How necessary is Tadalafil post RP?

User

Posted 11 Oct 2024 at 22:49

For those of you that had RP surgery, did your doctors prescribe either Tadalafil (Cialis) or Viagra to take regularly specifically to aid in healing? What is the consensus on how necessary this is? I'm just about 7 weeks post RP surgery and overall doing well on the ED front. At the appointment I had to remove my catheter (9 days post RP), my doctor prescribed Tadalafil (Cialis) 5mg prophylacticly, to take daily to help restore erectile function. Supposedly, being on it daily aids in blood flow to the penis even outside of sexual activity. It may not be noticeable to the individual but supposedly aids in the healing process. As I'm not a big fan of being on any medication daily, I decided to hold off initially to see how well (if at all) my "equipment" was able to work naturally. Well, I was pleasantly surprised to discover that I am able to get erections unaided though it does take a little more work to get there than pre-surgery. Also, I have found on some occasions although I can get the erection, I sometimes have trouble maintaining it. But overall, I'm doing really well naturally. I have tried taking the Tadalafil though to see if it makes any difference and I have to say it does. With Tadalafil, I'm 100% and that ultimately is where I'd like to end up naturally someday.

If that's all there was to the story, I would just take Tadalafil daily and would be drinking a pint right now instead of typing this. But life is never that simple now, is it? I'm afraid Tadalafil my conflict with another condition I have. You see, I have very thin retinas due to having very high myopia (near-sightedness). I already have some tissue breakdown in my maculas which may someday lead to some vision loss so I have to be very careful about anything that can cause additional harm to them. There is some evidence out there that drugs like Cialis and Viagra do cause some harm to the retina, though most of the research showing this is at higher doses. Never the less, I'm hesitant to take Tadalafil on a daily basis even at the low 5mg dose. At the same time, I'm also afraid NOT to take it as I don't know if NOT taking it may cause me to either not fully heal or worse, possibly even cause me to develop scar tissue which could ultimately make things worse.

So, again, for those of you who had RP, did your doctors want you on Cialis or Viagra for healing purposes? Can you fully heal without it? Not sure what I should do.

User

Posted 12 Oct 2024 at 02:10

Mangia

I am on sildenafil (viagra) low dose 20mg. My Surgeon started me the evening of surgery as he felt important to keep blood flow although you have no sense of it and it is not being used to get you an erection. I am 8 weeks post RP surgery. He explained to me that you did not want to try and get yourself aroused even if you felt sensitive. He said the nerve sparing still causes trauma and damage to the nerves, but this damage is reversible through the nerves slowly regenerating themselves through this rest period of recovery from surgery. He explained if you try to cause the nerves to react prior to their healing this can cause irreversible damage to the nerves. He also explained that he gradually increases the dose, but actual sexual activity needs to come slowly. He said after 12 weeks I could slowly begin to engage in more arousal activities but should not try to orgasm and would likely be closer to six months for full erection and intercourse. He said I should feel more arousal awakening in the morning and more girth which means the nerves are regenerating. He just said it should be taken slowly so as to get the full rehabilitation. If you are able to get that feeling without cialis or viagra great, as that means you certainly are getting blow flow early, but I would still go slowly. After all the surgery and recovery what is a couple more months.

User

Posted 12 Oct 2024 at 09:29

I had a non nerve sparing prostatectomy over 18 months ago. Ever since then, I've spent hundreds of hours doing research in an attempt to preserve Percy.

It seems, that despite ED being one of the most common and upsetting side effects, there has been very little research on the subject.

Anything to restore blood flow to your penis is good, whether it be pills, pumps or jabs or a combination of the three. Increased blood flow improves penile health.

Most sites, dependent of your doctor's advise, recommend starting penile rehabilitation, as soon as possible.

It seems some men will be lucky enough to achieve their former glory but sadly most, to varying degrees, will not.

