I read and hear that 80% of all men who have ths surgery are impotent or Erectile dysfunction.
Hi Casper, and welcome. I'm sorry to hear about your diagnosis.
I wanted to quickly address just one of your questions/comments...the one copied above.
When you are in the "drinking from the firehose" situation that is common to many newly diagnosed patients who feel overwhelmed with new information, the statistics run at you so fast they are hard to fully comprehend. This one is a little more dynamic; meaning, it really needs another dimension of time added to fully understand the full outcome. I'll try to "add some color", as the saying goes; in other words, more fully explain (in relatively simplified terms).
The neurovascular nerve bundles which enable an erection are wrapped around the prostate. When the prostate is surgically removed, the doctor examines the possible spread of prostate cancer (PC) up the seminal vesicles and/or outside the prostate capsule. If it appears that the cancer is contained in the capsule, the surgeon can usually do a "nerve-sparing" surgery and carefully dissect the nerves from the prostate and either fully or partially save them. There are nerves on both sides, so they could be saved only on one side, or “bi-laterally.” The individual patient’s anatomy is also a variable factor.
The disruption of the very “gentle” nerves during surgery very often causes temporary erectile dysfunction during the recovery process, although some men (small percentage) come out of the surgery with no difference functionality. Many doctors give the caution that it might take a year or two to recover, but this is often a conservative estimate and most recover within the first year. Some recover completely, and some recover with somewhat less capability. Many end up using one of the Viagra-like pills to improve performance during the first year (or more), with some perhaps smaller percentage using the pills longer term. A small percentage struggle for extended periods regaining erectile function.
So, your reference of 80% men with ED right after surgery is probably very accurate, but after a recovery period, the percentage drops for most men. One thing is for sure, erectile performance (unassisted) after surgery is no better than it was before...you are getting to the age where many men begin to lose performance naturally due to aging.
Unfortunately, with Gleason 8’s and 9’s, you are at a higher risk for PC escaping from the capsule, which decreases the likelihood of a full bi-lateral nerve-sparing procedure. Also, because of the high Gleasons, if you have surgery, there is also a higher likelihood (than the typical lower-risk patient) that escaped PC may have taken root in your prostate bed, in which case a follow-up prescription of radiation may be in your future.
I wish you the best, and encourage you to immerse yourself in the next few weeks to learn all that you can about prostate cancer so that you can directly participate in the decision-making process for treatments.
Post Edited (Casey59) : 4/13/2011 8:12:29 AM (GMT-6)