Any info about Penile rehabilitation after prostate cancer treatment?

Posted by milans @milans, May 27 8:31am

As a response to one of my posts (which I seem to be unable to find now) someone suggested “penile rehabilitation”. There was a connection link to a course by a PA in Australia. Have any of you had experience with this? My surgeon started me on Cialis daily low dose which I started when my catheter came out. Not surprised at no erections only three weeks post RP but wouldn’t mind improving outlook for
Future performance. Any recommendations?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

There is a good video on PCRI (Prostate Cancer Research Institute) that discusses this issue. Videos on this site are short, well done and accurate (IMO). See if this helps.

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Patience. 3 wks sounds a bit early.

Very personal: My surgeon's assistant advised that I should "exercise the function". And I have tried to do that.

ED has improved now almost 2 years postop. I also had Salvage radiation treatment w/ 4 mos ADT, and that put a definite 6 mos+ "hold" on ED progress.

I now have improved and for me satisfactory, function, although not equivalent to preop.

Age 72 at surgery; now 74.

Good luck, patience and effort are required.

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I have looked at these sites and read whatever I can find in the literature. Penile rehabilitation, as I understand it, refers specifically to regaining (or not losing) erectile function. There are multiple issues at play, including the health of the smooth muscle tissue that stiffens during erections, the health of the blood vessels which add blood pressure in the penis by fueling engorgement and restricting venous leakage, the health of the nerves which tell it all to happen, and the instructions from the brain that trigger the nerves.
Taking pills is designed to help the blood vessel process, which in turn sustains the health of the smooth muscle tissue that can atrophy, especially while waiting for the traumatized nerves to calm down or otherwise rehabilitate after surgery or while being damaged (progressively) by radiation.
Using a vacuum erection device or a "RestoreX" physical muscle tensioning device is designed to exercise the muscles through external stimulation either by vacuum pressure or physical tension. In hindsight, I wish I had used a "sex toy" available for around $30 online to provide the vacuum pressure early on rather than the RestoreX or a medical grade VED, both of which are over 10x more expensive.
Intercavernosal injections (shots) create an erection biochemically, and the dose is regulated to make it last 30-90 minutes.
Generally the belief is that it is best to start this within 1-2 months after surgery in particular to avoid atrophy while waiting for the nerves etc to recover from RP. Since radiation is progressive, these tools would used as the damage develops.
One thing to watch out for: Generally online content regarding these treatments is funded, directly or indirectly by Boston Scientific, who sell the most common penile implant (physical pump) or the surgeons who perform this surgery. This is not penile rehabilitation, and should generally only be considered when other things don't work, but that message doesn't always come through so clearly.

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Thanks. This is quite helpful

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As I wrote in that earlier reply to you, I included that program in my arsenal to rebuild my sexual life after surgery.

Last year I wrote a story about my recovery journey. It's kinda long, and likens the process to what I had gone thru 13 years earlier when I lost my ability to swim. An excerpt, and then a link to the blog posting:

"Breaking it down, I hoped to reawaken my ability to become erect, penetrate, and produce an orgasm. Up until my surgery, I had taken this all for granted, the anatomic, circulatory, hormonal, emotional, and neurological components involved. But as with swimming, I had always been able to perform, so never gave the details, much less the possible loss, any thought. Now I would have to break down that process, rebuild the components, and eventually put them together."
http://bikrutz.org/triblog/

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Two additional resources for you for penile rehab post PC treatment.

The first resource is https://www.atouchysubject.com/ It's based out of the UK but has great content.

Next is https://melissahadleybarrett.com/

Both are candid and positive. I'd highly recommend them.

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