I had a Radical Prostatomy on 16 January 2007. I am in 8 weeks post operation. I had the "nerves ‎spared" to my penis so that I can maintain erections. So far nothing! Doctor says that there was ‎alot of loss of blood; however nerves were spared. My question is, if there is damage to the ‎nerves how long does it take the body to repair and how do we know if nerves are actually ‎spared? I have tried Cialas 20mg's, Viagra 50mg's, 100mg's and I have not had any erectionsat ‎all;though I know that with these medicines for ED you need to be excited sexually. I do ‎sometimes get the feeling that penis want's to get erect, but not hard enough to penatrate.I do not ‎know if this is "wishful thinking." This is very hard on me (or any man) knowing that after this ‎‎"major" surgery that ther is a possiblity of impotency. Anyone out there feel like I do. I talk to my ‎wife about this, but she say's that she does not know what to do as a wife, and could go ‎without sex if I should never gain potentcy. "What a horrible thought!" For some of us men to go from a sexually active man to man ‎who is incontinent, has no control, has severe ED problems after surgery and everyone is saying ‎"be patient.” Though I do not have the problems with “incontinent”, other than the erections I have ‎no other problems.‎

Yes I've been there I had my surgery September 3, 2005 it was nerve sparing with the Da Vinchi method. I had successful intercourse with my wife 18 months later. I read some books that said it would be six weeks that was a crock of bull. It is going to be difficult to go through this and your mind is going to play some serious games with you. No one is going to understand this unless they have gone through it. My best advice is to stimulate your mind because after a while I noticed I no longer thinking about sex anymore. Which at 44 was unthinkable. So keep your mind going. Find a way for both you and your wife get along (you'll have to change how you do thing). Once you get a little further down the line I'll let you know how I handled the situation. But be patients it is going to take time to heal.I'm not back all the way but it was strong enough to get in. There is also a book called The Hardness Factor that offered great tips on exercise and supplements. If you have a pump use it regularly to keep your size. I know I've lost some from lack of use and bloodflow over the past 18 months and the pumps helps with keeping the bloodflow. Just hang in there I know when I went back to doctor about 6 months after sugery complaining I was not getting erections and he told me it could take up to 18 months I know from the look on my face he thought he was in physical jeopardy. But the books I had been reading gave me false hope it takes a long while for these nerves to recover. But little by little I saw progress, keeping taking your ED medication, and I found exercise was a great stress relief. Hang in there. I hope this helps. Let me know how you are doing. Reach out if you need to.

Eight weeks isn't long enough for nerves to heal. Even though the nerves are spared, they have been traumatized and it takes a while for them to start functioning again. And they will probably need lots of help to jump start them. Hopefully your doctor has you on an aggressive regimen with a vacuum pump and ED drugs. Many guys have found that starting on ejection therapy (Caverject, Bimix or Trimix) at an early stage gets them over the hump before they start functioning again without any help. This all gets very complicated but you need to keep working toward the prize. My wife and I became more sexually active during this time period and it helped with the frustration. There are plenty of ways to give your wife orgasms without a hard penis and you can have orgasms without erections as well. I think there is a lot of danger that you will drift apart if you shy away from each other physically. I felt more vulnerable and maybe even a little foolish without an erection at first, but without the sense of urgency I was able to focus a lot more on her needs which paid dividends in the long run. It's important to keep stimulating the mind if you ever want your penis to get the message. It is the brain that will ultimately trigger those nerves. So stay sexually active even if you aren't doing what you like to do best. This can take anywhere from six months to two years, so don't get too upset after only eight weeks. Relax and get your mind in the gutter. Your penis will follow someday.

EB02,bghjul...thank you for your words of incouragements. I have heard and read boards where people say that they were up and going in weeks. But I somehow find that hard to believe, as some people are not honest in what they are or actually wnet through. You two are one of three people that have posted that actually are truthful. I agree that I need to get my mind focused on other things, more time with wife and to see how she is doing. I was into music, and other stupid things took me away from it, and I need to get focused back into doing music, and reading. Wife feels that I am not getting any pleasure out of it. I tell her I am. That my pleasure is that she is happy. I have always felt that if your woman feels happy you in turn will both be happy in life, love, sex. So I am not going to concentrate on when my penis is going to get erect. (Like you said bghjul, at 42yo that is a hard thing to do!) So I will keep my mind going. I will take my meds again. I was soo upset that the ED meds did not work that I trashed them, I never knew they were so expensive for so few. EBO2, I have seen the pump, but only in those novalty stores or magazines are they the same ones that the doctors prescribe? Are they safe? Do you know any sites that I can order ED meds on-line that do cost so much? This is a great site. Thank you both

hope it works for you -

my age 53 - four years past RRp - I am dead - winkie curled up and died like a dandelion in a summer drought!

good luck to you!

