Someone quoted my previous post, then asked the question, “Are you saying that ED gets better for men after prostatectomy?” I saw this just before going out to lunch, and said to myself that, first of all I thought the answer to this was well known, but secondly that this question deserves a well-thought response…which I would do after lunch.
Upon return, I see that the poster has since returned and deleted that post/question, but in the spirit of “there are no bad questions,” I will give a (perhaps shorter) response to the now absent question…
“Are you saying that ED gets better for men after prostatectomy?”
Yes, absolutely. ED recovery is different on an infinitely-varying scale case-by-case, but I will speak to the well-understood, well-documented general trend which most medical descript
ions of the post-surgery experience align with. Moreover, and perhaps equally as important, it aligns closely with the personal (albeit anecdotoal) experiences of many here at HW/PC
First and foremost, the most obvious determinant of postoperative ED is the preoperative potency
status. It’s not going to get better after RP; and there are other factors which affect ED (broad topic; another day)…but high level is that if you had ED before surgery, that’s something that doesn’t improve. The other somewhat obvious factor is nerve-sparing
; someone who did NOT have nerve sparing surgery is immediately subject to a much higher stack of issues. For the rest of this discussion, I’m really talking about
nerve-sparing cases (such as Subdenis would likely have).
Second is the understanding that some men never
recover erectile function from treatment even with meds…although (ultimately) a mechanical implant (another surgery) can simulate functionality (another broad topic for another day). The recovery CAN be influenced by the experience level of the surgeon
due to the highly technical nature of RP, BUT broad randomness
(rather, unidentified/unassigned causes) appears to be a greater factor because plenty of patients from very experienced surgeons experience extended or complete ED…it’s fact, though, that this happens more frequently with less experienced surgeons. Choose an experienced surgeon
to stack the controllable odds in your favor for the best possible outcome. Period.
Finally, to the main point of the question, ED generally gets better after a post-PR recovery period. The recovery period varies like an impulse decaying function. Not to geek out too much, but our electrical engineering 101 textbooks provide similar graphical representations where the x-axis is time, but the y-axis is erectile funcationality. (See THIS
) There is an impulse (surgery) and immediate response (ED), some recover functionality in weeks, others months, most within a couple years
(and some never, as mentioned). [Some may argue with the use of this impulse response chart as a visual description…I think it’s a pretty good visual description, but I’ll point out one key difference influenced by the first factor which I talked about above, which is that the level of erectile function after RP rarely (never) returns to the same pre-surgery level…it’s going to be at least a little worse. Might be functionally similar, but not as good.
Why is this 3rd point true? There is actual physical recovery
which takes place. There is, for example, mechanically induced nerve stretching that may occur during prostate retraction, thermal damage to nerve tissue caused by electrocoagulative cautery during surgical dissection, injury to nerve tissue amid attempts to control surgical bleeding, and local inflammatory effects associated with surgical trauma. Different, "newer" surgical techniques
can help to reduce some of these contributors (and there is continuous process improvement in surgical techniques), but no technique completely eliminates them. For example, lower heat energy—most obviously from cauterization, but also simply from the laparoscopic lighting techniques—is understood to result in better outcomes.
OK, got a little longer than I thought in response to the question which was deleted…but if someone stepped forward to ask the question (even though they then deleted it), then that tells me that there are probably many others who are thinking the same question and afraid to ask. Don't be ashamed to ask. No dumb questions.
Time to disconnect! Adios, have a great weekend...!
Post Edited (NKinney) : 12/8/2017 12:07:57 PM (GMT-7)