Non-Nerve Sparing Prostatectomy: Are erections ever possible? Professor Declan Murphy Interview
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- čas přidán 23. 07. 2024
- Should all men be told they won't get erections after ‘Non-Nerve Sparing’ prostate Surgery?
Professor Declan Murphy has performed over 2000 Prostatectomies. In this video he answers our questions about non-nerve sparing surgery.
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WHAT ARE MY QUALIFICATIONS?
My name is Victoria Cullen and I'm a sexual health educator. I have a masters in Psychology, and I'm a current PhD researcher within the field of sexual health design to help people who have undergone prostate cancer surgery. When I refer to 'clients' I mean men and their partners who book to see me for a one hour educational consultation to design a sexual recovery plan post prostate surgery based on their sexual goals. You can read a full list of my qualifications and experiences here that I draw upon to create my videos and resources: www.atouchysubject.com/about
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MEDICAL DISCLAIMER:
This video is for informational purposes only, this is not intended to substitute diagnosis, treatment or advice from your medical professionals.
This is so thorough, thoughtful and positive. I find myself wishing Dr. Murphy could have been my surgeon. I'm 5 months post-op from non-nerve sparing surgery. The hard part for me, besides minimal, almost avoidant communication from my urologist, is living with the uncertainty about possible nerve recovery. I keep wishing there were more I could be doing.
Will look forward to more videos especially one on where the nerves are and how the position of these can vary . I just assumed they were in the same position in every man so this will be an interesting forthcoming video. Thank you, very much Declan ,for doing these videos in addition to your busy life. It means so much to get information from experts such as yourself, to reassure patients and their partners and make it easier to deal with a prostate cancer diagnosis and the sometimes unavoidable consequences of necessary removal of the prostate and the cancer. Nobody wants this diagnosis but with you and Victoria offering the support that is much needed, it certainly helps in coming to terms with the changes and challenges that it brings. Very much appreciated! Keep up the great work you both do.
Thank you for sharing great questions to stimulate discussion Jenny, and many thanks for your answers Declan, I look forward to deep diving on the cavernous nerves in a future video!
I am so thankful I found this YT channel and website. So, so helpful. Thank you.
Hi Bob, we are so pleased to have you here!
Thank you both! Just the question I wanted answered. I like the perspective you give on expectations. Great post!
Thank you Allison! I'm so pleased this answered your question. Look forward to cooking up more videos for you
This is so helpful thank you! You are both direct, clear and unflinching in discussing difficult topics. I wish all urologists were as forthcoming about these matters as Dr Murphy!
Hi there thanks for your thoughtful comment! We are so pleased you found this video helpful and informative!
Right, I had a non-nerve sparing prostatectomy, and my urologist didn't give me half of this information
Thank you both for this video. I am 6-months post RALP (non-nerve sparing) and that "change in mindset" thing is definitely hitting now (after two superb post-surgery PSA tests). This was helpful, and I felt normalized seeing it.
Hi Seattlecounselling, thank you for sharing your experiences we are so pleased to hear that you feel seen!
Nearly 12 month post rp. These chat are so important and thank you for posting this
Hi there thanks so much for your comment. We are so pleased to hear you have found our resources valuable. We wish you will the best on your rehabilitation journey!
Great Vid again Victoria and wonderfully explained. Being in my late 50's and 3 months down the track from a prostate surgery I'm in the hopeful stage as only one side of my nerve bundles could not be saved due to the high grade nature and position of the cancer. My surgeon is very much in the same camp as you, its a roll of the dice. We do everything we can during the surgery to minimize the impact on the nerve bundles and sometimes there's a good outcome with ED and sometimes there's not and it can't be rationally explained. Anyway I live in hope but enjoy where I am at the moment and am thankful I have a good prognosis for the future.
Cam
Hi Cam. It sounds like you are very early in your journey and I do hope that you do have a good result. Undoubtedly, it can take a long time, up to two years, before we really know whether there will be spontaneous return of erections. It is not unusual at all for patients to come back at the two year check up and say that they have only just noticed that they are having some meaningful recovery. Of course, there are many other men at the two year time point who have not had meaningful recovery, and that is an important conversation we then have as previously not considered options such as a penile prosthesis etc will then be on the table.
