Tuesday, July 22, 2014

Double Nerve Sparing Surgery-Hope or Hoax?

I believe the overwhelming majority of men who undergo double nerve sparing surgery are set up for long term disappointment. Disappointment is an understatement. In fact I'm beginning to wonder whether the expectations men are given post surgery could be considered a hoax.

A  hoax is defined as: something intended to deceive or defraud. So my question is whether or not men are receiving accurate information about the return of their erectile functioning post-surgery.

I'm aware that many men never loose their erectile abilities. As soon as the catheter is removed, they are capable of achieving an erection.  I also know of men who after a period of weeks, months, or years regained their pre-surgery levels of their erectile abilities.

I'm also aware there is a very large group of men who are either disappointed, angry, depressed or devastated by their lack of erectile abilities after double nerve sparing surgery.  Every man who is offered double nerve sparing surgery should be told the following:

"Double nerve sparing does not necessarily mean a return of erectile functioning. Even if there is a return, in all probability it will not be comparable to your preoperative abilities." 

If you received that information, you were provided with accurate information.  I believe far too many men went into surgery expecting a return to preoperative erectile functioning. There are a few reasons why this could have happened.

It's possible you were given inaccurate information. It's also possible you were told but didn't remember. Another possibility is the  issue was never discussed. Whatever the caused this gap between what you expected vs what actually happened doesn't matter in terms of the devastation men experience post-surgery.

Men who experience this expectation gap experience anger, depression, bitterness, a loss of self esteem or manhood, and relational  problems. Too man men suffer emotionally, sexually, physically, and relationally as a result of the gap between what was expected and what actually happened with regard to erectile abilities.

Make sure you understand ALL the effects that surgery will have on your sexuality. For example a man will no longer ejaculate. Spontaneous erections may be a thing of the past. No amount of visual auditory or physical stimulation will result in an erection without the use of ED medication, penile injections or a vacuum pump. Orgasms may be less intense. It's possible you'll leak urine before, during or after an orgasm.

Far too many men are choosing aggressive treatment and unnecessarily suffering some of these consequences when aggressive treatment may not be necessary.  My advice is this: Don't let fear determine how you treat your prostate cancer. Get all the medical tests necessary to give the most information possible about your cancer. If it's life threatening treat your cancer aggressively. The risks and consequences of surgery may cause you to consider other forms of aggressive treatment. If your cancer is not aggressive, seriously consider active surveillance.

If you want more information about the surgical option check out my book:
I Left My Prostate in San Francisco-Where's Yours?