P-01-018 ED post radical prostatectomy

Abstract

58 y/o male presents with acute/global ED for the past 4 month after having had a nerve sparing radical Prostatectomy. Patients states some ED before surgery which was responsive to oral PDE5i. Currently states normal desire. No intercourses since the surgery. On Psychosocial history he reports having good relationship with a 54 y/o partner whom they have been married and lived together for over 30 years. He denies any past contributory factors. On past medical history he denies having any major issues except hyperlipidemia which he has been taking Atorvastatin. He denies any coronary artery diseases, hypertension, nor thyroid diseases. He denies smoking tobacco. Drinks alcohol occasionally. Routine labs ordered. All came back normal. PSA was also close to zero in value. Patient was educated in depth that ED is the most common side effects of his surgery even with nerve sparing techniques and that it could take up to two years for the neurovascular boundless to heel. The importance of penile rehabilitation was explained in details to patient and was advised to start taking Tadalafil 5mg daily and 10mg PRN. On two-month f/u patient returned to office with still very minimal improvement. Patient Advised to continue the meds, have regular penile stimulation every day for the next 2 year period. Patient was also advised if no improvement then penile prosthesis could be next option. On one year f/u patient reported slightly better erection and on two year f/u he was able to regain relatively good erection.