Sexual rehabilitation after prostate cancer surgery

Minimizing erectile dysfunction after radical prostatectomy

Post-prostatectomy Sexual rehabilitation Protocol at NYU urologyThe recovery of erectile function after radical prostatectomy begins with a good nerve-sparing operation. The urologists at the Smilow Center and NYU Urology Associates have pioneered techniques to minimize erectile dysfunction after radical prostatectomy. Despite our best surgical efforts, all men will experience a decrease in erectile function after prostate cancer surgery. The extent and duration of the dysfunction is dependent on many factors, such as your age, your preoperative function and the degree of nerve sparing. Our goal is to help you minimize the extent and duration of the dysfunction. With our current 'bag of tricks', there is no reason for you not to resume assisted penetrative sexual activity within six weeks of prostate cancer surgery, if you and your partner are so motivated.

 

Smilow patient, Mark Tillinger talks about why he chose to have open prostate surgery, the recovery process and the importance of post-care rehabilitation after prostate cancer surgery. 

 

 

Early intervention

The need for early intervention cannot be overemphasized. Every man has heard the expression "use it or lose it." There is increasing evidence that sexual rehab regimens after prostate cancer surgery help prevent irreversible long-term functional damage to the penis. NYU urologists have pioneered rehab strategies that utilize Viagra, MUSE, penile injection therapy, the vacuum erection device (VED) and even gene therapy.

Your role

The best patient is an informed patient. Key to the success of the program is your understanding of the rehab program. We recommend that both you and your partner meet with one of our sexual medicine experts (your rehab 'coaches') prior to prostate surgery. At this visit you will undergo a comprehensive interview, physical exam, and blood work. Diagnostic tests will be ordered if appropriate to your case. The sexual medicine experts will then discuss realistic goals and expectations for your recovery of sexual function and develop an individualized rehab plan.

Our sexual rehabilitation plan 

Our standard rehab plan, which begins before prostate cancer surgery, includes the following:

Before prostate surgery

  1. Viagra 50mg nightly starting the week before surgery.
  2. A VED (vacuum erection device) prescription is provided pre-operatively.

After prostate surgery

  1. Resume taking nightly Viagra 50mg after discharge from the hospital.
  2. Start once-a-day usage of the VED after the removal of the catheter.
  3. Follow-up visit with rehab “coach” one week after catheter removal.
  4. Start MUSE 2x per week (VED and Viagra not used on those days).
  5. Follow-up visit at 3 months. Injection therapy will be initiated if you are not having adequate erections for intercourse.

Our rehab plan helps maintain sexual satisfaction and overall quality of life for you and your partner as you head into prostate cancer survivorship. Although sexual dysfunction may not be your first concern as you contemplate surgery for prostate cancer, it is probably the single most common long-term problem you will encounter after open or robotic surgery. Our rehab protocol is based on research conducted at NYU Urology and other leading centers for both prostate cancer surgery and sexual medicine. We are excited to have the opportunity to help with this vitally important challenge, and we are dedicated to helping you retain your sexual function after your prostate surgery.

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