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Viagra Alone vs. Viagra + Vacuum Pump After Prostate Surgery

Overview: A January 2021 study has found that a combination of therapies, specifically a vacuum constriction device and a daily dose of 50 mg sildenafil (Viagra) is among the most effective for treating erectile dysfunction after radical prostatectomy, especially six months out from the procedure.

Does Radical Prostatectomy (RP) Cause Erectile Dysfunction?

While there’s some dispute over the likelihood of erectile dysfunction being a side effect of RP, it’s agreed that it’s relatively common; up to 85% of patients experience at least some form of it. In some cases, this is medical, as nerves and blood vessels crucial to erection may be removed as part of a surgical procedure or damaged due to chemotherapy. “Nerve-sparing” procedures are becoming more common in order to prevent these complications, and generally patients with intact nerves and blood vessels see function return within a year.

Regardless of the procedure, however, RP’s overall impact on sexual health can be profound. Due to the role of the prostate in creating semen, for example, total removal means a man can no longer ejaculate. While a man can orgasm without ejaculation, the inability to ejaculate can cause erectile dysfunction for psychological reasons, as it impacts sexual desire and the patient’s mental state, even if sexual functioning is otherwise intact.

What Options Are There For RP Patients To Treat Erectile Dysfunction?

  • PDE5 inhibitors. More commonly known as ED drugs, PDE5 inhibitors such as sildenafil (Viagra), Levitra, and Cialis, have been shown to be effective to some degree for many RP patients. PDE5 inhibitors are vasodilators, which open up blood vessels and allow more blood into the penis to stimulate an erection. However, if blood vessels have been damaged or removed, these oral medications may not work as well.
  • Vacuum constriction devices (VCDs), generally called “penis pumps,” draw blood into the penis to achieve an erection using suction, and then a retaining band (i.e., a penis ring) is slid onto the base of the shaft. There are side effects, however, such as numbness, bruising, and difficulty with orgasm.

Can I Combine These Therapies?

Yes, and in fact, a 2021 meta-analysis has found combining Viagra/sildenafil and a VCD to be the most effective treatment for post-prostatectomy ED. A team at the Department of Urology of West China Hospital combined the results of 24 studies encompassing 3500 patients to compare the effects of ED drugs and VCDs, separately and in combination.

They found that the combination was the most effective treatment. In particular, they found that a combination of VCD and 50 milligrams of sildenafil, either daily or on demand, worked best six months after the procedure. This makes sense when you consider how the two methods work.

The important points:

  • The sildenafil allows more blood flow into the penis by opening up blood vessels, particularly important when function is impaired by surgery.
  • The VCD helps to pull blood into the penis, making it easier to achieve and hold an erection.
  • The timing is important because the patient has healed and possibly regained some sexual function.

Although the study’s findings are promising, the combination therapy is not a perfect solution. Post-procedure issues such as the lack of semen and difficulty with orgasm, not to mention the mental health effects of any surgical procedure, will need to be addressed. Yet using these tools in combination can help you overcome erectile dysfunction after prostate surgery.

To learn more about Viagra (sildenafil) or the other PDE5 inhibitors we offer, please see our medication guide or visit the eDrugstore.com blog. If you decide to give Viagra a try, take advantage of our free medical consultation with a U.S.-licensed physician by calling 1-800-467-5146 when you’re ready to have the conversation.

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