Question:
Hi, I’m 65 and have enjoyed a strong sexual relationship with my wife. At first I would go limp immediately after orgasm and I would be done even when my wife wanted more. Then it got to the point where o could not get a hard erection. About four years ago for about 8 months I would have a wet dream about twice a week. Because I am a spiritual person I thought it was wrong and would wake up and try to suppress it. My wife and I at the time were not overly sexually active and weren’t for several years. About three years ago I went to my doctor for a good physical checkup. My PSA level was elevated to 6. I then went to a urologist and had a prostate biopsy which showed Gleason score 3+3=6. After discussion with my urologist I decided to watch and wait for a year. I think that because cancer was growing in my prostate that it caused the night time orgasms. That’s just my uneducated assumption. A few months ago I underwent a second biopsy and found progression to 3+4=7 Gleason score. I am scheduled to have prostatectomy next month which will eliminate any possibility of orgasm ever again. I’m disappointed because sexual relations have been a good thing in the past. But at least I will be alive. I wanted to try Sildenafil one time prior to to help get an erection one last time and share the moment with my wife. I also wanted to let men know that if you are suffering from ED do not rule out prostate cancer as a cause. See a urologist for testing.
Answer:
Hi Allan,
I’m very sorry to hear that.
But you shouldn’t not lose faith. Within one year from the surgery, about 40 to 50% of men will have returned to their pre-treatment function. After two years, about 30 to 60% will have returned to pre-treatment function.
An early ED rehabilitation after surgery can help restore erectile function. The success of ED rehabilitation depends on a good assessment of overall health condition (other health issues, medications than cause ED, etc…)
The use of a vacuum erection device (VED) along with Viagra or Cialis before sexual activities usually gives the best results. However, if that doesn’t work, we then consider adding a daily low-dose of Viagra or Cialis for at least 12 weeks (it shows some benefits in some cases), if it doesn’t work, we then consider alprostadil pellets, injections (intra-urethral and intra cavernosal prostaglandins) or topical alprostadil, and lastly a penile implant.
But it’s also very important to include an exercising program, a healthy lifestyle for eating and sleeping, pelvic floor exercises, and psychosexual therapy.
The ED rehabilitation after prostatectomy is a complete rehabilitation program and it may take longer for some men (up to 2 years) to see good results. Please discuss with your doctor the next step of treatment, I can’t recommend a certain step for you now because I’m not fully aware of your overall health status.
Best wishes for a quick and complete recovery.