Prostatectomy for Prostate Cancer: Will PDE inhibitors work for me?
Many men wind up having ED after prostatectomy for prostate cancer even if their erectile function was normal before the surgery.
If your procedure was a nerve sparing radical prostatectomy, the first line treatment is oral PDE 5 inhibitors and there’s a good chance that these medications will work for you.
What if the medications don't work?
1️⃣ Use Medication Optimally
First, make sure that you have used them optimally with dosage adjustments in consultation with your doctor.
If the medicines have still not worked, there are other options available to treat ED. This is best done under an experienced urologist or other physician who specializes in sexual health.
2️⃣ Intracavernosal Injection (ICI)
The second line therapy is generally considered to be intracavernosal injection (ICI) of alprostadil. This causes erection in most men. Also, Bimix (paparavine + phentolamine), or Trimix (alprostadil + paparavine + phentolamine) are sometimes used.
Talk to your urologist about which would be right for you. Intraurethral alprostadil can also be used. It is usually considered third line treatment due to side effects such as pain.
3️⃣ Vacuum Pumps
Vacuum pumps with or without a ring at the base of the penis to help maintain erections are another option.
4️⃣ Penile Prosthesis
Lastly, if none of these work, or if side effects are not tolerable, a penile prosthesis can be surgically placed.
This information is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice. If you have any questions or concerns, please talk to your doctor.