daVinci robotic vs brachytherapy and performance

Seems to me from what I read here, as far as sexual function after treatment, many of those who have had this surgery are having trouble with erections whether it is soon after surgery or later on; while it seems like a much bigger percentage of those who have had seed implants continue to have far less difficulty. Am I getting the correct impression or not?

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I can only speak for my self. I had the robatic surgery do to family history. My father had 5 brothers 2 died within 5 years of thier PSA jump all the others had surgery( Robatics did not exist) They did not have any cancer later in life. My father had surgery at 72 and had a great life until his passing at 90(stroke). My older brother at 60 had robtic surgery from a great surgon in Seattle. His PSA jumped from 1.2 to 5 in one year. PC had spread to the margins very rappidly. He had to have follow up radiation. Three years now undetectable PSA. My PSA jumped at the same exact physical age 60 by the same exact degree my last psa test had been 7 months befor the jump . Sept. 2011 biopsy showed one 3/3 one core out of 12
I had made my decision based on my brothers Rapid PC growth rate prior to my PSA jump. Surgery. 6 weeks after biopsy I had Robatic nerve sparing surgery and patholagy showed that the cancer had developed in other area including a quadrant that was tested but was all contained! not in margins, bladder neck or ducts . I have had to take Viagra to jump start things increase blood flow and am makeing good progress. Close to full erections now, and no pads after 3 1/2 weeks . My brother had full erections at two years no drugs any more and he had radiation after Surgery. I felt seed implant at age 60 was not the choice for me. I plan to out live my father at 90. My doctor agreed that had I not had my psa check 3months early with other blood work the out come could have been similar to my brother based on the spread rate. PC is not always slow growing I wish everyone the best of luck !PSA is now 0.01

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Most studies I have read, and I've read lots, on the subject, indicate that the loss of sexual function and incontinence are immediate after surgery, and in 80 to 30 percent of men (mostly age dependent), incontinence improves or disappears over time, and sexual function also improves, especially if nerve sparing surgery was done. With radiation, the seminal vesicles remain, but are irradiated, so that sexual function and incontinence problems increase with time. Either way, it's a gamble with regard to side effects.

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Read this... http://seer.cancer.gov/statfacts/html/prost.html

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Harley - that's a very interesting report. Never knew about SEER before. Thanks for the link.

Where in that report do we find info on sexual performance, which is what Dobie was asking about?

Tom in CT

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Not sure, but look at the death rates for men under 70, almost non-existent! Why not try watch and wait, change lifestyle take the recommended supplements? That way you will not have to worry about sexual performance. No matter what treatment you have and I don't care if it's surgery, Rad,hormone, etc. your sex life will never be the same. If you value sexual performance...just saying'

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My impression from the research I did was that the robotic surgery erectile disfunction could be (it does not affect everyone) experienced right away but there is hope of therapy and alternative treatments restoring erectile function to pre operation levels within months to two years. However, radiation treatments and freezing seems to destroy the tissue and affect the restorative capabilities of the tissue and erectile function starts to slowly deteriorate after treatment. Since it takes some years it is attributed to the aging process and NOT the PCA treatment.... I am not aware (as I did not research it) of the success factor when experiencing ED due to radiation or cryogenic treatment and the use of vacuum pump, Rx pills, injections and the possibility of implants.

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I had brachytherapy and experienced NO ED.

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All of my Doctors talked about sex after surgery as a black or white issue, either you will or you won"t! In truth, after prostate surgery,, sex will never be the same, period! Doctors should advise their patients of this condition. After surgery I could still have an erection but the ejaculation was like firing blanks. My cancer was still growing so I had Radiation and lost the ability to have an erection. My cancer was still growing (PSA continued to climb) and was finally brought under control with Hormone thereby Lupron. I had no choice with a stage 4, Gleason of 9 but if I did have a choice I would wait and see. I was only 55 at the time and had no symptoms only a high PSA getting higher with every passing day. Biopsy verified the cancer.

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