Will Nerves Regenerate After Prostate Surgery? - EDrugstore

Highlights 

• During prostate surgery, doctors try to avoid nerve damage, but surgery always causes some damage to erectile nerves.

• The younger you are and the better the nerve sparing, the higher your odds of regaining erectile function.

• You can take Viagra or Cialis after surgery and self-stimulate to get your erections going again.

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Dr. Michael DiLeoContent Reviewed by Dr. Michael DiLeoMichael DiLeo, MD, has over 30 years of experience in clinical and academic medicine. Through medical school, residency, and private practice, he has functioned as both a specialist and a primary care practitioner. He has twice served as chief of staff of a large regional hospital. He is a published author on women's health for McGraw-Hill. Learn More Latest posts by Dr. Michael DiLeo (see all)

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During prostatectomy, the nerves that control erections are usually damaged. In most cases, those nerves will regenerate, allowing you to regain erectile function. Full recovery depends on factors such as age, erectile function before surgery, the extent of — and the ability of doctors to preserve the nerves during — surgery. [Español]

The Nerves You Need for Sex

Full male sexual function requires three nerve groups:

• The nerves that control orgasms
• The nerves responsible for conveying sensations from your penis
• The nerves that control your erections

Of these, only the erectile nerve bundles are in harm’s way when you have a prostatectomy. The damage they sustain during surgery partially defines how quickly you can regain your erections after the fact. Two bundles make up the nerves that control your erections. Both are located between your prostate and rectum.

Nerve Preservation During Prostate Surgery

Nerve preservation during prostate surgery is the priority of doctors and patients alike. Surgical advances like the da Vinci® surgical robot have improved surgeons’ ability to protect these nerves. Still, it’s not always possible to preserve both erectile nerve bundles. Sometimes doctors have to remove one or both, partially or completely.

Damage to the nerves does not happen accidentally or due to clumsiness of medical staff. The purpose of prostate surgery is to remove cancerous cells. If cancer has spread to the nerve bundles on the prostate, doctors must remove it.

If cancer doesn’t affect the nerves, the surgeon will leave the nerves intact. Patients who retain both nerve bundles are more likely to regain full erectile function quickly. The good news is, however, that even with a single remaining nerve bundle, it is possible to reclaim your erectile function.

Why Do Erectile Nerves Sustain Damage?

Prostate surgery is an invasive procedure. To preserve your nerves when removing your prostate, the surgeon needs to separate the nerves from the prostate. When scalpels and other surgical tools peel the nerves off your prostate, they can cause some damage.

Unlike other nerves in your body, your erectile nerves lack a protective sheath. This makes them even more prone to damage.

Even when they can be left intact, surgery can still traumatize them. Being stretched, bruised, and inflamed limits the ability of nerves to function as they normally would. This damage needs to heal before you can achieve a proper erection again.

Another reason your plumbing needs to regenerate following prostate surgery is that the intervention removes arteries that go through your prostate and supply your penis with blood. Your body needs to make up for the loss of these arteries by pumping more blood through other arteries so you can achieve an erection.

Even preserved nerves typically suffer some damage during radical prostate surgery. “Radical” does not mean “renegade” or “revolutionary.” The word is a medical designation to label the most extensive procedure often needed to do the job.

How Quickly Do Erectile Nerves Regenerate?

The speed of recovery after prostate surgery depends on many factors, including:

• Age. The younger a patient is, the more quickly he can recover his erectile function. In some cases, recovery is immediate.
• Previous function. Patients whose erectile function is good going into surgery may find it easier and faster to reclaim their abilities.
• Whether nerve bundles are left intact. Those who keep both erectile nerve bundles can make a full recovery quicker.
• General health. Patients without preexisting health conditions, such as high blood pressure and diabetes, recover faster.
• Mental health. Psychological factors may also play a role in regaining erectile function.

In most cases, erectile function returns in 12 months, and patients reach the peak of their post-surgery erectile abilities in three years, on average.

Most patients in the 40-49 age bracket fully regain their erectile function whether they retain both or only one of their erectile nerves.

In 50- to 59-year olds, the extent of nerve damage starts to make more of a difference. While 92 percent of those who retain both nerves regain erectile function, only 67 percent of those who lose a nerve get to experience full erections again.

What Can You Do to Accelerate Erectile Nerve Regeneration?

Fortunately, you can create a set of circumstances that favor quicker nerve healing.

Self-stimulation

Following surgery, allow your tissues to heal for three to four weeks. Then you can try to return your nether regions to “business as usual” by stimulating yourself 2-3 times a week. If you have someone to do it for you, the results should be similar. Remember that you can achieve orgasm without getting erect.

In some cases, self-stimulation alone can work wonders. Others may want to give the effort a boost by taking an ED medication like Viagra, Cialis, or Levitra.

Taking Sildenafil

Evidence shows that ED medication, such as Viagra (sildenafil citrate) or Cialis (tadalafil), can help you speed up nerve regeneration after prostatectomy.

According to researchers, sildenafil can speed up recovery of erectile function in three ways:

• It helps regenerate the thin membrane that lines your blood vessels, improving their function. This membrane controls vascular relaxation and contraction, improving blood flow.
• It hastens neuronal regeneration directly.
• ED drugs improve the protection of the nerves.

Injections

Having a medication like alprostadil injected directly into your penis is another option. If you are not squeamish and can give yourself an injection, you may find that this approach works for you, even if you fail to respond to Viagra. However, some men find that alprostadil-enabled erections can be painful during the recovery process.

Urethral Suppositories and Vacuum Pumps

Many patients may not tolerate having something injected into their penis. They may still consider other options, however, such as:

• Muse. Muse is a small wax suppository form of alprostadil that’s inserted into the urethra. While the efficacy of this approach may be good, it’s costly and may cause pain or irritation.
• Vacuum pumps. These devices offer a non-invasive approach to regaining or improving erections. Their efficacy is limited, however.

You Won’t Completely Lose Sexual Function

Regardless of the damage your prostate surgery causes to your erectile function, you never lose your sexual function in its entirety. While you may lose your erections, you will retain:

• Sexual arousal
• Your ability to orgasm
• Sexual fulfillment

While it’s true that few patients return to full presurgical erectile function, research is clear that the majority of prostate surgery patients do regain a level of functioning that allows them to resume satisfying sex lives.

eDrugstore Can Help

We stock the FDA-approved ED drugs that can help you regain your erections following prostate surgery. We carry Viagra, Cialis, Levitra, and others, along with their generic versions. Our U.S.-licensed physicians can provide you with the prescriptions you need to get your love life back on track. Even more important, they can be a necessary part of your doctor’s strategy for erectile rehabilitation.

Don’t give up on your sex life. Sex is an important physical expression of intimacy. At eDrugstore, we have helped millions regain satisfying sex lives. Start treating your erectile dysfunction today and get busy between the sheets again!

James West

James West is a seasoned health and wellness writer with a focus on topics related to physiology, sleep, and men’s health. He has contributed articles on a range of subjects, from erectile dysfunction treatments and sleep aids to hair loss, providing well-researched insights to help readers make informed health decisions.