Sex back on for erectile dysfunction sufferers

Erectile dysfunction cure for men with prostate cancer


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A nerve graft is allowing prostate cancer surgery patients to regain erectile function. Image: Shutterstock

A nerve graft is allowing prostate cancer surgery patients to regain erectile function. Image: Shutterstock

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"They're smiling and so are their partners": treatment saves sex lives of prostate cancer patients.

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MELBOURNE surgeons are saving the sex lives of men with erectile dysfunction caused by prostate cancer surgery.

The surgeons have modified a minimally invasive technique using a nerve removed from the patients leg, and have had a 71 per cent success rate, with two participants achieving their first erections in 12 years.

Of the 8500 Australian men with prostate cancer who have a radical prostatectomy each year, at least 70 per cent experience erectile dysfunction. Many are unaware of the risk or suffer in silence.

Treatment usually involves injections or a prosthesis, which can have side effects.

A study on the procedure which can restore the ability to have satisfactory sexual intercourse and improve sexual quality of life in men with erectile dysfunction following a nerve-sparing or non-nerve-sparing radical prostatectomy, has been published in European Urology.

Microsurgeon and University of Melbourne Department of Surgery Professor, Christopher Coombs, and Monash Medical Centre urologist, Mr David Dangerfield, developed the new procedure.

Professor Coombs said the early results were promising. Those who could achieve erections again were extremely grateful - as were their partners, he said.

"We looked at sexual quality of life before and after. Regaining erectile function had a significant impact on quality of life and the way the men felt about themselves," Professor Coombs said.

"When they walk back in after 12 months you know if it's worked - they're smiling and so are their partners. They think it's great."

Radical prostatectomy can injure the penis' nerves to the spongy tissue, the corpora cavernosa, which are responsible for initiating an erection.

A review followed 17 patients aged under 70 with severe or moderate post-prostatectomy erectile dysfunction, who had a sexual partner and undetectable PSA (Prostate Specific Antigen) levels.

Between March 2015 and October 2017, the men underwent 'end-to-side' surgery to remove the sural nerve from the leg and graft it to the side of the larger femoral nerve in the thigh. New nerve fibres then grew along the sural nerve graft into the corpora cavernosa of the penis.

All patients were discharged after an overnight hospital stay.

Erectile function was restored in three men within six months and nine within 12 months, a total of 71 per cent.

After a year, all 12 with restored erectile function had clinically relevant improvements in their sexual function, and 83 per cent were less bothered by their symptoms. Of the 12, seven did not require drugs to achieve erectile function "sufficient for satisfactory sexual penetration".

In 2017, Brazilian surgeon Fausto Viterbo reported on his use of nerve grafting to restore erectile function in men after prostatectomy.

The Melbourne surgeons' innovation is to induce minor injury to the femoral nerve to stimulate regeneration.

The new procedure aims to provide more axons (threadlike part of a nerve cells along which impulses are conducted) to the penis due to that partial injury to the femoral nerve.

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