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1958wins
Posts: 4
Joined: Oct 2018

I had my annual physical the day before Independence Day and although all bloodwork was clear and my PSA was 1.4, my doctor noticed some nodules during the digital exam and referred me to a specialist. One month later, (the day after Labor Day) I had a  robotic RP by a local urologist and have had an unremarkable recovery thus far. After five weeks, I'm still having some minor incontinence, but that's improving. At my post-op doctor visit to remove my catheter and get some instructions, my doctor said when I was ready we'd discuss ED treatments, because that would be an issue down the road. At that point in time, that was the LAST thing on my mind. Now that my healing has progressed, I'm starting to think it may be time to get started with that phase.

I'm just wondering how soon most men start ED treatment after their surgery? Since the nerve bundles were spared, he said pills would be the first course of action, so what is the most common/effective medication? How soon after starting the medication should I hope to see some evidence of return to normalcy?

Wins  

Georges Calvez
Posts: 229
Joined: Sep 2018

Hi there,

Congratulations on your successful operation and getting to the point where you are over the incontinence.
When it comes to post prostatectomy erections you enter the great unknown, some men have erections quite spontaneously within the first few months of a nerve sparing prostatectomy, others take longer or need medication and others have a lot more problems.
The first thing to try is Viagra or Cialis, after that there are pumps, injections which are not as scary as they sound, and finally implants.
Maybe try some Cialis, give it an hour before you cuddle up to the missus and see if Mr Sleepyhead wants to play.

Best wishes,

Georges

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3257
Joined: May 2012

Welcome to you, Wins.

My urologist had me start on Cialias shortly after I came home from surgery.  He said it was NOT to cause erections, but simply to maintain blood flow in the penis, to prevent atrophy, or loss of tissue.

Some doctors order a "pump" device, but I never got one.  I did start Trimix injections for erection within about a month or so after surgery, and started having sex then. Not the greatest, but still sex.  Trimix is a self-injected shot, via a tiny needle. It did not hurt at all. The drug is a dialator, and basically bypasses the nerves.  My only issue with it was related to the "Four Hour Warning" from the TV commercials.  Until you learn to adjust the dosing, there is no telling how long it takes for an erection to go away after sex.

I did not have any hint of spontaneous erection for several months, even on Cialias. I am a little over 3 years since surgery today, and have no need of Cialias at all, and can do the deed pretty much any time duty calls.  But it is a SLOW process. Note the word SLOW.  Do not let lack of progress in the first few months cause worry, since ED recovery takes most guys around a year or thereabout.

If interested ask about the Trimix. And also get going on the Cialias first opportunity.

max

 

lighterwood67's picture
lighterwood67
Posts: 185
Joined: Feb 2018

I am 6 months and a few days past RP.  My surgeon put me on Sildenafil 20 mg, about a month before suregery.  He said look at it as "fertilizer".  It was not for ED at time but to facilitate blood flow.  I stopped taking the Sildenafil about a month ago.  I am not 100 %, but my wife and I are intimate.  Your question maybe, as my surgeon asked me, does it get hard enough for penetration.  My answer was yes, but inconsistent sometimes.  Like Max says this is a slow process for a lot of the RP folks.  On the other issue, I am pretty much 100 % continent.  I will get my second PSA test this coming Monday.  The first one was undetectable.  I am 68.  Gleason 4+3=7.  I am still here.  Smile, I am.

1958wins
Posts: 4
Joined: Oct 2018

Thanks to Georges, Max and lighterwood67!

I probably should have included that I'm 59 and in otherwise good health, but as I told one of my buddies this was my first "glancing blow with mortality". I realize from spending a few minutes looking at this and other forums how truly blessed I am. This will help me and make me more appreciative of who, what and where I am.

My next scheduled appointment isn't until December, so I think I'll give my urologist a call and tell him I'm ready to take another step and see what he suggests. Thanks again, all!  

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3257
Joined: May 2012

1958,

I was 59 also for my DaVinci (62 today).

I would get going on the Cialias.  Bless your progress,

max

edH
Posts: 2
Joined: Mar 2018

I used a pump starting 30 days after the catheter was removed.  I started on Viagra (sildenafil) at the same time.  It is a little over a year since DaVinci surgery and things are getting better in the ED department but still not as before.  As others have stated nerves take time to heal.  In the mean time I use a pump.  Orgasm is not a problem.  (66 yo at time of surgery). Good luck.

1958wins
Posts: 4
Joined: Oct 2018

I called my urologist's office and he prescribed Tadalifil, 15mg. It's coming by mail from a compounding pharmacy in California, because it's supposedly customized and less expensive. I was prepared to get something through a local pharmacy, but I'll try this first and see how things go.

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