Harvard Men's Health Watch

Penile rehabilitation after prostate cancer surgery

Think rehab, and you may conjure up the image of an athlete working his way back from a torn ligament or an older guy getting back on his feet after a total hip replacement. Penile rehabilitation is harder to picture. Indeed, it may sound more like a creative pick-up line than serious therapy, but it's a real, if unproven, program advanced by many urologists.

The problem

Before you decide that penile rehabilitation sounds like fun, remember that it's triggered by a diagnosis of prostate cancer. About 218,000 American men will receive that diagnosis this year, and all will face the difficult decision of what to do next. Some men will choose to defer treatment ("watchful waiting" and active surveillance programs). Others will decide to have radiation therapy (external beam radiation or brachytherapy with implanted seeds). And many men will opt to "get it all out" by undergoing the radical prostatectomy operation; it's a particularly good choice for younger men with life expectancies of over 10 years and aggressive-looking cancers still confined to the prostate itself.

Men who choose to have surgery face an additional decision since the procedure can be done using time-tested open surgery, less invasive laparoscopic surgery, or even newer robot-assisted techniques. It will take time to sort out the relative merits of these alternatives, but in each case, the experience and skill of the surgeon and his team is the major determinant of success.

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