Why isn't viagra working post Prostatectomy?
Viagra needs ‘online’ cavernous nerves (those less-than-paper-thin erection makers surrounding the prostate). Prostate surgery tends to traumatise or damage these nerves during surgery, and the rate of recovery differs between individuals. Viagra depends on certain chemicals floating around the erectile tissue in order to bind to and create that wanted ‘oomf’. The nerves are the controllers for whether those chemicals are present or not.
Viagra will only ‘work’ if you are the good kind of hot and bothered. Arousal is 100% necessary because erections begin between your ears, not your legs. The brain registers a sexy context (this could be from pleasant touch, a hot visual, a saucy fantasy), it then essentially ‘makes a phone call’ down the spine to the cavernous nerves. If the nerve’s are online (see point one) they answer the phone and start to cook up the chemistry necessary for penile-hydraulics. Other factors to consider include being in a low stress state and taking on an empty stomach.
You might get a better result (or less side effects) from a different type of PDE5 inhibitor. There are a few types of ‘erection pills’ you can try, and your system may prefer one to another. Therefore it’s worth talking to your prescribing doctor about trying a different type or dosage if you’re not getting results from the first type you try.
So if viagra isn’t working for you post surgery, it’s not you, it’s likely one of these factors. And if you weren’t told about these factors I am very sorry, because it’s awful to have high hopes dashed.
In fact, one study found that 73% of men quit Viagra after trying it once post Prostatectomy. Mismatched expectations were the main reason for quitting (Salonia, 2008).
Hopefully these pointers help you avoid that disappointment.
Learn more about why men are prescribed PDE5 inhibitors like Viagra and Cialis post Prostate Surgery in this podcast interview with the Godfather of penile rehabilitation, Professor Montorsi.
reference : Salonia, A., Gallina, A., Zanni, G., Briganti, A., Dehò, F., Saccà, A., Montorsi, F. (2008). Acceptance of and Discontinuation Rate from Erectile Dysfunction Oral Treatment in Patients following Bilateral Nerve‐Sparing Radical Prostatectomy. European Urology, 53(3), 564‐570.