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Sildenafil prescription

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User
Posted 22 Jan 2020 at 21:17

So here I am, 7 months on from RP and my last follow up on 17 December went well. PSA still unrecordable, unfortunately, so too is my sex life. Bought some viagra as GP would not prescribe until I had seen the consultant. That’s now done and he prescribed 8 tablets. So I had 12 in all and I’ve used 6 but to no effect whatsoever. I’ve read that it takes time but have people had experience of the tablets suddenly kicking in?

User
Posted 23 Jan 2020 at 00:39
You are only 7 months in - it could take 1-2 years. Are you taking it on an empty stomach and then leaving enough hours for it to kick in? In our house, it has to be taken mid afternoon to have sex in the evening - it isn't an immediate response. Do you feel randy when you take it - it won't work if you are not in the mood. Were your nerves spared?

What are you doing in the meantime to keep your penis healthy? Do you have a vacuum pump? Are you masturbating regularly?

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

User
Posted 23 Jan 2020 at 08:25

I echo everything Lyn said, although the time it takes to become effective varies in different people - typical time for effectiveness is 1-4 hours after taking.

I would suggest you ask for 5mg daily low dose tadalafil instead of occasional sildenafil/viagra. It might not work any better at generating erections now, but it will do a better job of protecting your penis in the absence of erections. I discussed this in more detail just now in another thread. The daily low dose tadalafil is continuously effective, so you don't have to play around trying to work out what the effective window is for you after taking it.

User
Posted 23 Jan 2020 at 18:42

Sparrow / Subbuteo

Interesting what you said re the GP. I asked for Tadalafil/Cialis and was told it was too expensive. I said I thought that all copyright etc was finished. He agreed but still said too expensive. I have had sidenafil for 6 months now. 50 mg did not touch the sides. 100mg for date night sort of improves - lazy lob style. The most improvement is definitely the pump. However this is gone within 5 minutes even with 100mg sildenafil/Viagra at the same time. 

I have ED Clinic appt next month at Urology Dept to hopefully get a new prescription. I am sure the subject will be caverject but I am wary of this before trying the daily tad/cialis option 1st.

I was RP May 2019.

Edited by member 23 Jan 2020 at 18:47  | Reason: Not specified

User
Posted 02 Feb 2020 at 19:16

I would echo that at your stage, my first choice for penile rehabilitation before erections are working would be Tadalafil, either 5mg daily low dose, or 2 x 20mg/week (which I would break into 4 x 10mg unless trying to get an erection).

He's given you an ED dose of sildenafil, not a penile rehabilitation dose (for which sildenafil isn't ideal - too short a half life).

Edited by member 02 Feb 2020 at 19:17  | Reason: Not specified

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User
Posted 23 Jan 2020 at 00:39
You are only 7 months in - it could take 1-2 years. Are you taking it on an empty stomach and then leaving enough hours for it to kick in? In our house, it has to be taken mid afternoon to have sex in the evening - it isn't an immediate response. Do you feel randy when you take it - it won't work if you are not in the mood. Were your nerves spared?

What are you doing in the meantime to keep your penis healthy? Do you have a vacuum pump? Are you masturbating regularly?

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

User
Posted 23 Jan 2020 at 08:25

I echo everything Lyn said, although the time it takes to become effective varies in different people - typical time for effectiveness is 1-4 hours after taking.

I would suggest you ask for 5mg daily low dose tadalafil instead of occasional sildenafil/viagra. It might not work any better at generating erections now, but it will do a better job of protecting your penis in the absence of erections. I discussed this in more detail just now in another thread. The daily low dose tadalafil is continuously effective, so you don't have to play around trying to work out what the effective window is for you after taking it.

User
Posted 23 Jan 2020 at 17:59

For me, tadalafil works much better ( as a one off as required ). I also use Caverject injections in combination, yes dual therapy, it works and no I haven't had priapism or finished up in A&E. The GP won't offer this option it has to be a urologist so maybe next time you see him/her ask for it?

John

 

Edited by member 23 Jan 2020 at 18:00  | Reason: Not specified

Gleason 6 = 3+3 PSA 8.8 P. volume 48 cc Left Cores 3/3, Volume = 20% PSA 10.8 Feb '19 PSA 1.2

Jan '20 PSA 0.3 July '20 0.1 Jan. 21 < 0.1 Dec 21 <0.01 June '22 <0.01 April '23  <0.01

User
Posted 23 Jan 2020 at 18:42

Sparrow / Subbuteo

Interesting what you said re the GP. I asked for Tadalafil/Cialis and was told it was too expensive. I said I thought that all copyright etc was finished. He agreed but still said too expensive. I have had sidenafil for 6 months now. 50 mg did not touch the sides. 100mg for date night sort of improves - lazy lob style. The most improvement is definitely the pump. However this is gone within 5 minutes even with 100mg sildenafil/Viagra at the same time. 

