Wednesday, March 25, 2015

The Truth About Erectile Functioning After Prostate Surgery

Here's what many of us heard before surgery "The likelihood of erectile function at 12 months following robotic surgery is 93.5%."
A new study turns that statistic upside down. A group led by Dr Mikkel Fode, from the Herlev Hospital in Copenhagen, asked 210 patients to complete the IIEF questionnaire, around 23 months after Radical Prostatectomy surgery. However they added an additional question: “Is your erectile function as good as before the surgery (yes/no)”. Only 14 patients (6.7% of respondents) reported that their erections were as good as before surgery.

Put another way 93.3% of the men who were 23 months post surgery said their erections were not as good as before surgery and they were struggling with erectile problems.

I was told my erectle functioning would return to my pre surgery levels. Four years post surgery I was impotent.  I was seriously depressed for 18 months because I was waiting for the pre surgery return of my erectle abilities. Turns out the majority of men won't have this experiennce.
Here's the link to a new study which tells the truth about erectle functioning after prostate surgery. 
ReplyReport post

Friday, March 20, 2015

PTSD Drives Men Away From Penile Implants

Even though I've been a Medical Social Worker I had no clue I'd been suffering from PTSD, short for Post Traumatic Stress Disorder.

How and why would I experience PTSD when I made a choice which would put an end to my suffering with erectile dysfunction? To say I was confused would be the 
understatement of the year.

 Post-traumatic stress disorder (PTSD) can affect those who personally experience the catastrophe, those who witness it, and those who pick up the pieces afterwards. Receiving a dx of prostate cancer, coping with the loss of urinary control, & erectile dysfunction are catastrophic changes in the life of a man and in the life of a couple.

What are some of the symptoms?

Symptoms of PTSD: Re-experiencing the traumatic event

  • Intrusive, upsetting memories of the event
  • Flashbacks (acting or feeling like the event is happening again)
  • Nightmares (either of the event or of other frightening things)
  • Feelings of intense distress when reminded of the trauma
  • Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating)

Symptoms of PTSD: Avoidance and numbing

  • Avoiding activities, places, thoughts, or feelings that remind you of the trauma
  • Inability to remember important aspects of the trauma
  • Loss of interest in activities and life in general
  • Feeling detached from others and emotionally numb
  • Sense of a limited future (you don’t expect to live a normal life span, get married, have a career)

Symptoms of PTSD: Increased anxiety and emotional arousal

  • Difficulty falling or staying asleep
  • Irritability or outbursts of anger
  • Difficulty concentrating
  • Hypervigilance (on constant “red alert”)
  • Feeling jumpy and easily startled
After I scheduled myself for implant surgery I began to experience many of these symptoms. Especially trouble sleeping and a high level of anxiety. In  addition, my  wife and I saw a dramatic rise in irritability and fighting. We didn't understand what was happening in our marriage. We saw a counselor who confirmed both of us were suffering from PTSD. 

That took me by surprise. I was expecting to be restored by surgery, It was a choice I made and I was expecting a positive outcome. I didn't understand why these circumstances would bring about symptoms of PTSD. 

For the last four years, there's only one thing that brought my wife and I into San Francisco, Every trip involved something to do with the diagnosis and treatment of prostate cancer. Pre surgery & post surgery visits as well as my unsuccessful penile rehab all took place in the city San Francisco. Receiving the news I'd be impotent for the rest of my life also took place in San Francisco.
Even though I was cured from cancer in San Francisco, my life was unalterably changed for the worst in that city as well. Now I was returning to UCSF in San Francisco once again, hoping for a positive life changing experience. 

Our minds were locked into all the negative life changing events that happened as a result of our visits to San Francisco. Although we wanted to feel positive about the reasons why we were returning to San Francisco once again, we got stuck re-living the trauma of all that happened there during the last four years. 

For many men it's not the return to a city that triggers PTSD, it's a return to ANY surgeon that triggers PTSD. That's the reason why I hear the following comments when I discuss the amazing restoration brought about by the implant procedure. Here's a sample of those comments:

"I"ll never go within a mile of another surgeon."
"There's no way I'll have another surgery." 
"I won't let a surgeon touch me ever again."

