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User
Posted 26 Nov 2020 at 12:21

Hi all. First post here so apologies if this has already been asked. I searched the forum but thought I'd get a bit more specific info by posting my own experience. 

I am 56 years old and 7 months post nerve-sparing robotic radical prostatectomy. I didn't require any other treatment and am now cancer-free. My last 2 PSA levels were negligible. Hopefully, it will stay that way.

I had the usual incontinence issues after surgery but that has now mostly resolved itself, thanks to the skill of the surgeon and the pelvic floor exercises. However, I do leak sometimes if I have that "extra" glass of wine at the weekend. I wear a pad to bed for this. I know I can fix this by not having that "extra" glass of wine but can I expect it to improve in time?

Erectile dysfunction is an ongoing issue. I have a very understanding and helpful wife and we have always enjoyed an active sex life before and indeed, after recovery from surgery. 
At the moment, I cannot get an erection. I have been using Tadafil (20mg) for the last 3 months. I take it about twice a week and one hour before sexual activity with my wife. I believe Tadafil is more rehabilitative and think that it is indeed "working behind the scenes". I do have some spontaneous slight engorgement regularly. 

A week ago I started using the SOMAerect Response II and can achieve an erection with that, although it's awkward, time-consuming, and a bit messy to form an airtight connection.
However, I don't think the erection is stiff enough for penetrative sex - we haven't tried yet - I was in the practicing mode this last week. :-) It is engorged and hard but also a bit floppy - pointing out instead of up - kinda hard to describe if you haven't been there. :-)
Can I expect this to improve in time or have you any other tips or tricks to help along the way? 
Thanks in advance for any replies, and for all the info I picked up here since my surgery. 

User
Posted 26 Nov 2020 at 18:56
Hey welcome and glad u seem cancer free. Click my picture and read my profile if you like. Seven months is early. Use the pump as much as possible maybe daily. You don’t need the ring just to engorge and rehab each day. Andy is right. Yes the pump and ring work for penetration but you have lost the ‘ root ‘ within your body for now. It takes a LONG time to get back. I would cut your tablets and take 5mg daily which may give better results in honesty. My surgery was 5 1/2 yrs ago. I’ve managed penetration for 5 of those years. Tablets , injections , pump , everything. I know it seems an age away to you , but for the last 2 1/2 yrs I’ve been able to have sex at will ( especially in the mornings ) by just sticking to 5mg daily and a simple rubber cock ring. I’m back to 100% hardness but you will lose length over time as things settle. It seems unavoidable. Luckily I started off with plenty so I’ve ended up not too bad. If you work and work and give it the time you can get back to perfect.

Sadly because of my inability to accept further treatment over the years I’m now deep in the sh**t if I’m honest but still stand by my quality over quantity attitude. So many people on here cured but then not enjoying that cured due to lack of sex or mental worry or psa testing angst. Or just having endless treatments and further ill-health. Anyway I’m off-subject. Persevere and it will all come good. In the meantime do all the other stuff and risk the pump penetration. It’s still good :-))

User
Posted 26 Nov 2020 at 18:36

J56yo,

That is the nature of erections with a pump. They only generate an erection in the external half of the penis, and not the internal half which anchors it to your pelvis. So you have a much more flexible hinge where it enters your body, than would be the case with an erection the whole length of the penis. You might need to hold it to direct it into the right place.

Edited by member 26 Nov 2020 at 18:39  | Reason: Not specified

User
Posted 26 Nov 2020 at 18:54

Hi J,

I had nerve sparing surgery just over a year ago and like you I have been prescribed 2x 20mg tadalafil per week. 

Checking my notes.. at 7 months I was at a similar stage as you are now and managed penetration at 8 months using a ring and some lube. It wasn't a substantial erection and needed a 'hand' to get started. Since that day, we've been making slow but steady progress, and while some positions work better than others, it seems that extended foreplay with a lot of stimulation (hand & mouth) definitely helps. 

I have also experimented with sildenafil but I'm not sure if it works for me yet as results are a bit hit and miss. 

