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Penile Rehabilitation After
Prostate Surgery

Patients who undergo prostate surgery or significant prostate intervention are likely to experience erectile dysfunction (ED), penis shortening and orgasmic dysfunction.  With no treatment, some or all of the complications can be permanent.

Erectile dysfunction
Affects up to 87% of patients
0 %
Penis shortening
Affects up to 71% of patients
0 %
Orgasmic dysfunction Affects up to 77% of patients
0 %

Patients who undergo penile rehabilitation are much more likely to return to successful sexual function after prostate surgery. At Pollock Clinics, our evidence-based treatments are designed to keep the blood flowing in your penis after your operation, protect your sexual function and grant you peace of mind.

enjoy sex like before surgery Vancouver BC

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What Is Penile Rehab?

Penile Rehabilitation is like physiotherapy for your penis. 

The goal of our penile rehabilitation program is to help patients maintain or regain their ability to achieve natural and spontaneous erections, to prevent penile shortening, and to protect the quality of your orgasms. Our clinically advanced treatments boost blood flow, improve oxygenation and prevent penile fibrosis.

It is a combination of medical and physical therapies designed to exercise your penis and help you maintain the sex life and penis size you had before.

When an athlete is injured they undergo rehab to get back to peak performance. The same should go for prostate surgery patients. It’s like sending your penis to the gym!

Which Procedures Require Penile Rehab?

We strongly recommend penile rehabilitation before and after the following procedures:

  • Radical Laparoscopic Prostatectomy 
  • Radical Open Prostatectomy
  • Robot-assisted Prostatectomy
  • Left/right or Bilateral Nerve Sparing Prostatectomy
  • Radiotherapy 
  • Brachytherapy 
  • Prostate Biopsy 
  • Other prostate procedures

Patients who use a penile recovery strategy have up to a 3 times better chance of recovering erectile function and penis size compared to patients undergoing minimal or no treatment.

Why Do These Complications Occur?

Prostate surgery can temporarily or permanently damage the blood vessels and nerves necessary for getting and maintaining an erection. The prostate is stretched and manipulated, nerves are cut, and blood and nerve supply gets interrupted. This also leads to penile shortening because the penis does not expand properly anymore and loses the ability to engorge or fill with blood. Trauma occurs during the procedure to cause long-term damage (even during nerve-sparing procedures).

Our evidence-based treatments and procedures keep blood flowing to the penis before and after surgery to help protect against these adverse complications.

Erections For Protection

To maintain sexual function and size after surgery patients should be achieving a minimum of 3-5 erections a week. If you have a catheter, this should begin after its removal. Our clinically advanced program goes beyond medications like Cialis and Viagra to facilitate consistent, strong erections.

What Often Happens After Prostate Surgery

Patients are typically referred to a urologist by their family doctor. Both parties may expect the other to recommend and implement interventions to prevent or reduce postoperative complications. The treatments offered may not be sufficient to give patients the best chance at an optimal recovery.

The urologist’s primary goal is to successfully perform prostate surgery and in some cases the rehab component is overlooked. The family doctor’s primary goal is to ensure the procedure takes place, and there can also be a knowledge gap about the importance of rehabilitation or where to refer patients.

The rehab treatment window is time sensitive. Early intervention and rehabilitation is crucial for maintaining sexual function. Studies show that enduring months or years of wait times can worsen complications or make them significantly harder to reverse

What Are The Benefits of Penile Rehab?

Patients who use a penile recovery strategy have up to a 3 times better chance to recover erectile function and penis size compared to patients undergoing minimal or no treatment.

Starting your rehabilitation protocol with Pollock Clinics as soon as possible before or after your surgery will lead to better long-term results. 

We strongly encourage all patients to notify us immediately upon scheduling their prostate surgery because early prehab and rehab has been shown to make all the difference.

What is Prehab, and Why Does it Matter?

Prehab, or treatment before your prostate intervention, paves the path to functional recovery. Studies show that patients who undergo pre-treatment experience improved rates of return to erectile function compared to those who only undergo postoperative treatment.

Prehab also allows us to establish a baseline for your sexual function prior to your prostate procedure. When rehabilitation begins after your operation we can refer to that baseline and better evaluate your progress.

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What Are The Treatments?

