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Prostate Cancer Network
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AM erections at age 70

Just wanted to check in and possibly give some hope to others.

Decided to have surgery 2 1/2 years ago. I was 68 at the time and in good health, exercised regularly all my life (no Diabetes, vascular disease, some BP elevation treated with losartan) with a PSA of 6.4 which had fluctuated around 6.0 for 7-10 years. The Opko 4k blood test resulted in my deciding to have a biopsy (offered with IV sedation). Gleason 7 [4+3] and [3+4]. I work in nursing homes and met enough men with advanced PC to decide I needed to rid myself of the 45 gram beast within. If I didn't get treated I'd go berserk in spite of the fact that my wife and I had a pretty active intimate relationship.

Erectile Dysfunction followed surgery despite "nerve sparing". Used cialis, viagra, rings, pumps,

L-arginine, turmeric with inconsistent results.

Well...in the 30th month of recovery I've had 4 AM erections sufficient for penetration this past week! Bottom line - keep trying to improve your physical and mental health.

PS: It would be really helpful when posting to include your age, other health issues, previous treatment/duration of treatments.

Hang in there! Thanks for reading.

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Sounds like you're doing extremely well. There's a lot of 70 year olds who haven't had a prostatectomy that don't do as well.

The only thing I can think to say is, "Keep it up" :)

Alan

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Hi

My post-op ED experiences are similar to yours.

But on most AM awakening erections l can't put it into action before it gives up and goes soft 😥.

Still l live in hope☺.

Regards Roland 71.5 yrs

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Hi, I don't know if you'll get this reply, it's a while since your post. I have experienced erections which evaporate at the vital moment. (After prostatectomy). In my case it was performance anxiety. I'm not saying that this is definitely what your problem is, but it sounds like it. I got over it by using low dose Cialis to give me more confidence. Mainly, I consulted a psychosexual counsellor who worked wonders. It's worth a try.

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Hi tim2131,

Thanks for your comments .... I don't feel my ED problems are due to performance anxiety, but are pretty much due to post-op nerve damage.

The surgeon did do "nerve sparing" but things only work intermittently. I've tried the Cialis and Vacuum Pump routes to no avail. The pre-op days of "up for instant action" pretty much any time are gone. Having never suffered with performance anxiety, I feel my path is now pretty much set .... very little ... not very often. Even then I have to hand start the little bugger !!

Anyhow, glad the counselling route has worked for you.

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Yes of course the main cause of your erection problems will be due to the effects of nerve trauma immediately after the surgery. You know yourself better than I know you so you are probably right about performance anxiety.

There are lots of factors which affect erectile rehabilitation following surgery. The reason I suggested there might be a psychological element is your mention of AM erections. You may be already aware of this, but one of the ways in which physiological ED can be distinguished from psychological ED is that with truly physiological, AM erections will be entirely absent.

I just thought it might be another avenue you might like to explore.

Don't dismiss the fact that we're getting older. I recall from my youth that older cars had to be hand cranked :-)

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Hi again Tim,

I thank you for your helpful postings to me. I know I get the odd AM erections and I can get self induced erections ... after quite a lot of effort and time so I know the erectile system does still sort of work but all spontaneity has gone.

The other discouraging aspect is that since I've had the AUS fitted, immediately post orgasm, I now get considerable but fairly short lived pain around the AUS plumbing scrotal area. I have discussed Penile Implants with my surgeon but in all honesty at 70+ I really can't be bothered with all the hospital visits, post-op recovery etc etc.

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It sounds like you've had enough struggling with this. Spontaneity is important and if you have to struggle to get going it does take that away. I agree, I don't think I'd want an alien device stuck in my Willie, no matter what.

It's easy for me to say, there are other pleasures in life and there are other ways to have sexual pleasures even without erections, but then I don't now have much of a problem myself. I think I'd be quite distressed if I lost it. I hope you can come to accept your loss.

I don't know what advice, help or information you been given so far. Prostate Cancer UK have produced guidelines for dealing with ED following treatment. If you feel you might to try a little more, you might find the guidelines useful.

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Congrats on the AM erections. That's great. Had surgery two and a half years ago at age 70. Emerged without cancer, but also impotent and incontinent. Tried the kegels, etc. for the incontinence, but zip. Just had an artifical sphincter implanted. Working well. Took me a long time to work up to that. Ick factor. But it's great. Now for the impotence. Like you, I was in good physical condition before the operation and was surprised at the Imp & Inc result. That said, I don't blame the surgeon. Just one of them things, and grateful the cancer's gone. I was having trouble maintaining erection prior to surgery though my wife and I could still play around. Now that it's zero, I can still masturbate (Who knew?) but any kind of sex with spouse is pretty awkward. Have an appointment in August to see about the remedies you mention. Thanks for the encouragement.

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I forgot to mention that I have used trimix. 2 test doses in urologists office were 60% effective but not enough for penetration. Used the uro's recommended dose for 1st trial at home....well I had an E that lasted 3.5 hours despite eating, 120 mg of sudafed, and exercise (hard to do with E). Message here is when you use TriMIX at home for first time go with a dose that is lower than what you used in the uro's office...your womans presence will provide for an effective 0.15cc increase in dosage. And get the autoinjector.

Good luck!

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VERY helpful. Thanks. Will take advice.

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I never knew that an erection could differentiate between AM and PM. Live and learn I guess.

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I’m speculating but in the AM (presumably in a fasted state) more blood is available to help with an erection. Cortisol levels are greater also.

PS- The AM erections was news to me but then again remembering events 50 years ago is also an issue.

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That's great news. There is hope for all of us. Never give up. Where there is a will, there is a way.

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