Erectile dysfunction following radical robotic prostatectomy is a significant side effect. Impairment of erections is due to the unavoidable nerve damage (20-50% of men with good pre-operative sexual function) however, with the introduction of nerve-sparing which is the technique used at the time of surgery, most men should expect to regain erectile function within the first two years following surgery.

The nerves and blood vessels which control the physical part of an erection are known to be very delicate and therefore any disruption to the area will naturally result in a change in erectile function.

Where nerve-sparing is performed at the time of surgery, you will be offered safe therapies that will not hamper the likely recovery of spontaneous erectile function. Phosphodiesterase 5 (PDE5) inhibitors are often used to support erectile function recovery, your Consultant or Nurse Specialist will be there to help you and instruct you on the use of these and discuss further therapies available to you. Please see below for more information:

Treatments Available For Post-Prostatectomy Erectile Dysfunction

PDE 5 Inhibitors (Phosphodiesterase 5) – Cialis, Viagra, Levitra

• Dilates the blood vessels of the penis
• Allows relaxation of musculature
• Requires sexual stimulation
• Safe in cardiac patients, but care needed in assessment to ensure not with nitrates and caution with alpha blockers

How to take them:

• Take at lease 30 minutes before sexual activity (45 mins for Viagra).
• Avoid heavy meals 2 hours prior to taking Viagra (not a problem with Cialis).
• Will require sexual stimulation / intimacy to acquire an erection.
• May require up to 8 doses to gain optimum effect (on separate days).
• Don’t give up!

Possible Side Effects:

• Headache
• Vomiting
• Indigestion
• Flushing
• Nasal Congestion
• Dizziness
• Visual Disturbances
• Back Pain – Cialis

NB: Side effects diminish with repeated use.

Vacuum Constriction Device

• Blood drawn into the penis using a vacuum device and constriction ring
• Physiotherapy to penis – Used to increase oxygen to the penile tissue and maintain length and girth
• Works within 5-6 minutes
• Effective in patients that cannot have PDE5 inhibitors

Advantages:

• Rapid and effective
• Suitable for most men
• Few contraindications

Caverject Dual Chamber