USE IT OR LOSE IT

There has been a good deal of discussion regarding the best method of preserving the erectile function after treatment - surgery in particular. Despite advances in surgical technique, including the use of laparoscopic and robotic approaches, most contemporary reports continue to demonstrate significant rates of erectile dysfunction.

A study pubished in February, 2009 Penile rehabilitation following treatment for prostate cancer: an analysis of the current state of the art summarises some of the current views and concludes that there is cealr evidence supporting the importance of an experienced surgeon in improving rates of erection preservation and that evidence shows improved erectile functioning among patients exposed to intracavernous vasoactive injections and/or PDE5 inhibitors such as Viagra, Levitra and Cialis is supported by the bulk of the data in reports.

THE ADVICE BELOW IS BASED ON A PROGRAM DEVELOPED IN A LEADING CLINIC IN THE UNITED STATES AND WAS WRITTEN IN MARCH 2008. AT THE TIME OF WRITING THERE WERE NO PUBLISHED STUDIES THAT CLEARLY SUPPORTED THIS THERAPY, WHICH SHOULD BE DISCUSSED WITH YOUR MEDICAL ADVISOR BEFORE IT IS UNDERTAKEN.

Erectile Tissue Preservation For Patients Undergoing Radical Pelvic Surgery

The erection nerves travel along both sides of the prostate on their way to the penis. During the prostatectomy procedure, these nerves are manipulated to allow access to and removal of the prostate gland. Even in cases of nerve-sparing operation, some decline in nerve function occurs, lasting for up to 24 months. As a consequence of this nerve dysfunction, the erectile tissue in the penis may undergo atrophy (degeneration). Early treatment, starting even before the surgery, has been shown to protect erectile tissue and may facilitate the chances of erectile function recovery. The following course of action is suggested to minimise atrophy and optimise recovery:


Take Viagra 25mg (a quarter of a pill) before bedtime, nightly. Start this treatment 2 weeks prior to the surgery. You should not expect any erection to occur at such a low dose.

Discontinue Viagra 25mg the night before surgery and during your hospital stay.

Resume Viagra 25mg nightly, after you are discharged home even with the catheter in place.

After catheter removal (usually at 7-14 days after surgery), consult your surgeon whether it is safe to attempt to get an erection.

After this time (usually 2-3 weeks after surgery), switch to Viagra 25mg 6 nights per week and Viagra 100mg once per week. The Viagra 100mg dose should be taken in an effort to get an erection. Take the pill on an empty stomach (we suggest 2 hours before your evening meal). The pill lasts at least 8 hours so you will have plenty of time to attempt stimulation.

It is suggested that you should make 3-4 attempts at Viagra 100mg after surgery before you see your doctor again - usually about 6 weeks after surgery to discuss how you responded to the Viagra 100mgs dose.