Penile Rehab Protocol

[jpcp01628]

I am 68 and had robot assisted radical prostatectomy in June 2020 (unilateral nerve sparing). After surgery, I was very incontinent for about 3 months, but once I started leaking less, I improved to 95+% continence in just a few weeks. I was taking 20 mg sildalafil 3 times per week for about 4 months after surgery. My penis was about 1.5 inches shorter than pre-surgery and I was 100% erectile dysfunctional.

I began physical therapy in Sep 2020. Sessions were weekly for about a month and then at one month intervals. The first issue was improving pelvic floor strength for continence. Kegel exercise frequency has varied, but I’m currently doing 20 contractions daily holding for 10 seconds and releasing for 10 seconds. My pelvic floor muscles are in really good shape. I experience only rare leaks and these are only a few drops. I do experience more frequent leaks while I’m performing my kegel exercises and other physical therapy.

Also in Sep 2020, I began using a vacuum erection device (Vacurect brand pump) and also using a Hitachi vibrator based on my physical therapist’s recommendations.

About 5 months after surgery, my shortened penis condition changed to experiencing more “frightened turtle” penis. When confined to underwear, I experience “frightened turtle” with increased frequency. With the help of my physical therapist, I began penis pull exercises in Jan 2021. Grabbing just the head of my penis, I stretch out my penis until I feel resistance. Number of pulls and duration have varied since I started doing this exercise. I am currently performing 10 pulls per day at a 90 second duration each. This might seem long, but pulling just to feel resistance creates no discomfort at all and the stretched length increases from pull #1 to pull #10. Penis pulls and penis pumping successfully extends my penis to pre-surgery condition (length, girth and hardness).

After 30 months post surgery, I have no erection response at all. I was talking 5 mg tadalafil. The drug did nothing for me and I found by accident that it elevated my blood pressure about 15 points. It has become apparent my absence of any erection response is permanent.

I have read from many of you on the blog about pills, injections and implants. I’m not saying anything bad about any of these solutions, I’m just telling you my opinion and what I’m comfortable with. Given my condition, my primary goal is keeping my penis tissue healthy.
• I don’t want to risk developing fibrosis or Peyronie’s disease. Daily penis pumping and daily penis pulls are providing exercise to hopefully prevent these two negative results from happening.
• Pills have proven to elevate my blood pressure so that is out.
• Injections create the risk of scar tissue and fibrosis so that is out.
• After all the collateral damage done from prostatectomy, another surgery for implant is a risk I don’t want to take.

With the help of my physical therapist and an incredibly understanding wife, I will continue on my journey of keeping my penis tissue healthy and getting on with life. I get a PSA test every 6 months and these have been near 0.

In my opinion the medical establishment is grossly disingenuous when it comes to being honest with what can happen to a man after prostatectomy surgery. Articles and studies do not tell the whole story or gloss over important side effects. In my own case, my urologist (whom I like and trust), told me about incontinence and erectile dysfunction. He DID NOT tell me about my shortened penis condition.

This discussion board has, without a doubt, been the most informative resource for me as well as A Touchy Subject website run by an Australian physical therapist. For me, finding a Physical Therapist that is knowledgeable and engaged in addressing my post prostatectomy issues has been a critical to me. Unlike most physical therapy, I believe I will need her help long term insuring I’m doing everything I can physically to compensate for lack of erection response.

Good luck to all of you and thanks for listening to my story.

[bldoink]

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[bldoink]

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[ftwabeck3533]

In my opinion the medical establishment is grossly disingenuous when it comes to being honest with what can happen to a man after prostatectomy surgery. Articles and studies do not tell the whole story or gloss over important side effects. In my own case, my urologist (whom I like and trust), told me about incontinence and erectile dysfunction. He DID NOT tell me about my shortened penis condition.

This discussion board has, without a doubt, been the most informative resource ....

If you're interested in my post-prostatectomy journey, feel free to PM me.

You are "right on" with the quotes I emphasized above.

[Ginsulator]

Brother, you need to try Pt141 and cialis, or trimix or perhaps an implant. Do not let the rest of your life go woodless.

[still_crazy]

Very similar story as OP and many others here, I'm sure.

However, like BLDOINK said, try injections, what have you got to lose?

Hell, I already had Peyronies before the prostatectomy... happened due to a bending trauma when I was in my mid 50s.
It has actually gotten better over time and I think using the VED has helped... I do have some plaque, but my erection is definitely usable.

I had non-nerve sparing surgery, and was told I would never have another erection... ha ha, wrong thanks to Trimix.

Life goes on and I'm still cancer free.