I've found this link very good for ED and the treatments for it. It seems to cover everything.

https://truenorth.movember.com/sex-after-prostate-cancer/learn/erectile-dysfunction/

Psychologically it's help me to not entirely blame PCa for my ED. Most men, with or without our disease will, through ageing and other health conditions, suffer a similar fate.

Edited by member 12 Oct 2024 at 09:49 | Reason: Additional text

User

Posted 12 Oct 2024 at 15:30

Adrian,

So well said. At 71, when you hear 6 months to a year to recover from ED, if you are not fully recovering is it because of surgery or just getting older when someone is 72 going on 73. Up until surgery at late 70, things were totally fine not needing any ED medication and I knew because of aging or the cancer I was soon going to hit a wall. If you read the statistics about what percent of patients need ED med’s at age 70 start having ED dysfunction and need the use of ED med’s it’s extremely high in the 60%. I feel regardless reaching my age without dysfunction I did darn good. Yes I do want it to return but also felt I was likely getting towards the end of the line anyway and was not even thinking about the ED medication if I made it to the mid 70’s without real problems. Yes I am optimistic and my Surgeon is really optimistic but aging regardless is inevitable.

User

Posted 12 Oct 2024 at 16:29

I was prescribed tadalafil 5mg every other day post surgery. I suggested breaking it in half and taking 2.5mg a day which my surgeon supported as smooths out the peaks and troughs. I did it for a few months and now just take that or viagra if ever needed or when a bit tired and the good lady has a spring in her step 😵‍💫🤪

User

Posted 12 Oct 2024 at 21:41

Can your ophthalmic consultant give you some advice on the risk of Tadalafil in your case?

It does have a small risk of causing damage to the optic nerve, but that's so small people mostly ignore it. Same with rare damage to hearing.(I think these apply to all PDE5 inhibitors.)

Given you have erections back, and the Tadalafil does help making them better, its use is probably less important in your case. Maybe consider taking it just when you go for an erection, or every other day? You may find it still works the following day in any case.

Snapping PDE5 tablets in half does increase the chance of them causing acid reflux due to contact with the esophagus during swallowing, and having broken the film coating which is there to prevent this contact. There is a 2.5mg dose for people who get unacceptable side effects on the 5mg dose.

User

Posted 13 Oct 2024 at 17:35

Originally Posted by: Online Community Member

I am 8 weeks post RP surgery. He explained to me that you did not want to try and get yourself aroused even if you felt sensitive. He said the nerve sparing still causes trauma and damage to the nerves, but this damage is reversible through the nerves slowly regenerating themselves through this rest period of recovery from surgery. He explained if you try to cause the nerves to react prior to their healing this can cause irreversible damage to the nerves. He also explained that he gradually increases the dose, but actual sexual activity needs to come slowly. He said after 12 weeks I could slowly begin to engage in more arousal activities but should not try to orgasm and would likely be closer to six months for full erection and intercourse.

Hi Ned. That's interesting. My doctor told me the exact opposite. He told me I could begin sexual activity as soon as 2 weeks following surgery - just a few days following catheter removal. His exact words were "Go for it. It won't hurt anything.". I'm not looking to start any debate on this topic but I did follow his advice, and have been sexually active since the 2 week mark and it hasn't seemed to cause me any harm.

Originally Posted by: Online Community Member

Can your ophthalmic consultant give you some advice on the risk of Tadalafil in your case?

It does have a small risk of causing damage to the optic nerve, but that's so small people mostly ignore it. Same with rare damage to hearing.(I think these apply to all PDE5 inhibitors.)

Andy, I do plan on asking my retina specialist about how much of a risk Tadalafil poses to me when I see him next month but I doubt if he'll be able to give me a solid answer as my retina condition is extremely rare so there's not much information out there in any regards. I feel I need to err on the side of caution as my eyesight is more important to me than my joystick :). For now, I'm just taking the Tadalafil every other day. And I'm not even super comfortable doing that. Again, I'm just curious if anyone's doctor said that NOT taking it all could cause harm?

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