Prostate cancer is a common disease among men, especially among older men. Radical prostatectomy can be a very effective treatment, but it can also have serious side effects, including erectile dysfunction and urinary incontinence, both of which can be moderate or severe. Many doctors recommend radical prostatectomy for men with moderate to high-risk prostate cancer who have a life expectancy of more than 10 years.
There is help for those who have had a prostatectomy (or are considering it). The Urology Health Store offers products aimed at helping men with erectile dysfunction after prostate cancer treatments. Not only can these products help with ED, which typically lasts 18 months to three years after prostate cancer treatments. They can also aid those with urinary incontinence.
At the Urology Health Store, we consider erection recovery to be a dynamic process. That process includes support from one's spouse, patience and taking advantage of the pathways in the body that lead to natural erections in the first place, such as nerves, muscles and blood vessels.
We offer a complete erection recovery program in one kit that can help you get back on the road to sexual wellbeing.
Please visit:SexHealthMatters.org for wealth of information about sexual health and support groundbreaking research!
Immediately after prostate cancer treatment most men are more concerned about loss of urinary control and its possibility of not returning quickly. Most men regain their urinary control within 3 months. In some cases, this may be delayed (large prostate, Parkinson's, history of TURP, tumor close to the apex).
Most sexual medicine experts believe that some form of rehabilitation is helpful to regain sexual function after prostate cancer surgery. However, data remains controversial and not fully established at this time. The program being recommended in the next paragraph is meant to assist you in a multimodal approach to address all components of erection, which are weakened by surgery, NERVE, BLOOD FLOW AND MUSCLE. We believe that by addressing all components together, it is possible to regain erections more quickly and successfully depending on your age, pre-surgery sexual function and success of nerve sparing surgery.
Items recommended for the first year after surgery:
1. Viberect nerve stimulator
2. Pelvic RX- 8 week intense pelvic floor training program
3. Post T VAC manual erection system or ACTIVE REHABI penile trainer
4. Post T VAC premium/choice motor system or ACTIVE NT or ACTIVE ED system
5. Viagra or Cialis tablets to be taken on demand or every other day
6. Penile Alprostadil injections weekly or twice a month as recommended by your urologist.
Six weeks before surgery: Begin Pelvic RX program to fully strengthen your pelvic muscles in anticipation for surgery which will weaken them. Begin Vibratory stimulation with Viberect as well to fully experience the intense physiological events that occur before you have surgery.
Week 1 (after Urethral catheter removal):
Do kegel exercises only
-Every day or Every other day: Begin Viberect stimulation in a quiet, relaxed setting for 5-7 minutes. (you may use Viagra or Cialis is approved by your physician 30 minutes before Viberect stimulation)
-Every Other day: Use manual or motor erection systems without constriction rings and hold erection for 10 minutes to allow adequate filling of the penis with blood.
-Every Other day: Begin Pelvic RX structured pelvic floor training program week 1-8. This will greatly strengthen your pelvic muscles to improve urinary control and rigidity later
-Take Cialis or Viagra every other day or as prescribed by your physician
-Be intimate with your spouse or partner. This will enhance your recovery. Purchase female stimulators to help satisfy her. We recommend the Eroscillator, Fiera, or We-vibe tango.
-You may begin to use Vacuum erection systems with constriction rings and attempt sexual intercourse
-Continue Viberect stimulation every day or every other day for 5-7 minutes
-You may begin use of Edex, Caverject, Bimix or Trimix as indicated by your urologist. We recommend use every two weeks for sexual intercourse
-Repeat pelvic RX program and attempt to use magnetic weights either by provoking natural erection or with VED or injection.
-Continue Viberect, Pelvic RX, and VED's as needed.
Pelvic floor muscle training for erectile dysfunction and climacturia 1 year after nerve-sparing radical prostatectomy: a randomized clinical trial (International Journal of Impotence Research 2015: 28, 9-13, Geraerts, Van Poppel, Devoogdt, De Groef, Fieuws and Van Kampen) was a randomized clinical trial evaluating the effect of 3 months of PFMT in men with persistent ED 12 months or more after radical prostatectomy. Home PFMT was performed in conjunction with guided PFMT with a therapist emphasizing strength, endurance and coordination conditioning. Using IIEF criteria, the treatment group scored significantly better than the control group with improvements noted in penile hardness, length, tumescence and elevation. 17% achieved normal erections, 23% penetrable erections, and 60% did not achieve a functional erection. Additionally, PFMT was also found to have a beneficial effect on climacturia. The bottom line is that PFMT is a useful addition to the ED armamentarium.
So how do we get our patients to learn PFMT? One means is to send them to PT for biofeedback, but that can be time-consumptive and expensive with variable insurance coverage. A great alternative that is now available is a follow-along pelvic exercise DVD that is very similar to many of the quality general exercise DVDs available, such as P90x.
PelvicRx is an FDA-registered, comprehensive, interactive male pelvic floor training program that increases PFM strength, tone and endurance. It strengthens the levator ani muscle as well as the erection-vital perineal muscles--the ischiocavernosus and bulbocavernosus--both of which contribute to erectile rigidity and durability. The PelvicRx program helps to improve both sexual and urinary function post-prostatectomy and is best utilized when started pre-prostatectomy. It is an excellent first-line, non-invasive approach that empowers the patient by getting them actively involved with the management of their problem.