Prostate size correlates to return of erections? A Survey

New Topic Post Reply Printable Version
33 posts in this thread.
Viewing Page :
 1  2 
[ << Previous Thread | Next Thread >> ]

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4463
   Posted 8/27/2010 5:22 PM (GMT -6)   
In another thread, there's been some discussion and wondering if the size of the gland removed or radiated had any effect on the length of time to recover erections.

Common thinking was that the larger the gland the longer it may take to regain erections. Or does it? Who knows. So, lets open up the discussion with a survey of guys who have been there, got their ticket punched and are living it. What was the size of your prostate, in grams if possible, at surgery removal or when seeds were implanted? Also, what was your initial ED stage, say, 6 weeks after procedure. When, if ever, did you regain what could be considered 'full' erectile function, either with or without using the ED drugs? We won't consider the injections or pump, as these are more 'mechanical' methods. It'd help if you could tell us what your erections were or weren't both when natural and when using an ED drug. Another factor is did you get both nerves spared or just one or a partial. No nerve bundles spared probably wouldn't fit into this survey.
James C. Age 63
Gonna Make Myself A Better Man
4/07: PSA 7.6, Recheck after 4 weeks Cipro-6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS3+3=6
9/07: Nerve Sparing open RRP, 110gms, Path Report- Stg. pT2c, 110 gms., margins clear
3 Years: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4463
   Posted 8/27/2010 5:24 PM (GMT -6)   
I'll start. 110 grams gland removed, nerve bundles spared, no response of any type, at any time, natural or using the pills, now 3 years after.

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 8/27/2010 5:37 PM (GMT -6)   
I'll join you. 42 grams, gland removed, SRT, right side nerve  left intact, no ED at any point

Post Edited (Purgatory) : 8/27/2010 4:47:50 PM (GMT-6)

Regular Member

Date Joined Aug 2010
Total Posts : 245
   Posted 8/27/2010 5:41 PM (GMT -6)   
Husband 60yrs. old, no aids necessary pre-surg, 95 gram prostate removed by open manual radical prostatectomy 53 days ago, both nerve bundles spared, now has ED with very slight tumescence at tip only with stimulation, still orgasmic, no mechanical/chemical aids used to date but Viagra scrip filled today.

Veteran Member

Date Joined Nov 2007
Total Posts : 598
   Posted 8/27/2010 7:00 PM (GMT -6)   
prostate 61 grams at robotic surgery.
no ED at 8 weeks - but ED bounce came along and was back at square ED. Steady slow progress, two years later can have normal natural erections. oral meds make it much easier... oral meds even produce spontaeous erections with just mental stim. ED website for PCa guys

46 at Diagnosis.
Father died of Pca 4/07 at 86.
10/07 PSA 5.06 (Biopsy 11/07 1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC
Saved both nerve bundles.
Path Report: Stage T2cNxMx
-Gleason (3+3)6
Pad free on March 14 - (10 weeks.) Never a problem since.
ED - at one year, ED is fine with viagra.
Two year PSA - undetectable!

Worried Guy
Veteran Member

Date Joined Jul 2009
Total Posts : 3739
   Posted 8/27/2010 8:17 PM (GMT -6)   
56 grams, One nerve (supposedly) partially spared. One year out. I got nothing - unless I fill 'im with Trimix.

Regular Member

Date Joined Jan 2010
Total Posts : 363
   Posted 8/27/2010 10:10 PM (GMT -6)   
Prostate and seminal vesicles combined were 43 grams, both nerves spared, one "beat up a bit".

6 weeks after surgery mild "plumpness" gradually increasing function to the point of a usable erection a bit less than 4 months after surgery. At best it's 90% of what it was and getting there is nothing like it was pre surgery, today it takes 100mg of Viagra, vibrating ring and stimulation but I'll take it.

