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3 months post op/ED help

User
Posted 16 Jan 2020 at 23:21

Tomorrow is 3 months from my husband's RP surgery.  He is currently on Cialis .25 mg every day.  He is 53. 

His PSA in December was .10.  At the post op appointment the NP for his urologist told him he could start using the VED.  He has used is sporadically and trying to get into the routine of using it every day.  She offered injections but my husband is totally fearful of the needle he adamantly declined.  She did say if we change our mind when we go back in March she will gladly give us a script.  We did tell her we thought he was getting a little response with the pills and she told us he was ahead of the curve.  She said it is usually 6 months before there is a response.  

We thought on the Cialis he was getting some response.  I honestly do not know.  I feel like he may but I honestly don't know if he is.  He has feeling he says.  It just is not responding.  He can orgasm, not a problem at all that way.  We used the pump this week to have sex and yes we were able to.  However it felt very cold and made me wonder if it actually is getting blood flow.  I will say the pump took all the intimacy out for him and getting an erection normally was just not going to happen using the pump.  

His mental health is my main concern.  He admitted to feeling very defeated right now, he feels like he should be getting erections.  He mind spirals a lot with the thought of having to use injections for the rest of his life, taking medicine, being impotent and maybe having to get an implant.  I feel like his mental health may be inhibiting some of his recovery.  I am trying to encourage him every day and be positive.  I wish there was more I could do for him.  Before the surgery he never had a problem getting an erection.  Not even once.  And honestly I made sure we had as much sex before surgery hoping that would be some help in his recovery.

My husband is also frustrated with not knowing where he should be as far as ED recovery.  I do think he had the idea that "this will not happen to me" with ED, etc so when it did it took the wind out of his sails.  

So I am trying to find out from others where we should be at/going?  He did say he was going to use the pump every day.  Should we use it to try to have sex?  If so how often?  Does it help with recovery?  We found other ways to be intimate and for him to orgasm.  Is that helping with recovery?  There is also differing opinions on the injections.  The NP told us the injections in no way helped get blood flow.  It was only a means of having sex.  The US forums say just the opposite and recommend using the injections at 3 months.  Has anyone used injections for ED treatment for blood flow? If it is something we should be looking at I definitely want to get him on board with it.  I truly understand his hesitation with the needle thing but ultimately if it proves to be beneficial in ED recovery I know he will get over this hesitation.

Thanks so much to this forum.  I appreciate everyone who is here and your wisdom

User
Posted 17 Jan 2020 at 17:52
Adora,

I had RARP almost three years ago. 50% nerves spared. At three months I had some feelings but no swelling. I was prescribed 100mg sildenafil (Viagra) 16 per month and eventually added 5mg daily Tadelafil (Cialis). From about three months I used the pump. I started with a cheap one from Amazon and although I now have the prescribed Somarect I find the cheap one useful because it is light and stays on while standing in the shower etc. I used it mostly twice per day and sometimes three times. I still rarely miss a day. I was devistated at the thought of ed when diagnosed and nearly didn't have the op. It's a massive psycological blow to some men and it still effects me now. My wife has been been very supportive through out which is essential. After three years only recently I can get an erection sufficient for penetration, but there has been enough there for intimacy for much longer. Correct use of the pump is important and advice varies from using it once per week to three times a day twenty minutes each time and inflating and deflating five times each session. If OH doesnt use the pump shrinkage is likely and irreversible. I have tried the caverject and had no problem injecting, but they caused a prolonged and painful erection, otherwise I would still use them for certain. I just did/do as much as I can.

My point really is try to persuade him not to give up, even after three years I am improving but not there yet. Heed the advice from the other replies and don't give up.

Good luck to you both

Cheers

Bill

User
Posted 17 Jan 2020 at 05:51
Firstly , whatever nerve sparing he had done you are WAY too early to be expecting more than you have. It could easily be a year or more. I’m still getting improvements 4 1/2 yrs after op. It took 2 1/2 yrs for me to fully function normally again , and even then I’m still on daily Cialis.