The vacuum pumps I am talking about are not the toys you see in novelty stores and magazines. They are medical devices that usually require a prescription. I have used the Osbon Erecaid Esteem manual model. On another forum, many guys are satisfied with a device called Vacurect. You can look these up on the Internet. My doctor prescribed the Osbon and suggested six weeks after my robotic surgery in 2005 that I pump myself to three erections per day to prevent shrinkage and atrophy of the circulatory system that produces erections. These systems come with vinyl tension rings that can fit over the penis to hold the erection after the pump is removed. My doctor did not want me to use the rings at first, but just to use the pump to establish a therapy regimen for the penis to promote recovery. I also took 50 mg of Viagra three times a week, initially not to promote erections, but simply to establish blood flow. Eventually I experimented with the Viagra and pump in combination to sustain erections. The pump definitely over time helped me recover my original size. My doctor also wanted to begin injection therapy after three months, but I was too squeamish. Many guys have told me that the injection therapy was the turning point in their recovery. If I had it to do over again, I would have started it when my doctor wanted me to.

I am skeptical of web sites selling cheap ED drugs. I did that once, but when I compared the blue pill to the real thing it was an obvious fake. Live and learn.

This is complicated stuff and it is easy to get discouraged. It makes you appreciate so much more what you once took for granted. But it's worth it to keep trying. You're very young and if you had good erections before surgery, your prognosis for recovery is very good.

I am having surgery soon, so have talked to a number of people who have had it before me. The most surprising thing I have discovered relates to impotence. I "out the word out" to friends that I wanted to talk with post op people if they knew any. The result is that I have talked with four people whose friends, relatives, children, etc. referred me to. I knew none of them, but the people referring me had said they all had a great result regarding potency and incontinence.
What I discovered is that the men, in three of four instances, had sugar coated their recovery, even to their relatives and children. One, for instance, is still incontinent and impotent after 11 years (He did have advanced cancer), one had told people he was potent after three months, but it was 14 months, etc. So, you get the picture. If the cancer is not advanced and the nerves are spared, then return can be optimistically expected, but not as quickly as you hear. We men are vain and find it hard to be truthful with matters below the belt at times. As I heard it said, "God gave man both a brain and a penis, but only enough blood to operate one of them at a time!" Unfortunately, it seems to be the brain that wins out at first after surgery!!

I am having surgery soon, so have talked to a number of people who have had it before me. The most surprising thing I have discovered relates to impotence. I "out the word out" to friends that I wanted to talk with post op people if they knew any. The result is that I have talked with four people whose friends, relatives, children, etc. referred me to. I knew none of them, but the people referring me had said they all had a great result regarding potency and incontinence.
What I discovered is that the men, in three of four instances, had sugar coated their recovery, even to their relatives and children. One, for instance, is still incontinent and impotent after 11 years (He did have advanced cancer), one had told people he was potent after three months, but it was 14 months, etc. So, you get the picture. If the cancer is not advanced and the nerves are spared, then return can be optimistically expected, but not as quickly as you hear. We men are vain and find it hard to be truthful with matters below the belt at times. As I heard it said, "God gave man both a brain and a penis, but only enough blood to operate one of them at a time!" Unfortunately, it seems to be the brain that wins out at first after surgery!!
Flyfisher...to be honest I have not had an erection since the operation in January this year. What I have had is feelings on my penis getting an erection, but not hard enough. It usually takes between 1 to 2 years and if you have good erection before your operation (Like I had) we should have no problems. Men tend to "sugar-coat" thier manhood. But only it makes you depresssed. It's good to get it out in the open. Make co-workers ask me about this and I tell them the truth. This is a "life-altering" delima. I caught my cancer at the beginning. And I was glad I did the RP, it's better to live then die b/c of wanting to "maintain" and erection. I will let body mend. And ask doctor questions that I am having now. Flyfisher, you are going to be alright. I will pray for you.

