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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 29282
Experience:  MD
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After high dose Radiotherapy (Brachytherapy implants in Prostate)

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After high dose Radiotherapy (Brachytherapy implants in Prostate) followed by 15 treatments having previously been classed as being in a state of Castrate my right testicle is reducing and my left testicle has virtually gone away. I do not produce any testosterone and find it impossible to have an erection. Do I need to check for testicular cancer? I have been prescribed testosterone gel which does not help at this stage. ie. after 12 weeks daily treatment.
Dr Basu :

Hi there, This is Dr Basu, Experienced Specialist. I am here to address your concerns and provide great service.

Dr Basu :

Testicular cancer is unlikely since you are on brachytherapy.

Dr Basu :

However, your erection problem can be treated with Tadalafil tablets.

Dr Basu :

Tadalafil 10 to 20 mg daily will be helpful in achieving good erection.

Dr Basu :

Also penile injections with Alprostadil will be helpful.

Dr Basu :

These options should be discussed with your urologist.

Dr Basu :

Best wishes,
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Customer: replied 3 years ago.

I am NOT ON Brachytherapy! The 3 implants were inserted directly into my Prostate Gland. That treatment is called Brachytherapy.

The only treatment I am on now is Testosterone Gel for Hypogonadism and Tamsulosin for retention. The Sildenafil 100mg does not work now.

I do mean what you explained on brachytherapy.
This is for prostate cancer treatment.
Unlikely you have any testicular malignancy.
Still this can be checked by ultrasound.
Tadalafil ( cialis) is stronger than sildenafil.
So it should be tried daily at 20 mg daily dosage.
The next option is penile injection therapy.
Alprostadil is a prostaglandin analog and provides successful erection to people who fail oral sildenafil.
So this is worth considering.
Lastly, you have to consider penile implant if no medication works for you.
Best wishes