When to try using a pump?

Hi it's early days. I had a nerve sparring RP. I started using a pump soon after the catheter was removed and still use it 18 months later. Nerve sparring has many different outcomes, some men get erections fairly soon after others unfortunately never. In my case it's taken this long to get to perhaps 80% of where I was. Most noticeable improvement was after a year. 

Hi Badger07,

Yes, I had the same experience with the G.P.  They won't supply pumps or injections without approval from the E.D. Clinic.  In my case that delayed things by about 2 months.  

Best wishes,

JedSee.

Hi all.

First of all I want to say thanks and good luck to everyone who posts on here - it's been a great help with the emotional side of recovery.

I had the nerve sparing prostatectomy three months ago and luckily still have almost full sensation in my penis.

Bladder control is almost fully restored, which has meant that I've been trying to resume my love life.

At the moment I have sensation but no sign whatsoever of stiffening. I have an appointment with the ED clinic but that is months away.

My question is, should I wait for the ED consultation before trying a pump?

If not, are there any recommendations? I've see mention of the SOMAerect Response II and the Medintim on here.

Many thanks,

Steve

Nerve sparing means you have a chance of recovering erectile function. These nerves are nothing to do with sensation in the penis - that's not usually significantly impacted by prostate cancer procedures (biopsies and brachytherapy can impact that, although it's rare).

The important thing about penile health is not to go for too long without erections. If you can't get them naturally, then you should be doing so artificially.

Things it's worth trying at this stage are the higher dose PDE5 inhibitors (20mg Tadalafil/Cialis, or up to 100mg Sildenafil/Viagra). These won't give you an erection just by taking them - you need to get aroused too just like before.

If these don't work yet, or you can't get enough for at least 3 erections/week, then you need a pump too.

The other thing that's useful is to get on to regular Tadalafil for which there some evidence it helps nerve healing and preserving penile health with reduced numbers of erections. This is either 5mg daily low dose, or 2 x 20mg/week (which can also double up for trying for erections as above). Even if this dose doesn't generate erections, it improves blood flow in the area which helps with healing and preserving penile health. (None of the other PDE5 inhibitors have this extra effect, because they are too short acting.)

If you have a knowledgeable/helpful GP, they may be prepared to prescribe these for you in the absence of a timely ED clinic appointment.

You could also ask your CNS if they can schedule an appointment directly with a pump clinic for the pump - that may have a shorter waiting time than going via the ED clinic, since they're run by the pump reps. Some ICB's require all pumps to be prescribed via a pump clinic because it doubles the chances of using it successfully afterwards, and they only regard them as economically viable in such circumstances. The ICB covering Berks, Oxon, and Bucks has an ICB-level ban on supplying pumps.

Just to add to what Lyn said, for the SomaErect Response II, you also want the spare Surefit rings, which is NHS code 15222, as only one comes with the pump. These are only used for sex, not for penile rehabilitation, and it seems far fewer men find the pump useful for sex than do for penile rehab.

I have heard one of the Bathmate models is also available on prescription, but I never heard of anyone who got it that way. Most areas only offer one and if they use the pump clinic run by the reps, I think that's only the SomaErect.

Hi Stevie

To start with, following surgery, you need only use a cheap pump without rings. It is a matter of 'waking up' your penis and start the blood flowing into it on a regular basis; don't wait till you acquire a medical grade VED. This will also help towards regaining some length of your penis you are likely to have lost. This will require 2 to 3 months before you think of putting a ring on it, if you need to. Don't wait till you acquire a medical grade pump. If you suffer from ED seriously then you can begin to investigate various methods of overcoming your problem. Most men will seriously consider using a VED if all other options fail or, like me, do not wish any invasive or PDE5 options. In my view the benefit of using VEDs is under estimated; I have been very successfully using vacuum pumps for over 12 years - horses for courses.

Edited by member 01 Mar 2024 at 22:17  | Reason: Not specified

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