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User

Posted 30 Jun 2025 at 13:28

Hi all

New to this board despite reading on regular basis following RP in March of 2025 - nerve sparing surgery on right side only, had issues with bladder sutures so had catheter in for 12 weeks and been using ED pump with Viagra since July 24. Lost 1/2 inch in length and no erections achieved without mechanical intervention although even then penis will not stay upright from base even when hard.

I am after some help or insight please?

Firstly, despite not being able to sustain hard erection when using pump and tablets, I am getting very random almost full erections when lying down when I go to bed - these only last for about 20 seconds and as soon as my penis is moved or touched or I stand up they die away immediately though do sometimes come back for the same timeframe - anyone else had the same experience?

Secondly, before my operation I did have a slight penile fracture at base of left hand side and wonder if this is combining with the surgery to prolong my issues - when using ED pump with rings, penis goes hard but will not stay upright as appears to be no "strength" at base to maintain it upright; again any insight experience would be most welcome.

Many thanks

User

Posted 30 Jun 2025 at 22:23

Just to check - it sounds as if you had ED problems before having surgery. Or have I got the dates confused? Obviously it would be optimistic to expect recovery following surgery with only one side spared to restore better function than you started with.

But having said that, March 2025 is not that long ago. If you are getting erections already, even if brief, that seems pretty optimistic. From my own experience and those I have read here, it can easily take nine months or more to recover reasonable erectile function.

User

Posted 01 Jul 2025 at 04:56

Hi Ricky

Reading your bio it appears your RP was in Mar 2024? Prior to this you had a penile fracture. I'd never heard of that before, but having just researched it, found it to be quite a nasty injury. Did you receive any treatment for it? It sounds possible that it might be contributing to your erectile dysfunction.

On the brightside getting any sort of random erection after prostate surgery must be good news. I had none nerve sparing RARP over two years ago and have been unable to get any natural erections. Invicorp injections work though.

I definitely lost some length during the op, but Invicorp gives me erections that I suppose are about 80% as good as pre-op ones.

To get mine I went to an ED clinic and on their recommendation was prescribed the drug by my GP.

https://community.prostatecanceruk.org/posts/t29845-Hooray-for-Invicorp

I don't know if your penile fracture is still causing issues and would preclude you from such treatment. I would get some medical advice. I'm not sure whether pumps would aid or cause further damage to your penis if you're still having side effects from the penile fracture.

Incidentally I've found the opposite to you regarding erections. When I'm lying down the Invicorp is much less.effective than when I'm standing up.

Good luck mate, and I hope 'things' start looking up. 😉

User

Posted 01 Jul 2025 at 07:20

Thanks to all responders, I probably overstated the fracture, it was damage to the "tube" which was seen by doctor - caused some leanage to the left when erect but doctor said should hopefully repair itself over time, then 5 months later had the operation.

The lying down bit sounds like it's different for everyone - I will keep the faith as I've just been told I'm getting option of injections in August so fingers crossed.

User

Posted 02 Jul 2025 at 06:24

Erections with a pump and ring will always droop because of the hinge effect caused by the construction ring and the fact it can't trap blood in the base of the penis.

Injections do not have that issue..

User

Posted 02 Jul 2025 at 11:21

Hi RickyC

The constricting ring at the base of the penis causes the 'hinge' effect so the erections will be different from those you had before surgery. It is a question of adapting how you make love - carefully! If you find that with a ring on your erections are not sustainable you should try using two rings, a small one at the base of the penis and a larger one on top. I have been doing this for a number of years with great success. Also any penile-length shortening as a result of prostatectomy can be overcome by regular use of a VED; I find that after many years of using VEDs my erections are now better than pre-surgery level!

Edited by member 02 Jul 2025 at 11:22 | Reason: Not specified

'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.' Richard Feynman (1918-1988) Nobel Prize laureate

User

Posted 12 Sep 2025 at 13:08

Hi,

I'm not medically trained but I would like to make a couple of comments.

