Restoring Erectile Function After Prostate Surgery

Regain Erectile Potency

70% of post-operative impotence sufferers regain normal function after a ground breaking new procedure developed by Mr Dangerfield and Prof Chris Coombs. This procedure involves taking a nerve from the lower leg and transferring it to the penis. This replaces the action of nerves required for erections that have been damaged during prostate surgery.

Publication in “European Urology”

An article detailing our initial experience with this procedure has been published in the leading urology journal “European Urology”. Click the title below to read the full abstract.

Sural Nerve Grafting for Post Prostatectomy Erectile Dysfunction

Erectile Dysfunction or impotence is a common side effect following treatments for prostate cancer. Up to 70% of men who undergo radical prostatectomy suffer from erectile dysfunction. With around 9,000 radical prostatectomies done in Australia each year approximately 6500 of these men will experience erectile dysfunction despite penile rehabilitation.

This is due to damage to the nerves that pass around and through the prostate to the penis that are responsible for erections. Nerve-sparing surgical techniques have been shown to have only modest benefits. Medications and injections can been ineffective and poorly tolerated.

Dr David Dangerfield and Professor Christopher Coombs have spent four years refining a new, minimally invasive technique for restoring erections in men treated for prostate cancer.  Over 80 men have been treated and recovered with a success rate, in terms of functional intercourse, of over 70%.

This procedure involves using nerve grafts taken from the lower legs that bring a new nerve supply to the penis. Once grafted in, the nerves deliver a chemical to the penile tissues which acts like a natural form of Viagra, dilating blood vessels and causing an erection. Nerves grow at 1mm a day so there is a waiting time until the new nerves reach the penis but most men who have undergone this procedure have noticed some changes within six months and those who have had restoration of erectile function noted this by 12 months post nerve graft surgery.

The following criteria are what we look for to see if you are suitable for this surgery.

  1. Be aged younger than 70 years
  2. Have had satisfactory/normal erectile function prior to radical prostatectomy surgery
  3. Have PSA levels <0.1ng/ml in their most recent test following radical prostatectomy
  4. Have persistent impotence following radical prostatectomy despite rehabilitation
  5. Have no hormonal related conditions or diabetes
  6. Have not had radiotherapy to treat prostate cancer (external beam and/or brachytherapy)
  7. Have never taken androgen deprivation therapy
Sural nerve grafting. The diagram on the left shows the nerve graft which is moved from the leg to the groin. The diagram on the right shows the new path of the nerve into the penis.