ED and post surgery

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

Minn1951
Regular Member


Date Joined May 2010
Total Posts : 21
   Posted 5/26/2010 11:28 AM (GMT -6)   
Hello,
 
 I am new to the site and found out my diagnose on April 9th, so this is all so new.  Have appointment to vist a Robotic surgeon and a Radiation Specialist in June.
 
Worried about the ED issues after the surgery.  But it a appears by the posts that it's pretty common either way.
 
Never had to take Viagra.  just wondering how that med works.  Does it help with the erection, will you still have an erection after the organism?   Are you still able to have an organism?  From what I have it read, if I go with the surgery it will be a dry organism.  Is it the same experience?  Is viagra a given after surgery?  How soon after surgery can I try to have an erection?  Where does the cath come in to play?
Diagnosed with Prostate Cancer 4/10/2010
 
Age 58
Stage: T2B
Greason Score: 3+ 3 = 6
PSA: 3.0
Prostate volumne 19cc
Tumor present in 3 of 5 cores on both the right and left with 6 of 55  mm or 11% on the right  and 4 of 59 mm or 7% on the left
 
No angiolymphatic or perineural invasion.  No high grade prostatic intraepithelial neoplasia.


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2222
   Posted 5/26/2010 12:24 PM (GMT -6)   
Welcome Minn,
Glad you posted and you caame out firing with common questions. It is probably safe to say each of us have a different reaction to ED after surgery and or radiation. You might be one of the lucky ones who has very little problem with that. I am a year out and still working on it with Cialis so I'm not the poster boy for ED great results post surgery.
 
The catheter will be put in prior to surgery, you will likely be asleep and just as well, then 7-10 days later it is often removed unless some complications. People on here have a lot of good things to say about Dr. Strums book on Prostate cancer so that might be a good place to start as well. Keep us posted.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed, 61 yo 2010
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
2 pads per day, 1 depends but getting better,
 started ED tx 7/17, slow go
Post op dx of neuropathy
T2C left lateral and left posterior margins involved
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5 on 11/28/10
Starting IMRT on 1/18/10, Completed 39 tx at 70 gys on 3/12/10
6 week Post IMRT PSA .44 a drop from .5 but maybe more
Great family and friends
Michael


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 5/26/2010 12:40 PM (GMT -6)   
Minn, am answering as the wife of a PCa patient.

ED issues are common with surgery but I don't know that they are with radiation (my husband had surgery) - others who have undergone RT as a primary treatment can chime in about their experiences. Not every man experiences ED after surgery - you will notice that reading through posts here you'll see guys who never had a problem, those who had problems for a few months only, and those who experience problems years after surgery. There's no hard and fast rule with this one. As to Viagra, it increases blood flow which swells the penis allowing for intercourse (hopefully). Some report report problems with Viagra as well as the other ED medications. Some doctors will provide ED medication right after surgery to begin the "rehabilation" process even though sexual intercourse won't be allowed for a while. Yes, you cachave an orgasm. In fact, you can have an orgasm without ED medication - you don't need an erection for this (surprised - we were!). The orgasm will be dry as there is no more seminal fluid to ejaculate.

As to how soon after surgery you will have an erection, some have reported having one while the catheter was still in place (which is usually 7 to 10 days after surgery).

Your biopsy report looks good. Speak with your doctor about your treatment options including what is commonly referred to as active surveillance. Also speak with a radiation oncologist to see what he/she has to say.

Good luck, and come back to let us know how things are going for you.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009 - 0.1, September 0.3, October back to 0.0, December 0.0, March 2010 0.0. Next PSA in 6 months. Thank you God!


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 5/26/2010 1:50 PM (GMT -6)   
Hi Minn,

Yes you will have dry orgasms, the prostate gland generates semen so once thats gone none is produced.
But, you can still have orgasms and best of all you will not lose your erection after an orgasm, no mess with an orgasm and you can keep going, no recovery. you will also be sterile

There are three ED drugs, Viagra, Cialis and Levitra you will likely be put on one of those after surgery, ED recovery starts with nocturnal erections so there drugs will be a daily recovery plan. You may also get a VED pump to keep you penis muscles from atrophying during recovery mode

It can take 1 to 2 years to get your natural drug free erections back, but that varies greatly by patient. There are 2 nerve bundles that are either moved or removed during surgery, they need lots of time to heal

In the meantime there are also other options to maintain a healthy ( better than healthy) sex life. I use Trimix and I never had 2 hr erections no matter how I feel, what I drink or how often I orgasm. Its actually far better that I ever imagined

Orgasms are much more intense now as many have reported here

Viagra allows more blood flow to your penis, it in itself does not give you an erection, you still need to become aroused

The cath comes into play because your urethra runs through the prostate, once the prostate is removed then the urethra needs to be reattached. The catheter is needed for a week or so to allow the healing of the urethra

