Men's sexual function after colostomy

[roadrunner04]

hi friends. I'm a 46 year old male who underwent APR in May 2022 to remove a cancerous tumor. I underwent TNT (chemoradiation + chemotherapy) before the surgey. It has been more than a year and I'm very unhappy with my sexual function. My erections are extremely weak and not strong enough for penetration. I can ejaculate and the quantity of semen seems almost back to normal. I'm meeting a urologist soon.
Can anyone here share their experiences ? Is there any hope ? the nurses keep telling me that it can take up to two years for things to feel normal again.
Thank you.

[ot dave]

I had a total APR in March of 2009. Fortunately, I have not had any issues. The APR is a tricky surgery as the nerves that are responsible for erections are very close to where everything else that needs to be removed is located. My initial surgeon told me that she could do the surgery, but that she would prefer to send me to a surgeon with more reps in performing APR's. I got lucky, and the surgeon that performed my surgery is the head of the department at the university medical center that I went to, and teaches all of the other surgeons how to perform these surgeries. As an OT, I know that peripheral nerve injuries can take a long time to repair themselves. Also, how much damage will impact repair time as well. I would think that it's a positive sign that you are able to have an erection, even if it is weak. That seems like it would indicate that an electrical signal is getting through, but just not with much "voltage". Nerves are covered with a sheath of myelin which acts like an insulator which helps the signals go through with more strength and speed. If the myelin is damaged too, you could be battling two fronts, an injured nerve, and an injured sheath.
I can only imagine how frustrating this is for you. Make sure you discuss other possibilities with the urologist. Everyone knows about implants and the like, but there may be other alternatives as well. Might be beneficial to speak with an counselor/psychologist as well depending on how much anxiety this is producing for you.
Hope that helped some.

David