There are several effective non-surgical treatments available at our clinic. The solutions listed below are used together, because research shows that combining multiple treatments works better than one: 

Platelet-rich plasma (PRP) injection therapy promotes tissue and blood vessel regeneration and enhances recovery from surgery. We inject concentrated platelets made from your own blood into your penis. This effective, all-natural erectile dysfunction treatment stimulates blood vessel proliferation and tissue rejuvenation in the penis.

First we concentrate your platelets up to 5 times to what naturally occurs in your bloodstream. We use anesthetics to prepare the penis for virtually painless injection. Then we activate the platelets and inject them into the penis. Upon activation and injection, they recruit stem cells and release vascular growth factors. Those stem cells serve as building blocks to the new blood vessels you’re trying to grow, turning into blood vessel cells.

PRP also improves sensitivity which helps retain orgasmic function by building small nerves in the penis and making a successful orgasm more likely.

Studies show that low-intensity shockwave treatments can speed up the healing process after your prostate surgery or intervention. The targeted sound waves used in our clinic activate penile tissue and encourage blood flow. It works by causing a microtrauma in the penis to wake up the body’s healing mechanisms. Shockwave encourages healing cells to migrate to the penis from all around the body.

Trimix is a mixture of three ingredients: alprostadil, phentolamine, and papaverine. This vasodilator injection therapy increases nitric oxide levels in the penis, causing smooth muscles to relax and opening the valves for improved blood flow. For many patients, Trimix can immediately restore their erections.

Botulinum neurotoxin (Botox) is a neuromodulator produced by the bacterium clostridium A. It temporarily relaxes the smooth muscles in the walls of the blood vessels carrying blood to the penis. It blocks the nerve impulses sent to the vessel walls, which are normally in a constricted state.

After the Botox they are left in a relaxed state with a wider diameter so they are able to carry a greater volume of blood. This increased blood flow improves erections.

We use vacuum erection devices (VEDs) to help patients gain and maintain an erection. 

VEDs are pneumatic devices which use negative pressure to open up the existing tissue in the penis. They help patients gain and maintain an erection and are used in combination with our other treatments to treat your sexual health from multiple angles.

Vacuum erection devices are particularly valuable for preventing penis shortening because they stretch the tissue repeatedly using mechanical forces.

Oral medicines such as Cialis, Viagra and Levitra are commonly used after prostate surgery to help restore erectile function and blood flow to the penis. Often, these medications alone are not enough to reestablish consistent erections, and effectiveness can vary between patients. When used in conjunction with our other treatments, however, they can be helpful in supporting erectile function.

Post-operative complications like erectile dysfunction and penis shortening often include a psychological component. Patients may experience a depressed mood or anxiety after prostate surgery. Couples may also experience additional challenges and stress.

We usually recommend psychological support during your recovery process. Speaking with a professional can help you maintain your sexual function and a healthy outlook. We can connect you with a certified sex therapist.

When Should You Start?

For patients who have not had prostate surgery and are awaiting their procedure:

As soon as your operation is scheduled, contact us immediately to discuss your treatment plan. By starting with prehab before surgery we can establish your baseline function and optimize your rehab strategy to the fullest.

For patients who already had prostate surgery or intervention:

Contact us as soon as possible so we can start treatment. It is never too late. If you have a catheter, we can begin immediately after its removal. If you’re already past that stage, or if you have waited even longer, rehabilitation should be pursued as soon as possible to prevent long-term complications.

The sooner you start, the better your chances at recovery; however, even if years have passed, we can likely still help you.

Steps To Take After Surgery

What About Nerve-Sparing Operations?

Nerve-sparing or robot-assisted prostate interventions are becoming increasingly popular and accessible. Although these operations may slightly reduce your likelihood of complications, rehabilitation is still critical to protect and regain your sexual function.

Despite the promise that this technology brings, the outcomes between robot-assisted nerve-sparing procedures are similar to other prostate interventions.

What if I Already Take Oral Medications?

If you already take Cialis, Viagra, or Levitra and you’re not experiencing improved results, do not lose hope. Through our combined treatment approach we may be able to restore your erections beyond what conventional oral medications can offer.

What About Urinary Incontinence?

Urinary incontinence is a common complication after prostate surgery, characterized by unwanted leakage and urination. 

Our penile rehabilitation program focuses on sexual function recovery. We cannot treat urinary incontinence at this time. We can refer you to a pelvic floor physiotherapist to address urinary incontinence if necessary. 

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