Haven't noticed any nocturnal stirrings, usually take 10mg Levitra (generic from adc) every other night, 50 to 100mg Viagra (also adc) for play time.
Diagnosed 12-09 age 55
07-06 PSA 2.5
01-08 PSA 5.5 (PCP did not tell me of increase or schedule follow-up!!!!)
09-09 PSA 6.5 Sent for consult with Urologist
11-09 Consult, scheduled for biopsy, found out about PSA from '08 (yes I was pissed)
12-09 Biopsy, initial Gleason 9 (4+5) later reduced to 8 with tertiary 5, ain't much but I'll take it.
01-10 Bone Scan, "appears negative"
03-01-10 RRP in Durango CO by Dr Sejal Quale and Dr Shandra Wilson, no naked eye evidence of spread, Vesicles and lymph nodes taken for microscopic exam.

03-16-10 Removal of cath' and pathology results of samples.
Multifocal carcinoma with areas of Gleason pattern 3, 4 and 5, Overall Gleason grade 4+4 with tertiary 5, Bilateral involving 21% of left lobe, 3% of right lobe, Invasion of left Seminal vesicle, Tumor focally present at left resection margin, 9 lymph nodes removed all negative, Tumor staging pT3b NO MX

04-23-10 PSA <0.04....... 06-07-10 PSA <0.04..... 08-03-10 <0.04
05-03-10 1 week without pads
06-28-10 ;-)

Regular Member

Date Joined Oct 2005
Total Posts : 489
   Posted 8/27/2010 10:27 PM (GMT -6)   
Good idea on the survey James.

My stats so far:

Prostate 110 gm @ surgery (open RP, both nerves spared).
(Added to counter Proscapt argument about larger prostate may mean MORE PCa)
1 of 10 cores with 5% 3+3 gleason.
And hey, we're never going to do a scientific survey here -- we only WANT anecdotals!!!
(also yes I would think younger patients would be self-deselected (<50) -- seldom having large prostates or much BPH).

Some ED prior to RP and meds did help at that time.

1.5 years along and still no erections (drugs or au natural).

Some nocturnal tumescence (using full dose Viagra @ bedtime) lately but nothing really useful.

Post Edited (JimStars) : 8/28/2010 9:16:54 AM (GMT-6)

Veteran Member

Date Joined Aug 2010
Total Posts : 644
   Posted 8/28/2010 12:38 AM (GMT -6)   
My experience

63 grams, bilateral nerve sparing, robotic-assisted
with viagra at 6 weeks I had a partial response
at 6 months, half the time its good enough for sex with viagra; without viagra I get partial response, sometimes good enough for sex.

More broadly speaking, I think to James C's original question, there may be a spurious correlation. The bigger the gland, likely either the more advanced the cancer or the more BPH going on. More BPH is likely to mean an older patient which means not as good a recovery, and not as good a baseline performance status. The more advanced the cancer the more likely that bilateral nerve sparing was not possible. So their could be a correlation between size and ED, but the correlation may not be causal; it could be coincidence. You'd need to do a regression type analysis (nomogram?) to figure out impact of the different factors.

Veteran Member

Date Joined Dec 2009
Total Posts : 1267
   Posted 8/28/2010 5:20 AM (GMT -6)   
70 gram prostate. Nerve bundles spared. ED stage 6 weeks after - 1 out of 10 (no drugs); 15 months - 9 out of 10 (with levitra).

summer boy
New Member

Date Joined Aug 2010
Total Posts : 12
   Posted 8/28/2010 8:40 AM (GMT -6)   
35 grams, robotic rrp on 4/27/2009, no erections to date, but trying

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2460
   Posted 8/28/2010 12:01 PM (GMT -6)   
I probably shouldn't put my stats here since I had both nerve bundles removed but I'll do anyway. Prostate 57 grams, I can get 70% erection with stimulation. 100% with trimix.
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
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

Veteran Member

Date Joined Dec 2008
Total Posts : 673
   Posted 8/28/2010 12:57 PM (GMT -6)   
I couldn't find the weight on my path report. I do remember my surgeon said my prostate was about 20% larger than normal for my age/mass. I'll edit this post later if I do find it.
Oral ED drugs did nothing until recently. Used trimix from about 8 mo to 13 mo post-surgery. 13 months after surgery 10 mG of levitra was giving something usable...not consistent. That dose is giving pretty consistent results now at about 16 months. Both nerves were spared. I did have a pretty high cancer content in biopsy cores, so maybe the surgeon made the margins a bit wider resulting in more trauma to the nerves, etc. Nothing natural that's usable at this point but, staying optimistic.