I have ED Clinic appt next month at Urology Dept to hopefully get a new prescription. I am sure the subject will be caverject but I am wary of this before trying the daily tad/cialis option 1st.

I was RP May 2019.

Edited by member 23 Jan 2020 at 18:47  | Reason: Not specified

User
Posted 02 Feb 2020 at 12:33

Sorry I am late replying just feeling a bit down at the moment. Due back in hospital on Wednesday, have to have my gallbladder removed! Latest in a long line of treatment over last thirteen months. When I had my PET scan it showed a hotspot in my gut but it did give me the all clear for cancer. Whilst waiting for the colonoscopy I started suffering the most god-awful stomach pain. Eventually diagnosed as gallstones. Went into hospital at end of November for removal but cancelled at literally the last minute as they found I had a stone stuck in my bile duct. Had that removed by endoscopy in December. So fingers crossed.

Lyn, yes I am following the instructions and I am aware it doesn’t just happen, so I am trying. I sincerely hope that the nerves were spared, I was told they would be. Unfortunately my consultant resigned and my new one is a chap I first saw in January 2019 who told me ‘you won’t have cancer, you’re too young and it’s not in the family’. Very reassuring at the time but of course I learned the hard way that it was complete bollocks. Consequently I have no faith in him.

I have raised the issue twice now but no referral to an ED clinic. I shall have to try harder in March at my next follow up appointment. I would complain but I did that before and he simply denied saying it.

 I shall simply persevere.

Thanks for your support 

 

Rob

User
Posted 02 Feb 2020 at 15:24
You have to love a doctor that talks bullox :-/

Clarify with the urologist and the GP how ED support works in your area. In some areas the surgeon must make the referral, in other areas only the gP can make the referral, there are places where either can do it and, sadly, some CCGs provide no ED or andrology service at all. Fingers crossed for you that there is a service and it just turns out you have been asking the wrong person.

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

User
Posted 02 Feb 2020 at 19:10

In my area, consultant and GP can refer, or even the clinical nurse specialist.

You get to see a different ED clinic though, consultant refers to ED clinic at their specialist hospital, and GP at district general hospital, and clinical nurse specialist - depends which hospital's CNS I ask.

Clinical nurse specialists are good at chasing up appointments in my experience, so I would use them myself.

User
Posted 02 Feb 2020 at 19:16

I would echo that at your stage, my first choice for penile rehabilitation before erections are working would be Tadalafil, either 5mg daily low dose, or 2 x 20mg/week (which I would break into 4 x 10mg unless trying to get an erection).

He's given you an ED dose of sildenafil, not a penile rehabilitation dose (for which sildenafil isn't ideal - too short a half life).

Edited by member 02 Feb 2020 at 19:17  | Reason: Not specified

User
Posted 02 Feb 2020 at 19:16

I suspect my GP and consultant would end up sending me to the same hospital. I haven’t been in touch with with my CNS since 21 June, on my discharge from hospital. I simply failed to ever be able to contact her so gave up. I wasn’t alone, fellow patients have also given up.

User
Posted 02 Feb 2020 at 19:20

You do seem to have appalling support all around.
I'm wondering which health authority you come under?

User
Posted 02 Feb 2020 at 20:12
My dad, father-in-law and John were all allocated the same clinical nurse. We met her the day John was diagnosed and she gave him the PCUK toolkit. In 12 years, she has never once returned a call or contacted us about any of my three men.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 03 Feb 2020 at 10:17

Not just me then! There were two other blokes admitted to the same ward on the same day for the same op as me. It was ten feet away from her office door. She never came to introduce herself.

i wouldn’t want to say which trust, but the county is north of Gloucester and east of Hereford!

User
Posted 10 Feb 2020 at 14:44

Everything on hold at present. Had my gallbladder removed last Wednesday. Meant to be a 35 minute operation but I was on the table for 2 hours. Consultant reckons he has done about a thousand of these operations and he said that this was one of the most diseased gallbladders he has ever seen. It was full of stones and the cystic duct from the liver was like an ammunition belt’. He couldn’t understand how I had not been in agony for years.

It has brought many memories of last year back to me. Lying in bed unable to change my sleeping position, pain whenever I try to move and wearing those blasted TED stockings!

Never mind, I can feel myself getting better by the day now. So no more god-awful stomach pain.

 
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