nerve sparing is it worth it?

User

Posted 17 Nov 2016 at 22:14

Hi SDB,
You are quite right, I have lived my professional life quite successfully always flowing the advice of experts.

Now retired with PCa I have let my emotions and some fear cloud my decision making.

Many thanks to everyone, I have now gone back to my original decision of letting the surgeon make call on the day, rather than insisting on non-sparing. I feel comfortable with that.

Good luck to all,
Nigel

User

Posted 17 Nov 2016 at 23:08

Originally Posted by: Online Community Member

Less than 3% of men that have non-nerve sparing surgery can achieve natural erections and the assumption has to be made that some nerves were left behind. They can't regrow if they aren't there but it is true that burned or bruised nerves can sometime repair themselves. Viagra etc do not work for men with no nerves so injections, pessaries and/or the pump are best options.

Robgsr - did you have nerve-sparing or non-nerve-sparing ... it isn't clear from your profile?

Hi Lyn

I had non-nerve sparing. I will update profile.

Gordon

User

Posted 18 Nov 2016 at 07:46

Interesting, Rob. I too had non-nerve sparing as did at least one other forum member who has had some return of erectile function.

My urologist said it can happen where function was strong previously, and I specifically asked if it could mean an incomplete removal of the tissues. He looked offended and showed me the record that included both nerve bundles. It's therfore an incorrect assumption to imagine return of function must equal a botched or incomplete procedure.

It's clear like in lots of neurological physiology that there are gaps in understanding. People recover all sorts of functions after nerve procedures, and add to that we're all slightly anatomically different. And chemicals most definitely help.

Edited by member 18 Nov 2016 at 07:58 | Reason: Not specified

User

Posted 19 Dec 2016 at 22:44

Hi Nigel.
I see from your update post-op that you were getting erections straight away. Glad the surgeon spared your nerves - that should be possible with Gleason 6. I hope your continence is improving. It will do so with time and exercises.
Best wishes,
Henry

User

Posted 19 Dec 2016 at 23:22

Henry,

It is my understanding that it is not just a question of the assessed Gleason score, which could be undergraded anyway but even more importantly how extensive the spread is. Is there a reason why I am wrong in this?

Barry

User

Posted 20 Dec 2016 at 07:29

I'm not sure the Gleason score is important in nerve sparing , yes it just depends how near the cancer is to the nerve bundles. If it is seen or thought to be near the bundles then they won't save the nerves or advise against it. A friend had very rapid erectile recovery , meaning the nerves were very undamaged. Unfortunately this means more prostate tissue is left behind which can be a problem. Sure enough 18 months on he is needing salvage RT. Us guys desperately don't want to lose function , even more so us " younger " ones , but I guess sense wise they should take the lot out

If life gives you lemons , then make lemonade

User

Posted 20 Dec 2016 at 07:49

Barry . I agree.

User

Posted 20 Dec 2016 at 20:59

I had my catheter removed today and do am battling incontinence this evening. A wee bit of leakage, but it's been very manageable thus far. I had total non nerve sparing surgery. I don't know how I'll feel in a few weeks about it all, but my surgeon was clear before the operation that nerve sparing was not going to be possible. I told him to save my life. At 46, a future of erectile dysfunction is undesirable to say the least but, tonight, genuinely, I'm happy with my decision.

User

Posted 22 Dec 2016 at 08:08

Hi Chaps, 3 weeks post op. Almost full erections . Not rigid enough for penetration .

I had an extra blood vessel that had to be preserved, and an adhesion to the bowl.

Slightly leaky just before and after I have a wee.

I have had six blocks caused by blood clots, but managed to pass them all with out intervention.

But I am still getting lots of abdominal pain. I have had my post op appointment brought forward as the pain is thought to be unusual.

Good luck to all.

Nigel

User

Posted 22 Dec 2016 at 15:26

Wow
Erections at 3 weeks !! I'm just getting erections back at 18 months post op but only with Cialis.
I still have abdominal pain now in my bladder area each time it's full. Also if I need a poo. I've been told it's likely adhesions but very rare. No one wants to take responsibility for it , but it's really getting me down. Pain each and every day becomes very depressing. My treatment is ongoing though so they may find something yet. I know I have cancer left at bladder neck and in my lymphs.

If life gives you lemons , then make lemonade

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