I take Tadalafil which is basically the same as Cialis. My prescription is 20mg twice a week and I take 10mg every other day. The aching legs is a known side effect so it may be worth reducing the dose.

As for Caverject, I used it successfully but some people find their erections painful (I didn't). I would say to use the smallest possible dose on the first time. This is incase of an adverse reaction. For me, 2.5mcg worked well and lasted an hour.

If you don't have access to an ED professional, I think you should proceed with caution, you should be able to find online tutorials on the subject.

Good luck,

Kev.

User

Posted 12 Sep 2025 at 13:17

ralu22

It's a shame you can't try Invicorp but hopefully Caverject will do the trick and lift more than your spirits. 🙂

As for worrying about if its too early to start injections this video by Dr Scholz, encourages men to use them very quickly after surgery. It's an interesting presentation by the great sage.

Once again good luck and let's us know how you get on. It's an expensive drug and it's imperative that the injection technique is good. There are lots of good videos on YouTube showing how it should be done.

Edited by member 12 Sep 2025 at 18:22 | Reason: Typo

User

Posted 15 Sep 2025 at 20:05

Originally Posted by: Online Community Member

Actually you understood right, psa was 0.2 a month after surgery and <0.006 one month later. He started Rt a little over 3months after surgery because the Rt professor doctor recommended and explained to us that is the safest way to deal with it (Pn1R1).

Hi ralu.

Thanks for the clarification. You didn't mention Pn1 earlier, which led to us querying the need for salvage radiation treatment. Lymph node involvement justifies such treatment.

I hope your husband's PSA always remains undetectable and that the Caverject helps with the ED. 👍

Show Most Thanked Posts

User

Posted 30 Jun 2025 at 22:23

User

Posted 01 Jul 2025 at 00:15

Full nerve sparring, nearly three years on still in recovery. Everyone is different.

User

Posted 01 Jul 2025 at 04:56

Hi Ricky

I definitely lost some length during the op, but Invicorp gives me erections that I suppose are about 80% as good as pre-op ones.

To get mine I went to an ED clinic and on their recommendation was prescribed the drug by my GP.

https://community.prostatecanceruk.org/posts/t29845-Hooray-for-Invicorp

Incidentally I've found the opposite to you regarding erections. When I'm lying down the Invicorp is much less.effective than when I'm standing up.

Good luck mate, and I hope 'things' start looking up. 😉

User

Posted 01 Jul 2025 at 07:20

The lying down bit sounds like it's different for everyone - I will keep the faith as I've just been told I'm getting option of injections in August so fingers crossed.

User

Posted 02 Jul 2025 at 06:24

Erections with a pump and ring will always droop because of the hinge effect caused by the construction ring and the fact it can't trap blood in the base of the penis.

Injections do not have that issue..

User

Posted 02 Jul 2025 at 11:21

Hi RickyC

Edited by member 02 Jul 2025 at 11:22 | Reason: Not specified

'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.' Richard Feynman (1918-1988) Nobel Prize laureate

User

Posted 11 Sep 2025 at 23:22

Hello,

First I have to thank all of you for sharing your experiences, it is very helpful, seriously! especially when doctors don't seem to care about this topic... I'm tired of the "you should be grateful " attitude...

So, my husband, 46yo, was diagnosed with PC in November last year (Gleason7, psa 13.2, no spreading), 8 months ago had a robotic assisted prostatectomy nerves spared. Cialis was prescribed for 3months, unfortunately no erectile effect... this is the only drawback after the surgery. The surgeon said he should be patient and optimistic... Psa dropped to 0.2, then <0.006, but the biopsy was not clean on the cut, so he needed Rt for 30days. 2 months after Rt psa still <0.006, CT ok, blood work ok, the oncologist gave us 6months until next psa. All this time my husband used vacuum pump because all the information we have read here (thank you again! no doctor recommended...feels like stone age!). Mostly for exercising, tried to use constriction rings before releasing the pump, but it gets immediately deflated about 10% and is really difficult to have penetrative sex.

We kept 1 cialis pill to use 2 months after Rt and had no effect whatsoever.

