One of the exciting developments in urology that occurred over the last decade has been the improvements in treating erectile dysfunction after radical prostatectomy for prostate cancer through a process called penile rehabilitation. Patients who have erectile dysfunction after prostate cancer surgery can see spontaneous improvement in their erectile dysfunction up to three years after the surgery, but often the erection that they do get are inadequate for intercourse.
Penile rehabilitation has been shown to shorten the time for recovery of erections and give firmer longer lasting erections over the long run for patients. It may also minimize penile shortening after radical prostatectomy that many patients complain of.
Penile rehabilitation is typically done in two different ways, which can be combined. One is to take a low dose tablet such as Viagra, Cialis, or Levitra everyday to increase the blood flow to the penis. This prevents scar tissue from forming in the two cylinders that create erections, called the corpora cavernosa. This scar tissue prevents the normal functioning of the corpora and makes erections more difficult to obtain. The advantage this regimen is that tablets are very easy to take and the patient requires very little training to do this. This works even if patients do not get erections from taking these tablets. The disadvantage is the cost can be fairly high, particularly if insurance coverage is a problem for patients.
An alternative way of doing penile rehabilitation is to have patient get a good erection using medications at least 2 or 3 times a week. If oral tablets do not work, then this can be done using MUSE, which is a intraurethral suppository or injection of medications into the side of the penis (intracorporeal injections) at least two to three times a week to get a good erection. This also increases the blood flow into the penis, prevents the scar tissue from forming and has been demonstrated to have maximize long term outcomes.
As mentioned earlier, both of these daily dose medicines as well as injections or MUSE can be combined in a penile rehab regimen. The exact regimen that is best for you should be determined by a doctor after evaluation of your overall medical condition and after careful evaluation.
The urologists at the Uro Center in New York are experts in their field, bringing academic and research based innovation to the clinical forefront. Our urology team specializes in areas of treatment such as: robotic surgery, reconstructive urology, men’s health & infertility, kidney stones, urologic oncology, penile implant surgery, urethral stricture, BPH, Urinary incontinence treatment, Mesh complications, Enlarged prostate treatment, Urodynamics, vesicovaginal fistula and female incontinence in New York.Request an Appointment