Highlights from the European Society of Sexual Medicine attended by Dr. Savage 23 – 26 January 2020
Post Radical Prostatectomy patients
Most of these patients suffer with severe erectile dysfunction and even 2 years after surgery only about 50% have regained a degree of potency.
So, what can be do?
Most of these patients are prescribed tablets such as Viagra (Sildenafil) or, Cialis (Tadalafil) but unfortunately, most do not respond to these treatments, this is because of nerve damage from the surgery, despite “nerve sparing” surgery. At the conference, we discussed the evidence from animal research that suggested that taking regular tablets i.e. daily dosing with Tadalafil 5mg should help but in actual fact clinical experience in patients is often very disappointing, so that patients are understandably looking for alternative treatments. These will be either self-injection treatment or vacuum pumps or using both.
Vacuum pumps can be used on a daily basis for penile rehabilitation i.e. they help reduce penile shortening and help keep the penile tissues healthier whilst some degree of recovery occurs with time. Self-injection treatment is very effective in these patients to produce an adequate erection for intercourse and it seems very sad that many of these patients are either not offered that form of treatment or, think it sounds so painful that the patients declines the offer.
Dr. Savage finds at the Leger Clinic that the self-injection drug Invicorp is highly effective and virtually painless and patients and their partners are generally thrilled with the excellent results.
Can Testosterone be prescribed post Radical Prostatectomy?
Traditionally, a diagnosis of Prostate Cancer even after treatment, has been a strict contraindication for Testosterone Therapy but there is now a significant amount of research showing that in many such patients this can be used safely and indeed bizarrely in patients with a high risk of recurrence, that this recurrence rate may well be lower in those treated with Testosterone.