Hi guys.

I'm 11 days out from my RALP and have not talked to my surgeon yet. My post-surgery appointment is April 22nd. I thought I would ask here first.

My question is, when do I start thinking about, or trying, penile rehabilitation for surgery induced ED?
I know that on my April 22nd appt., he will give me a script for Viagra and we will discuss things as related to ED. I know I'm jumping the gun, but wanted an idea.

Is there a standard time frame?
Depends on doctor or progress of surgery/outcome?
Left up to the patient?
When did you start?

Thanks

Yes, I'll be speaking with them.
Was trying to get an idea what the "average" time was.

Thanks

Note from mod: we're right on the line here. I've snipped a bit. -- PeterDisAbelard

Talk to your doctor and and try getting some Cialis samples from him (if you need tablets at (price redacted) each you may e-mail me for (details redacted) Cialis) and take 5 mg. as soon as the Catherter comes out. That works out to (price redacted) cents per dose (you break them into quarters) and this will hopefully keep good blood flow happening. Viagra is not usually prescribed at this stage since you simply want a maintenance dose in your system all of the time and Cialis is better for that than Viagra. At about 2 months, you should start with a VED. Buy one off of Amazon.com and don't spend more than $125. This will help blood flow and may stop the shrinkage possibility. You may want to try BiMix injections at 3 months if things are not improving. I hope that you are one of the lucky ones, but most of us take a long time to come back from our ED. I was 58 with 0 ED prior to surgery and it took me 16 months to have natural intercouse (with Cialis) and 20 months to have "unmedicated sex". You are correct in getting your ED therapy started over the next few days but please don't get discouraged if things don't work at once. Most doctors don't tell you that it may be somewhat of a long road. If your doctor doesn't take your ED concerns seriously, then you will have to push him. The BEST THING IN YOUR FAVOR is your age and most guys in their 40's seem to respond quicker and better. Good luck.

Bill K. from NJ

Post Edited By Moderator (PeterDisAbelard) : 4/2/2013 3:01:12 PM (GMT-6)

My surgeon has an ED & Continence seminar every Monday which happened to be the day my catheter was removed. They had a representative from the VED pump company talk and after the seminar, they helped us fill out the insurance forms for the pump. There must have been 20 of us in the room. It was covered 100% by my insurance company, United Healthcare.

The surgeon, Dr. Vipul Patel, gave me a prescription for 100 mg Viagra and gave me some free samples. The plan was to brake one pill in half and take 1/2 on Monday, 1/2 on Wednesday and 1 whole pill on Friday nights followed by manual stimulation. My wife and I call Friday night, "Therapy Night" . I started the Viagra 72 hours after the catheter was removed and the pump 4 weeks post-op.

I have gotten lazy about using the pump these past few months and I can see a definite decrease in size, about 1" so stick with it. Need to wake up the nerves and get blood flowing again.

Good luck with your plan!

Bill

Sorry.. I didn't know that I was "on the line". I was only trying to help...won't happen again. My apology.

Bill K. from NJ

Bill K.

I know you were trying to help, and I think you did help. Don't think I am mad at you or anything. It's just that there are some things we have to do to make sure the forum is no fun for people looking to spam us. That means there are certain subjects we have to tap dance around. I appreciate your patience.

there is no normal here, really depends on you (the patient) and your personal recovery and how your surgeon's views the subject

I had open surgery, and it was my uro-surgeon's practice to do nothing until 90 days out. I had complications, and was on the catheter for 63 days in any event. long before the 90 days were up, I was having full natural errections on the catheter, and even experience 2 orgasms that way (would highly not recommend anyone try that one, very very creepy experience). by the time I hit the 90 day mark, my dr was all prepared to give me the standard speech, and I said, dr so and so, I don't need any help, everything is working fine. yes, in the ultra rare club of zero ED after surgery.

good luck, and be patience, even though you had robotic, still a lot of complex surgery took place inside you, and all things need to heal properly. if you are getting any natural signs of errections on your own, that would be a good sign of things to come.

david

You Brooklyn guys are always ahead of the curve :)

I have an appointment this Friday with my Uro and he is supposed to start me on 5 mg of Cialis...this will be seven weeks post op. He wants me to use a pump too, but I am still working on getting one, hopefully paid by insurance.

Sparky,

On my 3 week appointment my URO gave me a 30 day supply of 5mg daily Cialis more for blood flow than wood. He told me not to expect any wood but if it did it would be a bonus. I got nothing more than a terrible back ache for 30 days. I should add I was on 50mg Viagra for 3 years before my RALP as my hypertension meds and age caused me ED problems so I knew it would be worse not better than before surgery.  After the 30 days and no wood he mentioned injections and Trimix which scared the crap out of me. That night I Goggled Trimix injections and found the HW forum, the rest is history, still no wood without injections but I found this place and it is my home now.

I should add that my URO told me after surgery that my prostate was very large and that to get it our there was a lot of trauma to my nerve bundle and I still hope it may recover someday.

Terry

Sparky, as most have said, this is different for almost all of us. My dr gave me a test injection of a bimix the day the supra pubic cath came out. It was a low 5 unit dose that got a little "chubby" I guess but that was it. This was to show me how to do injections. They started me on daily Cialis 5mg for blood flow. First 30 day supply was free. Kind of the drug dealer mentality of get em hooked and then charge em. Problem is my insurance won't cover more than 4 pills a month. Hope this isn't censored, "Tufts Medical Insurance is for the birds". I decided I'd pay out of pocket when I needed a refill. Very expensive ($172 for 30 at CVS) but around $130 after AAA discount but till I find a suitable alternative I'm paying.

I started injections and pump 30 days out. Have not had any usable erection with bimix yet as I'm still trying to find my dose. The pump is less than pleasant but if it helps I'll continue to use it. I had a couple setbacks where bleeding resumed so I have suspended the pump and injections a couple times.

The best advice I could give anyone is to make sure that you have an ED rehab program lined up BEFORE SURGERY. If you are one of the lucky ones that doesn't need it, great. Just don't wait till after to find a doctor / program you like. I had surgery in Michigan and their program seemed good but as of late communication has been almost non-existent and I'm extremely disappointed with them for this. I've contacted a local expert and am hoping to get connected with them ASAP. IF you have surgery out of town MAKE SURE THEY'RE GOING TO BE REACHABLE AFTER OR GET A LOCAL DOCTOR LINED UP!!!