ED Challenges

My DaVinci procedure was completed in February 2007.  I experienced some problems for several months following the surgery and finally they had to do another procedure and found a clip daggling in my bladder which came loose and caused serious infections. It was no ones fault as I may have caused it to come loose by trying to do too much too early. In any case, once that was resolved I began to get back on the recovery track.  In time the incontinence subsided, with the occasional exception of a small leak with I sneezed but the ED has yet to be resolved.  I did the Cialis and Viagra for nearly 9 months, I began with the MUSE about 6 months ago and the best I have been able to experience is a very slight and not at all performance level erection, with some very minor pain.This has been the challenge for me.  My PSA is still "undetectable" which is where I place the most value.  However, I'm now, at the age of 58, still very interested in resolving the ED problem.  Someone on the chat forum said that it maybe that more men are having this problem with the DaVinci than earlier reported.  I'm not sure but I am interested if anyone may have experienced a similar experience with me with the Cialis, Viagra, pump and then MUSE and it still did not work but the injections did.  I have an appointment with my surgeon a week from Friday to discuss next steps and would welcome any advice.  Thanks. 

I'm beginning to believe (well, actually, I've believed this for quite some time)  that it is NOT the treatment option, but the treatment provider who is the crucial factor in the outcome.  Da Vinci seems to be used more and more (and in my opinion this makes perfect sense because of the extra resources made available by the robotic system), but this only means that more open RP surgeons are moving (and probably very reluctantly) to robotic, and are at the very bottom of their learning curve.  This could explain the variability in RP outcomes.

Federal privacy legislation has been a boon to the less talented surgeons, as no one within the medical community wants to talk about any aspect of a patient's care -for fear of losing his or her job.  So, no one is going to warn you about a poor surgeon, unless you are within the inner circle.  People gossip, everyone knows  -except you.

The Da Vinci robot DOES NOT carefully tease the nerves away from the prostate capsule, remove the prostate,   and then re-make that all-important connection from the bladder neck to the urethra.  The surgeon does this, using the tools the robot provides.

It follows then, that it is the surgeon who is responsible for the outcome.  Some surgeons have consistently good outcomes.  Doesn't it make sense that the newly diagnosed PC patient seek out this surgeon, if surgery is indeed his choice?

This argument probably holds true for the other methods of treatment.

I'm about 7 months post-op, the da Vinci procedure.  I've taken it slow regarding the ED matter.  When I first started the Cialis and Muse regimine post-op I didn't see much progress.  Then I stopped taking the medications three times weekly as suggested by my Urologist.  I'm doing that maybe once a week.  Last night, after the Cialis/MUSE treatment - for the first time since the surgery I achieved an erection about 90% of what I'd have had pre-surgery . . . without manual stimulation.  My Urologist tells me it generally takes his patients a year to year and a half to see measurable progress regarding erections but that if there's a sensation "down there" erections should return at sometime in the future.  Whether my erections will return without the use of Cialis or comparable medications I don't know - but, time will tell.