For several years we have prescribed Viagra, Cialis and Levitra to men recovering from prostate surgery. Before that, we recommended regular use of penile injections or a vacuum erection device. We call this approach ‘penile rehabilitation’. The goal is to keep the blood vessels in the penis ‘limber’. By doing this, the hope was that men would be left with better erections after the treatment and healing period. It is not so clear and some studies show and improvement. Other studies suggest there is no benefit. So what is a man recovering from prostate supposed to do?
A recent article in the Journal of Sexual Medicine, sheds some light on issue. It is not a study but an article called a meta-analysis. This type of article reports the findings of many existing studies. After very careful selection of the better studies the data is analyzed.
In a nutshell it’s a bit confusing but here’s my read:
- In terms of erectile function / recovery: penile rehab does not improve the degree / amount of recovery. Men who are on penile rehab do not fare better at the end of recovery with medications like viagra.
- Men who used medications, injections or vacuum for rehab however experienced better sexual function during the period of rehab. They had better erections as they recovered. I deduce that this is probably a happier patient.
- Penile rehab helps in the psychological recovery of men who wish to be sexually active. It allows them to experience better erections during recovery. I think it gives them more confidence.
- Even though the end function is not improved, there are benefits to the vascular tissue of the penis. As a result of rehab less stiffness in the blood vessels develops, compared to not doing it…. use it or lose it.
In summary, I think that penile rehab is a good idea for a man who is recovering from prostate removal surgery, if he wants to be sexually active during the recovery. His erections will be better than the guy who wants to be active but isn’t on rehab. And probably as important is that for men who aren’t interested in being sexually active during the recovery, they are not missing an opportunity if they aren’t treated with penile rehab. There are various approaches, but usually it involves taking a low dose of the erectile function medications on a daily basis.