EBO2, I have seen these same vacuum pumps in the magazine, and on-line. I thought they where just people using them for longer erections, not for medical use. My question is why get a prescription when you can just purchase it on-line. However I am going to ask my Urologist about a Rx. My question is: What is the difference between just masturbating and the pump?

Nate -whether or not you get a prescription, I would consult a physician before using a vacuum pump. These pumps do some pretty serious stretching of the penis and expansion of blood vessels. So you would want to make sure that it's safe for you. You wouldn't want to break anything down there. My doctor required an orientation with a male nurse to make sure that I understood how to use it correctly.

As for the difference between the pump and masturbation - the pump actually produces a true erection. I assume at this point when you are masturbating, it is without an erection, even though there may be some blood flow. The pump is actually producing an erection and is stretching the penis and expanding the blood vessels in the process. If you use the bands to hold the erection, initially the penis feels almost unnaturally hard as the result of trapping the blood in the expanded vessels.

I think masturbation is good post-surgical therapy, and it is particularly helpful in reestablishing orgasms. I'm sure it is helpful to blood flow as well, and it's just plain fun. But I don't think it has the same level of therapeutic value as the vacuum pump.

Nate
I have read that if you don't work the penis at this stage it will atrophy. Thats scarey isn't it? The idea is to get blood into that area. The pump will help regain the inches lost during surgery and will pump blood into the penis. It turns purple filled with blood. You can beat the thing to death and not accomplish what the pump will. It has to be used carefully. But it does help. The ED drugs also help bring blood into the penis. They are worthwhile. They also make masturbation easier.
You just had surgery and you can't expect tremondous things so quick. Give it time.

I agree with whats been said about those speedy recoverys where a guy has surgery and two weeks later is having sex with his wife. A lot of lies are being told.
It takes time. Good luck to you.

Regarding stories about "speedy recoveries": Yes! I've read posts where guys have come out of RP surgery and are in the recovery room and the attending nurse observes that an erection has occured. While I don't doubt that there's always room for that "miracle" recovery, I can't help but think that much of those kind of posts are a combination of wishful thinking and high levels of testosterone and bravado. We all know those bar-room bravado types that always have a story that is, "One better than yours!"

I believe (only my humble opinion) that the vast majority of post RP patients are in a daily struggle with incontinence and ED and are seeking "honest" posts from "truthful" individuals that have no vested interest in frustrating others by telling their bar-room bravado stories.

Regarding "nerve sparing" surgery: I watched a live webcast of a da Vinci (nerve sparing) RP a few weeks after my operation was completed. This webcast featured the same team that did my da Vinci procedure. It was facinating! The one thing that was made very clear in the webcast was the "nerve sparing" segment of the procedure. Although the team was very careful during this particular segment, there's no question, from what I viewed, that the nerves are stretched and moved around quite a bit. There's no wonder in my mind that there's temporary trama to these nerve bundles. There's also no question in my mind, after viewing this webcast, that it is completely understandable that these nerve bundles will require plenty of time to return to their original position and state within the abdomen. I'm almost 7 weeks post-op and I must say that my progress is very slow but I do see gradual improvement. Yes, maybe someyimes it is wishful and hopeful thinking but, I believe, that kind of optimism and confidence all contributes to overall healing. Maybe a wholistic approach? In summary, I plan to give it plenty of time. Why? Because I have no other choice. Best wishes guys!

Nate the Great/Tony,
I'm 1 year post-op from da vinci nerve sparing surgery. Tony, my post-op path report was nearly identical to yours. My PSA' since have all been
undetectable, scheduled for another April 2. Incontinence much better, wearing 1 Serenity pad/day, mainly for security reasons. Nice to have the urinary stream of a teenager again. Visit the bathroom often though as I drink a lot of water. I'll live with it though. On the potency front, things are progressing slowly. I've tried Viagra/Levitra/Cialis with limited success. Levitra seemed to work the best. Get quite a few free samples from my uro.
Also have the Osbon pump, which works quite well. I too have heard the stories of guys getting continence and potency back after a relatively short time. But I think they're exceptions to the rule, not what most of us experience. But I have adjusted to the fact that I'll most likely never be exactly where I was pre-surgery, except I'm cancer free! That's a VERY GOOD THING!

