Unilateral Vs. Bilateral Nerve Sparing and ED

A new study reinforces what we already know: that the Viagra family of drugs work for a lot of PC patients (I think it’s about 50%).  However, you will not get results from these drugs if the erectile nerves are damaged beyond a certain point.  If you are taking Viagra after RP and are not getting results within about two months, you probably won’t get any results — at least for a time.  You should try again in about 9 months when the nerves have had a chance to heal.   If you take Viagra in the interim, you will unwittingly be “donating money to the drug companies”, in the words of my husband’s famous ED doc.  (For more info, see roboticoncology.com.)

*What makes this study interesting is that the researchers found no difference in function between men who had unilateral and bilateral nerve sparing.*  I recommend that every man who has had RP order a copy of his “Operative Report” where this information is listed — you might get a surprise.  Husb’s doc told us he had spared both nerves.  But the Op Report read: “Nerve bundles have been excised on the left side”.  So whom do you believe?


 UroToday, June 5, 2008

Phosphodiesterase Type 5 Inhibitors in the Management of Erectile Dysfunction Secondary to Treatments For Prostate Cancer: Findings from a Cochrane Systematic Review

A group from the UK led by Bridget Candy report a meta-analysis in the BJU International on phosphodiesterase type 5 inhibitors (PDE5i) for the treatment of erectile dysfunction (ED) secondary to treatments for prostate cancer (CaP). [Note: PDED5 inhibitors include Viagra, Levitra (vardenafil) and cialis (tadalafil.)]

Two trials evaluated the effects of sildenafil, 2 tadalafil and one vardenafil.  Most were at the highest recommended doses of these drugs. In all trials the PDE5i drugs were significantly favored over placebo. <snip>  All trials had reported side effects, most commonly dyspepsia, flushing, headache, nausea and rhinitis.

<snip In one trial, the effectiveness of the PD5i by dosage and unilateral vs. bilateral nerve sparing radical prostatectomy found no difference.

Candy B, Jones L, Williams R, Tookman A, King M

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About Leah

Some introductions: First is yours postess with the mostest, yours truly. My name is Leah, but I sometimes I use the nickname "callalily," after my favorite flower. Next is dear husband Ted, who is the Prostate Cancer patient and the inspiration for everything. I consider everyone in the PC community to be family. So what I would like to do with this blog is to advocate for the humane and compassionate treatment of people with prostate cancer and their loved ones, and to try to do it by example. One area that could use a lot of improvement, in my opinion, is doctor-patient relations. I hope to write passionately and compassionately, and especially with a liberal sprinkling of *humor,* because I believe in its exceptional power to heal. I have also learned a lot of factual information about prostate cancer in the past year, from patients and from doing research, especially in the area of erectile dysfunction. So there will be a lot of substantive stuff as well. About me: late 40s, proudly born in Brooklyn, lived there for the first half of my life, then crossed over the bridge to Manhattan, where I've spent the second half. Have a B.A. in history and a law degree. Also worked in corporate communications, doing writing and editing. I love old movies, poetry and watching forensic shows on TV. My favorite topic is murder and mayhem. If I had my life to live over I think I would be a medical examiner, arson investigator or homicide detective. About Ted: He is 55, born in St. Louis, good-looking, fit, has an M.S. in Computer Science but has begun a new career as a writer for a medical ad agency. Ted was diagnosed with PC in August '05, had robotic prostatectomy on 10/15/05. The surgery failed. Ted had a positive PSA test last January, and underwent salvage radiation therapy at Memorial Sloan Kettering. Ted is the intellectual type, reads a lot, but he is also into working out and praying. Anything else, you want to know, you can email me privately @ lfcjjk@aol.com.

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