Today (3months from Rt) we went to see an urologist... he told us about caverject and then about implant... my heart dropped... I told him it will be the same cost as the robotic prostatectomy (15000E) and we already made a huge financial effort. He just explained that this is the reason he is not recommending robotic prostatectomy, better to have a classic procedure and then spend the money on implant... like there is no chance even for partial recovery of erectile function. He gave us a prescription for caverject, which we can buy only through an online international pharmacy.

Before I venture to get this injections (private prescription, all medications for ED are not included in the health insurance compensation list in my country) ... I kindly ask you for any advice.

Are we lying to ourselves thinking that maybe it's too early at 8months from surgery and 3months from Rt to see some recovery? With all the effort and stimulation the natural erection never gets more than 20%.

My husband is more optimistic than me, we managed to have ... some kind of sex, a lot of fun, he said that the sensation is more intense than before. However, we would like to regain our life back, at list as much as possible.

I have read most of the conversations here since I became a member, but only now I decided to ask you... I'm really frustrated with all the doctors, today i had the ugly feeling that we are customers, not patients ... the surgeon presented the procedure as the best of the best option, the rt doctor made the Rt sound like spa vacation (no side effects), the urologist proposed the implant as the only solution for the long-term (because of Rt...and maybe because he is doing the procedure)... only the pro's as any good seller...

I apologize for my long post and for my English, i'm not a native English speaker.

Thank you all! Any advice is welcomed.

User

Posted 12 Sep 2025 at 08:44

Hi ralu22.

I'm sorry that you've had to join our club, but welcome to the forum.

Your English is great.👍

There's very little information on here regarding penile implants, but Ulsterman has had one.

https://community.prostatecanceruk.org/posts/t28232-At-last--my-penile-implant

From what people have said, it would seem sensible to try penile injections first.

I've done quote a lot of research on injections and Invicorp seems the best.

https://community.prostatecanceruk.org/posts/t29845-Hooray-for-Invicorp

I had non nerve sparing surgery two and a half years ago and since then have never been able to have a natural erection. Invicorp saved my sex life. Give it a go!

Best of luck. Onwards and upwards. 🙂

Edited by member 12 Sep 2025 at 09:03 | Reason: Add link

User

Posted 12 Sep 2025 at 09:23

Hi,

Even with nerve sparing surgery it can take quite some time for erections to return. The nerves are very delicate and it will take time for them to recover from the operation.

I think it's important to keep taking the Cialis as this helps improve blood flow to the affected area and helps the nerves to heal.

Also, I think it's important to keep engaging in sexual activity and having plenty of fun together.

In my case it took several months before erections started to return, and I found it a frustratingly slow process. I started using injections for a couple of years which really worked well until I didn't need them anymore. I'm now almost 6 years post surgery and I'm really happy with my erections now so try not to be disheartened.

In my opinion, I wouldn't go down the road of implants just yet because I think it's too soon to tell when erections will return. I would stick with Cialis, use the pump for rehabilitation and try injections.

Good luck.

Kev.

User

Posted 12 Sep 2025 at 10:17

Thank you so much!

An implant is out of the question for many reasons... we don't think highly about any implants in general, no guarantees on the long-term, there is always a chance to ruin even the little you have... and there's the cost...

Unfortunately, we don't have Invicorp available, not even through this online pharmacy which imports medications by order and prescription, only caverject (possible because of some crapy UE regulations).

I have read your posts, also i took the liberty to screenshot some posts with tips about injecting (i apologize if it was wrong)... no need to say we don't have an ED clinic or ED nurse, so our main help comes by internet.

So your opinion is to go for injections... I haven't found any informations if the injections will negatively interfere with the recovery process (...if will ever happen)... but reading your both replies i don't worry about this anymore.

He had cialis 20mg every other day, started to have some pain in his legs ... not so good for his job (we have our own business, but are just the 2 of us and he's the technical one doing the actual work, I'm only administrator). Because of Rt the doctor recommended not to take it anymore, instead he was using the vacuum pump daily. Also the urologist yesterday was not recommending cialis (i can't buy it without prescription).