I would say keep trying, keep the intimacy going, relax and try to manage expectations. For me, this part of the recovery is frustratingly slow sometimes but definitely showing signs of improvement. Having a great understanding partner definitely helps. 

Best of luck with your recovery. 

Kev. 

 

User
Posted 27 Nov 2020 at 00:07

Hi Chris. Just read your profile and in awe of your ability to compartmentalise it all. You certainly seem to have made lots of lemonade out of those lemons. 
Tonnes of good advice too - thanks for that. Should I ask my doc about changing the tablet dose from once-off 20mg to daily 5mg?

I greatly admire your ability and self-belief to decide for yourself what you want to do, instead of being entirely led by your medical team.

Thanks for your considered reply. This place is like a breath of fresh air with so many able to talk openly and honestly about their experience. 

User
Posted 27 Nov 2020 at 07:37
Now that Tadalafil is cheap and not called Cialis anymore there is no reason for him not to supply 5ng tablets. They may be slightly more expensive. However you are lucky getting 2 x 20 mg per week. The guidelines used to be one per week. Yes you were only allowed sex once per week :-((

If you ain’t scared of sticking a needle in yourself you can privately source Invicorp25 which had wondrous results. Just don’t mix drugs though on the day and get GPadvjce re heart conditions etc. That was a game changer for lovely date night sex whilst natural recovery was continuing. You could be looking at 2 1/2 to 3 yrs to get back to a great place but don’t be despondent - we all know how time flies. You’ll be having more sex than the neighbours probably :-)

User
Posted 27 Nov 2020 at 09:01

Hi J,

I usually make notes in my calendar to track milestones in my recovery, and while I was experimenting with sildenafil. 

I have followed Chris J's excellent posts on the subject, truly an inspiration, cheers Chris.

As for tadalafil, my local trust prescribes 20mg twice a week so I cut them in half and take 10mg alternate days (they're oval shaped so don't quarter easily).

User
Posted 29 Nov 2020 at 21:30
I'm ordering the tadalafil online, found it to be less hassle than via the GP and not much more expensive. Also taking the cheaper (per mg) 20mg tablet, quartering them or even cutting into 8 pieces (slight unevenness in size as a result though). Like the other tablet they give me a slight headache so not using too often (very slight, but enough to wake me up two hours early).
User
Posted 29 Nov 2020 at 22:14
I take my 5mg tablet at bedtime so very little side effects whilst I sleep except for a very useable erection in the morning tbh. Which I have to say we have been using as much as possible given my present position.
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User
Posted 26 Nov 2020 at 18:36

J56yo,

That is the nature of erections with a pump. They only generate an erection in the external half of the penis, and not the internal half which anchors it to your pelvis. So you have a much more flexible hinge where it enters your body, than would be the case with an erection the whole length of the penis. You might need to hold it to direct it into the right place.

Edited by member 26 Nov 2020 at 18:39  | Reason: Not specified

User
Posted 26 Nov 2020 at 18:54

Hi J,

I had nerve sparing surgery just over a year ago and like you I have been prescribed 2x 20mg tadalafil per week. 

Checking my notes.. at 7 months I was at a similar stage as you are now and managed penetration at 8 months using a ring and some lube. It wasn't a substantial erection and needed a 'hand' to get started. Since that day, we've been making slow but steady progress, and while some positions work better than others, it seems that extended foreplay with a lot of stimulation (hand & mouth) definitely helps. 

I have also experimented with sildenafil but I'm not sure if it works for me yet as results are a bit hit and miss. 

I would say keep trying, keep the intimacy going, relax and try to manage expectations. For me, this part of the recovery is frustratingly slow sometimes but definitely showing signs of improvement. Having a great understanding partner definitely helps. 

Best of luck with your recovery. 

Kev. 

