Erection After Robotic Surgery

Some general observations with no details of your diagnosis  or skill of your surgeon:

It is possible to have erections after surgery. The time frame to regain erections can vary greatly

It is also possible to have a very good sexual relationship, and many say their relationshop is better than ever.

We incorrectly relate orgasm with ejaculation.

Although there will be a los of ejaculation (fluid): a man can still experience sexual climax without erections or ejaculating, as orgasms take place in the brain.

The expertise of your surgeon will have a large influence on your outcome. Assuming one or both nerves can be spared, time for the trauma to subside varies greatly.  Two men I know recently said their functions were good after 6 weeks, which can be a common time frame,  but you'll find many instances where it can be a lot sooner and  others where it can be considerably longer.

Dr Stricker of St Vincents Prostate Cancer Centre Sydney recently posted news on his progress with nerve sparing Robotic surgery and Prof Patel who is a world leader in the technique. You'll find useful information on their websites.

Regarding how to prepare and general recovery time:  it's important to remain active and keep up physical activity before surgery. Maintain a normal balanced diet, do kegel exercises, cut down on alcohol, no asprin, or supplements that affect blood.

Successful Robotic usually has less general  trauma and he should be active within days. Moderate exercise and  walking is good, but no heavy lifting or anything overly strenuous for a few weeks. A common problem is for some to think they are completely back to normal within days, and do something counter productive, so DO NOT OVER DO IT.

Viagra (LOW DOSE) or similar is often prescribed to take on a regular basis soon after surgery as it's believed to assist blood flow and healing.

The chance of impotence even with nerve sparing surgery is 70 percent and in 80 percent Viagra does not work.  The chance of incontinence depending on definition ie drs say 5-10 percent but base it on using up to 3 pads a day.  Patients rate it at over 20 percent ie (having to wear a pad , period).  After irradiation without ADT about 40 percent of men eventually lose sexual function, which in 80 to 90 percent of the instances is treated with Viagra.

As John states in irradiation and surgery there is a trend towards using low dose Viagra during and after treatment to increase CAMP levels and keep the vessels open.  This is thought to reduce the impotence.

All prostatectomies causes some insult to the nerve bundles, which are quite delicate. "Nerve-sparing" surgery means the bundles are not cut; it doesn't mean they're not bruised or harmed. The surgeon will be able to say immediately after surgery whether one or both nerve bundles were spared; he won't be able to say whether they remain perfectly functional.

There's a very wide variation on how long men start to regain erectile function post-RP. In rare cases, erections might return the following day without any artificial assistance. More usually, patients will have total ED at first, and should start taking a PDE5 inhibitor (Viagra/Levitra/Cialis) to keep the blood flowing to the region. If erectile function remains poor for the next 6 weeks or 3 months or so, escalate to VEDs (vacuum erection devices) or injectibles such as Caverject, bi-mix, or tri-mix.

After prostatectomy, orgasms should return, but there will be no ejaculation at all. Radical prostatectomy excises both the prostate gland and the seminal vesicles, and so there is no seminal fluid. There are rare exceptions where a very small amount of other fluid is secreted by other glands, but you should expect that all orgasms after prostatectomy will be completely dry (or maybe with a smallish squirt of urine -- not as bad as it sounds).

Gleason was 3+3=7; PSA presurgery was 7 or 8; Robot P 11/19/07.

Thanks for all of the info that you provided to my questions.  Everything went just a you said - GOOD!   ED exsit.  Biggest problem is the incontinence.  5 to 7 diapers daily.  Incontinence is out of control.  Foley stayed in for 14 days.