Everything you ever ( or never) wanted to know is on this forum
Stats:
Age: 52, PSA (2008)=1.9
Biopsy on 01/09/09, Gleason Score = 3+3
One (1) out of twelve (12) cores was positive, plus external nodule found
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Post Op Path 3+3
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, <0.01 - 3 months post-op
PSA 1/10 undetectable, <0.01 - 9 months post-op
Trimix provides 100% erectile function


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 5/26/2010 3:14 PM (GMT -6)   
Minn,
If decide on surgery and you are not one of the very few, you will most likely have ED issues that vary depending on how much of the nerve bundles were spared during the surgery. Orgasm will be dry but feels the same as before. ED drugs work well for some after a while. Others resort to injections which seem work very well.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm in circumference.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 5 months
2 months PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1
8 months PSA test 10/9/09 result <0.1
11 months PSA test 1/21/10 result 0.004
14 months PSA test 4/19/10 result 0.005


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 5/26/2010 6:44 PM (GMT -6)   
Minn, it is safe to assume that you will have ED after surgery, at least for a time. The extent of it is a very individual thing. Even with full nerve-sparing you might never recover; conversely even if you lose the nerves on one side, you might still have a full recovery.

I think it is important to experiment with the various treatments. I found a lot of trial and error necessary with both injections and the pump, and many failed attempts. I eventually got both working well, but after about 18 months finally settled on the pump alone.

There is a little natural recovery too so that helps. But I am resigned to the fact that I will never be able to "think it up" like I did before. However, I still have a sex life, and while less often and different to before, it is still good.
Pre-op:
Age 63 at diagnosis, now 65.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Operation:
Non-nerve-sparing open surgery on 7 March 2008.
Two nights in hospital; catheter out after 7 days.
Post-op:
Continent; no pads needed from the get-go.
Pathology showed organ confined and negative margins. Gleason downgraded to 4+4=8.
PSAs:
6-week : <0.05
7-month: <0.05
13-month: 0.07 (start of a trend?)
19-month: 0.09 (maybe)
25-month: 0.2 (yes, bummer)
ED:
After a learning curve, Bimix injections (0.2ml) worked well. From 14 months, occasional nocturnal erections. At 18 months, "graduated" to just the pump.


Drums
Regular Member


Date Joined Mar 2010
Total Posts : 134
   Posted 5/26/2010 9:06 PM (GMT -6)   
Minn,
One of the guys who has posted here in the past has a website you might want to check out. It's www.franktalk.org and is all about ED.
Bill
Age 53, father died of PCa, PSA: 10/16/09 - 2.8; 1/11/10 - 3.8
Biopsy 11/25/09, 11 core samples - HG PIN on right side
Biopsy 2/17/10, 11 core samples - left side, adenocarcinoma, Gleason 6, one core at 5%
Notified of dx on 3/12/10 (27th wedding anniversary)
MRI 3/17/10 and bone scan, 3/23/10, indicate: gland volume is 27mL, PCa is confined to prostate, seminal vesicles and vas deferens are unremarkable.
RALP conducted 19 May 2010 by Dr. Lee at U. Penn Presbyterian


NY-Sooner
Regular Member


Date Joined Sep 2009
Total Posts : 463
   Posted 5/27/2010 6:36 AM (GMT -6)   

I was one of the lucky ones with respect to erections. Within a few days of the catheter being removed, I was getting a rock solid erection without any drugs and to this day, 3 years post op, I still can get a rock solid erection without drugs.  In the last year, I have now been getting nocturnal erections like I use to get prior to surgery. 

The one thing that is very different is that I can not achieve an erection no more from just visual or mental stimulation. Prior to my surgery, just thinking about sex or looking a picture of a naked woman was enough to get me a rock solid erection.  Now, I can look at naked women 24/7 and nothing happens. The only way I can get a erection now is with a lot of manual stimulation. 

You asked the question about dry orgasms and orgasm intensity.  First of all, my orgasms are no where near as intebse now as before. They are about 50% of what I use to have. 

With respect to dry orgasms, don't I wish!!!!  I would give anything to have a dry orgasm now.  When I have an orgasm now, I ejeculate urine with such force, I can hit the ceiling.  Even if I try to empty my bladder before sex, I will still ejeculate some urine.  It is really frustrating because I am 100% continent at all other times, but as soon as I starte getting sexually aroused, I can feel my splinkter muscle relax and I will start to drip uncontrolably and ejeculate urine.   So now everytime I want to have sex, I have to lay towels all over the bed so I don't wet the sheets and drip on my partner.

The uro told me this is a common problem that happens after surgery that surgeons don't tell you about, and there is nothing you can do about it but learn to live with it. My uro said that urine is steril and if you get some in your partner, not to worry , but trying telling that to a woman.

