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Urology/Robotic-Assisted Laparoscopic Radical Prostatectomy - Recovery


Dear Dr. Leslie,

I'll be brief. Here're my stats:
53 y/o, athletic complexion, perfect health till 2015, never smoke, drugs or alcohol, no diabetes, overweight, or any of the other common risk factors. No erection or sexual problems before surgery

We'd been married since 2005, but this January we started filing for divorce. In the middle of the legal proceedings (by Jun) my routine annual checkup detected PSA of 4.6, and a biopsy found cancer

I was lucky to find a great surgeon. I had a DaVinci radical prostatectomy. They told me my gland was 85 grams, and that they spared my nerves

Post-op pathology report:
Gleason 3 + 3 = 6, 1% of the prostate was affected (organ-contained), the 5 lymph nodes, and other sorrounding tissue they removed were clean

Catheter removed on the 7th day. After that, incontinence not that bad. I can hold urine better when I have a lot of it than when I'm kind of empty, meaning when I'm empty and not paying attention, some drops may escape, or maybe a short leak. I'm doing Kegels now, I think that's improving

I'm starting my 4th week after surgery, and I've read that after 3 months w/o erection and/or good oxygenated blood flowing thru the penis, the erectile tissue starts decaying and permanent damage can occur

All I read online is how helpful and understanding the sex partners of recovering patients need to be, their role in recovery, etc. But I haven't found anything about my case: I'm divorced already, so no partner, and the odds of finding one before 3 months are zero :)

It's hard to approach somebody, like a date, and tell her my situation (no prostate. no erection)... If I tell up-front it's kind of blunt, but if I don't say anything until later, I might make the other party waste her time!

So, Doctor, here are 3 questions I'd like your advice on:

How to handle the tell/don't tell situation with the opposite sex?

What would you suggest in order to start the path to regain erectile function?

Are there any suggestions to help recovery in patients w/o partner?

Any information or pointers you could provide will be greatly appreciated




Since you are doing this without a partner, it's a little difficult.  Telling the situation to the opposite sex is delicate since you need to be honest but you don't need this to be the first thing you say.  At the appropriate time, indicate your situation but don't volunteer it too early unless you are asked.

Regular function is what seems to help most.  Use of vacuum systems and Cialis/Viagra can also help, but nothing is guaranteed.  Talk to your surgeon regarding what he suggests.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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