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Follow up appointment after surgery

User
Posted 17 Jul 2018 at 19:54

I have just had a follow up appointment after my surgery. I have been left feeling a little deflated. We talked about how i was feeling ok. Spoke about erections, had I had an erection since the surgery answered no. I was asked about my erections before surgery and was asked if I wanted viagra which I declined. Was not offered a chance to see a specialist nurse. Just feel a little deflated. Am i being impatient? I will see how I go in the weeks to come and seek some advise.

User
Posted 17 Jul 2018 at 21:25
You really need to accept anything that is offered if you are hoping for a return of erectile function. I was only 48 at surgery and it has taken 3 yrs to return to function albeit with a penis 2” shorter. A pump is your absolute priority and needs to be used every day ideally as long as you are 10 weeks post op or more. Not for penetration but for at least one daily good erection as pre op we would get five or more whilst asleep. Use it or lose it is what they say. The benchmark to return of function seems to be pump and daily 5mg Cialis if you beg for it. If your nerves weren’t spared you are stuck with pump and rings or injectables or pellets etc. Life long side effects from any treatment but you have to plug away and find a path

If life gives you lemons , then make lemonade

User
Posted 17 Jul 2018 at 22:23
In many areas of the country, the surgeon can’t make the referral to ED clinic or andrology clinic; it has to come from your GP. In a few Trusts,there is no ED nurse and the GP provides ED services. According to NICE guidelines, you have a right to a vacuum pump and daily Cialis but some CCGs have refused to approve Cialis.

Also worth saying that some men find that the pump is perfectly acceptable for penetration as well as penile health; and some men find that no treatment ever works, including the pump.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

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User
Posted 17 Jul 2018 at 20:41
Hello Osgood and welcome to the site

Perhaps he felt that as your operation was only in June there was still time for things to improve and the Viagra was offered to help you feel you were returning to "normal"

It is still very early days for you in terms of healing but I can understand that you are impatient. Were you offered Cialis at all?

Cialis is to keep the tissues healthy by keeping the bloody flowing to the region. Viagra is mainly for an "event"

I expect one of the men will be along to reassure you.

PS just out of curiosity, what was your objection to the Viagra?

We can't control the winds - but we can adjust our sails
User
Posted 17 Jul 2018 at 21:25
You really need to accept anything that is offered if you are hoping for a return of erectile function. I was only 48 at surgery and it has taken 3 yrs to return to function albeit with a penis 2” shorter. A pump is your absolute priority and needs to be used every day ideally as long as you are 10 weeks post op or more. Not for penetration but for at least one daily good erection as pre op we would get five or more whilst asleep. Use it or lose it is what they say. The benchmark to return of function seems to be pump and daily 5mg Cialis if you beg for it. If your nerves weren’t spared you are stuck with pump and rings or injectables or pellets etc. Life long side effects from any treatment but you have to plug away and find a path

If life gives you lemons , then make lemonade

User
Posted 17 Jul 2018 at 22:23
In many areas of the country, the surgeon can’t make the referral to ED clinic or andrology clinic; it has to come from your GP. In a few Trusts,there is no ED nurse and the GP provides ED services. According to NICE guidelines, you have a right to a vacuum pump and daily Cialis but some CCGs have refused to approve Cialis.

Also worth saying that some men find that the pump is perfectly acceptable for penetration as well as penile health; and some men find that no treatment ever works, including the pump.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 18 Jul 2018 at 07:50

Many thanks for the replies. I appreciate the advice and will go forward with a positive attitude.   Onwards and upwards as they say. Many thanks. 

User
Posted 18 Jul 2018 at 08:41

Hi Osgood
Your follow up seems very similar to mine. Talked about erections and continance but only prescribed 100mg viagra per week. Cialas was not mentioned at this stage. Soon after I got 16 per month from my gp and that continues now. The use of a pump was briefly mentioned with the Uro saying some men do and some men dont and said there is no scientific evidence that it aids long term recovery! He did explain that it could be used for penetration but never mentioned rehabilitation at this stage. Only after a future consultation when I said I had bought one on the web did he include in the letter to my gp that I was using it for physical therapy. He never explained how it is important to have regular engorgements to avoid atrophy.

I have learnt from others on this site especially Chris j and Lyn and from further research that there is significant evidence that both the pump and daily cialis are benificial to long term recovery. I believe I missed out on the best window of opportunity (I am 17 months post op) to aid nerve healing by not starting with the pump sooner and even now I cant get cialis prescribed.
I have my next psa check/follow up next week and will challange him again on the cialis. If he wont prescribe it I will try my gp or buy it on line.

Unfortunately some consultants are influenced by local policy and budget and my faith in my Uro is now low.

Sometimes we need to take responsibility for our own health and recovery. Dont take it for granted that your consultant has given you the full picture and challange him\her if need be.

To me life with out an erection has a big psychological effect. It is not only about sex and masculinity although that alone is bad enough, but also the feeling that there is just something missing, something just not right. It is difficult to explain but I assume must be the same for others.

Heed the good advice from those posts above and I wish you good luck in your recovery.

Cheers
Bill

Edited by member 18 Jul 2018 at 16:29  | Reason: Typo

User
Posted 18 Jul 2018 at 08:53
I had a prostatectomy on June 4th, and I have lost some length. There is no sign of life down there yet, except when I am defacating, where there is some tumescence, but nothing resembling even a ‘lazy lob’.

I can orgasm, however, so some bits are still working. I will enquire about a pump when I see the surgeon next month. I am on Cialis 5mg daily.

User
Posted 18 Jul 2018 at 09:31
Pumps maintain tissue elasticity and general penile health, they do not aid nerve recovery (IMHO).

Viagra and cialls (they do the same job but cialls lasts longer) improve blood supply and hence help with healing which can (according to my urologist) improve the healing process for nerves too. They can also help with spontaneous erections which removes the need to pump so regularly. Unfortunately they also give you aches and pains and blurry vision (or maybe that's to much sex? ? )

Bolinge you are a bit soon to thinking about stiffies!!

Chris you lost 2 inches!! man I'm so jealous if had lost that much there would be nothing left!!!

So yes get a pump and use it, yes take any meds you can get (if you can tolerate the side effects) DON'T give up!!

User
Posted 18 Jul 2018 at 09:49
I get no side effects from Cialis, not even erections at the moment......but I did try Viagra years ago and it made me nauseous.
User
Posted 18 Jul 2018 at 09:54
Yes frankij1 is totally correct, sorry if my post was misleading.

Pump is for penile tissue health, but atrophy which may or may not occur can be irraversable so best not delay to long.

Cialis is believed to aid nerve repair better than viagra because it improves blood flow to the damaged area constantly (when taken as daily dose) where as viagra only lasts a few hours.

Cheers

Bill

User
Posted 18 Jul 2018 at 10:36
Many thanks for the posts. Prior to my hospital discharge my surgeon advised me that I would need a pump, tablets and injections. None of this was discussed at my appointment or who I should be talking to about ED. The reason I declined the viagra was because I had not had the opportunity to discuss any of this. I felt it was a take it or leave it offer. In hindsight I should have led the conversation. I’m going to make an appointment with my GP to get a referral to an ED clinic. Thanks for all the replies and your own experiences they have already started to make me feel better about myself.
User
Posted 25 Jul 2018 at 16:54

Hi I am almost 11 months post RP and have been taking 5mg Cialis as recommended by my surgeon at the follow up. I was lucky to be caught after 6 years of PSA monitoring and an MRI showed nothing but just a year ago after a PSA of 13 I opted for the Template biopsy which came back with a Gleason of 3+4 so glad I made that decision (most days). I still haven't had an erection but  there does at least still seem to be some stirring. Just received my prescription for a pump today and looking forward to see how things progress. Been very informative to read everyone's candid posts

 
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