I assume hubby had nerves spared. 5 mg per day is better than 2.5. There must be visual and physical stimulation for these type of tablets to work. If he’s trying to masturbate he may be getting frustrated as I still can’t really. But with my lady it’s easy. Yes use the pump as often as possible to prevent permanent shrinkage of the penis through lack of regular erections. He will end up losing length anyway as all heals inside. You don’t have to use the rings or have sex. Just hold it on and keep the vacuum. The rings are very tight so yes they stop the flow and it will get cold. Shouldn’t be used more than 30 mins like this ok. Injections can actually be very effective and boost confidence loads. It’s really easy to do and well worth a try for the results. I don’t know what you guys weee like before , but heh go get a strap-on as well. Great fun and he should love that you are getting pleasure by any means. Any action is helping with blood flow also. Just be patient , ask if the Cialis can be upped , use the pump every day and good luck

If life gives you lemons , then make lemonade

User
Posted 17 Jan 2020 at 08:02

"She said it is usually 6 months before there is a response. "

12 to 24 months is more realistic

"However it felt very cold and made me wonder if it actually is getting blood flow."

It is a tourniquet- it draws blood in and then restricts flow out so it will feel cold.

"I will say the pump took all the intimacy out for him and getting an erection normally was just not going to happen using the pump"

The pump is not designed to produce a natural erection - you use it without rings simply to draw blood into the area to prevent atrophy (penile rehabilitation) OR with restriction rings for penetrative sex.


"I feel like his mental health may be inhibiting some of his recovery"

This is the reality of ED post op. Some men end up with no mechanical reason for being impotent but diagnosis, treatment and ongoing distress / fear of not getting erection leads to permanent ED. Physically, my husband can get a great erection but his head is so messed up we are rarely successful with penetrative sex.

"Does it help with recovery?"

Yes, the pump is essential to recovery if used correctly. The injections do nothing to assist penile health because you can usually only use them once a week.

Edited by member 17 Jan 2020 at 08:03  | Reason: Not specified

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

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User
Posted 17 Jan 2020 at 05:51
Firstly , whatever nerve sparing he had done you are WAY too early to be expecting more than you have. It could easily be a year or more. I’m still getting improvements 4 1/2 yrs after op. It took 2 1/2 yrs for me to fully function normally again , and even then I’m still on daily Cialis.

I assume hubby had nerves spared. 5 mg per day is better than 2.5. There must be visual and physical stimulation for these type of tablets to work. If he’s trying to masturbate he may be getting frustrated as I still can’t really. But with my lady it’s easy. Yes use the pump as often as possible to prevent permanent shrinkage of the penis through lack of regular erections. He will end up losing length anyway as all heals inside. You don’t have to use the rings or have sex. Just hold it on and keep the vacuum. The rings are very tight so yes they stop the flow and it will get cold. Shouldn’t be used more than 30 mins like this ok. Injections can actually be very effective and boost confidence loads. It’s really easy to do and well worth a try for the results. I don’t know what you guys weee like before , but heh go get a strap-on as well. Great fun and he should love that you are getting pleasure by any means. Any action is helping with blood flow also. Just be patient , ask if the Cialis can be upped , use the pump every day and good luck

If life gives you lemons , then make lemonade

User
Posted 17 Jan 2020 at 06:19
I agree with Chris!

Way to soon to be worrying.

User
Posted 17 Jan 2020 at 07:18

Adora S

I am coming up to six years post op. My surgery was supposedly non nerve sparing, but I was getting movement down below and was given daily sildenafil, it helped but did not provide a complete solution. I was given and used a pump but the development of a Urethral stricture limited the use of the pump , a cold penis with the pump and ring was also my experience. I was offered injections and was in the same mind set as your husband. I opted for muse pellets where you put a small applicator about 50 mm down the eye of the penis, not painful and various levels of success. 

About a year ago, five years after surgery I decided to opt for the injections. The process is simple but still not really appealing and   the results do vary. Although I was not given the injections for blood flow the health of my flaccid penis has improved considerably and I get stirrings in the penis as I was pre op.

So when the time is right get the injections. 

Thanks Chris

User
Posted 17 Jan 2020 at 08:02

"She said it is usually 6 months before there is a response. "

12 to 24 months is more realistic

"However it felt very cold and made me wonder if it actually is getting blood flow."

It is a tourniquet- it draws blood in and then restricts flow out so it will feel cold.

"I will say the pump took all the intimacy out for him and getting an erection normally was just not going to happen using the pump"

The pump is not designed to produce a natural erection - you use it without rings simply to draw blood into the area to prevent atrophy (penile rehabilitation) OR with restriction rings for penetrative sex.


