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Tackling ED sooner rather than later

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User
Posted 06 Apr 2022 at 19:20

Hi all, on discharge after my RALP the consultant spoke about taking Viagra (or alternative branded pill) as part of my recovery. I understand he is recommending I take this immediately and routinely as  ‘penile rehabilitation’ to help blood flow through vessels in that area and so aid recovery.

My GP hasn’t heard of this and believes Viagra should be taken only when needed later in recovery when the ‘urge’ returns or contemplating intercourse.

Does anyone have knowledge or experience of taking Viagra soon after surgery, not to aid intercourse but just to improve later ED outcome?

If so, what dose did you take and at what frequency ?

 

regards, GG

Edited by member 06 Apr 2022 at 22:01  | Reason: Not specified

User
Posted 07 Apr 2022 at 08:44
Like most GPs yours is demonstrating his/her ignorance and lack of knowledge of Prostate cancer rehab.

User
Posted 07 Apr 2022 at 07:29
It is usual to be given something (Tadalafil seems to be the most common prescription, but they all do similar things) for penile rehabilitation. Either your GP doesn't have the knowledge, or he is trying to save money. I'd see if the consultant, or more probably the specialist nurse, will issue a prescription - and possibly a letter to the GP. You should be getting this on the NHS.
User
Posted 07 Apr 2022 at 10:16
I have been on 50mg Sildenafil per week since 5th week after surgery, recently upgraded to 100mg on advice from urologist. That and the vacuum pump, both helpful.
User
Posted 06 Apr 2022 at 22:45
Hi GG, my hubby started taking tadalafil after catheter was removed last Friday. 5mg daily for penile health. He was given 3 months supply. He is struggling with severe muscle pain in his legs, which we now know is a side effect. We’re going to reassess on Friday. The pain has set him back, it’s been that bad but we’re hoping it will settle down and his body will adjust to the drugs. @lyneyre advised that there is a lower dose available, 2.5mg. From what the surgical team have said to us, it’s the norm post op to ensure everything is kept healthy. I believe it’s too low a dose to get an erection, and is purely for penile rehab. I suppose this could be another case of postcode lottery? Have you been discharged from the surgical team? If not, give them a call? Hope recovery is going well? X
User
Posted 07 Apr 2022 at 08:18

Hi Glasgow guy, when we saw the surgeon he told us if OH goes for RP he would be almost straight away on Viagra (or equivalent tablets) for penile rehab

User
Posted 07 Apr 2022 at 13:17

Interesting because although there is research to indicate that Cialis (tadalafil) daily dose (5mg or 2.5mg) aids nerve damage repair by drawing blood and therefore oxygen to the area of the nerve bundles, there is no research to suggest that Viagra (sildenafil) has any impact at all so your GP is technically correct :-/ My instinct is that anything is better than nothing, but the science doesn't support that. In your shoes, I would ask the GP whether they are willing to prescribe Cialis daily dose instead. 

If a man did not have any nerves saved, Cialis will do nothing to help repair nerves that no longer exist.

Edited by member 07 Apr 2022 at 13:18  | Reason: Not specified

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

User
Posted 07 Apr 2022 at 18:21

Six months post RP, I was advised to discuss taking Cialis with GP. She had no knowledge of improving blood flow post op and wouldn’t prescribe. I spoke to my Macmillan nurse and she arranged a call and letter to surgery and  Tadalafil was prescribed, I had some issues with it and, after Googling and a discussion with a user, managed to switch out to Cialis which is tolerated. Next checkup Consultant confirmed it is only Cialis they use due to its around the clock efficacy, the others react quickly and have a restricted window of operation.

User
Posted 08 Apr 2022 at 09:43

It seems that different surgical teams have varying opinions on this subject. I was prescribed 20mg Tadalifil twice weekly immediately following removal of catheter. When I asked if a daily 5mg dose would be more efficient, my surgeon responded in the negative and asked that I stay with his regime. I must say that for the two days following taking the tablet, my penis is noticeably fuller and hence I assume my nerves are benefiting from an enhanced blood supply. Side effect of occasional acid reflux is a bit of a problem. 

Edited by member 08 Apr 2022 at 09:43  | Reason: Typo

User
Posted 10 Apr 2022 at 18:29

It's two years since my RP and within a couple of weeks of the op my consultant prescribed 5mg tadalafil (Cialis) on weekdays and 20mg on weekends. Be patient and persevere as for the first few weeks not a lot happened, in fact I gave up as I was getting leg muscle pains and I moved onto viagra. These also had some but little effect so I went back onto tadalafil and persevered and eventually things started to change and erections became harder over time. The difference between the two drugs is that tadalafil gives an erection more naturally as and when needed whilst viagra tends to wear off after a couple of hours. My understanding is that tadalafil is more effective in providing the relevant nerve stimulation needed. I have now reduced my intake by stopping the 5mg on weekdays and usually now only take 20mg (sometimes 10mg) on a Friday which is sufficient for good erections that last a couple of days. That suits my needs however it maybe different for others.

