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Erectile Tissue Preservation For Patients Undergoing Radical Pelvic Surgery

THE ADVICE ON THIS PAGE IS BASED ON A PROGRAM DEVELOPED IN A LEADING CLINIC IN THE UNITED STATES. AT THE TIME OF WRITING - MARCH 2008 - THERE ARE NO PUBLISHED STUDIES TO SUPPORT THIS THERAPY, WHICH SHOULD BE DISCUSSED WITH YOUR MEDICAL ADVISOR BEFORE IT IS UNDERTAKEN.


The erection nerves travel along both sides of the prostate on their way to the penis. During the prostatectomy procedure, these nerves are manipulated to allow access to and removal of the prostate gland. Even in cases of nerve-sparing operation, some decline in nerve function occurs, lasting for up to 24 months. As a consequence of this nerve dysfunction, the erectile tissue in the penis may undergo atrophy (degeneration). Early treatment, starting even before the surgery, has been shown to protect erectile tissue and may facilitate the chances of erectile function recovery. The following course of action is suggested to minimise atrophy and optimise recovery:


Take Viagra 25mg (a quarter of a pill) before bedtime, nightly. Start this treatment 2 weeks prior to the surgery. You should not expect any erection to occur at such a low dose.

Discontinue Viagra 25mg the night before surgery and during your hospital stay.


Resume Viagra 25mg nightly, after you are discharged home even with the catheter in place.


After catheter removal (usually at 7-14 days after surgery), consult your surgeon whether it is safe to attempt to get an erection.


After this time (usually 2-3 weeks after surgery), switch to Viagra 25mg 6 nights per week and Viagra 100mg once per week. The Viagra 100mg dose should be taken in an effort to get an erection. Take the pill on an empty stomach (we suggest 2 hours before your evening meal). The pill lasts at least 8 hours so you will have plenty of time to attempt stimulation.

It is suggested that you should make 3-4 attempts at Viagra 100mg after surgery before you see your doctor again - usually about 6 weeks after surgery to discuss how you responded to the Viagra 100mgs dose.

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