I was operated for prostate cancer: what can I do for my erection?
Saturday 27 January 2018 Autore: Prof. A. Natali
Topic: Medical therapies in andrology
When we have been operated for prostate cancer from a sexual point of view, we are undergoing significant changes.
First of all we will no longer have the ejaculation. We will retain the sensation of orgasmic pleasure, certainly reduced compared to before the operation, but we will not see anything come out of the penis, because the prostate and the seminal vesicles, which produce 80-90% of the liquid part of the sperm have been removed.
Then it is necessary to know if the surgeon who operated on it (either with robotic technique, or with the classical open procedure) performed a nerve-sparing or non-nerve-sparing technique.
These terms are indicating two different post-operative situations. In the first (nerve-sparing) the surgeon managed to preserve the vessels and nerves (neurovascular bundles) that are important for erection. In the second situation instead these structures have been removed.
The two different types of intervention depend on the local spread of the tumor which can be seen clearly only at the time of the operation. If a nerve-sparing operation was performed, within 12-24 months, with specific medical treatments with vasoactive oral drugs, the pharmacological name is phosphodiesterase type 5 (PDE5-Is) inhibitors (Cialis ©, Viagra © , Levitra ©, Spedra ©), you can get the resumption of a satisfactory erectile activity even without the aid of drugs.
If non-nerve-sparing surgery has been performed, these drugs are not absolutely effective, but a drug to be injected directly into the cavernous bodies of the penis should be used, named alprostadil (Caverject ©). And this drug should always be used to get an erection.
Sex after prostatectomy is not necessarily a problem
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