Currently just the beginning of a work in progress needing a lot of work.
While much is discussed about Nerve-Sparing surgery for Prostate CAncer, the truth is that the vast majority of men that undergo surgery as well as those that undergo external beam radiation as a primary treatment for prostate cancer suffer a significant reduction in erectile functioning. When you add this to the fact that most men with prostate cancer are older males with some age-related decline in erection quality or the frequency it usually results in
Erectile Dysfunction. Even if erectile functioning ultimately returns it is likely to be present in at least for the initial months following surgery. If your primary treatment was radiation then the effect will likely be just as significant but delayed and gradually increase many months after radiation.
I will start by saying that the penis needs oxygen which comes from erections to maintain healthy tissue. That is why males routinely have night-time erections (
NTE's). With an absence of blood flow, it sets up conditions for
plaque or
fibrosis that if present will cause a loss in size and/or deformity in the way of dents and bends. At times such deformity can become severe.
The goal has to be to restore erections as quickly as possible with any method that is not itself damaging to the penis. I would recommend starting with the following:
Daily low-dose Cialis which is designed to support erections on demand rather than taking a pill only for intimacy.
I would add to this over-the-counter
L-Arginine 1,000 - 5,000 mg a day.
L-Arginine is a vasodilator that can help by itself but works synergistically with
PDE5 Inhibitors like Cialis, Levitra, etc.
I would strongly consider adding 1/2 of a 50 Mg Trazadone with a light snack before bedtime. Trazadone is an old antidepressant. When prescribed for depression it is dosed as high as 600 mg daily - Trazadone has a side-effect of causing
NTE's. In fact in healthy men at high doses, it can cause
priapism, a condition of a prolonged erection that needs urgent attention. It is dirt cheap costing pennies a tablet which you cut in half. If you have a good Dr. you can tell him you want it for the side-effect of
NTE's as you heal and try to regain functioning. If you have an uncooperative Dr. sugguest you need it for sleep since it is often prescribed at those low doses for sleep. More is NOT better. if it is going to work it will work a 1/2 of a 50 mg tablet with a snack. And NO, it does not do much for daytime usable erections. If has been established that
NTE's use different nerve pathways than stimulated daytime erections.
I would also get a good Vacuum Erection Device to induce erections twice a day to preserve day-time blood flow and maintain size. Do not use the constriction band unless you are planning to have sex.