Top Specialists in NYC For Treatment of Erectile Dysfunction after Prostate Cancer Treatment with Robotic Radical Prostatectomy and Radiation Therapy

by Alex Shteynshlyuger MD

---

If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5211.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office. 

We offer affordable appointment prices with or without insurance.  Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.

Dr. Alex Shteynshlyuger is a specialist in treating erection problems after prostate cancer treatment using the latest scientific and medical breakthroughs.

---

Effective Treatment of ED after Prostate Removal Surgery and Radiation Therapy

At New York Urology Specialists, we use the most advanced methods of ED treatment to help men recover erections after prostate cancer treatment with surgical removal of the prostate (prostatectomy) and radiation therapy (IMRT, ERBT,  proton therapy, seed implants, brachytherapy), as well as HIFU.

Our approach to the treatment of post-prostatectomy ED is very effective for men of all ages.  We offer treatment for impotence for men who are planning to undergo surgery for prostate cancer, men who recently had surgery as well as men who have been living with ED for many years after prostate surgery.  

We treat men who are planning to or had radiation therapy or hormonal therapy for the treatment of prostate cancer and experience decreased erection hardness or inability to obtain and maintain erections sufficient for sexual intercourse.

Erectile Dysfunction is a Frequent Side Effect of Surgical Treatment for Prostate Cancer with Radical Prostatectomy.

Is Erectile Dysfunction Associated with Prostate Surgery?

To some degree, ED is associated with every prostate cancer surgery. With rare exceptions, one cannot expect to have as good erections after surgery as before surgery.

Patient age and erection quality prior to surgery are the most important factors in predicting erection quality after surgery. Men younger than 45 have the best chance of maintaining their erections after surgery.  Of course, few men under 45 undergo prostate cancer surgery.

Most men who undergo treatment for prostate cancer are over age 50 and many have erection difficulties prior to surgery (erections are not as hard as they used to be, increased difficulty maintaining and getting erections).  Many men use medications such as Viagra, Cialis, Levitra, and Stendra prior to surgery for prostate cancer.  Erections after surgery are rarely as good as before even with medications such as Viagra and Cialis.

Erectile Dysfunction is a Frequent Side Effect of Radiation Therapy for Prostate Cancer with EBRT, IMRT, Proton Beam and CyberKnife.

Men treated with radiation therapy have increased risk of experience erectile dysfunction. Usually, erection problems occur 1-3 years after radiation therapy.  Pre-existing erection problems increase the chance of erection difficulty after radiation. At New York Urology Specialists we have extensive experience treating erectile dysfunction after radiation therapy for prostate cancer.

Is Erectile Dysfunction after Prostatectomy Permanent?

Many men recover at least some erectile function after surgery but many require medications to achieve erections. Younger men are more likely to recover sexual function.

It is important to understand that most men will require treatment for erectile dysfunction after radical prostatectomy or radiation therapy for prostate cancer even with nerve-sparing radical prostatectomy.   When surgeons quote that they have a high success rate with maintaining erections, it is important to understand that success is often defined as ‘ability to obtain erections with medications such as Viagra and Cialis”.

Nerve-sparing radical prostatectomy helps to decrease the risks of erection problems but does not entirely prevent them.

Causes of  ED after Prostate Removal Surgery for Prostate Cancer

During a radical prostatectomy, the nerves of the penis (cavernous nerves) are often damaged or sometimes removed with cancer. Nerve-sparing radical prostatectomy seeks to preserve as much of the nerves as possible.  Most prostate cancer surgeries performed nowadays as ‘nerve-sparing’ surgeries.  In my practice, I perform nerve-sparing procedures for around 90% of my patients.

However, in patients with high-risk, aggressive prostate cancer (Gleason 7-10, high PSA, palpable or hard prostate), it is important to remove all cancer tissue and sometimes that requires removal of cavernous nerves running in nerve bundles around the prostate gland.

Duration of Erectile Dysfunction after Nerve-Sparing Surgery:

• Erectile dysfunction usually persists for at least 3-12 months even after a nerve-sparing prostatectomy, whether open or robotic/laparoscopic.
• The patient may start to experience spontaneous erections during this period.
• It is important to start the treatment for erectile dysfunction as soon as possible.  There is no reason to delay treatment as delay can affect patient relationships and self-esteem

Penile Rehabilitation Therapy after Radical Prostatectomy in New York City

The penile rehabilitation program has been shown to accelerate the recovery of sexual function in men. In general, medications such as Cialis or Viagra or penile injections are used shortly after surgery to recover sexual function.  Penile injections with medications such as prostaglandin and Trimix as well as vacuum erection devices have been used as well.

Risk of Erection Problems after Robotic Prostatectomy Depends on:

• age – the older the patient the more likely he is to experience erectile dysfunction after surgery. This is likely related to an underlying increased risk of vascular disease that occurs as people age.  Vascular disease may be subtle enough not to manifest itself in other ways.
• diabetes – men with diabetes are at higher risk for erectile dysfunction. The stress of surgery to remove the prostate may tip the balance over and lead to the earlier manifestation of the underlying problems that predispose to ED.
• hypertension – erectile dysfunction is a known problem in men with high blood pressure.  High blood pressure affects small blood vessels that carry blood to the penis.  All men with high blood pressure are at risk of developing erection problems. Prostate cancer treatment tends to accentuate the problem by affecting the nerves in addition to already affected blood vessels.
• Coronary Artery Disease (CAD) – heart disease affects blood vessels to the penis the same way the heart vessels are affected.
• the baseline quality of erections (can a patient obtain erections easily? maintain erections? are erections hard enough?)
• the use of PDE-5 inhibitors (sildenafil, vardenafil, etc prior to surgery)
• type of surgical procedure

What Treatments are Available for Treatment of Erection Difficulties after Prostate Surgery for Prostate Cancer (Radical Prostatectomy or RALP)?

