Sural nerve grafting

[Blackpatch]

I’m almost at the end of 12 months of ADT undertaken with eSRT and, while my T and PSA are both still undetectable so it’s hard to forecast, I am hoping for either a cure or at least a few years before needing to do anything else.

Two years exactly post-RRP and erectile response has been zero despite full nerve sparing - it works with Trimix, but not otherwise.

So... I have decided to see if I can try the sural nerve grafting technique being developed here in Melbourne. The new nerves take about a year to grow in and I reckon it may take that long for my T to recover, so I might as well parallel process and get the graft done ASAP.

They weren’t wildly optimistic at the initial consult because they haven’t really treated men who’ve had radiation or HT, but it seemed like it could happen if penile Doppler scanning shows minimal venal leakage from radiation scarring... I’m having that tested in two months, which will be 12 months post-SRT... Trimix still holds up for a couple of hours so I reckon that issue should be OK, although I gather scarring takes 12-18 months to fully manifest.

Anyway, i’m back on cialis and Trimix/the odd bit of pumping, to try and give it all as good a chance as possible.

It’s not the most important issue in the world, but hopefully i’ll be able to have a crack at restoring some level of natural functionality - they’ve only done 60 guys to date, with ca. 70+% success rate... i’ll update here as events develop.

Stuart

[Dayatatime]

Some men can have a dry orgasm without the nerves intact and when on ADT. It's the natural act of getting an erection that is impaired when the nerves are severed during surgery. ADT makes it much more difficult, but not impossible for an erection because the sex drive is taken away. You can still have an orgasm while on ADT.

[Dayatatime]

I think most of us are on here because we don't want to die from this disease. Some of us are still in our 40's, 50's, 60's and have things under control enough that we can explore options to live a fuller life than what this shit disease took from us.

There is no harm in looking at potential future treatments to bring back some normalcy, especially if a guy remains in a durable remission or even cured. I would love to get back a normal sex life and what it adds to a relationship. At 50 years old and If nerve grafting is an option while I'm still looking at a possible 20-30 years in front of me I will be all over it.

[Blackpatch in reply to Dayatatime]

Hi Dayatatime

100% agree... we’ll put.

The medico-legal environment here means these guys don’t promote their treatment, so international patients have been mainly doctors who’ve read their recent publication. It is accessible, providing you meet their criteria - hence my decision to post re my experience with their process. A lot of us would value recovery of some natural erectile ability, for a few years at least.

Stuart

[Blackpatch]

Hello Nal

That is an extremely intemperate reply, particularly coming from someone who peppers his posts with references to his own prowess in a number of dimensions.

Dayatatime has made a far more intelligent reply below than I care to - for my part, I’d just note:

1) Read the original post! Erection is the issue, not orgasm; I have been able to orgasm throughout ADT.

2) You know SFA about my circumstances so get down off your high horse. I have five children including 10 and 13 YO youngest daughters - my first, second and third priorities have always been survival. I’ve added ADT, including zytiga, to eSRT to shoot for a “cure’ despite a Decipher of 0.91 and pT3b, with a 45% chance of metastatic recurrence within 10 years.

3) That said, my wife is 17 years younger and deserves some consideration too.

4) The RT may well have cooked my erectile ability (TBD) but I drove eSRT knowing precisely that.

Frankly, I only posted in the first place because this sural nerve graft stuff is a bit unusual and I figured some others may be interested - clearly that doesn’t include you... great... my advice is to keep your opinions to yourself if you don’t have anything useful or intelligent to add.

Stuart

[Murph256 in reply to Blackpatch]

I agree that quality of life should always be taken into consideration. And physical intimacy is a big part of QoL.

It’s always a balancing act.

[Tall_Allen]

It sounds like you are really on top of this and at the leading edge of this technique. I look forward to your updates.

[farmanerd]

Thanks for posting about the nerve grafting. I need to keep tabs on it for the future.

For me, 5mg daily Cialis gave a hint that it was doing something, but that was about a year ago and I was only a couple of months into ADT -- it hasn't seemed to help since then. Started pumping just before ART last summer, but had to discontinue towards the end due to skin irritation. Restarted intermittent pumping in December. With T starting to recover, about a month ago, we finally decided to try trimix injections. Titrated up slowly, but nearly had to go to the ER for priapism (about midnight, got up to get dressed and hop in the car, when I was relieved to notice it finally softening. I had even taken pseudoephedrine two hours after the injection). Lowered the dose, but now getting variable response. When using trimix, spontaneity is impossible and vigilance is needed. Even though different, spontaneity can be quite enjoyable without the trimix. I want and choose both, which has no impact upon my ability to also pursue survival.

The very personal question we each ask ourselves is "How do I want to live while I am surviving?"