Hey Steve. Congrats on picking Mayo in Phoenix. They set a standard for care that few other medical systems worldwide can match. I applaud you for your commitment to your wife. Good man!

I’m stage 3 locally metastatic with aggressive Gleason 9. They did nerve sparing on one side but I was warned that I’d be dealing with severe ED for a while or permanently. 6 months post surgery and 4 weeks post radiation that’s mostly still the case as I’m also on Orgovyx and Zyyiga which severely impacts libido and doesn’t help the situation. My oncologist and surgeon both support the idea of my seeing a urologist that specializes in the treatment of ED. I already tried a VED and did not like that at all. I see the specialist later this month and am willing to try the tri-mix shot. I know a couple guys that have used the shot with good success. If that doesn’t work, I will consider an implant. I know two men that have received them and are quite happy with the quality of their sex lives. I’m not giving up.

As for the incontinence and climaturia issue, I suggest you consider getting an appointment with a physical therapist that specializes in pelvic floor rehabilitation. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/pelvic-floor-physical-therapy-benefits I just started treatment yesterday and while my main concern is reducing urgency I’ve been told that I’ll also benefit somewhat sexually with increased blood flow and full resolution of the occasional climaturia that I experience.

Hang in there Steve! Never give up!

Bob