Restoring Sexual Function After Prostate Cancer Treatment - Tobias Kohler, MD Mayo Clinic

[@spitfirekid1]

Great video. I waited 8 months after surgery (2 months after salvage RT) to see a urologist specializing in men’s sexual health. I had near zero ED prior to surgery. He started me on injections right away to keep things healthy. My erections are as good as they were before surgery and the injection is not a big deal. If you are a post surgical prostate cancer patient reading this, don’t settle for a shitty life. Fight to get your sex life back. It is possible. Good luck.

[@janvanveelen]

I wish I had listened to this video (and some others) before I had my prostatectomy. I did not know that ejaculation would not be the same, erection is still a possibility, leakage during sexual activity is likely, penis curvature due to the surgery happens etc etc. I am 2 years past the surgery and have NEVER been even asked about all these issues by my urologists.

[@AstroBluePrelude]

I had prostrate radiation some years ago and wished I would have seen a video like this previously. This is the top video on prostrate surgery on any type. 5 stars..

[@Malecare]

We’re glad to have helped you

[@mgoksoy]

Very informative. Specially for someone who had to go through it all. And still suffering.

[@jaisvikt]

You give it your best shot.

[@jeremyv1783]

Prostate surgery is akin to castration although a Urologist will never tell you this!-The three piece implant is the only real solution and the sooner you can have the procedure the better-im 82, have had mine for 20 years and women marvel over it!

[@cloudsculptor1]

What is this ?

[@gfrydaymichael]

Please tell me, is the implant not noticeable to one's partner? And does it have any side effects?

[@hitechrr]

I had 26 rounds of radiation in 2020. I have had problems since. I also still have cancer in the same location.

[@roycastagnola333]

My surgery was 2012, age 60yrs, My surgeon told be my prostate cancer was moderate and confined to the prostate and that it "came out clean", but even after pills and exercises, have yet to achieve anything close tp a "usable" erection. One the plus side, I'm alive and well age 71.

[@MrMonkeylawyer]

Had my surgery Nov 3rd and I'm 48 , no incontinence after January but no erections. Viagra does not work at all, glad to be alive but it's tough.

[@nickstrapko7549]

You need more time brother. How about shots?

[@MrMonkeylawyer]

@@nickstrapko7549 thinking about it

[@c.l.8884]

Mr. MonkeyLaywer, can we chat? I just had surgery. Thanks

[@MrMonkeylawyer]

@c.l.8884 sure

[@MrMonkeylawyer]

@@c.l.8884 definitely

[@raymurray6822]

Again thank you for your candour just considering my options

[@stephenhuvane707]

I had nerve sparing RP in September, 2021. I'm 56 and in good shape, weight lifting my entire life. I still have leakage and I do kegels every day. It has improved but I still leak. The only erections I can obtain are through aprostidal injections which I can now manage quite well. Cialis and Viagra do not work for me. Im thinking about an implant down the road. I was definitely naive about the whole process thinking that my erections would come back on their own. Its a tough one but my PSA is currently 0 so I will stop complaining lol. Great video.

[@stevekimball2242]

Same

[@kevindaly9224]

for once ,,getting 0 score is great

[@en1chef54]

Wow I am 54 and had radiation treatments for my prostate cancer, one 1 and an half years ago. Plus hormones reduction shots too (Lupron). However I take 5mg of Cialis at bed time every night and I still get erections at night while I sleep. Plus, I’m able to still get am spontaneous erection as well. When I see an female I fine very attractive, and hot. Now my erections are not as frequent as they were before radiation and hormone therapy (because low hormones equals low libidos and desire for sex). But, I love the fact that I can still have sex anyway and make my lady happy. PS thing should get even better when I come off hormone therapy in 3 months. Additionally, my hormones should return to me 3 months after the shots stop! And I have my libido and I can enjoy the experience even more.

[@robertheinkel6225]

My surgery was three weeks ago. Incontinance was not an issue, just minor leakage once in a while. Only pads are needed. Erections on the other hand is unknown as when and if they return.