 

User
Posted 26 Nov 2020 at 18:56
Hey welcome and glad u seem cancer free. Click my picture and read my profile if you like. Seven months is early. Use the pump as much as possible maybe daily. You don’t need the ring just to engorge and rehab each day. Andy is right. Yes the pump and ring work for penetration but you have lost the ‘ root ‘ within your body for now. It takes a LONG time to get back. I would cut your tablets and take 5mg daily which may give better results in honesty. My surgery was 5 1/2 yrs ago. I’ve managed penetration for 5 of those years. Tablets , injections , pump , everything. I know it seems an age away to you , but for the last 2 1/2 yrs I’ve been able to have sex at will ( especially in the mornings ) by just sticking to 5mg daily and a simple rubber cock ring. I’m back to 100% hardness but you will lose length over time as things settle. It seems unavoidable. Luckily I started off with plenty so I’ve ended up not too bad. If you work and work and give it the time you can get back to perfect.

Sadly because of my inability to accept further treatment over the years I’m now deep in the sh**t if I’m honest but still stand by my quality over quantity attitude. So many people on here cured but then not enjoying that cured due to lack of sex or mental worry or psa testing angst. Or just having endless treatments and further ill-health. Anyway I’m off-subject. Persevere and it will all come good. In the meantime do all the other stuff and risk the pump penetration. It’s still good :-))

User
Posted 26 Nov 2020 at 23:45

Hi Andy. Thanks for your reply. That makes sense to me. 

User
Posted 26 Nov 2020 at 23:51

Hi Kev T. Interested to hear you keep notes - any reason why and do you recommend it? I did actually write some things down myself and even took many photos during my stay in hospital to document it all - the mind has a habit of forgetting things that you'd rather not remember and I wanted to have a record of this time, in case I forgot. 
Thanks for our advice about relaxing and "managing expectations" - I think at my stage, it may be all about learning to walk before I can run. 
Appreciate your help.

User
Posted 27 Nov 2020 at 00:07

Hi Chris. Just read your profile and in awe of your ability to compartmentalise it all. You certainly seem to have made lots of lemonade out of those lemons. 
Tonnes of good advice too - thanks for that. Should I ask my doc about changing the tablet dose from once-off 20mg to daily 5mg?

I greatly admire your ability and self-belief to decide for yourself what you want to do, instead of being entirely led by your medical team.

Thanks for your considered reply. This place is like a breath of fresh air with so many able to talk openly and honestly about their experience. 

User
Posted 27 Nov 2020 at 07:37
Now that Tadalafil is cheap and not called Cialis anymore there is no reason for him not to supply 5ng tablets. They may be slightly more expensive. However you are lucky getting 2 x 20 mg per week. The guidelines used to be one per week. Yes you were only allowed sex once per week :-((

If you ain’t scared of sticking a needle in yourself you can privately source Invicorp25 which had wondrous results. Just don’t mix drugs though on the day and get GPadvjce re heart conditions etc. That was a game changer for lovely date night sex whilst natural recovery was continuing. You could be looking at 2 1/2 to 3 yrs to get back to a great place but don’t be despondent - we all know how time flies. You’ll be having more sex than the neighbours probably :-)

User
Posted 27 Nov 2020 at 09:01

Hi J,

I usually make notes in my calendar to track milestones in my recovery, and while I was experimenting with sildenafil. 

I have followed Chris J's excellent posts on the subject, truly an inspiration, cheers Chris.

As for tadalafil, my local trust prescribes 20mg twice a week so I cut them in half and take 10mg alternate days (they're oval shaped so don't quarter easily).

User
Posted 29 Nov 2020 at 21:30
I'm ordering the tadalafil online, found it to be less hassle than via the GP and not much more expensive. Also taking the cheaper (per mg) 20mg tablet, quartering them or even cutting into 8 pieces (slight unevenness in size as a result though). Like the other tablet they give me a slight headache so not using too often (very slight, but enough to wake me up two hours early).
User
Posted 29 Nov 2020 at 22:14
I take my 5mg tablet at bedtime so very little side effects whilst I sleep except for a very useable erection in the morning tbh. Which I have to say we have been using as much as possible given my present position.
 
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