Erecticle Function Rehabilitation

It is important to remember that regaining erectile function takes time after prostate surgery. Nerve tissue, even when spared takes time to recover from the inflammation and scarring that can occur after surgery.  This optional program has been customized to help you get on the road to recovery of your erections and maximize your chances of a healthy sex life after prostate cancer surgery.

Think of your erections as a well conditioned athlete, who has been injured. This injury is going to take time to heal. You should try to remain patient, and remember that this will be an ongoing rehabilitation program that will last for 6-12 months. Rehabilitation of potency is much like a sports injury. Proper conditioning and medical treatment may potentially speed up recovery, but it is not guaranteed.

Your Two Part Customized Program

Dr. Leung’s erectile function program is made up of two components:

  • The use of Cialis (or another similar medication)
  • The use of a Vacuum Erection Device (VED). This combined therapy has been specifically designed to take advantage of both active and passive rejuvenation of your erectile tissue.

Cialis
We will prescribe for you Cialis 20 mg, but you may purchase a “pill cutter” from your pharmacy and divide Cialis into 4 pieces.  These 4 pieces do not need to be exact.  Take ¼ tablet every other evening on an empty stomach just before bedtime. The reason for this is that during your sleep cycle your brain stimulates nighttime erections. Immediately after surgery it is unlikely that you will have rigid nighttime erections, however, taking Cialis at night on an empty stomach allows for improved blood flow to the penis during these stimulation periods.  You may use a full 20 mg tab on a night that you want to attempt sexual activities.

This improved blood flow has been shown to have some significant benefits to the recovery of your sexual function. Specifically, following this regimen for 6 months has been proven to reduce scarring in your erectile tissues and retain the smooth muscle necessary for erections to occur. Four weeks after surgery you will have healed up enough to attempt sexual stimulation. Although many patients are able to achieve erections satisfactory for sexual activity and climax this early after surgery, seeing “some action” at this point is your goal and is expected to improve over the next 6-12 months. The use of Cialis is the “active” part of your rehabilitation regimen because it involves your body actively pumping good oxygenated blood to your penis.

Vacuum Erection Device (VED)
The “passive” portion of your erectile rehabilitation program involves the use of a vacuum tumescence device. At 4 weeks post-surgery you may begin using a device twice a day to passively pump good oxygenated blood into your erectile tissues and holding it there for 5 minutes. This device uses a vacuum mechanism to pull healthy blood into the erectile tissue of your penis helping to stretch out these tissues and keep them healthy. You have the option of meeting with a Clinical Specialist that comes to Urology Associates of Central California once a month.  This specialist can act as your “personal trainer” for this portion of your erection rehabilitation program. The purpose of this consultation is to focus on the correct use of the vacuum device and maximizing the results of your erectile rehabilitation program.