Hey Ellen and Alex,
I am just now at six months post robotic surgery. I had T2c stage disease at the point of the operation, and one nerve had to be cut. My doctor did plastic surgery on the nerve, and I know it's growing back because of all the weird sensations and because I can notice that there is a little more firmness on awakening. I believe the real recovery rate is one millimeter per month, because the place where the nerve isn't that long to begin with.
Alex, there is also a step before having to use the shots, and that is the MUSE, which is a little suppository about the size of a sesame seed that is put into the urethra with what someone called a Barbi Baster. It has the same effect as the injection only not as strong and in some folks not as effective, but it is a little less gross sounding than a shot in the you-know-what. It takes about 30 min to work just like the other things, so you can have foreplay. I haven't had the shot, but it takes more than just a few minutes to work, so foreplay is also possible. Other people have posted that they didn't need these artificial enhancements forever, and eventually, with enough sex, they were able to go back to the natural way. If the nerves are spared (and your best shot at this is with the robot, in my opinion) then the likelihood is you are going to get back what you had before.
I was using Viagra before, because of high blood pressure, high blood pressure medicine, and an SSRI antidepressant which can really take the lead out of the pencil. I was put on a small daily dose of Viagra, and a weekly full dose to check the response. I also use a pump to keep the tissues elastic. Still waiting but hopeful. Many say that it really takes a year.
But I'm here to tell you that the orgasms are something else! Can make your eyes water! With continued stimulation, they go on and on and on... Like I said on another post, for these orgasms, if I'd have known, I'd have had the prostate out years ago. I like the "productive" (wet) kind, too, but, as odd as this may sound, these are more than a fair trade.
If your nerves can be spared, you may not need anything in the way of pills, shots, suppositories, or pumps, especially in the long run. In the short term, this is a operation and the area has been traumatized and the nerves go into a kind of state of shock. They may not work right away, but with a little time, the area will heal and the function will start up again.
Also, don't worry about the peeing. With robotic surgery, you will have a great chance of being dry right away (as soon as the catheter is out). I was the second day after that, even though I had to have one for a month. I still wear a little pad, because sometimes there are a few drops of leakage with some exertion (lifting, passing gas, coughing).
Alex, and everyone, get the book by Dr. Scardino, and also the one by Dr. Patrick Walsh called Surviving Prostate Cancer. Read them carefully. You will feel much better. Knowledge is power.
All the best, and we are all here for you.
PSA (10/04): 2.9; PSA (2/06):4.4, on Androgel (serum T about 450) at age 56; negative DRE, no symptoms.
PSA (5/06):5.7 with a free PSA% of 8, OFF Androgel (serum T 163).
Biopsy (5/06): 4/12 samples positive; postitive samples only on right side; max Gleason 4+3=7 (in 2 of the 4 -from area nearest bladder.
DaVinci robotic-assisted laparoscopic radical prostatectomy + bladder lift + Right nerve plastic surgery (8/23/06).
Catheter out 4 weeks postop, due to internal pinhole leak at bladder-urethra junction.
Final pathology report:T2c-both sides,but in capsule; neg. margins, neg. lymph nodes, neg. seminal vesicles; final max Gleason still 4+3=7.
Follow-up PSA (11/06): <0.008; serum T: 195 OFF Androgel (at present).