Post-Surgery Concerns: Erectile Dysfunction and Nerve Damage

Could you please provide more details about the post-operative care for penile surgery?

Hello Doctor, I discovered last year that I had a problem with erections that easily subside.
After examination, I was found to have venous leakage, so I underwent a venous stripping surgery.
However, my erectile function has not improved significantly since then, and I occasionally experience a sharp pain in one or two areas of the penis.
When I apply pressure with my hand, the pain is not very noticeable, and there is no inflammation or swelling.
Could this be due to compression or damage to the dorsal nerve? Post-surgery, my reflexive erections are not as good as they used to be and also tend to subside easily.
I have been taking daily Cialis, but it hasn't made a difference.
I am very concerned that this might be a nerve issue.
If I follow the doctor's advice to use a vacuum erection device to promote blood flow and prevent fibrosis, and also use extracorporeal shockwave therapy to enhance blood flow or tissue repair, what are the chances of recovery?

kuai bengkui le, 30~39 year old female. Ask Date: 2016/06/19

Dr. Liu Jiaju reply Urology

Postoperative tingling sensations are considered normal and may gradually improve.
The venous stripping procedure should not affect erectile function nerves.
If the tingling persists, it is advisable to discuss it with the original surgeon.
Vacuum erection devices and extracorporeal shockwave therapy are second-line treatment options for patients with poor response to medication.
However, the effectiveness of these treatments may vary depending on individual circumstances.
It is recommended to have a detailed discussion with the treating physician.

Reply Date: 2016/06/19

More Info

Post-surgery erectile dysfunction (ED) can be a complex issue, particularly when nerve damage is involved. Your experience of erectile difficulties following the venous stripping surgery for venous leakage is not uncommon. The surgery aims to correct the underlying issue of venous leakage, which can contribute to ED, but the recovery of erectile function can vary significantly among individuals.

Understanding the Mechanism
Erectile function is primarily dependent on the proper functioning of the nerves, blood vessels, and smooth muscle in the penis. The presence of nerve damage, particularly to the dorsal nerve of the penis, can lead to difficulties in achieving or maintaining an erection. This nerve is crucial for the sensory and autonomic functions of the penis, and any trauma or surgical manipulation in the area can potentially affect its integrity.

Symptoms and Concerns
The symptoms you describe, including occasional sharp pain and reduced responsiveness to touch, may suggest that there could be some nerve involvement. While the absence of significant inflammation or swelling is a positive sign, the presence of pain and altered sensation can indicate that the nerve may have been affected during the surgical procedure.

Potential for Nerve Damage
It is indeed possible that the surgery could have impacted the dorsal nerve or other surrounding structures. Nerve injuries can lead to a range of symptoms, including numbness, tingling, and pain, as well as erectile dysfunction. However, it is essential to differentiate between temporary nerve irritation and more permanent damage.

Treatment Options
Regarding your treatment options, using a vacuum erection device (VED) can be beneficial. VEDs work by creating a vacuum around the penis, which encourages blood flow and can help maintain erectile function. This method is particularly useful in preventing fibrosis and maintaining penile tissue health after surgery.
Extracorporeal shock wave therapy (ESWT) is another option that has been explored for improving erectile function. This therapy aims to enhance blood flow and promote tissue repair, potentially aiding in the recovery of erectile function. While some studies have shown positive outcomes, results can vary, and it is essential to discuss this option with your healthcare provider to determine if it is suitable for your specific situation.

Follow-Up and Monitoring
It is crucial to maintain open communication with your urologist or healthcare provider regarding your symptoms and any changes you experience. Regular follow-ups can help monitor your progress and allow for adjustments in your treatment plan as needed. If your symptoms persist or worsen, seeking a second opinion from a specialist in sexual medicine or a urologist with expertise in erectile dysfunction may provide additional insights and treatment options.

Conclusion
In summary, while it is possible that nerve damage could be contributing to your erectile dysfunction post-surgery, there are various treatment options available that may help improve your condition. Utilizing a vacuum erection device and considering additional therapies like shock wave treatment could enhance your recovery. Always consult with your healthcare provider to tailor a treatment plan that best suits your needs and addresses your concerns.

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