Dr Eve | Radical Prostatectomy | Dear Dr. Eve | learn | Creating Unique Sexual Lifestyles

I recently underwent a radical perenial prostectectimy, following prostate cancer and now have a problem in gaining erections. My PSA count is now zero. My Urologist tells me that he spared all the essential nerves during the procedure. My urologist says I may benefit from acquiring an "erection pump." Please advise in this regard and from where are such are obtainable together with costs etc.

Dr. Eve Answers:

I write to you fresh from ISSWSH conference so information I share with you comes after presentations attended and consultation with the finest experts in cancer and sexuality, in the world. I do not say this with arrogance but factually. I share with you clinical treatment protocol but please, please understand that each person needs individual assessment- treating any sexual dysfunction requires a unique and complete history taking of you and your partner. Fact is that one never knows - nor waits- for nerves to repair. Treatment of expected erectile dysfunction must start, as Anne Katz sexual health care provider of cancer patients in Canada, says , the moment the catheter is removed. First line treatment is PDE5I, which is either Viagra, Levitra, Cialis. You must take it correctly and give it time - get your dosage correct and you need at least 8 regular doses inside of you to get results. However if you find you are not satisfied with results, your next line of therapy is injection therapy. This is highly effective and really manageable once you are well taught and get dosage correct.

I urge you to visit your urologist with your concern and let him/her know what i have recommended. Be sure to have your partner's sexual health checked too. If your partner is a woman hopefully her sexual health is in good order. Obviously the rest of your health must be good- blood pressure, cholesterol, blood sugar, thyroid and hopefully you are not overweight, drink too much or smoke- this will have to be modified to get really good sexual health restoration.

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Penile rehabilitation

I am the specialist that Dr Eve talked to. She is 100% in her advice to you. The important thing is for you to take the medication at a low dose EVERY NIGHT. This is called penile rehabilitation. The medication allows for a small amount of blood flow to the tissues of the penis to keep them healthy while the nerves recover after surgery. You may have to take the medication for a long time before you see results. This is usually months but recovery can take years too. Usually by 2 years after surgery you will know how good your function is. If you have more questions, send them to Dr Eve and she will pass them on to me and I will try to help too.

Dr Anne Katz , February 22, 2010