Cam - I hope that you are doing well otherwise and are being well supported by your team. Victoria's website also a great resource for you www.atouchysubject.com
Hi Cam I felt a lot like you for about a year, but now at 15 months post surgery there are definite signs of life and I am very grateful for all the rehab information I got via A Touch Subject that helped me through the dark months.
Thanks for your feedback we appreciate it!
Thanks for this video - this is something I am going to have to follow up on!
Hi Charles, you are most welcome!
Of course this is a very difficult thing to go through. 😮 I've been there. But the good news is you can survive .what is a difficult time . Fortunately l still have my good looks. .🚴 73. Now no problem.
Really interesting video - thanks to both of you. It's so refreshing to hear Declan talk about the fact that there are still so many unknowns when it comes to regaining erectile function. I think that is a reminder to maintain a positive mindset and to be persistent.
Declan's comments about expectations are spot on.
If erections are important in your life, keep on trying - don't give up! Do something every day and make it as much about fun and pleasure as possible. Have a laugh and don't take it too hard (pardon the pun) if you don't succeed. Just try again. Get yourself a vacuum pump and use it daily. Make time to be "sexy" with your partner (or think sexy thoughts if you don't have a partner).
Whether or not you regain full erectile function, you can still make things better at some level. It's worth the effort.
Brilliant comment Fiona, thank you for sharing. Love your end point: "Whether or not you regain full erectile function, you can still make things better at some level. It's worth the effort"
I am 10 months post non nerve sparing prostatectomy. 66 yrs old. I have regained continence but still have not had an erection without using a pump. (Vacurect) 😮I take 5mg of tadalafil daily to promote blood flow to the penis. On occasion I have had a tingling sensation in my penis and seemed a little harder than usual in the morning but not a full erection. It’s difficult because my wife and I had a healthy sex life prior to surgery. I’m not giving up hope. Thank you Victoria and Dr Declan for your great information and candor!
Hi Kevin thanks for your comment and for sharing a bit about where you are at. We are so pleased you have found this content valuable!! We wish you all the best for your rehabilitation journey!
4 months post non-nerve sparing RARP and the ED is almost cured (except when sneezing) but complete ED which I fully expected. It was great to find this video linked from the UK Prostate Cancer support forum and it helped a lot to hear you both - am off to look to see if you did a follow up video on the actual RARP procedure. I could watch it now whereas before I was quite happy to remain ignorant LOL
In my case, the orgasm was much more important than the erection and the good news is that having an orgasm is still possible with a floppy willy :)
Hi there thanks for your comment we are so pleased you found our resources and hope you enjoy the other videos on our channel. We are so pleased to hear your ED is almost cured and you are enjoying orgasms again!
Another excellent talk. Thanks. Too soon for me to know what the outcome will be, as surgery was 4 weeks ago.
Thank you for your comment! Glad you found it helpful!
Thank you Declan and Victoria for this much needed video on non nerve sparing surgery.
Can I ask about the man who had presumably spontaneous erections at 2 years with no erection nerves. Can you give some idea as to what may be going on for this to happen. Did the the nerves regrow or did other nerves take over the erectile function? What are the qaulity of the erections? Are they enough for intercourse or maybe some stiffening? Are they morning erections? You did say that there must be something else going on that is not fully understood but are there any theories or ideas you could discuss?
I was interested to know that up to half your patients have non nerve sparing surgery so it is at least as common as full or partial nerve sparing. This begs the question as to why there is very little information about non sparing erectile function post surgery. The information is almost exclusively related to nerve sparing erectile function and much of this information is not helpfull for the non group(such as Viagra not really able to work to cause erections in the non group).
This video is at least a start to be more inclusive of this group and hopefully stimulate more research into it.
Also very interesting and important is the man's expectations and how this can change over time, as you explained very well. The pyscological aspect of this type of surgery is extremely important and sometimes I feel it is sometimes overlooked, but I was heartened to hear you recognise that some men can suffer greatly when their spontaneous erections disappear. Unfortunately, many jokes are made about erections which may be why most men find it difficult to discuss it.
My partner is 67 yrs and 15 months post non nerve sparing surgery and we manage with Trimix injections but he occassionally wonders if he will get spontaneous erections again. Once he sees this video I am sure he will start getting hopefull again!
Anyway this video is a breath of fresh air and I hope to see more!
