Erectile dysfunction is a common concern following radical prostatectomy. Although prostate surgery is often effective in treating prostate cancer, it can impact the nerves and blood vessels responsible for erections.
This article explains the rationale for penile rehabilitation, available treatment options, and how early intervention under the care of a qualified urologist in Singapore can improve long-term outcomes.
What Is Penile Rehabilitation?
Penile rehabilitation is a structured treatment programme designed to help men recover erectile function after prostate surgery. It involves early, regular stimulation of the penis using medication or devices to maintain tissue health and encourage natural healing of the nerves and blood vessels responsible for erections.
Why Erectile Changes Happen After Prostatectomy
During radical prostatectomy, the prostate gland is removed from a location close to the erectile nerves and blood vessels. Even when nerve-sparing techniques are used, these structures may be affected. As a result, it is common for men to experience temporary or long-term difficulty achieving or maintaining erections.
Several factors influence recovery potential:
Type of surgery: Nerve-sparing surgery offers better chances of regaining function, but sometimes cancer location requires more extensive removal.
Pre-surgery erectile function: Men with strong erections before surgery tend to recover better.
Age and general health: Younger, healthier individuals often experience quicker recovery.
Healing timeline: Nerve regeneration can take up to two years, and early support helps preserve function while healing occurs.
The Importance of Penile Rehabilitation
Penile rehabilitation encourages early and regular stimulation of the penile tissue to maintain its structure and promote recovery.
Potential benefits include:
Improves blood flow: Promotes oxygen delivery to maintain tissue health.
Prevents scarring: Reduces the risk of long-term structural changes.
Better functional outcomes: Men who begin rehabilitation early often show improved erectile function at 12–24 months.
Rehabilitation Methods Used in Post-Prostatectomy Care
Dr. Lee tailors each rehabilitation plan based on the patient’s medical history, type of surgery, and recovery goals. Common strategies include:
Oral Medications (PDE5 Inhibitors): Drugs like sildenafil (Viagra), tadalafil (Cialis), and vardenafil improve blood flow and are often used on a daily or as-needed basis when some nerve function remains.
Vacuum Erection Devices (VEDs): These non-invasive devices use gentle suction to draw blood into the penis. Daily use can help preserve length and prevent tissue scarring.
Penile Injections: Medications can be injected directly into the penile tissue to induce an erection. While this method may seem unfamiliar at first, most patients adapt with appropriate instruction.
Intraurethral Suppositories: A needle-free option that involves inserting a medicated pellet into the urethra. Effectiveness varies between individuals.
What to Expect During Recovery
Each patient’s recovery timeline differs, but the following stages represent typical progress:
0–3 months: The focus is on maintaining tissue health. Erections are uncommon during this period. Oral medications or vacuum therapy may be initiated.
3–6 months: Some individuals begin to observe signs of spontaneous erectile activity. Continued use of prescribed treatments is encouraged.
6–12 months: Improvement may continue. Medication dosages may be adjusted, and attempts at sexual activity may resume gradually.
12–24 months: Most recovery occurs within this period. Some men regain full erectile function, while others may continue using medical aids effectively.
When to Seek Medical Advice
Follow-up with your urologist is important to ensure that your rehabilitation plan remains appropriate. Dr. Lee may recommend reassessment if:
- There is no improvement despite consistent treatment
- Side effects interfere with continued use of medication or devices
- Progress has plateaued and new strategies are needed
- Emotional or relationship concerns arise during recovery
In such cases, adjustments can be made to optimise your outcomes.
Long-Term Outcomes
Recovery of erectile function after prostatectomy varies between individuals, depending on surgical technique, overall health, and consistency with rehabilitation. Some men eventually regain natural erections sufficient for intercourse, while others achieve satisfactory sexual function with the aid of medications or devices.
Regardless of the path to recovery, the goal of penile rehabilitation is to preserve long-term sexual health and quality of life. Ongoing follow-up care is essential to monitor progress, adjust treatment strategies, and provide support throughout the rehabilitation process.
Dr. Lee, an experienced urologist in Singapore, offers personalised rehabilitation plans and expert guidance to help patients navigate each stage of recovery. With timely intervention and tailored support, most men can achieve meaningful improvement in sexual function after prostate surgery.