[@stephenhuvane707]

@@en1chef54 Thank you for your story brother. An update for me is that in the last two weeks, I have had a few spontaneous erections after using the 5mg of Cialis. I may be turning a corner.

[@michaelf8837]

Wow ! He nailed it ! As far as not wanting to go out and being very careful not to engage with the opposite sex for me ! Also I really did try local him but they weren't even sure if they were performing a procedure at the clinic anymore !

[@Malecare]

Thanks for sharing your experience

[@lincolnmiller919]

Urologist that did my surgery said 2-4 years for erectile function to return. I am 3 years out. Still not happening even after aggressive rehabilitation. I did ask about rates of erectile recovery, Cancer was completely organ contained. No metastasis.

[@EliasSaenz-t3c]

I'm in the same predicament.

[@williamkane4485]

The surgeon I interviewed about the Ams. 700.said that if for any reason it had to be removed, that it would be nearly impossible to replace??, makes me very concerned

[@jaisvikt]

It would've been nice if "Daryl" had been properly introduced with a last name and professional credentials. He was a great interviewer and gave to me, at least, a better understanding of the role of a social worker and tasks required. Many thanks.

[@bjhelder]

Criminal to not fully inform patients about the outcomes

[@daisuke6072]

Would like to see post radiation ED discussed more. Mulhall does not recommend vacuum pump due to venous leak problems. Says rings don't work as they have to be too tight.

[@Malecare]

An excellent suggestion. Thanks.

[@nycblueyes10024]

Yes, could you please direct us to guidance regarding ED after radiation treatments for prostate cancer. I had 5 radiation treatments almost a year ago. I’m just now experiencing some discomfort after sexual engagement. Thanks

[@mauriceobure2308]

Is it true that after prostatectomy, chances of receiving erection is fifty fifty

[@mauriceobure2308]

Am 1 and 1/2 years since the removal of prostate glands and no signs for erection,what can I do or I will die like that

[@mattd9094]

Do you have an idea as to when you may have a video available for ED after post radiation treatments? I finished my 9 week radiation treatments a year ago and I am still dealing with ED which I did not have prior to radiation treatments@@Malecare

[@loisfaruolo6932]

Is there any way to get more detailed advice on use of pump and jelquing. Like how to , how often , how long to exercise, and for how many yrs??

[@Malecare]

Those are the kind of questions your doctor should answer

[@jamesmc1016]

What about restoring sexual function after radiation and or ADT?

[@leonardola9161]

Im 64 i had adt and radiation 1 month out and not enough errection will have to wait another month and see what happens

[@jamesmc1016]

@@leonardola9161 Everything I have read and have been told is the condition gets worse with time, not better.

[@spitfirekid1]

I’m a success story. I had surgery, then salvage radiation, and am on ADT. My libido is not what it used to be, but with the help of injections I can get great directions and I’m working on restoring my full sex life. Good luck to you.

[@gordonculp3646]

Ok Doc, how about you cut all the verbiage and simply tell us what are the percentages you will not be able to have a penetrating erection after surgery and the different types of radiation and particularly testosterone deprivation. Then tell us what we can do before, during and after the treatment to maintain erections.

[@Vincent50]

I’m right with u. My Radiologist Oncologist didn’t even talk about this and I didn’t even ask I guess because my sister went with me for support but I’ll ask him the next time I see him when I start the treatments.

[@DeathSentryCoH]

@@Vincent50 Mine sort of dismissed it, basically saying you will be alive!

[@rolankelly9683]

Doc will there ever be a prostate transplant or is it no possible?

[@joelpointon3830]

Question: what was the frequency that was recommended for vacuum pump therapy? Did I hear mention of every six weeks?

[@robertheinkel6225]

Mine Dr stated to start after four weeks out from surgery. Ten minutes a day.

