LRP Recovery - ED

[James]

In my readings from various surgical web sites (really ads for different

surgical practices) - thre are some practices that mention that they encourage

the use of Viagra (or similar) a few times a week post surgery (as soon at

catheter is out)  to assist with ED recovery.  Others go farther and say if no

impact after a month - encourage weekly use of injections for ED.

 

I looked for studies - and found a little - very little on this.

 

So - Dr K - in the absence of knowledge (i.e. good studies) can you share with

us your opinion and practice in this area.  Do you find that using these modes

early on after nerve sparring surgery helps patients recover potency.

 

Now - I know that preoperative function matters, as does overall health and

issues like diabetes etc.

 

But - that aside - have you found that on average - using something like this

helps men who are healthy and potent presurgery - recover faster or better?

 

Additionally - do you have any stats on your younger prostatitis patients (under

55) as opposed to generally older cancer patients - chances of ED recovery.

 

In reviewing your surgical web site for prostatitis - it seems most men still

refer to erections as "a work in progress" or "improving" - and few refer to

recovery of potency.

 

So - I just want appropriate expectations.  Is it fair to say that even a young

potent man will likely have permenent ED after LRP?  Because - if it is - it

would not necessarily stop me or others - but it would be best to know such

things up front.

 

I know a lot of factors go into this - and you are likely going to say "...the

only thing in the surgeons controll are..."  and I get that.

 

But patients like me really want/need to know what we are in for in reality (are

we signing up for a life of impotence or not).  Again - it is not a deal breaker

for many of us - we just need to know.

 

When I review the prostate cancer blog sites - most of those men who had nerve

sparring robotic LRP are basicly impotent (could be those are the only ones that

post....)."

 

[imnotcrazy]

i can tell you this. after the injections my urine stream is amazing . i have never had a erection problem. but i do notice after injections . i can keep it up alot longer!! so they are good for me all the way around. but everyone is different .

[Arnon Krongrad, MD]

James,

Injections do induce erections. Induction of erections is a concept apart from acceleration of recovery of spontaneous erections. One should keep them clearly distinguished. So if a man wants erections and cannot achieve them spontaneously, injections are one method by which his desire can be satisfied. But does use of injections bring about faster recovery of erections? I have not seen data to support that.

The links lead to a review paper and a post by a surgical center. Neither provides original data. The review referrs to "effective" treatments but it's not at all clear that "effect" was demonstrated by placebo controlled, randomized studies. Without such study design, one cannot distinguish selection bias, volunteer bias, and other forms of bias from what one is seeking to test: The idea that medication causes erection, and is not simply associated with erections.

Warning: Injections can be associated with potentially very serious complications, including priapism: An erection that will not go away. These complications can actually lead to permanent erectily dysfunction. One should never use such injections without the supervision of a qualified physician.

[James]

Thank you Dr. - just looking for as much info from someone qualified to give it as possible.
Thank you again.

imnotcrazy - I am refrencing PENILE injections for erectile dysfunction post prostate removal - not prostate injections.
IS that what you are refering to as well?

Thanks again Dr. K.