The comments above are all  expressions of  a powerful desire to avoid any further surgery that's now associated with the devastating effects of  erectile dysfunction. This avoidance that comes from PTSD is powerful and resistant to any form surgical treatment no matter how successful.

It's often worse for the men who've had double nerve sparing surgery, yet  failed to re-gain their erectile dysfunction, In this situation issues of trust are involved. Many men with double nerve sparing surgery believe they've been lied to or betrayed, As a result, they've made a life long decision they'll never  trust a surgeon again. That decision effectively sentences a man to a life time of misery coping with erectile dysfunction.

My point here is this, while penile implant surgery isn't for everyone, it's important to make this life altering decision based on the merits and risks involved in surgery rather than have the power of  fear, the loss of trust,or avoidance that comes from PSTD make your decision for you. All too frequently, the  resistance to penile implant surgery comes from PTSD, fear, or the lack of trust, rather than an objective analysis of whether this surgery could benefit you.

Penile Implant surgery has the highest success rate in treating ED. There's no other treatment of ED that has a higher user and partner satisfaction rate. I can say from personal experience that my implant restored what prostate cancer and surgery took away from me.

So don't let PTSD,  fear, or the lack of knowledge determine your choice whether or not have implant surgery. Base your decision on the facts about penile implants. Here's a link to provide you with some of those facts. I hope you'll read it.
Treating ED With A Penile Implant

That's my view, what's yours?

Rick Redner and his wife Brenda are the authors of an awarding winning book written to help men and couples cope with life without a prostate. I Left My Prostate in San Francisco-Where’s Yours? can  be previewed and purchased at 

Wednesday, March 18, 2015

Penile Implants A Cure For Erectile Dysfunction

It wasn't supposed to happen. I had double nerve sparing surgery. Based on my pre-surgical sexual history my Surgeon assured me I'd have a return of return of erectile functioning. To insure this would happen I got involved in a penile rehab program which included penile injections. When they stopped working I switched to daily ED medication.

At three years post surgery my success rate with ED meds was no better than 50%. Even then erections didn't last very long. By fours nothing working and I found myself facing the rest of my life impotent. This outcome was totally unexpected and certainly unwelcome. I was prepared to give up sexual intercourse for the rest of my life.

I began doing research on penile implants. What I learned surprised me. Penile implants are the most successful way to treat ED. Additionally they have the highest user satisfaction rates than any other form of treatment. Satisfaction rates in studies of men who've had penile implants run in the range of 85% -to 97%.

I made an appointment with a Urologist at UCSF who performed penile implants. When we discussed the where I landed four years post surgery, he was very supportive of my decision to have an implant.

Here are my thoughts feelings and experiences about my penile implant activation. I was very embarrassed to lay on the exam table while my surgeon demonstrated how to pump and deflate the implant.

1. At the advice of many men, I took Tylenol 1 hour before my appointment to help with any pain associated with using the pump for the first time.

2. I tried many times at home to squeeze the pump. It required more pressure than I was comfortable using. I'm glad I didn't activate the pump. You should NOT use the pump unless you are certain you know how to deflate it. I had no clue how to deflate the implant.

3. You may be very sore. Most men are left semi-inflated during the 6 weeks post surgery. I had one specific stop where the tip of the implant put a lot of pressure on my penis. It was a relief when I experienced total deflation.

4. The pump starts off very difficult to squeeze and takes a lot of pressure. I was only able to get 4-5 pumps before it got too hard to pump more

5. I'm glad I was prepared before surgery about the loss in size. I lost about an inch.

6.  It was a very good thing my wife learned how to inflate and deflate the pump. When we tried the implant for the first time, I was completely unable to find the deflate button. My wife learned that the implant was facing sideways so the deflate button was not where I expected it would be. If my wife didn't learn how to deflate the implant I would have needed to drive back to San Francisco the next day to have my surgeon deflate the implant.

7. After a few days of use my wife and were enjoying our sexual experiences together as much as we did before my prostate was removed. 

