What is Penile Rehabilitation? Five Ways to optimise your erection recovery.
What is Penile Rehabilitation referring to?
Let’s look at this with an analogy. Say you’ve had surgery, and the doctor explains that as a side-effect some of the nerves in your arm are in a state of trauma. This means that thinking about and willing your arm to move, won’t make your arm move. You’re going to need rehabilitation, regular exercises that will keep the blood flowing in and out of your arm so the muscle tissue stays healthy and strong.
Penile rehabilitation is exactly that; it's just for your genitals. Penile rehabilitation refers to activities that facilitate erectile tissue health.
Who is penile rehabilitation for?
Some men's cancer treatments can significantly alter erectile function, prostate cancer surgery (radical Prostatectomy), for example.
There is an extremely delicate set of erection nerves surrounding the prostate that is usually sent into a state of trauma during surgery - even with nerve-sparing surgery.
This state of trauma and the recovery from it is called neuropraxia. Neuropraxia can take up to two years, and we may still see some changes in erectile function even after the two-year mark. This is a long time for your erections to not be receiving blood flow from either arousal or nocturnal erectile function.
Fun fact: Every single person on the planet has nocturnal erections, regardless of age and gender! They aren’t sexual, and just the body’s way of moving blood in and out of the erectile tissue. And yes, women have erections too...it’s called the clitoris!
While we don’t know exactly why the body has this nocturnal function, we do know that men who do some form of rehabilitation after prostate cancer surgery are far less likely to experience scar tissue developing within the penile structure which can lead to Peyronie’s disease. Peyronie’s disease is a severe curvature of the penis which can make intercourse almost impossible and can be extremely painful.
Studies suggest that penile rehabilitation may also help restore length to the penis after surgery.
Many men that I have consulted with say the most devastating sexual side effect of this procedure is the shortening to their penis. Some men even say they can no longer stand up to urinate, a daily reminder of what they have lost.
There is evidence that daily penile exercise with a vacuum device could further prevent shrinkage and restore some length (please see the ‘clinical literature’ section of our Pump Penile Rehabilitation Protocol guide for references):
How do you do penile rehabilitation?
There are five options for penile rehabilitation below. Some links have been included for you to learn a little bit more about each one.
1. Intracavernosal injection: Trimix or Caverject.
There are different formulas for injections and my recommendation is that you talk to your urologist or urology nurse practitioner about which one is for you.
I also highly recommend having an injection therapy training session by someone who is experienced in this area. There is a bit of tweaking involved so they’ll need to monitor your results too.
If needles concern you, let me encourage you with this. I’ve had clients who couldn’t stand needles come back to me and say how much their erection was like the ones before. Once they got their right technique and dosage they were extremely happy with the results.
Read our Guide to Penile Injections for more FAQs.
2. Vacuum Erection Device.
The big pro of this is it can be used daily...sort of like doing daily push-ups.
It is very safe and effective, there are five possible side effects if you don’t know the correct technique (all easily avoidable), I have an article about the side effects here.
I recommend the Vacurect and you can find some more information on this right here:
3. Pills - Viagra and Cialis.
You have probably heard these names before! Viagra and Cialis are a collection of pills called PDE5 Inhibitors. Some people respond better to one than the other, so it is worth discussing both with your Doctor.
I recommend you talk to your urologist or urology nurse practitioner about this option and let them make a prescription for you. It’s important they know your full medical history to make a determination on whether this is the right option for you.
Never buy anything over the internet. You don't want to be putting anything into your body when you don't know where it came from.
Something to note if you’re looking at this rehabilitation option. Viagra and Cialis both need working erection nerves in order produce an erection...without those nerves online, they won’t work. So, don’t worry if you take one and nothing happens. This is very normal below 2 years after surgery.
There is a growing body of literature supporting the idea of taking a small amount of Cialis or Viagra every day, like a multivitamin for your penis. But again, talk to your urologist about what is going to be best for you.
4. Sexual pleasure.
Whether it’s alone, with a partner, with or without the erection, sexual pleasure is certainly an option for penile rehabilitation.
Every time you orgasm the pelvic floor contractions increase blood flow and pelvic floor exercises contribute to penile rehabilitation.
Don’t forget, the erection begins in the mind. When your brain says there are pleasure and arousal signals, things begin to take place to create an erection. And when you do that you’re exercising your full sexual system.
UPDATE 2021: We now have a study exploring the potential impact of masturbation on erection recovery - hurrah! Please watch this video for more details:
Products we recommend to enhance pleasure and sensation include Uberlube lubricant, the Manta, and the We-vibe Match.
5. Cardiovascular Exercise.
Looking after your heart health is going to help your erection (keep in mind: “your heart health is your hard health”); so consider things like quitting smoking, cutting down on alcohol and increasing your physical exercise.
An erection is a cardiovascular event and needs good arteries and veins. In fact, many urologists refer to the erection as the ‘canary in your pants’ because it can often be an indicator of your heart health.
My top tip is to see an Exercise Physiologist. They are trained to help you get a program together that’s going to fit your needs and account for any other injuries while still getting the exercise you need for your general health...and your erection health.
So, when is the best time to start penile rehabilitation?
This is actually one of the harder questions to answer because there isn’t a standard guideline on a penile rehabilitation that applies to everyone.
If you’re considering when is the best time to start rehabilitation, here are three pieces of advice:
Talk to your urologist and your urology team. They know what you've gone through in your individual journey and can make recommendations.
Listen to your own body. If you are feeling pain when you start any kind of rehab, it may be your body's way of telling you that it's still in a period of healing. So, leave it for a bit and then come back to it later.
Just do something rather than leaving it. Men who do something positive towards maintaining blood flow tend to have better recovery rates and penis health than those who do nothing.
Remember: Practice Makes Progress.
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