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Ralph Inorio
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- Branford, CT
- United States
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Roger - There's clinical proof of 15-20% loss of penis size with any treatment, radiation or RP. The VED can help get an erection, but can't bring back the lost inches! I miss them! lee
Barrie,
On the good side, even with the perineal approach, I'm doing pretty well and incontinence is not much of an issue...but it did take 6 months or so to notice a lot of improvement. I also had radiation so there were some other issues up to o...
Harvey: I had perineal radical prostate surgery Sept 25/09 and catheter removed Oct 5/09, I am currently using 2-3 pads per day and have frequent squirts when moving at this time. I am doing kegels and have days better than others re incontinence,...
Hi Ralph, I attended an ED conference sponsored and led by a New York Univ.Hosp. Urologist this past week. I have been very depressed by ED and shrinkage. I had radiation 2 yrs. ago. He discussed "shrinkage" saying that a 15 - 20% shrinkage should...
Thank Ken,
I was not prepared for the news of shrinkage, my doctor as i said earlier has not ever mentioned this. Like it isn't bad enough to suffer through ED but then to find that what you had (which by the way was just average) will be shorter....
Ralph,
I have been using the firmamedical VED since surgery, (9 months), and it works, but... I used it daily at first, but now, if I miss a day, so what? It is difficult to keep it up (pun intended) since it's no fun. The "erection" you get with ...
This sounds alot like my situation... I am 5 months after RP and had to go back for scar tissue removal a few weeks ago. Viagra, Cialis, levitra, they all suck, no luck with them at all, I am in process of getting a VED now. My doctor tells me it ...
I guess i deleted my earlier response... its not here...
Any way, Thenk you all for the replys definately makes me think its time to try something more than the pills. I have tried Viagra, Cialis and levitra with little to no success. I am looking...
I don't think anything can stop the shrinkage and my pee-shooter is so short now that I have to punch myself in the butt and yell Snake! in order to get a hold on it in order to pee. Seriously, maybe this is not normal but, on soft, I have to dig ...
Hi Ralph,
4 months out from daVinci surgery myself. Using a small panty liner daily, ED is in full swing. I wish my Dr. was more aggressive on the ED regimen. Maybe it's just me.
I bought a VED recently as a matter of physical therapy mostly. Whil...
Ralph, I assume you're referring to the unerect penis? If so, I think the apparent shrinkage comes about because you've lost the inch or so of your urethra where it passed through the prostate. Although the urethra will have some elasticity, the l...
There is definitely shrinkage. The VED used early on will help prevent it. I started on Viagra 50mg per day after the catheter was out and did the VED everyday. It should be part of your rehab program. I am 18mos. out and the shrinkage is minimal....
OK... you read things on the internet and they make you say is this true?? I am on my 5th month after RP surgery, My incontinence is pretty much gone, except for the surprise "squirt" every once in a while. I am still suffering through ED, I didn'...
Comment Wall (11 comments)
- At 3:03pm on August 18, 2009,
E. Michael D. ("Mike") Scott said…
- Ralph:
What you describe is a very normal series of events in someone with a bladder neck contracture. Loist of men have been there before you. It may be a small problem for a while, but it should also be an eminently solvable problem.
- At 2:13pm on August 18, 2009,
E. Michael D. ("Mike") Scott said…
- Ralph:
Bladder contracture is a problem for a small but significant number of patients.
The use of catheterization, cystoscopy and related techniques to resolve this problem is VERY normal and should not "set you back."
Simply ask the doctor to be very clear abpout what he wants to do and any specific risks associated with these techniques in your specific case.
I am pleased to hear that you have pretty much recovered full continence. Make it clear to the doctor that you are worried about the treatment for the bladder neck contracture setting back your recovery of continence. Listen carefully to what he has to say and take careful notes.
- At 10:07pm on July 6, 2009,
E. Michael D. ("Mike") Scott said…
- Ralph: The fact that you urine is sterile is good and simply means that there are no signs of any urinary tract infections post-surgery.
The PSA of 0.2 ng/ml, however, is something you do need to talk to your doc about. Ideallt the patient's PSA should drop to less than 0.1 after surgery, and yours hasn't (or at least, not yet). There are all sorts of possible reasons for this, so don't have a coniption ... but you DO need to talk tom your doctor and ask him why he thinks your PSA may still be slightly elevated. Don't let him "pooh-pooh" this. It may be very important ... or it could drop to < 0.1 in another month's time.
