ED progress. what next?

The two things you have, 5mg daily low dose Tadalafil and the pump are for penile rehabilitation - i.e. keeping the structures of your penis in good shape during the absence of erections. The Tadalafil helps with blood flow even when you don't have an erection, and that both helps with the health of the tissues of the penis, and gets more oxygen to the healing nerves.

Not sure what you mean by 50%, i.e. 50% of length, or 50% of rigidity?
Also, have you had a clinic session where you are told how to use the pump and it demoed on you? This is important and doubles the chances of using it successfully at home. If that hasn't happened, ask if you can have a pump clinic appointment (it's an off-shoot of the ED clinic, but probably has a much shorter waiting list). It's often run by the supplier reps who are very expert in it.

When you start using a pump, you have to go through a 2-4 week training period, which is usually uncomfortable and even painful while your penis gets used to being stretched in a way it hasn't been before, but this stops being uncomfortable by the end of the training period. During the training period, don't try using the construction rings, and you don't use them anyway for penile rehab. At only 9 weeks post op, you would still be in the training period. The pump should be able to get you completely rigid while you have the pump on, but it might be too painful to go that far at the beginning of the training period.

An erection using the pump won't be as long as a natural erection, because the pump only generates an erection in the external half of your penis, and not the other half which is inside your body.

I think it is worth asking for some event dose PDE5 inhibitors in addition to the daily low dose, and that would be 20mg Tadalafil or 100mg Sildenafil. Trying these occasionally will give you an earlier indication of erections returning (although it won't speed up the process). Another option would be to switch your 5mg daily low dose Tadalafil for 2x20mg/week Tadalafil which gives you the event dose twice a week to test things out, but because it lasts a while in your system, the level only drops a little below the 5mg daily low dose level just before the next 20mg dose, and you still get the continuous dosing. (This doesn't work with Sildenafil, as it only works for around 5 hours, and can't achieve continuous dosing.) The higher dose does increase the chance of side effects, but most people don't get side effects.

The pump can be used to have sex too, for which you use the constriction rings. Give this a go if you want to, but many men don't find the pump very satisfactory for this, even though very successful for penile rehab. If you can't yet get good enough erections with the event dose PDE5 inhibitors, you could ask for the vasodilator injections (Caverject, Invicorp, etc), which don't require working nerves.

Edited by member 07 Aug 2023 at 00:23  | Reason: Not specified

As already been mentioned, it is a bit too soon after surgery. I had my surgery about 15mths ago, it has taken me up till now to get some level of erections, so not fully there yet. I take the 20mg ciallis 2ce a week (I must confess I have not been consistent), the pump as well not consistent. I read somewhere, that we should persevere with the tablets even if it does not feel like it is working as it crucial we get some blood flow going. I also tried the injections Alprostadil 10mcg - tried 4 different times - increase the dose from 2.5 - 10mcg in a stepwise manner. The last dose worked. I have been prescribed an alternative one 20mcg, however not tried that yet, I have a phobia for needles! 

I also feel if I had been consistent with the pump exercise and the tablets, I might have recovered a lot faster. I purchased a strap-on and penis sleeve to wear on the strap-on, we used that for 5mths, so got lazy and thought to myself this could be an easier alternative, who needs a hard-on! Overall, I am beginning to see some progress despite my not following the recovery process correctly.