 


 
Age 56, Biopsy 6/2007 - PSA 4.5, 2 of 12 with  <5% cancer Gleason 6
Surgery 9/2007 Strong Memorial,  Rochester  NY with Dr. Jean Joseph (1300 plus surgeries)
 Path - Negative margins, cancer in 20% examined tissue, Gleason 6
 Post Op - No ED issues, full erections without drugs,  used 5-7 pads a day for 3 months. Now dry except for stress leaks now and then.
 All post op psa's <.04


hb2006
Regular Member


Date Joined Nov 2008
Total Posts : 299
   Posted 5/28/2010 7:31 AM (GMT -6)   
NY
 
Not to be flippant or anything, and not knowing if you are single. But if you are, maybe you should look for a "squirter". She wouldn't have any issue at all with the urine.
 
Good luck
Age 60, PSA 2007 4.1, PSA 2008 10.0
Diagnosed April 2008, Biopsy: 6 of 12 cores positive, Gleason 4 + 5 = 9
CT and Bone Scan negative, Open surgery at Shawnee Mission Medical Center May 21, 2008
Right side nerves spared, Radical prostatectomy and lymph node dissection
Cather removed on June 3rd, totally dry on July 9th, pT2c, lymph nodes negative
PSA Sept 28, 2008 0.00, PSA Jan 22, 2009 0.00, PSA June 29, 2009 0.00
PSA Sept 2009 0.00, PSA Dec 21, 2009 0.02, PSA March 29, 2010 0.03
ED Status- Currently using Trimix, Levitra daily for increased blood flow.
Noctural Erections have completely returned on a nightly basis, same hardness as before.
Stopped the injections except for "Fun" weekends. Really don't need them anymore.


mjluke
Regular Member


Date Joined Jan 2009
Total Posts : 189
   Posted 5/28/2010 8:38 AM (GMT -6)   
hb2006 said...
NY
 
Not to be flippant or anything, and not knowing if you are single. But if you are, maybe you should look for a "squirter". She wouldn't have any issue at all with the urine.
 
Good luck

Hey Hb:
Hopefully we will get some comments from a "squirter".  Wahoo!

 
63 years old-tumor discovered on digital exam- biopsy December 2008-
4 of 12 samples positive-all on right side
Gleason 3+3=6
PSA-3
Otherwise excellent health.
Brachytherapy- May 19, 2009 -so far, so good.
 
  "There may come a day when the courage of men will fail, but it will not be this day."


Drums
Regular Member


Date Joined Mar 2010
Total Posts : 134
   Posted 5/28/2010 1:03 PM (GMT -6)   
Saw a recent episode of Dr. Oz who made comparisons between the male and female anatomies around the genital area and indicated how each has it's corresponding body part in the other. He said the G-spot was a possible source of female ejaculate and corresponded to the male prostate. The female ejaculate in fact has PSA. So maybe a squirter wouldn't be such a great idea for us?!?
Age 52 at diagnosis, father died of PCa, PSA: 10/16/09 - 2.8; 1/11/10 - 3.8
Biopsy 11/25/09, 11 core samples - HG PIN on right side
Biopsy 2/17/10, 11 core samples - left side, adenocarcinoma, Gleason 6, one core at 5%
Notified of dx on 3/12/10 (27th wedding anniversary)
MRI 3/17/10 and bone scan, 3/23/10, indicate: gland volume is 27mL, PCa is confined to prostate, seminal vesicles and vas deferens are unremarkable.
RALP conducted 19 May 2010 by Dr. Lee at U. Penn Presbyterian
1 pad per day mainly for insurance - going when feel the urge alleviates accidents


hb2006
Regular Member


Date Joined Nov 2008
Total Posts : 299
   Posted 5/28/2010 10:25 PM (GMT -6)   
My limited experience with "squirters" is via certain web sites and the women who are squirters, do warn about it. They stress the need of extra towels, extra sheets and waterproof mattress pads. The amount of fluid released is not small.
 
 
Age 60, PSA 2007 4.1, PSA 2008 10.0
Diagnosed April 2008, Biopsy: 6 of 12 cores positive, Gleason 4 + 5 = 9
CT and Bone Scan negative, Open surgery at Shawnee Mission Medical Center May 21, 2008
Right side nerves spared, Radical prostatectomy and lymph node dissection
Cather removed on June 3rd, totally dry on July 9th, pT2c, lymph nodes negative
PSA Sept 28, 2008 0.00, PSA Jan 22, 2009 0.00, PSA June 29, 2009 0.00
PSA Sept 2009 0.00, PSA Dec 21, 2009 0.02, PSA March 29, 2010 0.03
ED Status- Currently using Trimix, Levitra daily for increased blood flow.
Noctural Erections have completely returned on a nightly basis, same hardness as before.
Stopped the injections except for "Fun" weekends. Really don't need them anymore.

New Topic Post Reply Printable Version
Forum Information
Currently it is Sunday, June 24, 2018 9:10 AM (GMT -6)
There are a total of 2,974,702 posts in 326,202 threads.
View Active Threads


Who's Online
This forum has 161300 registered members. Please welcome our newest member, Snooks11.
373 Guest(s), 3 Registered Member(s) are currently online.  Details
cyclinglady, getting by, PA_grandma