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Suggest Remedies For Erectile Dysfunction Post A Prostate Surgery

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Posted on Tue, 31 Oct 2017
Question: I have had prostrate cancer surgery with nerve sparing. For the first two year everything was great. But now I am unable to ejaculate. I just keep going and get close sometime but for over a year I have not been able to achieve ejaculation. Also, I am not as sensitive as before. I feel some pleasure but it is not as intense.
doctor
Answered by Dr. Dr. Muhammad Sareer Khalil (1 hour later)
Brief Answer:
Post prostatectomy ejaculate fluid isnt produced

Detailed Answer:
Hello and Welcome

I appreciate your concern

A nerve-sparing prostatectomy involves the surgical removal of the prostate gland, sparing the two cavernous nerve sheaths that produce erections. After the removal of prostate and seminal vescicles, ejaculation does not occur. The orgasms experienced are dry without the previous release of seminal / prostatic fluid.

One can improve upon the overall sensitization/ erectile dysfunction but there aren't any practical options to produce ejaculate.
Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

For future follow up / correspondence you may ask me directly at the link given below

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107

Dr. M.S. Khalil

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Muhammad Sareer Khalil (2 hours later)
When the surgeon performed the prostateomy he asked prior to that surgery if I wanted a dry or wet orgasm, and I said wet.
For quite a while they were wt. I'm sure they were not the norm sperm bt something liquid and in full disclosure it was often too much maybe two ounces of liquid. But it increased the feeling of pleasure.

You state that there are ways of improving the overall sensitization, could you describe the treatment or the name of the medication, how this could be done.
Thanks
doctor
Answered by Dr. Dr. Muhammad Sareer Khalil (21 hours later)
Brief Answer:
Explained

Detailed Answer:
Hello again

I would advise a Color Doppler Ultrasound of the penis to look for any atherosclerotic changes that may have lead to narrowing of the vessels.

Initial treatment would include folic acid, mecobalamin in addition to either tadalafil or sildenafil. This combination has yielded good results in majority of my patients. Try to consume at least 4 almonds and ground nuts daily with milk in addition to this.

Intra Cavernous Injection of Alprostadil would be the next step if this doesn't help.

Wishing you best of health

Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Muhammad Sareer Khalil (19 hours later)
Doctor is giving this answer I must ask, did you consider that I have have a sucessful penile implant?
doctor
Answered by Dr. Dr. Muhammad Sareer Khalil (2 hours later)
Brief Answer:
Explained

Detailed Answer:
Hello again

I am sorry for your distress

Failure to ejaculate and decreased sensation overall comes under the umbrella of Erectile Dysfunction. Even though you have penile implants but that is only related to attaining an erection and not necessarily improving overall sensitization.

Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

For future follow up / correspondence you may ask me directly at the link given below

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107

Dr. M.S. Khalil
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr. Muhammad Sareer Khalil

General & Family Physician

Practicing since :2012

Answered : 2906 Questions

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Suggest Remedies For Erectile Dysfunction Post A Prostate Surgery

Brief Answer: Post prostatectomy ejaculate fluid isnt produced Detailed Answer: Hello and Welcome I appreciate your concern A nerve-sparing prostatectomy involves the surgical removal of the prostate gland, sparing the two cavernous nerve sheaths that produce erections. After the removal of prostate and seminal vescicles, ejaculation does not occur. The orgasms experienced are dry without the previous release of seminal / prostatic fluid. One can improve upon the overall sensitization/ erectile dysfunction but there aren't any practical options to produce ejaculate. Wishing you best of health Thanks Let me know if you have any query Please consult your doctor before deciding on any further course of action. For future follow up / correspondence you may ask me directly at the link given below http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107 Dr. M.S. Khalil