Erections usually begin to return as partial erections 3 to 6 months after surgery and then continue to improve for about 36 months after surgery, as the nerves recover from the trauma of surgery. Despite expert application of the nerve-sparing prostatectomy technique, early recovery of natural erectile function is uncommon. Even when the nerve-sparing surgery is performed with meticulous technique, patients do not recover erectile function as quickly as they do urinary continence.

Yes, nerve sparing radical prostatectomy was started in the early 1980's. I have been performing this operation since 1984 with very rewarding results.

Furthermore, postoperative erectile dysfunction is compounded in some patients by preexisting risk factors that include: older age, cardiovascular disease, diabetes, cigarette smoking, physical inactivity and taking of some medications such as anti-hypertensive drugs or psychotropic medications. The impact of these risk factors on patients’ eventual outcomes has led to the acknowledgment that rating erection recovery potential after surgery should involve relevant risk factors.

The nerves are like railroad tracks with the prostate being like a boxcar on top of the tracks. In this surgery, doctors try to gently lift the “box car” off the railroad tracks without damaging the “tracks.” If the cancer is detected early, then the prostate can sometimes be removed very nicely without disturbing the nerves.

Almost any man with localized prostate cancer who chooses to have his prostate gland removed is a candidate for the nerve sparing operation.

The concept of focal cryosurgery is to freeze that area of the involved prostate gland and leave the other side unfrozen. This has the potential advantages of causing no urinary or sexual dysfunction, but may leave unfrozen prostate cancer on the other side. Even if the biopsy did not reveal cancer, there can still be areas of small cancer that were not detected on biopsy.

Bladder capacity is usually reduced somewhat by the surgery, but the main cause is that, after surgery; the bladder wall is swollen and thickened and irritable. Normally, the bladder wall is thin and elastic and maintains a low pressure until it has stored 8 to 10 ounces of urine. After surgery, the swollen bladder does not store much urine at a low pressure. As soon as it starts to fill, the pressure goes up and you feel the need to urinate.

a: Even with just the device used alone, most users felt their erections were stronger due to the increased cell activity and blood flow. In addition, with the ProExtender System, you get a powerful erection enhancer in pill form, which further enhances hardness and staying power.

It is not possible to say for certain where the recurrent cancer is located, but there is about a 70% chance that it is in the “bed of the prostate” (where the prostate used to be). Accordingly, radiotherapy has a good chance of controlling it. After the prostate gland has been completely removed, any PSA in the blood is produced by prostate cancer cells that have left the prostate gland and spread to other areas of the body.

With any cancer, not only prostate cancer, there’s always a possibility that the cancer can come back and that’s why patients need to have follow up visits. I recommend a PSA test every six months for 15 years after the operation.

The two treatment options are postoperative radiotherapy, which should begin before the PSA rises above 1.0ng/ml, and intermittent or continuous hormonal therapy, which can be initiated immediately or delayed until the PSA rises to 4.0.

This swelling could be related to lymph node dissection, which sometimes causes swelling in the groin, penis, scrotum, and pubic area. In such circumstances, I recommend a visit to the surgeon and perhaps a CT scan of the abdomen and pelvic region.

Uncomfortable or painful hernias have been known to cause such problems, because erectile function is very easily interfered with and if one gets any kind of pain with erection, the self-defence mechanism kicks in and prevents the pain by reducing the erection. It can be as simple as that. This should get back to normal as soon as the underlying cause, namely the hernia, is dealt with.

Sexual stimulation is required for VIAGRA, CIALIS and LEVITRA to work. You will not get an erection just by taking the medication without sexual stimulation.

The neurovascular bundles or nerve bundles, one on the left side of the prostate and one on the right side carry nerves and blood to assist in achieving an erection. If surgery is chosen as the treatment of the cancer, these bundles may or may not be spared.

The hospital stay for prostatectomy averages about five days and depends mostly on the nature of the surgery and the health status of the patient. In addition, a high level of patient support from others, including family, relatives, and friends, can promote the healing process and shorten the hospital stay.

A radical robotic prostatectomy incorporates the advantages offered with laparoscopy together with the delicate maneuvers and techniques previously only available with open surgery. Standard laparoscopic instruments can be cumbersome and do not avail themselves to delicate surgical procedures. Minimally invasive robotic radical prostatectomy allows the surgeon to perform sensationally an "open" radical prostatectomy without the need for the large incision.

bull;Greater surgical precision, which, in turn, potentially means more accurate removal of cancer and reduced risk of impotence and incontinence

While the da Vinci technology allows for the precise translation of the surgeon's movements while eliminating any tremor present in all surgeons’ hands it does not provide tactile feedback. As surgeons however, we rely on tactile sensation only when we do not have an accurate or clear view of the operative field. The camera system utilized with the da Vinci system is a clear 3 dimensional field with ten times the magnification of even the surgeon with 20-20 vision.

Usually, the patient is in the hospital for 2 to 3 days. The catheter remains for 10 days. The patient can drive once the catheter is out. No vigorous exercise should be performed for 6 weeks. The patient can return to work after 3 or 4 weeks, but he usually tires easily because of anemia for the first 6-8 weeks.