"I feel like his mental health may be inhibiting some of his recovery"

This is the reality of ED post op. Some men end up with no mechanical reason for being impotent but diagnosis, treatment and ongoing distress / fear of not getting erection leads to permanent ED. Physically, my husband can get a great erection but his head is so messed up we are rarely successful with penetrative sex.

"Does it help with recovery?"

Yes, the pump is essential to recovery if used correctly. The injections do nothing to assist penile health because you can usually only use them once a week.

Edited by member 17 Jan 2020 at 08:03  | Reason: Not specified

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

User
Posted 17 Jan 2020 at 14:24

Thanks to all for your responses and wisdom.

I went home last night after writing this to find my husband online researching injections with a truly defeated look on his face.  I watched many a you tube videos of Dr John Mulhall, a NY Urologist who preaches ED therapy and pushes these injections as part of therapy too.  My husband says he is now considering it but not happy about it.

As far as the Cialis, I actually think it is .50 mg and not .25.  My son has gran mal seizures and I am in the midst of switching med/adding other meds with him and right now dosages are scrambled eggs in my head.  

I will say his defeatedness and mindset has put him in a slump and trying to do any arousal/sex therapy, etc is completely off the table.  If I try to encourage it he gets angry and completely shuts me out.  So I feel at a loss on what to do and how to help him.  He told me he has to get his mind in the right place and I know it is not there.  The injection consideration has made it much worse I am afraid.

I am hoping he gets to the understanding that 3 months post op is not a reason for concern yet.  Last night I found helpful hints from LynEyre about how to use the pump and sent it to him (thanks so very, very much for your input, you have no idea how much that helps!).  I also said exactly what everyone else is saying...3 months is too soon for a complete recovery, it takes time, do the pump, take the pills and try to get your head straight to let intimacy happen naturally.  I told him I wanted injections off the table for now because he has not tried the pump on a regular basis and I want to try to do other things before going to the injections.  I just know the injections are going to kill the intimacy even more than ED already has.  

 

User
Posted 17 Jan 2020 at 15:11
Adora if he doesn’t accept it for what it is then he will never get over it. I’ve heard from many men and women whose relationships completely break down over this. If he sits sulking and angry and not trying then it won’t fix at all. I’m a very negative person generally but my wife and I worked our ass*s off trying everything and anything to fix the problem , and as you know time flies quite quickly. As I’ve said before , despite the grief of initial ED my wife and I actually had tons of new fun exploring everything else in the meantime.

If life gives you lemons , then make lemonade

User
Posted 17 Jan 2020 at 15:28
I am nearly twenty months post-op and the Christmas card to my excellent surgeon said ‘ Thank you, my PSA is still undetectable, as are my erections’.

My continence is fine, so I am not bothered, and Her Loveliness is quite relieved. I can have a sort of orgasm, but basically I am very glad to be rid of Tommy the Tumour!

Hope it all works out for you in the end.

Cheers, John.

User
Posted 17 Jan 2020 at 17:52
Adora,

I had RARP almost three years ago. 50% nerves spared. At three months I had some feelings but no swelling. I was prescribed 100mg sildenafil (Viagra) 16 per month and eventually added 5mg daily Tadelafil (Cialis). From about three months I used the pump. I started with a cheap one from Amazon and although I now have the prescribed Somarect I find the cheap one useful because it is light and stays on while standing in the shower etc. I used it mostly twice per day and sometimes three times. I still rarely miss a day. I was devistated at the thought of ed when diagnosed and nearly didn't have the op. It's a massive psycological blow to some men and it still effects me now. My wife has been been very supportive through out which is essential. After three years only recently I can get an erection sufficient for penetration, but there has been enough there for intimacy for much longer. Correct use of the pump is important and advice varies from using it once per week to three times a day twenty minutes each time and inflating and deflating five times each session. If OH doesnt use the pump shrinkage is likely and irreversible. I have tried the caverject and had no problem injecting, but they caused a prolonged and painful erection, otherwise I would still use them for certain. I just did/do as much as I can.

My point really is try to persuade him not to give up, even after three years I am improving but not there yet. Heed the advice from the other replies and don't give up.

Good luck to you both

Cheers

Bill

 
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