Post Edited (mikey1955) : 8/28/2010 12:11:21 PM (GMT-6)

Regular Member

Date Joined Jan 2010
Total Posts : 55
   Posted 8/28/2010 5:30 PM (GMT -6)   
Interesting topic - 43 gram prostate, RRP (nerve sparing) on 12/1509, no ED problems before surgery, now 8 months after surgery require either 50 mg Viagra or 20 mg Levitra to get an erection which is functional about half the time - but has been slowly improving with time. No spontaneous erections, no nocturnal erections (that I am aware of). I still look at it as a long haul, and still use pump therapeutically three to four times a week.

Regular Member

Date Joined Oct 2009
Total Posts : 46
   Posted 8/29/2010 4:32 AM (GMT -6)   
hi good idea this .mine was 62g and there is no sign of action on the ed probs prior to op .have taken cialis and viagra but use the pump and  can have sex but its painfull.i think i may try the jabs

New Member

Date Joined Mar 2010
Total Posts : 7
   Posted 8/29/2010 3:42 PM (GMT -6)   
Husband had RRP 12/22/09. Prostate was 110 grams. He has total ED, but can have orgasm with stimulation. We are just thankful that the cancer is out. PSA 0.001.

Veteran Member

Date Joined Nov 2009
Total Posts : 7269
   Posted 8/29/2010 4:00 PM (GMT -6)   
52.7 gms.
Surgery 1/26/10
ED --yes. Cannot get anything usable. Orgasmic after lots of stimulation.
No big deal as far as we are concerned.
Major concern remains the cancer. Fortunately, 100% continent.

Regular Member

Date Joined May 2010
Total Posts : 89
   Posted 8/29/2010 6:36 PM (GMT -6)   
50 Grams..... No problems at all before Davinci.... both nerves sprared... 7 weeks post op... still ED, even with a trial pack of Cialis. shakehead
Diagnosis June 1, 2010 @ age 50
PSA 1.7 Sept. 2008
PSA 2.14 Sept. 2009
PSA 2.75 April 2010

May 11, 2010 - DRE Negative - PCA3 Test
May 18, 2010 - PCA3 Results 39 (cutoff = 35)
May 25, 2010 - Biopsy 1 of 12 cores positive; Gleason 3+4 = 7 25%; Stage T1c
June 04, 2010 - CT and Bone scan - All Negative
July 07, 2010 - Da Vinci Robotic Lap. Surgery

Tumor involvement - 15% both right and left halves
Gleason Down graded to 3+3=6
Seminal Vesicles - Negative
Lymph node - Negative
Sub capsular perineural Invasion - Present
Bladder Neck Margin Positive (right posterior) - Microscopic invasion-1mm Focus

Incontinence - Dry at night, 2 or 3 pads during the day
5 weeks post op... down to 1 pad a day and a couple of drips - still dry at night

ED - Total flat tire.... but there is signs of life!

First PSA scheduled for 10/14/2010

Northern NJ

Regular Member

Date Joined Oct 2009
Total Posts : 419
   Posted 8/29/2010 7:30 PM (GMT -6)   
77 gms. ED immediately after RP. Viagra/Cialis gave side effects so did not use. Incontinence dominated last two years so did not work on ED. No natura erections. Can use pump but to painful so stopped trying intercourse after one time. Can have orgasms with pump and stimulations. Libido is way down following RP.

Regular Member

Date Joined Apr 2009
Total Posts : 179
   Posted 8/30/2010 12:19 PM (GMT -6)   
58g and I was having erections before the catheter was removed.