Thanks for answering
Hi Jenny. There are a few possible explanations for why a "non-nerve-sparing" procedure may end up with surprising recovery of erections. One is that there may have been incomplete removal of nerves, and perhaps just enough of the important (parasympathetic) nerves may remain to allow an erection to occur. These are usually not of great quality (so additional help is needed). but if the expiation was to have zero recovery, then this may still be a happy result. Another possible explanation is that there can be some variability in the course of the nerves, and they may run a little distant from teh classical bundle, and be inadvertently (but happily) preserved.
We will soon do a video about nerve-sparing where few ill show you some examples.
I had my prostate removed November 8th. I had ED for years prior to surgery. Post op I have no incontinence issues at all thankfully. I'm on 20 mg Cialis for 30 days and am supposed to start self pleasure, pump, and other things to start in a couple weeks. Hopefully they will work.
Hi John thanks for sharing your experiences so far. So glad to hear that your rehabilitation journey has started off positively for you!
this is good info to know. I had aggressive cancer so I have a feeling no nerves were spared. Will have to ask the surgeon on the follow up. Nothing works at this point but it can take up to 2 years so it is just wait and see and meanwhile do therapy. thanks for the somewhat hope, maybe something will happen down the road, who knows.
Hi Andrew, thank you for your message. We are pleased you found this helpful, and that it's provided you with some hope. We wish you all the best for your rehabilitation - if you haven't signed up already, you may be interested in our Free Penile Rehabilitation Program: www.atouchysubject.com/help-for-ed-post-prostate-surgery
Thank you for watching! Please like the video and subscribe to the channel if you want free resources on Life after Prostate Removal.
Download FREE Checklist for Recovery after Prostate Treatment:
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Watch video interview on Nerve Sparing Surgery:
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Follow Declan Murphy’s work and research.
Twitter: twitter.com/declangmurphy
Website: www.cancerspecialists.com.au/team/declan-murphy/
Instagram: instagram.com/wearecancerspecialists/
Calling from UK found all your talks usefull ,but I can,t wait 2years for an erection that "might" occur,I could well be dead by then! Had non nerve sparing surgery 7 months ago. and am extremely frustrated as I have a wonder full new partner ,with which i would like to consumate our relationship properly.How can I acheive this????Do I have to travel to Australia for nerve grafting??
Hi Mike, thank you for your comment, we can appreciate your frustrations. Unfortunately, at this point and time nerve grafting is only available in Australia but I believe plans are in motion to extend to the US as the next point. I hope this helps. You may like to check our website www.atouchysubject.com for more resources or options for you to consider.
Would Trimix work with non nerve sparing surgery?
Absolutely…
Hi Phil, yes, Trimix works with non nerve sparing surgery as it acts on the blood vessel mechanism rather than the erection nerves. You might find this longer interview about penile injections helpful with expert specialist, Melissa Hadley Barrett: czcams.com/video/GH3XIYSx3zo/video.htmlsi=qzrgumKovKCa9rPg
What about minor shock stimulation.
Hi there, we do have a resource about shockwave therapy here: czcams.com/video/kVI8zuCJ1UU/video.html
I wished that my VA doctors would have been more transparent with not just me but all the Vets that I see on Eurology forums with the same complaint. They rushed me into the surgery first of all and rejected all the options like radiation or pills...The serious psychological effects with men not being able to get wood is not a "ha ha" situation as it tell the rest of your body that all is well when you get that morning wood. Thanks for this video but kindof late for many. I would suggest emphasizing after care and erections a whole lot more including the mental health aspects.
Hi there, thanks for your comment. It sounds as though you have been through a challenging with ED. We appreciate your feedback and suggestions for content.
So there’s still a chance!!!!!!! Woohoo!!!
yep , just thinkin that .
Yes there is still hope! If you haven't already you can sign up for our penile rehabilitation program: www.atouchysubject.com/help-for-ed-post-prostate-surgery
Well ive this oppo. In the past .it is a problem .of kinds. ? That no doubt differs for different people .but if you dont work at things .nothing changes. You know you may be a sexy beast 😂 lady ❤
Hi Chris, thanks for sharing you experience. It is very different for each person how recovery goes. You are right, regular exercise to keep the penile tissue healthy is important!
I’m 47 had a nerve sparing radical prostatectomy 2 years ago. Erections never returned and I had a penile implant done five months ago. No regrets at all, it works every time!
Hi Sam thanks for your comment and for sharing a bit about your rehabilitation experiences. We are so pleased to hear that your penile implant surgery was successful!