How long does Erectile Dysfunction last after Prostate Surgery? (Prostatectomy)
I've worked with hundreds of men wanting their erections back after prostate cancer surgery.
The most asked questions are about how long erectile dysfunction after surgery lasts, and what are the signs of ‘recovery’.
I’m going to be honest with you - There is no straightforward answer.
This is not a matter of ‘x’% of all men get erections back in ‘x’ years.
There are so many variables involved in erection health and function. It’s tricky to put an estimate on any person’s future when it comes to spontaneous recovery.
That’s why you’ll constantly hear ‘everybody’s journey is different’ when it comes to sexual function after Prostate Cancer Treatment.
How many men get their erections back post surgery?
If you go to the clinical literature, you will see statistics on erectile dysfunction recovery post Prostatectomy that range from 10% to 90%.
… Not especially helpful, right?
It’s the statistical equivalent of someone doing a big shrug.
This isn’t surprising though. Both due to the many variables governing erectile function, but also the way studies report and evaluate ‘erection recovery’.
Many studies use the IIEF (International Index of Erectile Function). If you’ve ever been asked to fill this out, you’ve probably already given it the side-eye in terms of how well it reflects post-prostate erection reality.
Even knowing your nerve sparing status doesn’t necessarily predict your outcome (watch this interview with Urologist, Professor Murphy to understand why).
Therefore, trying to find one statistic to predict your future might not be the most helpful strategy.
I’d like to pose a new approach.
Rather than focusing on statistics, or another bloke’s story, instead ask yourself:
“What is going to put me on the side of stats that I want to be on?”
“What is in my control in terms of boosting my erection health and recovery?”
How long does it take for the erection nerves to heal after prostate surgery?
There is a lot in your control (go back to the Free Penile Rehabilitation Course for reminders).
However, the one part of recovery that is not in our control: the progression of erection (‘cavernous’) nerve recovery (‘neuropraxia’).
Sometimes these ‘erection nerves’ are damaged or have to be removed during the prostate surgery procedure, but even if they are sparred, the trauma from the light and the heat of the operation can make them go ‘offline’.
These erection nerves surrounding the prostate can take two years or longer to recover.
Currently, there is no way of measuring the state of those nerves post surgery, and there no known way of ‘speeding along’ this part of recovery.
I really hope we do have this capability one day. Or treatment options that don’t affect these nerves at all. But this is where we are right now (this article was written in 2021).
That can sound a bit daunting, but again, come back to the many parts of erection health you can focus on to keep the architecture of your penis in good condition while waiting for these nerves to recover (these activities are what Penile/Erection Rehabilitation is all about).
And remember, those nerves are only responsible for arousal/nocturnal-induced blood flow in and out the penis - they are not involved in your ability to experience orgasm, pleasure, or arousal. These are completely separate nerve pathways.
See our Pleasure Masterclass for how to enhance sensation/orgasm post Prostatectomy.
What are the signs of erection recovery post prostate surgery?
I often hear that one struggle with erection recovery is how different it is to continence recovery.
It’s not linear, and it’s difficult to measure.
You can’t exactly weigh an engorged penis in the same way you might have weighed your incontinence pads.
I think it’s important to know that progress isn't going to look like suddenly waking up with a full erection one day.
It's more likely you’ll notice some slight engorgement or some tingling at first, but maybe no stiffness.
You may then experience a long plateau where you achieve a semi-erection through arousal, but still need manual aids like pumps and pills.
Extra: Read a story about what erection progress can look like.
This is why it can be helpful to consult with a penile rehabilitation specialist along your journey, to share signs of progress, and at each stage of progress try a new strategy to help you reach the next level.
I highly recommend Melissa Hadley-Barrett’s services for this. She has created a guided online penile rehab program including consultations for tailoring. Or, you can have the occasional one-on-ones with her over Zoom or in person (she’s based in Western Australia).
Feel free to book a free 15 minute phone call with her if an erection-guide appeals to you.