- At 12:50pm on July 4, 2009,
E. Michael D. ("Mike") Scott said…
- Ralph:
I don't think there's a problem here. It sounds to me as though your and your wife have a very caring relationship. You may indeed have had your first "dry" orgasm. Unfortunately, I can't confirm or deny that for you!
Is any of this associated with additional "signs of life?" If you think you are ready to try the Viagra, then do it!
- At 3:11pm on July 2, 2009,
Arnon Krongrad, MD said…
- Also Michael and Marcelo were in their 30s when they were diagnosed. Click to see their videos.
- At 3:09pm on July 2, 2009,
- Brent Sower, a member of this network, was 30 y old at diagnosis. I am quite sure he also did not expect prostate cancer.
- At 2:20pm on June 26, 2009,
E. Michael D. ("Mike") Scott said…
- Hi Ralph.
Any "signs of life" that suggest the possibility of return of erectile function are very definitely a GOOD THING! However, I suspect you need to wait for perhaps a couple of months from the time of surgery before seeing whether the Viagra can help things along.
I don't know anything about any "exercises" that can be carried out to help with this, but here are some other materials you can look at that may be helpful:
-- There is an online video on YouTube about penile rehabilitation by my good friend Dr. Gerry Chodak.
-- Here is a relatively detailed article (intended for physicians) on the same topic (by a highly regarded expert on the topic).
-- Here is a link to a detailed article intended for the patient community.
Last but not least, Dr. Mulhall has written a book called Saving Your Sex Life: A Guide for Men with Prostate Cancer, which you can find on Amazon.com. Some men and their wives swear by this! It also deals with penile rehabilitation.
- At 7:36am on June 23, 2009,
E. Michael D. ("Mike") Scott said…
- Ralph:
First your pathology report ...
This looks good. You have negative surgical margins, the cancer was organ-confined, the seminal vesicles were negative, etc. Your Gleason is a "good" 7. On the whole, I would say you were in good shape here. Based on these data -- and an assumption on my part that your PSA was no higher than 7 at the time of diagnosis -- I ran your data through the Kattan post-surgical nomogram, and it gives you a 95% probability of progression-free survival at 10 years.
Now, with regard to the ED ...
Some physicians recommend the use of drugs like Viagra and Cialis after initial recovery from radical prostatectomy to assist with the early ability to regain erectile function. This is NOT universally accepted practice, however.
The time it takes men to recover erectile function post-surgery varies significantly -- even in young men like you who (presumably) had very adequate (or better) erectile function prior to surgery. We really don't understand all of the reasons why this is the case. What we do know is that the degree to which the nerves are impacted by the surgery makes a big difference, so when you surgeon says that the nerves on one side of the prostate got "pretty beat up," I think you have to assume that it will take them time to recover. On the other hand, you ARE young and the nerves on the right side may well be enough.
The question you are going to need to ask your doctor is (a) whether he thinks that erectile rehabilitation with Cialis or similar would be helpful for you and (b) whether the use of a drug like Cialis in this way is even covered under your insurance plan.
I suggest you also specifically leave messages for a couple of the other young men on this forum who had surgery, and ask them to share with you information about their personal experiences of recovery. Possible "youngsters" include Brent Sower and Brian (of Marla and Brian).
Hope this is helping!
- At 4:43pm on June 22, 2009,
E. Michael D. ("Mike") Scott said…
- Dear Ralph:
Getting one's doctors to actually talk to one is an art form that can take some time to develop!
It sound to me as though you are dong pretty well with the incontinence at 3 weeks. Just don't go lifting heavy objects. That can set you back big time!
The ED is a whole other issue. It will depend on exactly what your surgeon did durig the operation (so ask him). You should also ask him about some form of sexual function rehabilitation initiative and what he recommends. Here is a link to a recent review on this topic by Mulhall (considered one of THE experts on this topic here in the USA).
- At 1:07pm on June 22, 2009,
E. Michael D. ("Mike") Scott said…
- Hi Ralph. It is normal for men to be worried about ED and related issues. You are going to need a little patience, but there are good reasons to hope that things will recover if you had a really good surgeon.
What type of surgery did you have? Did they spare both nerves? How are you coming along with incontinence issues? Have you received the post-surgical pathology report? If not, ask for a copy of it!
Profile Information
- Have you been diagnosed with prostate cancer?
- Yes
- What brings you to the New Prostate Cancer InfoLink social network?
- Poet op questions
- About Me:
- I am a 41 year old, recovering from the DI Vinci surgery. IT Manager for a BIOTech firm.
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