6. I find the implant to be light years better than penile injections.

7. My wife and I look forward to enjoying many years of making love. Both of us feel very grateful to re-experience what we thought was lost forever.

To those men who feel the don't want to go within a mile of another surgeon, don't let your past experiences cheat you of having a procedure that restores your sex life. Getting the implant was the best decision I've made after I didn't regain erectile functioning. I feel completely restored.
Implants have the highest satisfaction rate than any other form of treatment for ED. That said, this type of surgery is not a solution for everyone. For anyone coping with ED, the implant is an option worth exploring.

Rick Redner and his wife Brenda are the authors of an awarding winning book written to help men and couples cope with life without a prostate. I Left My Prostate in San Francisco-Where’s Yours? can  be previewed and purchased at
If you'd like to ask me a personal question about penile implants you can reach me at:
my website at:
Welcome Page  Click on the "Contact Us" button on the left hand side of the Welcome Page.

Sunday, March 1, 2015

Turning Your Cares Into Prayers

Did you ever read something then say to yourself I wished I'd read that years ago? I had that experience when I read a sermon that Charles Spurgeon gave about the topic of care & prayer.

Here's a summary of what he wrote:
Once you become careful, anxious, fretful, you will never be able to count your cares, even though you might count the hairs of your head. And cares are apt to multiply to those who are care-full and when you are as full of care as you think you can be, you will be sure to have another crop cares growing up all around you.
Cares are numerous and, therefore, let your prayers be as numerous.
Turn everything that is a care into a prayer. Let your cares be the raw material of your prayers and, as the alchemists hoped to turn dross into gold, so you, by a holy alchemy, actually turn what naturally would have been a care into spiritual treasure in the form of prayer.

Since a large portion of those who read both my blog, pre surgery, & post surgery forum are not Christians, I wanted to reach them without offending them, so I made the decision not include a very important part from Spurgeon's sermon. 

Now I have to ask myself did I misrepresent what I wanted to share about prayer by leaving out an essential truth? I suspect I did. What good is it to pray if you are praying to a God of your own imagination? Is there any value in that? I suppose there could some value in that in the same way some people experience an improvement in symptoms when they are given a placebo.

If prayers are going to be answered by the Creator of the Universe, it's important they be directed to the Creator of the Universe. Otherwise you might as well hold up your pillow and pray to that or anything else of your choosing.

So here's the last line I left out:
Baptize every anxiety into the name of the Father, and of the Son, and of the Holy Spirit—and so make it into a blessing!

Agree or disagree, we are blessed to live in a free country. Our culture places very little value on Biblical truth, but when you are coping with a potentially terminal disease, it's important for me as a Christian to tell the Truth with a capital T.

You can turn your very real fears and cares into prayers. I pray you will be wise enough to do that by directing your prayers to the Creator of the universe.

As a result of my decision to leave out the last sentence, I created a new Facebook Page for Christians Coping with Cancer. where prayer and bible verses will be welcome.

Rick Redner and his wife Brenda are the authors of an awarding winning book written to help men and couples cope with life without a prostate. I Left My Prostate in San Francisco-Where’s Yours? can  be previewed and purchased at

Sunday, February 22, 2015

Three Orientations Toward Prostate Cancer

For the last 4 years I've been reaching out to men with prostate cancer via the Internet. In that time I've observed three distinct orientations toward cancer. They are the (nose) Diver, the Survivor and the Thrivor.
The majority of people dx with cancer will spend some time in the Diver phase.

How do you know you are in the process of taking a nose dive? You will experience a few of these symptoms:
1. Trouble sleeping or concentrating
2. Persistent and intrusive thoughts about cancer or treatment.
3. Ever present feelings of anxiety, fear, irritability
4. Feelings of helplessness or loss control
5. A sense of pessimism or fear about your future
6. Excessive Worry- where we think and believe we will suffer all kinds of worse case scenarios.
7. You can experience depression, isolation, and withdrawal from previously satisfying relationships.
8. You might use drugs or alcohol to alter your mood or help you to cope.
9. Thoughts of suicide may be present.

