OM DENNE EPISODE
The biggest mistake after prostate cancer treatment may be waiting for erections to “come back” on their own.
Dr. John Mulhall of Memorial Sloan Kettering has spent three decades in sexual medicine, sees roughly 600 prostatectomy patients a year, and served as a senior author on sexual-medicine guidelines. His central message: recovery is a race to protect erectile tissue while nerves heal. After prostatectomy, erection nerves can remain functionally “asleep” for months. During that window, reduced blood flow, oxygenation and stretch can allow penile smooth muscle to deteriorate and be replaced by collagen-rich scar tissue. Radiation follows a different pattern: function may look preserved at first, then decline over two to three years as vascular injury develops.
In this episode, you’ll learn...
- Why penile rehabilitation is about preserving tissue, not simply taking a daily pill.
- How surgery, radiation, and ADT disrupt erections through different biological pathways.
- Why sleep apnea, diabetes, and very low testosterone can reduce recovery.
- How reducing performance pressure can rebuild sexual confidence.
📚 Chapters
00:00 Sex Recovery Starts Early
05:28 Why Erections Fail
07:36 Radiation And ADT Effects
11:07 Collagenization Explained
12:39 Modern Penile Rehab Plan
16:14 Choosing A Prostate Surgeon
19:49 Orgasms After Prostatectomy
21:38 Erection Recovery Timeline
24:19 Confidence And Intimacy
34:34 Injection Safety Standards
40:48 Testosterone Before Treatment
45:24 ADT Risks and PSA Monitoring
56:32 When to Consider Implants
59:37 Choosing the Right PDE5 Pill
01:01:23 Trials and Where to Find John
This is the conversation men need before treatment—not months after sexual function has already changed.
Dr. Mulhall X handle@saveyoursexlife
Website: Dr. John Mulhall - MSKCC
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📌Thank You To Our Sponsors
Sponsored by PathRight Medical. This episode's guest, Dr. Landon Trost, is the majority owner of PathRight Medical, manufacturer of RestoreX® and RestoreXL®. Dr. Geo Media retains editorial control over the interview and its independent clinical content.
Find the Right Device for You linked to https://bit.ly/3VnIsU0.
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This podcast is for educational purposes only and not medical advice. The views expressed are Dr. Geo’s and not those of his employer(s) or affiliated organizations. Use of this content is at your own risk. Geovanni Espinosa, N.D., assumes no liability for direct or indirect consequences, including economic loss, injury, illness, or death.