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User
Posted 06 Apr 2022 at 22:45
Hi GG, my hubby started taking tadalafil after catheter was removed last Friday. 5mg daily for penile health. He was given 3 months supply. He is struggling with severe muscle pain in his legs, which we now know is a side effect. We’re going to reassess on Friday. The pain has set him back, it’s been that bad but we’re hoping it will settle down and his body will adjust to the drugs. @lyneyre advised that there is a lower dose available, 2.5mg. From what the surgical team have said to us, it’s the norm post op to ensure everything is kept healthy. I believe it’s too low a dose to get an erection, and is purely for penile rehab. I suppose this could be another case of postcode lottery? Have you been discharged from the surgical team? If not, give them a call? Hope recovery is going well? X
User
Posted 07 Apr 2022 at 07:29
It is usual to be given something (Tadalafil seems to be the most common prescription, but they all do similar things) for penile rehabilitation. Either your GP doesn't have the knowledge, or he is trying to save money. I'd see if the consultant, or more probably the specialist nurse, will issue a prescription - and possibly a letter to the GP. You should be getting this on the NHS.
User
Posted 07 Apr 2022 at 08:18

Hi Glasgow guy, when we saw the surgeon he told us if OH goes for RP he would be almost straight away on Viagra (or equivalent tablets) for penile rehab

User
Posted 07 Apr 2022 at 08:44
Like most GPs yours is demonstrating his/her ignorance and lack of knowledge of Prostate cancer rehab.

User
Posted 07 Apr 2022 at 10:16
I have been on 50mg Sildenafil per week since 5th week after surgery, recently upgraded to 100mg on advice from urologist. That and the vacuum pump, both helpful.
User
Posted 07 Apr 2022 at 13:17

Interesting because although there is research to indicate that Cialis (tadalafil) daily dose (5mg or 2.5mg) aids nerve damage repair by drawing blood and therefore oxygen to the area of the nerve bundles, there is no research to suggest that Viagra (sildenafil) has any impact at all so your GP is technically correct :-/ My instinct is that anything is better than nothing, but the science doesn't support that. In your shoes, I would ask the GP whether they are willing to prescribe Cialis daily dose instead. 

If a man did not have any nerves saved, Cialis will do nothing to help repair nerves that no longer exist.

Edited by member 07 Apr 2022 at 13:18  | Reason: Not specified

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

User
Posted 07 Apr 2022 at 18:21

Six months post RP, I was advised to discuss taking Cialis with GP. She had no knowledge of improving blood flow post op and wouldn’t prescribe. I spoke to my Macmillan nurse and she arranged a call and letter to surgery and  Tadalafil was prescribed, I had some issues with it and, after Googling and a discussion with a user, managed to switch out to Cialis which is tolerated. Next checkup Consultant confirmed it is only Cialis they use due to its around the clock efficacy, the others react quickly and have a restricted window of operation.

User
Posted 07 Apr 2022 at 22:43

Timber, not sure what you are saying. Cialis is just a brand name for Tadalafil. There isn't any difference.

User
Posted 08 Apr 2022 at 06:34

Originally Posted by: Online Community Member

If a man did not have any nerves saved, Cialis will do nothing to help repair nerves that no longer exist.

really useful information Lyn x

User
Posted 08 Apr 2022 at 09:43

It seems that different surgical teams have varying opinions on this subject. I was prescribed 20mg Tadalifil twice weekly immediately following removal of catheter. When I asked if a daily 5mg dose would be more efficient, my surgeon responded in the negative and asked that I stay with his regime. I must say that for the two days following taking the tablet, my penis is noticeably fuller and hence I assume my nerves are benefiting from an enhanced blood supply. Side effect of occasional acid reflux is a bit of a problem. 

Edited by member 08 Apr 2022 at 09:43  | Reason: Typo

User
Posted 10 Apr 2022 at 18:29

It's two years since my RP and within a couple of weeks of the op my consultant prescribed 5mg tadalafil (Cialis) on weekdays and 20mg on weekends. Be patient and persevere as for the first few weeks not a lot happened, in fact I gave up as I was getting leg muscle pains and I moved onto viagra. These also had some but little effect so I went back onto tadalafil and persevered and eventually things started to change and erections became harder over time. The difference between the two drugs is that tadalafil gives an erection more naturally as and when needed whilst viagra tends to wear off after a couple of hours. My understanding is that tadalafil is more effective in providing the relevant nerve stimulation needed. I have now reduced my intake by stopping the 5mg on weekdays and usually now only take 20mg (sometimes 10mg) on a Friday which is sufficient for good erections that last a couple of days. That suits my needs however it maybe different for others.

 
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