As you can see your not alone. We all are going through this same struggle. My advice is to keep your mind right, get plenty of exercise, do what you can make your wife happy, and be patient.

We are all in the same boat with you. Trying to get up stream.

Hi adgetter2;

Nice to hear from you. It's encouraging to get some post-op data from a veteran like you. Yes, things may never be "exactly" the same but that's okay. Just another speed bump of life! The key to us post-op guys seems to be "creativity and innovation". Like maybe learning to ride a bicycle all over again. Maybe not even that difficult! I'm learning that attitude has a lot to do with my recovery. Good days and days that are not so good. Hopefully the former out numbers the latter. Thanks again for the encouraging words. Peace!

tony, jackcc, adgetter, and bghjul and others:

Question? Are all of you currently using "Vacuum devices?" If so what brand? Are they battery operated or manual? Which is better? They seem expensive, does insurance cover these Rx? I would like to see a webcast of such operations on "Radical Prostatemy" I tried Viagra (which is taunted as the best cure all for ED, so THEY say!) I would of NEVER know that life would hand me having to depend on the "lil' blue pill" I feel down sometime and have to think of happy thoughts to pick myself up. Cialas did not work niether so I guess I will try Levitra. So, I need to take these ED pills even if I do nor attempt intercourse? I have an appointment for a "follow-up" on 12 April.

RE: Vacuum devices...

Sorry I can't comment. I'm not there yet. Still dealing with incontinence issues.

Me and my wife have an agreement...

NO WET SEX!:eek:

Nate the Great/Tony,
I use the Osbon manual model. I figured the less complicated device the better. Would hate to run low on battery power at a critical moment. This was the make my surgeon and urologist recommended. I'm blessed, my insurance covered it all. Tony, I agree the incontinence issue can put a damper on sexual relations. Creativity is the key. Sometimes you have to forget spontaneous sex and plan it out, like watching what you drink before, etc. I think most importantly though is to discuss openly with your mate your concerns and fears. I've been married 31 yrs. to a real "GEM" who has stood by me through all this. She made my recovery so much easier. Take care guys, feel free to post more questions. I think I speak for a lot of us that these boards have been a tremendous help and support before, during and after treatment.

Yes adgetter2;

Me too! Married to a real "gem". 34 years this past Sunday. She made his journey much easier! I'm surprised your "equipment" was covered by insurance. Pretty good policy!

For those who want a video on the Da Vinci system, there is one on the Vanderbilt site with Joseph Smith.
My urologist said he has had one patient who had an erection while still in the hospital, though the patient "later had some difficulty." He has done 900+ open prostatectomies.

There's a live webcast of the entire da Vinci RP procedure that was saved and is now available over the internet. This is the same team that did my da Vinci procedure. It's amazing to watch the nerve sparing manuvers and how gentle and delicate they are with the robot arms and attachments. I was blown away seeing the same faces on the webcast that I saw when I was escorted into the OR. Pretty neat! ( REMOVED )

The radical prostatectomy (RP) is the complete surgical excision of the prostate, seminal vesicles, tips of the vas deferens, and, depending on oncological considerations, surrounding fat and nerves.

Laparoscopic radical prostatectomy (LRP) is a minimally invasive form of radical prostatectomy, an operation previously done with open surgical techniques. I believe sometimes this is referred to as “keyhole surgery”.

The original way an LRP was performed was with human guidance of the surgical instruments and camera. One of the more recent ways they perform an LRP is with the assistance of a robot to guide the surgical instruments and camera. The surgeon controls the robot arms using a remote console and his assistants are at the robot sidecar to change the various surgical tools required by the surgeon and assist the camera.

My surgery was performed using the “da Vinci” robot. The best ways to learn about this particular robot assisted LRP is to do an Internet search for “da Vinci LRP” and visit the many websites that describe this technique.

Hope this helps!

I'm new today to this board. What a wonderful help this is!!! I had the Davinci LRP Feb 21st. My original urologist only suggested the open radical prostatectomy and I didn't know any other method until I searched the internet a bit. I'm really greatful that I found the davinci internet site. It linked me to a urologist and hospital in my area. The doc was able to spare nerves on both sides but for now, my penis has no erectile function. I can come to climax but it's funny because I ejaculate urine.:) I do Kegals all the time and today, I didn't have any leaks all day for the first time since the surgery. I still leak at night though in my sleep. Thank you all so much for your honesty and candor.