-winded" again, but here goes..
 
Although we did not use injections as part of our rehab process (this was a personal and informed decision - really just our choice),  our situation was similar to James,  and when we were at your point in recovery, (ie. 3-4.5 months) and actually,  up to 6 months post-op, the situation seemed grim. The depression was suffocating so we sought further reassurance from the Surgeon and others here, had a break,  and tried again. Now at 11 months,  we are back to what Puget is describing,  but using Levitra instead of Viagra. I definitely believe now that the 12-18 month mark for full ED healing will be more or less accurate in our case, taking our Surgeon's words into account. However you should see my personal diary (!) .. when I wrote an entry when my husband was 4 months post-op, I was scathing in my words about the surgeon, the condition, the pain, and what it was doing to my husband inside - you name it.. it was hard.  
 
At 7 months post-op however,  I was instead praising the Surgeon (albeit cautiously..), in my diary,  as there had been a suprising amount of healing going on after that time. At 11 months now,  I am blessing the Surgeon with a lot more grace than I blessed him before!! (although we were grateful of course for his overall skills in saving my husband's life always). Therefore, I can see now that my husband may still be recovering at 2 years post-op,  so we are much more settled at the current 80% (like Puget), and expect that to further improve over time.
 
Other guys instead, go for the injections at about this time with guidance and advice from others here,  with a lot of success, so there are many things you can do. However all you are describing now is great,  and very positive for healing side of things.  Hubby also had his T level checked at 4 months due to the emotional issues described by others, and when it came back within normal limits,  we were lucky to rule that one out, thankfully. But that is an issue to be ruled out.
 
I sincerely hope this comment helps in some way, Sama.  I think it takes a full year to come to grips (partially) with this whole experience actually and I think you can expect a whole lot more healing too. Contacting your doctor now might be a good thing.  From what you describe it may all be OK with a few more months under your belt, or alternatively, you may decide on some active intervention now, if that is your choice after getting some medical advice. Good luck with your recovery. cheers, Lana.
 
PS. Chas - thanks for all your posts in this area. James, you are always spot on with your words. Lifeguyd & Puget - Hi y'all - glad to hear you are both doing well!
 
Creed_three (Lana & CJ)
 
Husband CJ aged 50 yrs (49 years at diagnosis and surgery)
PSA (2002) 2.1.  PSA (Nov 2006) 3.5.  1 x (5%) core of 12 positive at biopsy. 11 cores negative. Open Radical Prostatectomy with nerve sparing, on Tuesday 17th April 2007 (Sydney, Australia).
Gleeson 3 + 4 = 7.  Cancer confined. Margins all clear, including bladder neck and seminal vessicles. No incontinence (thankfully).
1st PSA 0.01 (June 07) 2nd PSA 0.02 (Oct 07) undetectable.
ED post-op recovery: Returned 8 months after surgery with Levitra 20mg as needed. Next PSA March 08.


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1463
   Posted 2/7/2008 2:57 PM (GMT -7)   
Disturbed nerves just take a long time to heal. I had ED and used Lavitra before getting PCa. Now I am almost to the point where Viagra without using Trimix gets me up enough for sex. That is my goal, to be as good now as I was pre-surgery. I think I'll make it...

Jim


Age 73. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06.  Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
PSAs from  1/3/07 - 1/17/08 0.00. 
Next PSA test on 7/17/08
"Patience is essential, attitude is everything."
 

Post Edited (biker90) : 2/7/2008 6:26:40 PM (GMT-7)

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