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Am I expecting too much too early for ED problems after RALP?

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Posted 7/29/2011 2:07 PM (GMT -5)
I am new to posting on this forum but have been following it for awhile. I am almost 8 weeks post DaVinci surgery which my Uro said spared both nerve bundles. Before PC my wife and I enjoyed sex on average twice a week and for the last 4 years I have been taking 25mg Viagra due to the blood pressure meds I am taking. With Viagra I had what I would call a 100% erection. I have also been dry and pad free since week 3.

On week 3 my Uro put me on a daily 5mg dose of Cialis for 4 weeks and stressed how important it was to get back blood flow in my Penis. He also told me to be patient as the trauma to the nerves can take a while to heal. I got absolutely no response from the Cialis and this week the Uro gave me 2 doses of 100mg MUSE to try. The first dose resulted in about a 50% erection but not good enough for penetration. We are going to try the second dose tonight and hope for better results.  The Uro told me if the MUSE does not work well enough he wants to start TRIMIX injections next week. He is hoping that either the MUSE or TRIMIX will jump start things and only be a short term solution until I can go back to the oral pills again.

I guess my question is, am I expecting too much too soon after surgery? From reading many threads in here I have not found this answer yet. Also i would like to know if anyone who has done injections eventually got off them and had normal erections after surgery even with pills?

Thank you for any insight and help.

Terry

Posted 7/29/2011 2:23 PM (GMT -5)
Hi Water Guy,

Last weekend I watched the video from Sloan Kettering on YouTube about ED. It's very good, and over an hour long. It's well worth watching.

I think eight weeks is a bit early to expect a great response. The Sloan Kettering doctor said that many folks don't get good response until after 12 to 24 months. Some get early results for sure, but even that is not a full erection.

In my case, I had a limp erection for many months. Now, 12 months out, with the help of low-dose Cialis, I can get almost stiff. In fact it is the stiffest close to orgasm, probably because that's when there is the most stimulation of the nerves to generate the nitrogen oxide (?) that stimulates the erection.

I'm sure everyone's experience differs, but I was pretty happy with my situation. I had a sufficient erection for successful penetration after about six months, although it was still fairly droopy.

Hope things get better soon for you.

Nellie
Posted 7/29/2011 2:42 PM (GMT -5)
Neille,

Thank you for the response this was the type of information and experiences I was looking for. BTW do you have the link to the ED video you referenced?

Thanks

Terry

Posted 7/29/2011 3:06 PM (GMT -5)
Hello Waterguy
My doc also started me on low dose cialis 5mg daily, and also said use a ved (vacuum erection device) daily as it is really important to get blood into tissues etc. He also made an appointment for me to see a mens sexual health doc and off I went, same thing use ved keep up with cialis and try the larger 30mg dose once a week and see how it goes. Cool thing about this doc is he gives you his email address for contact and advice to see how it's going.
After first post op visit with surgeon he wanted me to start injections, as no erections, he said it is different to ved in that it will fill internal and external parts of penis with blood and promote healing. So off to mens health doc I go he has different opinion says there is two schools of thought on this matter, but it was fine to start injections. Which I am doing and have been since week 6 post op, the process doesn't hurt but it is painful sometimes afterwards, emailed doc he said if too bad he will adjust mix. I have another appt soon so will go for something different at present it is aprostatil 10mcg/10ml I think without going to freezer, and it works fine except for the pain after. I think at 8 weeks it is a little early to expect to much, it is disappointing not having spontaneity but hopefully it will improve, have to plan a bit more thats all.
Ausboy
Posted 7/29/2011 3:18 PM (GMT -5)
I have seen from other threads and from AUSBOY many are using the vacuum pump and my URO has said that is what he will try if the MUSE or TRIMIX injections do not work. My Uro is also a leading authority and physician locally on ED problems and treatments, so I hope he is doing the right treatments for my situation.
Posted 7/29/2011 4:02 PM (GMT -5)
It took me 11 to 12 months to regain anything useful.  It was a very gradual return.  about 8 months out I tried a few injections which helped the process.

So, from my experience, I'd say "yes", you're probably expecting too much at 8 weeks out.  Patience.

Dave

Posted 7/29/2011 4:47 PM (GMT -5)
Waterguy,

You can start the YouTube viewing here:

http://www.youtube.com/watch?v=ie8NkOu2VNA&feature=relmfu

This is a series of related videos, so hop to others with the same doctor.

You'll see he says that even when the nerves are spared with the least handling, they are bruised and swollen and take time to recover.

Nellie
Posted 7/29/2011 6:32 PM (GMT -5)
In my opinion, erectile recovery is a crap shoot.  I am 4 1/2 years past DaVinci surgery.  I was very sexually active before my surgery.  My wife and I had sex several times a week without any pills, aids or other help.  Since my surgery with "one side spared"  I am batting ZERO...I have never had a full  natural erection. None of the pills worked for me.

We still have sex several times a week, but every time it requires a shot of .15 bi-mix (30/1 Papvarine/phentolomine).  The good news is that it works every time.  I get a full, long lasting erection.  So, things change, but you can still have a sex life.

My doctor kept reassuring me before surgery that he would find a way to save my sex life if I was "motivated enough"...I have always been motivated when it comes to sex..  I assumed that I would go back to having regular erections.  I was wrong, the doctor IMO was not as honest or at least as clear as he should have been.  You are only 8 weeks and barely healing. things will get better.  However it will not be like it was before...guaranteed. 

Posted 7/30/2011 7:35 AM (GMT -5)
Here's the link to the Sloan-Kettering Doctor and his excellant video. It's in 4 parts and can be watched as your schedule allows. Lots of good practical and honest info in it.

www.mskcc.org/mskcc/html/95204.cfm
Posted 7/30/2011 10:20 AM (GMT -5)
James C, and Riviere

Thank you for the links to the Sloan Kettering video by Dr Mulhall. I just finished watching the whole series and it has answered so many questions. It is the best information I have found on the web about this issue. It also confirms why my URO is so concerned about my penile blood flow and the course of treatment he is doing is almost what Dr Mulhall recommends with his patients. I am actually looking forward now to the start of injection therapy next week. My URO keeps telling me that any erection is good for blood flow now and if it is strong enough for sex that is just a bonus.

I think that I have just been expecting too much too soon and Dr Mulhall and posts in this forum confirm that for me.  Everything else with my surgery like continence just went so smoothly that I assumed  the ED would be just as smooth. I am so glad I found this forum turn

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