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Had A Robotic Prosectomy. Problem In Erection, Swollen Penis. Practice Masturbation, Strong Sex Drive, Having Orgasm. Suggest?

Posted on Mon, 20 May 2013

Question: I am 61 years old had a Robotic Prosectomy 2 years ago had promise of developing an erection however as time goes on progress has increasingly waned. Do I give up all hope of ever attaining one ever again. I am in very good physical shape work out every morning and practice masturbation every other day. Sex drive is strong and I achieve orgasm even with a slightly swollen penis.

Answered by Dr. Dr. P. T. Patil (32 minutes later)

Hello
Thanks for your query.Based on the facts that you have posted it appears that you have undergone Robotic Radical Prostectomy for cancer of prostate 2 years back and now facing problem of Erectile Dysfunction.

During any radical surgery for cancer prostate there is possibility of injury to the nerve plexus in the vicinity of prostate which are involved in process of erection. In majority of cases this injury to the nerve plexus is transient and gets resolved by regeneration of nerves over a period of year or so resulting into getting normal erection.

But in some cases it does not happen so and leads to Erectile Dysfunction.

Please consult qualified Urologist and explore the possibility of trial of medicine like Phospho Diesterase inhibitors (Sildenaphil) or putting Penile Prosthesis.(Penile Implant) so that you can enjoy your sexual life,

Hope I have answered your query.
Please feel free to ask if you have any more questions I shall be happy to help you.
Thanks with Regards.
Dr.Patil..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (5 hours later)

I understand there are medications to help, I have tried Cialus, Viagra, and Levitra which in the first year seemed to very mildly work. However in the last year results seem to have waned. My question is do you think that there ANY hope in the years to come for any regeneration or even semi erection other than using injections or implants. I can't believe I am in the physical shape that I am yet I can't exercise or rejuvenate this muscle group.

Answered by Dr. Dr. P. T. Patil (8 hours later)

Hello
Thanks for follow up.
Since there is improvement in getting erection even after years of surgery there are less chances of regeneration and getting normal erection

The drugs which tend to improve erectile Dysfunction have their action on vascular component of erection and not on nervous component of erection.

The only option left is to put Penile Prosthesis (Implant).
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (13 hours later)

One more question and it may be related to the erection problem. I have recently had some back or sciatica problems which were resolved by epidural injections. Months prior to the problems however I noticed I would cramp once in a while as well as get a strain pain on my inner thigh. I also noticed that I was losing strength in the same leg I am wondering if all of this could be circulatory in that my ability to attain an erection during this same time diminished.

Answered by Dr. Dr. P. T. Patil (18 minutes later)

Hello
Thanks for writing again. Problem of erectile dysfunction can not be due to sciatica.It is definitely secondary to robotic radical prostatectomy.
Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar