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12 month update

User
Posted 28 Nov 2019 at 17:22

I am now 12 months on,  almost to the day, from my RARP. My PSA is undetectable, although I have resisted the urge to request the more sensitive test. My surgeon advises that this simply causes unnecessary anxiety and that further treatment would not be offered until the PSA has risen to at least 0.2, whatever the results of the sensitive test.

 My continence is  to all intents and purposes back. The only time that a small drop escapes is when I am  very tired or when a very hard sneeze or cough takes me by surprise. I have not felt the need to wear pads or any sort of shield for about 6 months.

 On the ED front, I can now “function” without chemical or other assistance, although not entirely rigid and not for long. However 100mg of Viagra easily bridges the gap, although I find the optimum time is about 2-3 hours after taking it, not the 90 mins or so recommended in the instructions.

Apart from the inevitable anxiety of the 3 monthly PSA checks,  life has for the most part returned to normal. Whilst the possibility of a reoccurrence is always at the back of my mind, the surgeon is confident that the likelihood of this is quite low based upon my path. rpt etc. As such I am trying to take his advice to “stop worrying and get on with your life”.

 I am in a much better place than last year when I was first diagnosed and I hope that this update will provide some reassurance to those who have recently received a similar diagnosis. I would also like to thank those who responded to my posts at that  for there support and advice, which was much appreciated then and now. 

User
Posted 28 Nov 2019 at 20:15

Originally Posted by: Online Community Member
On the ED front, I can now “function” without chemical or other assistance, although not entirely rigid and not for long. However 100mg of Viagra easily bridges the gap, although I find the optimum time is about 2-3 hours after taking it, not the 90 mins or so recommended in the instructions.

A urologist at a recent support group meeting commented that one of his patients told him Viagra works much faster if you chew it up. He wasn't particularly advocating this, just passing it on.

Something else you could try if you can get it is a 5mg daily low dose tadalafil. If that's enough to work for you, then it's ready and waiting in your body 24x7.

The fastest acting PDE5 inhibitor is Avanafil (Spedra) - typically 15 mins.

Not all PDE5 inhibitors work for all men, and they bring different side effects in different people too.

User
Posted 28 Nov 2019 at 22:44
In our house, Viagra works 6-8 hours later.

I think Zebulon already had the daily dose Cialis and moved onto Viagra later.

Worth noting that not all trusts will prescribe Cialis / tadalafil and in those areas where it is available, 2.5mg is often the starting dose and may be enough for penile rehabilitation while reducing the side effects.

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

User
Posted 29 Nov 2019 at 09:42

Hi

Thanks for update.  I randomly drop into forum. As still learning a lot. Much appreciated and all the very best.   

I don't live in this NHS  .  Link below.  Found  doc very useful. I got told very little re. ED.  I only just found it after reading  your  post.  

Andy spot on.  PDE5 all work diff. and worth trying.   I haven't  tried  Spedra.

I wasn't offered PDE5 before op. Not sure if any regions offer that now.   I'm sure Lyn or others will know.

http://ntag.nhs.uk/docs/app/PDE5-inhibitors-prostate-cancer-NTAG-Apprasial-FINAL-for-web.pdf

Gordon

 

Edited by moderator 17 Oct 2023 at 06:09  | Reason: Not specified

User
Posted 29 Nov 2019 at 12:47

Originally Posted by: Online Community Member
Worth noting that not all trusts will prescribe Cialis / tadalafil and in those areas where it is available, 2.5mg is often the starting dose and may be enough for penile rehabilitation while reducing the side effects.

Of the many men I've spoken with, never come across anyone on 2.5mg tadalafil, but many do get the 5mg dose. There's no difference in cost per tablet.

The 2.5mg dose is intended for people who get side effects on 5mg but still want to keep using the drug.
(Same with the 10mg versus 20mg doses, for sex events.)

User
Posted 29 Nov 2019 at 21:17
Interesting, in our area the standard practice from the ED nurses is to request the GP prescribes 2.5mg post op and increase it to 5mg if progress seems slow. Getting GPS to go along with it is a different matter.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

 
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