 When you experience a nose dive you are completely overwhelmed by your dx of cancer or the changes in your life, brought about by the treatment of your cancer. Divers are frequently depressed and often highly resistant to getting help.

According to my website site survey about 8% of those dx with prostate cancer remain stuck in the diver phase long enough to damage or tear apart their relationship with their partner. Approximately 92% move to one of two different orientations. 

Cancer Survivors- Place a high value on overcoming problems They view cancer as a problem, a life challenge to be solved and resolved.  They want to get over things without too much introspection. They have a high need for control over the events and challenges in their lives. They are assertive.  They tend to have large networks of support.  They are not necessarily introspective.  Survivors are conquers.  Many people in this group will be the ones who will be socially & politically active. They are your leaders. They’ll start support groups, they will look to find ways to help others. `The best way to help a cancer survivor is to offer them options for each problem they face. So if the issue is coping with ED that’s not responsive to ED medication, you offer them a vacuum pump or penile injections or the possibility of a penile implant. They’ll make a decision. If they find an option that works, it’s on to the next problem that needs to be solved.
Folks in this group  would say that cancer has put a lot of stress on their relationship and some would readily admit their relationship is not as good as it was prior to a dx of cancer. Yet they get up every day and  do what needs to be done. Survivors  take pride in overcoming obstacles and their cancer is one of those obstacles. If you ask a cancer survivor if they could push a button and go back to their life pre-cancer, overwhelming majority would say yes without any hesitation.

Cancer Thrivors will tell you that their experience with cancer has transformed their life as an individual and as a couple. They will tell you how much more they appreciate the gift of life, and how much closer they feel toward their spouse and children. They talk about the ways in which  cancer has transformed their lives as individuals and as a couple. They’d tell you they’ve become more loving, open, honest, and caring. They’d say their sex life isn’t the same as it was prior to cancer, but they found ways to mutually satisfy one another and they enjoy their physical and sexual relationship together. Many will say it’s different but it’s better than pre-cancer days. This group of people usually have a network  consisting of friends and/or family They go places together as a couple and know how to have fun. Laughter and humor plays an important part of their lives. They cultivate an attitude of gratitude, they are grateful for the smallest things and they’ll thank you profusely for any act of kindness you show toward them. 
Thrivors are interested in interpersonal growth opportunities and if you work a thrivor they’ll be interested in books or conferences that involve personal growth opportunities.

The Diver phase is the most dangerous phase, emotionally, relationally, and physically. The risk for suicide doubles for men in this phase. Since most men are highly resistant to getting outside help, I'd encourage anyone living a  diver who is refusing to get outside help, to encourage them to either go on-line to a prostate cancer support forum and start off my reading threads that interest them. Buying a book about coping with prostate cancer is another option.

If you are interested in sharing your experiences in any of these phases I hope you'll share your story.

Rick Redner and his wife Brenda are the authors of an awarding winning book written to help men and couples cope with life without a prostate. I Left My Prostate in San Francisco-Where’s Yours? can  be previewed and purchased at

Friday, February 13, 2015

Why I Decided to Get a Penile Implant

Almost four years ago, I had my prostate removed via da Vinci surgery. I had double nerve sparing surgery. My surgeon was certain I'd regain erectile functioning. I participated in a penile rehab program which included penile injections. I had no doubt my erectile functioning would return.

Over the course of the next 3 years I had off and on results with ED medication. Approximately 50% of the time I could achieve an erection that worked. In the 4th year nothing worked. My failure rate jumped from 50% of the time to 100% of the time. It was clear that I was facing the rest of my life with erectile dysfunction that would respond to injections or medication.

At age 63 I asked myself an important question. Did I want to live out the next 10-15 years of my life without the ability to have sexual intercourse. My answer to this question surprised me. I'd gotten older than I realized. In my 30's, 40's and 50's, it  would me a second to answer that question with a resounding NO. I was now in my 60's and what my wife thought about the whole matter was important. If she said I wouldn't miss making love with you, I would not have bothered with a surgery.

Both of us missed the physical closeness that's all part of making love . Both of us wanted to have this experience again. When I say again,  I'm not talking about making love once a month, I'm talking about multiple times per/week.

