You are probably reading this because you have had prostate surgery and are suffering from erection problems or are planning to have prostate surgery and are concerned about erection problems after the surgery.

This blog entry with giving you an idea of what can be done to help you get your erectile function back after prostate surgery.

Video on What is Erectile Dysfunction

First of all some pieces of good news:

  1. Recent surgical techniques these days do not damage the nerves leading to the prostate. In other words, leaving a much better chance for you to regain your erection.
  2. Almost everyone will suffer from erectile dysfunction after prostate surgery. So do not worry, you are not alone.
  3. About 70% to 80% of patients will go back to how they were before the surgery in about 6 months.

So what do doctors usually do when they see a patient who has had prostate surgery and is suffering from erection problems?

1. PDE5Is – ED Medications

This is the standard first step. PDE5Is Medicines can all be used for ‘penile rehabilitation’ which is basically the technical term for helping you get your erection back after prostate surgery. One of the erectile dysfunction medication also comes in a 5mg once-daily dose which has shown very good evidence for penile rehabilitation.

Make sure you maximize the dose of these medicines before deciding that they do not work.

2. ICI – Penile Injections

If PDE5Is does not work, the next usual step is to use Intra-Cavernosal Injections. Basically injections into the penis to get an erection. It is very commonly done and really not as difficult or as painful as you might think.

For patients on ICI, we usually get them to try PDE5Is every month or so. Because hopefully there will come a time when the patient starts responding to PDE5Is and does not need the injection anymore.

For more details on ICI and how to do it, follow this link.

3. Vacuum Devices

Remember Austin Powers? This is a device that goes over the penis and by way of vacuum, draws blood into the penis thereby causing an erection. The blood is then kept in the penis by a rubber band or ring the base of the penis.

I must say this is not very popular in Asia. But it is painless and easy to do. Some patients do not like it because they feel it is too ”artificial”.

4. Penile Implants

This is obviously the method of last resort.

Modern implants are actually quite tolerable. It consists of a water bag that is stored in the abdomen and a pump that is in the scrotum. By pumping the scrotum, you get an erection. Most couples use this as part of the foreplay.

5. ESWT – Electro-Shock Wave Treatment

I put this right at the end because the data for this is still not very established for ED post-prostate surgery. ESWT has shown great results for people with ED due to blood vessel problems.

I am sure as we get more data, it will show that this treatment is very good for ED due to prostate surgery.

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