The erection nerves travel along both sides of the prostate on their way to the penis. During the operation you are scheduled to undergo, these nerves are manipulated to allow access to and removal of the prostate gland. Even in cases of nerve sparing operation, some decline in nerve function occurs, lasting for up to 24 months. As a consequence of this nerve dysfunction, the erectile tissue in the penis may undergo atrophy (degeneration). Early treatment, starting even before the surgery, has been shown to protect erectile tissue and may facilitate the chances of erectile function recovery.

We suggest the following:

  1. Take Viagra 25mg (a quarter of a pill) before bedtime, nightly. Start this treatment two weeks prior to the surgery. You should not expect any erection to occur at such a low dose.
  2. Discontinue Viagra 25mg the night before surgery and during your hospital stay.
  3. Resume Viagra 25mg nightly, after you are discharged home even with the catheter in place.
  4. After catheter removal (usually at 7-14 days after surgery), switch to Viagra 25mg six nights per week and Viagra 100mg once per week. The Viagra 100mg dose should be taken in an effort to get an erection. Take the pill on an empty stomach (we suggest two hours before your evening meal). The pill lasts at least 8 hours so you will have plenty of time to attempt stimulation.
  5. Dr. Scherr would like to see you 6 weeks after surgery. At that time he will inquire as to how you responded to the Viagra 100mg dose.