Hi all,
I was just wondering - has anyone here had a gradual recovery of erectile function on sildenafil? Share any good news stories with me, please!
I had a radical prostatectomy 16 weeks ago. Was diagnosed early with PSA at 4.1, Gleason 3 plus 4 equals 7. Nerves spared, continence recovered quickly, no previous erectile problems at 53 y.o., PSA <0.1 at the first test, so I've been as lucky as I could have hoped so far.
I was started on 50mg of sildenafil at my first appointment post-op (twice weekly). This has been upped to 100mg, for 3 weeks. There's more increase in size during arousal than before (weeks of hanging loose in shorts while on furlough might be improving appearances too). No problems with sensitivity or desire. It *looks* like an erection, but I'm just not getting any lift-off.
Now, I don't for a moment think that I should be, yet, and would be thrilled with any improvement over the next year or so. I would just like to hear whether anyone can say that they started as I have, continued with sildenafil 100mg, and eventually got back to roughly where they were before. Or, has anyone switched to another drug at some stage (what, and when?) and found that they got more hard more easily? When might a consultant decide to try something new?
Any guidance / uplifting tales / tips would be greatly appreciated.
Oh yeah - do penis rings have any rehab function? Haven't thought about trying this yet.
Many thanks, and best wishes to all.
RP 07.03.20, PSA 4.1, Gleason 3+4=7 |
User
Hi,
I had RP on the 1st October 2019 (44 yrs old) and am currently on Sildenafil 100mg. It took exactly 6 months for the pills to work, the erections are now back to full strength.
The viagra works about an hour after consumption.
Unfortunately i'm almost 9 months post op and still suffering from incontinence, changing about 2-3 light pads a day🤦🏻♂️🤦🏻♂️🤦🏻♂️
Good luck in your recovery!
User
there is no research data to support the idea that sildenafil helps the nerves to repair so it isn't going to have any impact on your long term recovery in the way that Cialis (tadalifil) would. For sildenafil to work, you would a) need to have made significant recovery and b) be feeling randy 1 - 6 hours after you take the tablet with c) no anxiety. Some men find that it works within an hour or two but in our house, J would take a sildenafil in the afternoon to have sex that evening.
For nerve repair, the usual route would be cialis daily (2.5mg or 5mg) from soon after the op, with a pump once the consultant is happy that the urethra has repaired. Here, we had the cialis for 3 or 4 years I think, with a pump from not long after the op, viagra from about 6 months post-op and then the injections a few months after that. The greatest recovery was between months 24 - 36 although the specialists usually say that whatever you have at the 2 year mark is as good as it is going to get. You can get the details of J's treatments & progress on my thread 'one wife's story of ED'
There are a very small number of men who get erections soon after the surgery but for the vast majority, the main recovery period is between 12 and 24 months so you are worrying very early and perhaps over-expecting.
A penis ring has no rehab function.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
It seems for a large majority of people with nerve sparing surgery that daily 5mg Tadalafil and regular use of a pump is the gold standard for long-term erectile recovery. You are very very early to expect too much. I’m now 5 yrs post op and have been on daily tadalafil for 4 yrs. Despite earlier comments , erections are still going from strength to strength and more natural every day. Totally back to normal but with loss of length. Even all this time on I use a pump whilst shaving to keep him healthy. I wake up fully hard every morning without fail. Simple penis rings don’t help with rehab but can make a massive difference to a 70% erection , and turn it into a 95% erection. No shame in using one and trying. They really can work.
If they got the cancer out there is a real chance for a total happy recovery. Sadly I totally recovered from the side effects but am now incurable with recurrence at 53
User
I disagree with Lyn re penis rings. They may have no physical rehab function but they certainly have a mental rehab function!
Maybe not yet though you are pretty early in recovery.
User
Fair point - I should have been more specific. Cock rings make no contribution to nerve bundle repair and don't aid the physical aspects of regaining erectile function. However, if you can get an erection or a semi for long enough to put a cock ring on, this can make for a marked improvement in emotional aspects of ED and also (if done a few times a day) may also help to avoid priapism
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
Hi all,
Many thanks for the advice and kind words, and apologies for the belated reply.
