Nerve Grafting Surgery: the 'cure' for ED after Prostatectomy?

Professor Declan Murphy is a Urology Surgeon and Director of Genital Urinary Cancer at Peter MacCallum Cancer Center. He was a reviewer on this Nerve Grafting Paper, in the journal of European Urology. In this interview, filmed at Cancer Specialists, we discuss nerve grafting surgery.

What is nerve grafting surgery?

This surgery involves taking nerves from the ankle then grafting them into the pelvis.

In the past, this procedure has been tried but with disappointing results. In the last couple of years however, Dr. David Dangerfield (Urologist, Melbourne) and Professor Chris Coombes (Plastic Surgeon, Melbourne) have modified the technique with some encouraging results.

Why is this surgery recommended for men 2 years post prostate surgery? 

We need to wait for some time after prostate cancer surgery to determine if there is going to be a spontaneous return of erections (with a penile rehabilitation regime to maximise those chances). 

We often see patients at the two-year mark noting their erections have only recently returned. It is believed that full cavernous (erection) nerve recovery can take two years for full potential to be realised. 

Does the procedure restore erectile function?

A small group study of 17 patients showed that ⅔ of the patients had some return of erections sufficient for intercourse over a couple of years post nerve grafting surgery. This was a group of patients where we had low expectations for these results.

“At 12 months after nerve grafting, 71% of patients had erectile function recovery sufficient for satisfactory sexual intercourse, and 94% had clinically significant improvements in sexual function” (Reece, Dangerfield & Coombs, 2019)

As with any research, it needs to be replicated. But as it’s been published in such a prominent journal as European Urology, this tells you there is a lot of interest in this topic. 

What should someone interested in this procedure be aware of?

This is not an approved treatment anywhere, it's still under evaluation. It isn’t well established or replicated so you have to have realistic expectations.

You need to be highly motivated and prepared to undergo more surgery.

This procedure requires further research before it becomes a standard treatment. But the rebirth of nerve grafting techniques as a possible solution for permanent erection problems after prostate cancer treatment is something of interest now. 

This shows the two-year window after surgery is an important time for recovery, and an opportunity to explore and enhance your sexual function and health.

Take our FREE penile rehabilitation program for ideas on how to maximise your chances during the first 2-years.