For many men, the treatment of erectile dysfunction should start prior to radical prostatectomy if they experience signs and symptoms of ED.

In general, two types of treatment options are available.

1. Non-surgical treatments
2. Surgical treatment

Non Invasive Non-Surgical Treatments of Post Prostatectomy ED:

These are pharmacologically based treatments and medication-free options. The following drugs may be useful: Cialis (tadalafil), Viagra, Levitra, and Stendra.

Shockwave therapy for ED, a new, medication-free option may be a good option for some men with post-prostatectomy ED. 

Penile Injection Therapy:

Intracavernous injection of prostaglandin E1, or Trimix injections are very useful for men after radical prostatectomy. We teach our patients to self-inject medications right before intercourse. The injection is nearly painless, just a little needle-prick.  The success rate is up to 80%.  Penile injections improved sexual function after prostatectomy by improving erections hardness, improving satisfaction with the relationship, and boosting sexual confidence

Nerve Graft

Sural nerve grafting has been tried in the past with inconsistent results.  It is not generally used at the present time.

Surgical Treatment: Effective Treatment of ED with Penile Implant

A penile implant is a good treatment option for men who do not respond to medications such as Levitra, Cialis, and Viagra. Men tend to be very satisfied with erection quality after penile implant.

 

https://www.youtube.com/watch?v=nwbtqmxfTMc&index=5&list=PLDX0bW3_JUH0ueNMDGu9qcQ9ZYu443af8

Learn More About:

• Penile Implant (Inflatable Penile Prosthesis)
• Shockwave therapy for ED in NYC
• Treatment for Erectile Dysfunction with MUSE (intraurethral alprostadil)
• Vacuum Erection Device Therapy (VED Pump)

Where to Get Treatment for ED in NYC?

At New York Urology Specialists, we offer specialized treatment for ED for men. Same-day appointments are available.

Call/text today: 1-646-663-5211 or make an appointment online.  

We treat sexual and erection problems and offer comprehensive STD testing for infections.  We treat penile problems in men, including phimosis, balanitis, penile irritation, and penile redness. We perform a no-scalpel vasectomy, vasectomy reversal, cosmetic circumcision, circumcision revision, penile frenuloplasty. We offer confidential appointments.

Our prices are ED treatment prices are affordable with or without insurance.  Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.  We offer free insurance verification.

Read Real Stories of Men who Underwent Treatment for ED at New York Urology Specialists.

We offer ED treatment to patients within driving distance to our offices as well as from other states and countries.  Our patients come from New York, New Jersey, Pennsylvania, and Connecticut, and over 30 countries worldwide.

• Read RealStories: 47-year-old with ED – Tadalafil Does Not Work 
• Read RealStories: 52-Year-Old Man with Erection Problems Caused by Venous Leak (Veno-occlusive insufficiency).
• Read RealStories: 61-year-old Shockwave Therapy for ED for a Diabetic Man 
• Read RealStories: 69-year-old Man Treated with Ambicor Penile Implant after Prostate Surgery for Prostate Cancer 
• Read RealStories: 77-year-old with Erection Problems Treated with Penile Implant 
• Read RealStories: 56-years-old diabetic treated with testosterone replacement therapy and Trimix

What do Penile Problems Look Like?

You can find pictures of penile problems including before and after treatment images in our image gallery.

What You Need to Know:

• Erectile Dysfunction in Young Men
• No scalpel vasectomy: Who is a good candidate?
• Why Cialis No Longer Works for You: Top 5 Reasons
• How Does Shockwave for ED Work? – Mechanism of Action

Why Choose New York Urology Specialists for Treatment of Erectile Dysfunction?

• All treatment is performed by a board-certified urologist experienced in treating men with symptoms of ED, premature ejaculation, and other sexual problems using medical therapy, minimally invasive therapies, lasers, and surgery.
• We are one of the few practices in the region to offer a full range of options for the treatment of sexual, and erection problems in men.
• We offer diagnostic testing in our office, which avoids hospital costs.
• Extensive Experience: Thousands of men have been treated successfully using medical therapy, shockwave therapy for ED, penile injections with Trimix, and penile implant surgery.
• Confidential and Understanding Care. We understand that most of our patients desire privacy.  We see patients with a variety of urological problems. Your reason for visiting us is entirely confidential.
• We are one of the few practices in the region to offer a full range of options for the treatment of sexual and erection problems in men.
• We are conveniently located within a 30-60 minute commute to men who are seeking ED treatment in Manhattan, Brooklyn, Queens, Staten Island, Westchester, Long Island, Bronx, and New Jersey.

Scheduling Appointments for ED Treatment at New York Urology Specialists

---

If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5211.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office. 

We offer affordable prices with or without insurance.  Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.

We offer weekday, weekend, and evening office hours.

Dr. Alex Shteynshlyuger is a board-certified urologist, who specializes in all aspects of care for sexual problems in men including ED, premature ejaculation, and other sexual concerns.  He has successfully treated hundreds of men with sexual problems including ED and poor libido.

---

Patients Reviews