[@stevekimball2242]

My surgeon left me with extreme incontinence and severe ED. I wouldn’t phrase it this way but I know other guys with no issues…

[@msbowie58]

My husband has the same issue after 21/2 years. After Prostatectomy. He regrets having it done to this day! Has changed his life forever.

[@swimfit57]

I had BPH and had frequent urination. So they put me on Flomax . It was ok but I thought I should go to a urologist and have things checked. Make sure I don’t have cancer. Found out I had a lot of tissue growing in the prostate and blocking my urethra and I had it growing into my bladder. So I had the Holep procedure! Well after the surgery I really was any better and had more bladder retention. So we did another cystoscope and found out I had stricter, then went in and had a dilation. Went he got in there he discovered the stricter was larger than was showing on the x-ray so he lasered the stricter some more! Now the flow is better and I don’t have to pee every 20 minutes! 👍 but now After the Holep I can get an erection but the orgasm starts building, and then it’s like a switch goes off and it stops, no curling of the toes. I still have the capsule of the prostate, and he said there was no cutting on the outside and that’s where the orgasm builds. I’m still retaining about 300 cc of urine in my bladder and I really can’t feel that until it gets higher then I have to go?

[@Malecare]

Thanks for sharing your story

[@leonardola9161]

Im 64 i had28 radiations treatments and 1 month from last radiation and only halfway errection with 40 units of trimix and 50 units is max will try that next 11 5 24

[@KimberlyMitchell-g2v]

You have BPH is my opinion

[@robertalbitre3770]

Question why does the radiation stop ejaculation 25% of the prostate produces fluid the other 25 and 50%com from the seminal vesicles and the testicles so why is there no fluid coming out is it because radiation kills the muscle Glenn up the prostate cause other than that I just don’t get it I had radiation done I still have sexual desiresBut I just cannot climax anymore it’s from whole milk to powdered milk and can it be cured knowing it’s 75% is still available from The seminal vesiclesAnd the testicles Fluid remaining behind Why do they say it goes into the bladder and not out of the urethra like it used to

[@leonardola9161]

Its called retrograde ejaculation and its not the same feeling as before radiation treatment and harder to have a orgasm

[@RamSingh-ww3so]

Can you explain all this in Hindi

[@rolankelly9683]

It’s unfortunate you have to take a doctors word that you had the nerve sparing technique done but really you have no way of knowing if it was done or not.. smh

[@tedskandy]

Does the penile implant effect, in any way, urination.

[@oceansunsetak]

25 years ago age 46 I had a radical prostatectomy before robots at Mayo in Rochester. At the time there were 3 surgeons in the US that had superior results with urinary continance and sexual funtion. One Washington missouri, one john hopkins R P Meyers at Mayo. I called Dr Meyers office he returned my call. Very positive. Post op with stage 3. I was freaked He said son your not a statistic your gleason score is not high you will be ok. I had sex 3 weeks after the operation . little incontinence. I attribute sex funtion to having a good women that love sex and oral sex before penetration . However the shrinkage thing is real. I used to be a shower before the surgery now I am a grower. looks like I just took a cold shower even on a hot nude beach.

[@oceansunsetak]

Great video on penis health and restoring sexual function after prostatectomy

[@tjjones-xj7kq]

Being in my late 20s I notice I now have to pee like 4x a night. Just maybe 5 years ago it was like 2x a night. I asked my family doc and they said it could be the start of prostate issues if I was concerned they would suggest someone who works with that more. I'm typically a worrywart so I don't want to jump to conclusions but what age did you guys start to notice issues. (My erections are still strong so no issues with that) Also what were your early signs of cancer vs regular dribbling after peeing and more frequent night time pees?

[@davidbuha9132]

Get your psa checked and see a urologist.

[@tjjones-xj7kq]

@@davidbuha9132 okay thanks!

[@leonardola9161]

Get a psa from ur general doctor

[@domenicozagari2443]

TO RESOLVE THE PROBLEM OF THE PROSTATE WHEN YOU HAVE A SHOWER SPRAY WATER ON YOUR GROIN AS HOT AS POSSIBLE.