Three weeks ago I went to UCSF for penile implant surgery. I must confess I was embarrassed each time a nurse entered my room. They knew exactly what type of surgery I had and why. I wondered if they were disgusted or grossed out with the thought that a 63 year old man enjoys sex.

According to Hollywood, sexuality is  reserved for the young and beautiful. I do not possess either of those qualities. Yet in our 60's both my wife and I agree that our sex life is better now in our 60's than it was in our 20's. I wouldn't go back.

In Feb 2015,  I made a decision to get back what cancer took away, my erectile abilities. In a few weeks my wife and I will have a test run on my new bionic equipment. Since ED is such a distressing act of life for many men without a prostate, I'll be reporting back about my experiences and whether or not it's worth it to go through the risks and pain of this surgical procedure.

Saturday, January 31, 2015

Penile Implant Surgery Tips

Did you ever wish for a re-do button that would allow you to re-do a decision or event knowing what you know today. Even though I'd spent hours on-line researching information on penile implants and reading dozens of threads written by men who've had surgery, I didn't get the information I needed.

I thought I'd make a list of things that I didn't know but wished I had. One week post surgery, if someone offered me a re-do button,  I'd push it without hesitation.

Knowing these ten recommendations would prevent a week of unrelenting pain. I'd have avoided waiting an extra 3-5 weeks to have my implant activated. I would have  reduced the number of weeks I had to stay at home unable to drive a car or go back to work. In other words, this list could save you from unnecessary grief, delays in healing,  and physical pain.

If you are considering a penile implant, allow this blog to replace your wish for a re-do button.

1. Insist your surgeon use a drain-otherwise your scrotum could swell up to the size of a grapefruit
2. Jock straps aren't the right support for everyone. Sometimes they will cause the pain you are trying to avoid. If you decide to use a jock strap make sure it's large enough to give you the scrotum support you need. Not all jock straps are created equal. The wrong strap will cause you serious pain.

3. If your scrotum is too large for comfortable support from the jack strap use a folded towel. Don't let a swollen scrotum just hang down with no support.
4. If compression underwear is comfortable use it. If it hurts go with loose fitting boxers with some form of scrotal support.
5. If non narcotic pain meds are not effective start with a STRONG narcotic pain med or you may suffer from unnecessary pain. It took a week of unrelenting pain before I got an effective pain med.
6. Don't over use ice. You can't decrease the time it take to reduce you swelling, but  it will feel good. No more than 20 minutes at a time. No more than 3-4 times in a day.
7. It takes effort to find a comfortable way to sit in a chair. You'll need some type of support under your scrotum in order to sit without discomfort.

8. Reclining chairs are wonderful. I slept in one for a week

9. If you sleep on your stomach as I do, you may find it necessary to sleep on your back. It was impossible for me to sleep on my back a flat bed. For the first week I slept on a recliner. Then my wife and I purchased a sleep number bed which allowed me to adjust the head and feet. With the head portion up I was able to sleep in bed, on my back.

10, Even with the most comfortable recliner and sleep number bed I could not fall asleep without the use of medication. I had my Doctor order a month supply of sleep medication  Every few days I'd  to go asleep without medication.  The following rule governs my use of medication for sleep: I'm still awake 1 hour past the time I go to bed, I'll take medication for sleep. I've used sleep medication seven out of the last eight nights.

Eight nights  post surgery (with severe scrotum swelling) It's too painful to sleep on my stomach and . I truly hate sleeping on my back, Our reclining chair was a life saver. What brought me back to my bedroom was a very expensive (but worth the price) sleep number bed with adjusting head and foot positioning. I long as my head is raised up by a 45 degree angle or more, with the help of medication, I can sleep well.

Sleep is essential for healing. If you have having difficulty in this area, make sure to discuss this with your Surgeon or your General Physician,  Sleep impacts how you will heal and how you will feel.

Rick Redner & Brenda Redner are the authors of:
I Left My Prostate In San Francisco-Where's Yours? 
Their award wining book was written to help men and couples cope with prostate cancer