Veteran Member

Date Joined Sep 2009
Total Posts : 3172
   Posted 8/30/2010 9:10 PM (GMT -6)   
Dr Patrick Walsh makes this point:

"We believe that the operation is also more successful because these men [younger men] have smaller prostates. There is more tissue surrounding the prostate, and the margins of resection (the surgical border between healthy tissue and cancer) are wider. Finally, in younger men, the neurovascular bundles are located farther from the prostate and are easier to preserve."

Many of you know who Dr Patrick Walsh is, but for those who might not he is the father of nerve sparing RP technique, and is considered by some to be the world's foremost authority on prostate cancer.

Regular Member

Date Joined May 2010
Total Posts : 21
   Posted 8/31/2010 12:22 PM (GMT -6)   
I haven't had my surgery yet, I have to wait until January. But geez, I hope what you are guessing is true. My prostate is only 19, that's tiny compared to some of yours!
Diagnosed with Prostate Cancer 4/10/2010

Age 58

Stage: T2B

Greason Score: 3+ 3 = 6

January 2008 - PSA: 1.5
January 2010 - PSA: 3.0
May 2010 - PSA: 3.7

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.

S Mark
New Member

Date Joined Nov 2008
Total Posts : 12
   Posted 8/31/2010 9:10 PM (GMT -6)   
95 grams. Both nerve bundles spared. 50% erection only with Trimix combined with VED. On top of that, now have Peyronnies

Regular Member

Date Joined Oct 2005
Total Posts : 489
   Posted 9/26/2010 4:04 PM (GMT -6)   
Doing double duty here both bumping this thread back up for additional contribs and also to update my status.

We had liftoff this morning -- with a good solid and lasting what-are-we-gonna-do-with-all-this erection. Took 20 months to get there but finally did. And this was not one of those fleeting middle of the night ones that disappear as soon as you wake up. It stayed around for about an hour (with help from the missus).

Yes I am using Ceebis regularly, but it was long after (8+ hrs) taking 20mg (I don't think the 36 hr thing applies in any way to RRP patients really).

So the stats once again were 110 gram prostate size, first real erection at 20 months.

Note to NeIrish: I also try Viagra and Levitra at times -- no real difference from Cialis. I do use MUSE once or twice a week now and that lasts for up to 4 hours (softening up by the 4th hour). Overall the 20 months I think Willie just has had a mind of his own and does what he wants no matter what I want (and my wife ruefully agrees). No real side effects for me from any of the Big 3. I have aches here and there -- but that's from Volleyball not the pills.

Post Edited (JimStars) : 9/27/2010 2:42:57 PM (GMT-6)

Regular Member

Date Joined Aug 2010
Total Posts : 245
   Posted 9/26/2010 8:08 PM (GMT -6)   
JimStars: Congrats on reaching the stars. Did Viagra ever do the job for you? We're still trying it and the improvement in the ED is barely noticeable. Not usable, anyway. Any side effects from the Cialis (that's what ceebis is, right?)?
Husband 60yrs., no symptms: PSA 10/04 2.73, 12/06 3.64, 5/09 3.9, 10/09 4.6, 1/10 5.0w/ free PSA 24
6 core biop 4/1/10 path rept: rt mid: adnocarc. G=3+3, 5% of core; R apx v. susp. minute ca, R base bnign w/ mod. atrophy, L side atrphy only; 2nd opnion JH confrmd
MRI - 15mm nodule
BiLatRP surg 7/6/10, path: T2c, nodes, sem.ves, extra caps. neg., adenoc both sides G=3+3 cntinent, Viagr-8/27 ED
New Topic Post Reply Printable Version
33 posts in this thread.
Viewing Page :
 1  2 
Forum Information
Currently it is Wednesday, September 19, 2018 12:32 AM (GMT -6)
There are a total of 3,004,519 posts in 329,151 threads.
View Active Threads

Who's Online
This forum has 161743 registered members. Please welcome our newest member, worldmicroblade.
284 Guest(s), 3 Registered Member(s) are currently online.  Details
mauricesr, auzzie, BOB 46