They're all very helpful thoughts, so thank you for letting me pick your brains.
I guess I've reminded myself that the main point of receiving sildenafil etc is to keep the blood flowing, to keep the vessel healthy while you carry out your rehab and recover. Rest assured that I'm not expecting progress with the erectile recovery so soon, or any time inside a year, so am not worried about how things are at all - am just looking ahead to the future.
Thanks again for taking the time to write, and best wishes to all.
RP 07.03.20, PSA 4.1, Gleason 3+4=7 |
User
"I guess I've reminded myself that the main point of receiving sildenafil etc is to keep the blood flowing, to keep the vessel healthy while you carry out your rehab and recover."
There is no evidence to suggest that sildenafil can do that; it is daily tadalafil that does that job. Unfortunately, some CCGs won't fund daily tadalafil and so men are given a medication (with attendant potential side effects) that is cheaper and may make no difference at all.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
I am a year post op with 50% Nerve sparing. 50mg Sildenafil, nada, 100mg Sildenafil a bit better but fully flushed face. Pump use almost daily for 6 months now. I am now on 5mg Tadenafil daily and I can really feel the difference with this constant dosage. There are definite stirrings.
So Pump & Cialis best together with 50mg Viagra for events. No way 100% but a definite improvement. Spoke to the Consultant the other day & asked about "nerve regrowth/repair". He said that after 12 months or so that would be the final result for most people. I hope he is wrong as I will still be optimistic and trying for more improvement.
User
Consultant is definitely wrong, he may be technicaly correct regarding physical healing but he does not take account of the physiological effects.
5 years on things still improve for me as I have had to re learn what works now and what definitely doesn't.
So what works? Basically I need to be really turned on to get most physical effect, I can no longer just have a mildly sexy thought and get a stiffy, it has to be intense and continuos excitement.
The practical impact of this for me and my wife is less frequent but much more satisfying and intense encounters.
User
Yes he's definitely wrong. 3.5 years post one side nerve sparing RARP and definitely still improving and not only mentally for sure. Also daily pump, Daily 5mg Tadalafil and about 50mg of Sildenafil for events.
Good luck
Cheers
Bill
Edited by member 29 Jun 2020 at 14:15
| Reason: Typo
User
Prosixty
Six years on and things still improving.
Thanks Chris
User
Five years on and still steady progress. To be fair I could probably ditch the Cialis now he’s so well-behaved
User
It is commonly said by surgeons & ED specialists that whatever you have at 2 years is as good as it is going to get (I think that is actually stated in the NICE guidelines for treatment options post-RP) but John's most significant improvement was between months 24 - 36.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
Forgot to mention above. Pelvic floor exercises are not only for the leaking, but are thought to help increase blood flow and help ED
Cheers
Bill
User
I had non nerve sparing ralp mid march, and am now on pump, starting at 8 weeks.
But when I saw surgeon for histology results 2 weeks ago he prescribed me 100mg sildanefil 3 times a week.
I thought without nerves there was no point, but he seemed quite sure.
I'm doing fine with just the pump, and don't like pills, but am instructed to give it a 'proper go' which I will do but don't feel there much point?
Martin
User
Mr Bee, I was supposedly non nerve sparing,but did get some stirring a few weeks after surgery. My ED guy put me on daily 100mg of sildenafil. It didn't have a great effect but if it doesn't cause any side effects it may be worth a try .
Thanks Chris
User
Yes I guess,as long as side effects are manageable. I've only been prescribed three times a week, so not every day. Will you keep on it even though no great effect?
User
Mr Bee, my surgery was just over 10 years ago. I probably took the sildenafil daily for six months, I then dropped the dose and frequency, although that should be done with your doctors agreement.
There have been a number of non nerve sparing guys on here who have been given similar treatment to you and me.
Thanks Chris