Erectile function recovery chances with only one nerve spared

Hello Andy (Andy B24 (0fd3b74d9df746328d8c97bd6c7c12df)) 

A bit of a tricky one this - and i don't want to put you off and as you are aware i still have my prostate.

Off the Community I do attend various meetings and a few months ago I was chatting to a surgeon and his own words were

"I can't give any guarantees before I operate as you don't know what you will find until you get in there - and once in you can't ask the patient questions so you have to try your best. There are lots of nerves around and through the prostate but basically there are 2 larger bundles that control the erectile function and the urinary function - we try to save them!"

I know this isn't going to help - but it's "from the horse's mouth".

Good luck with the surgery, do let us know how you get on.

Best wishes - Brian.

Hi my husband had bilateral nerve sparing in February of this year and he has had no erectile improvement. This has been devastating for us as a couple and my husband is struggling to come to terms with this. This wonderful group has helped us so much since my first post back in February. I don’t think surgeons know what nerve sparing will be achieved and even if a full nerve spare is achieved there is no guarantee of ANY recovery.  We weren’t taken through an MDT and now living with decision regret (even tho we weren’t given any other options). Being prepared will help you, my husband says nothing could have prepared him for this. I wish you all the best for your surgery next week x

Hi All

My husband had RT and HT and has ED even a year and a half plus  after finishing HT. We were referred back to urology and he chose to try a pump - with no success. He can’t take the medication because of other health problems. Nobody warned us about this before treatment. He has found it very hard to psychologically come to terms with this.i have told him that for me it’s me important to have him still here!

We are the same Worriedwife 

we are having a rough time with the medics as our councillor had suggested the pump for penile health as he has to sit to pee and finds it awkward . Sk it was round the houses as our gp contacted his oncologist and he said not my problem go to urology . So email to urology and urologist does agree with using it for penile health so the alternative is buying it ourselves . But it’s a lot of money if it doesn’t work . He’s already on the waiting list for ED so you think they would have agreed to supply.

any information would be appreciated 

Hello Joham, I think you live in Scotland where nhs /Nice rules may differ from England? NICE guidelines in England are that men left with ED after treatment for prostate cancer must be provided with help on the NHS. This help consists of pumps or viagra type medication, injections into the penis or pessaries onto the penis. My husband can’t have the medications as they are contradicted. He opted for the pump which was supplied on the NHS. The retail cost was stated as about £200. I know some men here have found that it works for them. For us, it was failure which made my husband even more upset. 

Hello I sorry to hear the pump isn’t working for you. My husband got his prescribed in the NHS (he’s had 2 because he broke one)! It was prescribed through his GP. We live in Cumbria tho surgery was at a private hospital in Scotland, worst mistake ever. It works for my husband but it’s not reliable every time x

Hello DF I think the message is that ED can happen after both surgery and radiotherapy. The urologist told us that radiotherapy can ‘frazzle the nerves’ and that is what has most likely happened with my husband. 

Thank you for your message, I think you are right that both treatments can have an effect on ED, I still believe surgery carries a much higher risk. For us it would have helped if we had been told and was better prepared. I’m happy my husband is alive, I worry for him so much he is struggling psychologically and emotionally with this ED. We will get through this but it’s been the worst year of our lives and has put such a strain in our marriage. 

Hi dobbie florence 

they are declining to prescribe the pump which is just a farce. They don’t agree that the pump will increase the blood flow for penile health but only for ED. Think they need to go back the drawing board . I might be thick but penile health is essential for any man having HT.

Hi DF , I quite agree that we should be informed about this possibility before treatment. We were not either! We were warned that the HT would reduce libido and might cause temporary ED. My husband’s distress has been incredibly painful to witness. I hope you can work your way through it all. We are all on a rocky journey with this PCa and I don’t think the medical profession acknowledge sufficiently that this really is a couples disease.