Post Operation Erectile-dysfunction

[Wakeyguy63]

Hello allI'm 12 weeks in post op since my successful robotic prostatectomy for prostate cancer.

I'm recovering generally, very well. Incontinence is getting a lot better now. Down to using a small pad.

My main issue now is on attempting masturbation, I hhave no erection, or sensation feeling at all. Just limp even if i take 30mg cialis. Plus I constantly leak a lot of pee the whole time I'm trying to masturbate.

I can soak two hand towels in a couple of hours, or for as long as I try to achieve anything.

I fully empty my bladder beforehand, dont drink much before either. I've just no idea why I constantly leak pee the whole I'm trying to wank.

Any advice please.

Thanks Neil

[xsevenx]

Sorry you are going through this. I hope things improve and your surgeon is helping you.

[EDgreen]

It can take up to 18 months for any functional erection to return - the length of time and the strength of the erection depending on several factors, such as age, general health, and how successful was nerve-sparing during the operation. One has to patiently allow the body to recover, and no one can predict what your outcome will be. That said, 12 weeks seems unrealistic to expect Cialis to help.

Some urologists recommend taking a 5mg daily dose of Cialis to maintain healthy erectile tissue, but it's not universally accepted. If you have no cardiac or other health issues, speak to your doctor about upping the Cialis dosage. My urologist told me some men take even 90mg.

If Cialis doesn't help, you can try the injections. They're a bit of a headache to use, and one has to get over the psychological issue of sticking a needle in your most sensitive part, but if you can do that and you have no painful side effect, though many men - including myself - do, then that will give you an almost immediate and useful erection. Here too you will have to start low and up the dosage until you get what you need.

About the leakage: exercise your restraining power throughout the day whenever you get an urge to pee. Do Kegels exercises also.

It is more important to focus at this point on getting erections and holding your pee during the day. Masturbating without an erection, especially if you're also leaking, may only frustrate you, but otherwise you can just pleasure yourself without regard or concern about results and let whatever happens to happen.

Though the erection nerves are still not functioning, other nerves in the pelvis that prepare the body for ejaculation are, which put pressure on the bladder and cause you to leak. Your mind is also elsewhere and not focused on restraining. Eventually you may be able to withhold your pee until ejaculation, which in some men shoots out the contents of the bladder instead of semen.

Be kind and loving to yourself. That's really the most important thing.

[trimix52]

There is a lot of reading you need to do! Assuming you had nerve sparing surgery your erectile nerves were still damaged and may or may not recover. Some say up to two years to regain erectile function. In my case, 5 years out and no recovery on that front and most fixes haven't worked. I know it is hard to believe, but you are still in the first turn of this race.

[Wakeyguy63]

Thank you for the response. Much appreciated. I've noted your comments. Neil

[Surv]

Another option (if you have not tried already), is the use of a vacuum erection device (ved) or pump. Once I successfully conquered the incontinence hurdle, I began using the pump which brought me to full erection strength…..no pills needed. The pump, with its clips and bands will allow full manual stimulation and let you experience ejaculation. I used the pump every other day for the first several months and now use it a few times a week to replace the morning erections I had prior to surgery. For intercourse, I use the pump/band combo or a quad-mix injection. I try to vary the approach as sex feels different with each. I’m also taking 5mg Cialis daily,

Don’t be discouraged. As the other posters have said, it takes time. I’m coming up on 3 years post surgery and it’s taken a while to get sensations to return to normal. I’m 52.

[Wakeyguy63]

Thank you so much for the advice. Im also taking 5mg of cialis every day. Once my incontinence is sorted, I’ll try some of the techniques you suggest. My problem with tbe pump , which I do have is due to penis shrinkage following surgery, and I wasn't well endowed to start with unfortunately, has made the size in the pump when erect, now a lot smaller than before sadly. But as long as it's big enough to wank with and orgasm, I'm not too worried as nit having a partner, I don't have to worry about intercourse and letting anyone down due to my size now. Thanks again.

[luvbunda41]

your body is still healing. Do a lot of kegel exercises and keep using daily cialis and a pump

[Jacob_S]

Hi Neil,

Firstly, congratulations on your successful prostatectomy and your progress in recovery!

It's not uncommon to experience erectile dysfunction post-operation, especially after a prostatectomy. However, there are several options available to address this issue:

Medications: You've mentioned trying Cialis (tadalafil), but there are other medications like Viagra (sildenafil) or Levitra (vardenafil) that might work better for you. Sometimes, it's about finding the right dosage or combination that works for your body.

Penile Injections: Another option is penile injections, such as alprostadil, which can help induce an erection. This method might be more effective for some individuals, even when oral medications aren't working.

Vacuum Erection Devices (VED): These devices use a vacuum pump to draw blood into the penis, creating an erection. They can be effective for achieving and maintaining erections, especially when combined with a constriction ring placed at the base of the penis.

Penile Implants: For more severe cases of erectile dysfunction, a penile implant may be considered. There are different types available, including inflatable implants and malleable (semi-rigid) implants, which can restore sexual function.

In addition to addressing erectile dysfunction, managing urinary leakage during sexual activity is crucial. Pelvic floor exercises (Kegels) can help strengthen the muscles that control urination, potentially reducing leakage. However, if leakage persists, speak with your healthcare provider as they may recommend additional strategies or interventions.

It's essential to have an open and honest conversation with your healthcare provider about your concerns and explore all available options tailored to your specific needs and circumstances. Don't hesitate to seek support from a urologist or sexual health specialist who can provide personalized advice and guidance.

Take care, and best of luck on your journey to recovery.

[Wakeyguy63]

Thank you Jacob for all of your detailed advice. Much appreciated. I'm doing very well with the inconvenience issues. Just wear a small pad in my pants now, 15 weeks in. I'm using a vacuum-pump, also increased cialis. I have managed 3 good dry orgasms so far, albeit with a very flacid penis, but still with quite bad pee leaking throughout masturbation. Doing my pelvic floor exercises 4 times a day. I appreciate the help. Neil