We are having fun, open minded about accessories and we communicate well with each other... but also we have an 11yo son in the house (the 20yo one comes only on vacations)...which makes things a little weird, requires planning, preparation... but we manage to enjoy each other.

I'll order the caverject, 10mg prescribed, and we'll see from there...

I'm not ungrateful, it was just a routine check up when we discovered the level of psa... i believe we were lucky to find out now, not after 10years... but when each doctor assured us it will be ok, well ...we were ok, now everything is different. I don't understand why some people and doctors dismiss the sex subject when is so important. Yes, it's important to be alive, but is more important to enjoy life.

Honestly, we feel like we became stronger and closer (if that is even possible for us... we were already that kind of annoying couple who spent most of the time together and does everything together).

Thank you again ...i really appreciate your messages, boosted my spirit!

User

Posted 12 Sep 2025 at 13:08

Hi,

I'm not medically trained but I would like to make a couple of comments.

If you don't have access to an ED professional, I think you should proceed with caution, you should be able to find online tutorials on the subject.

Good luck,

Kev.

User

Posted 12 Sep 2025 at 13:17

ralu22

It's a shame you can't try Invicorp but hopefully Caverject will do the trick and lift more than your spirits. 🙂

As for worrying about if its too early to start injections this video by Dr Scholz, encourages men to use them very quickly after surgery. It's an interesting presentation by the great sage.

Edited by member 12 Sep 2025 at 18:22 | Reason: Typo

User

Posted 12 Sep 2025 at 14:35

Thanks again!

I'll ask the urologist next time for cialis as adjuvante for blood flow, thanks for suggesting.

I ordered caverject, it will be at list 1 week until we'll receive it, in the meantime YouTube instructions...

We watch some videos about the injections, but most of them were using a silicone penis which mimic the erect one... that's why I found really pertinent some of your tips regarding injections in a flaccid penis or using the pump before.

We really need to do some serious homework before proceeding to the actual injecting. First of all we don't want more damages, and also it's not a cheap medication. Main goal now is to do it right.

I'll let you know how it went. Thanks again!!!

User

Posted 12 Sep 2025 at 16:07

Ok so I would think about getting a new urologist, if your PSA went to <0.008 you didn't need the RT regardless of margin status. I guess that's history but you may have a negligence case for over treatment.

Re Caverject it worked wonders for me, no pain just a fantastic erection that lasted about 2 hours every time. BUT! Injection technique is very important, you have to be confident and stab it in the right place! The key test is that it will inject very easily with no resistance if it's in correctly. If the plunger "resists" take it out and try again.

If you have been prescribed 10mg I would use that first and then back it off if the erection lasts to long. My urologist gave me 20mg! It worked to well! I ended up on 2.5mg.

After 2 years natural erections came back enough to get by with a cock ring, initially I was a fan of the Durex cock ring, but I am now a Firmtech convert, they do one specifically for ED.

Finally VERY IMPORTANT do not allow an erection to exceed 3 hours, have some sudafed handy and walk up and down stairs if it is erect. If that doesn't work you need to seek medical assistance urgently... I never had this issue but I did get a lot fitter walking up and down stairs!

User

Posted 12 Sep 2025 at 18:17

Originally Posted by: Online Community Member

Hi francij1, I thought the same, but maybe something's been lost in translation. Perhaps the lady meant following RARP her husband PSA was or rose 0.2, triggering salvage treatment which reduced it to 0.006 and it's remained at level?

Edited by member 12 Sep 2025 at 18:28 | Reason: Typo

User

Posted 15 Sep 2025 at 17:19

The oncologist was the main doctor after first biopsy, she asked for all body CT, bood tests and bone scans to see if it spread and recommended surgery. In the hospital (private hospital- for robotic surgery) a multiple disciplinary committee agreed the surgery is the best option. After surgery and biopsy, the committee recommended radiotherapy consult. We went back to the oncologist with the biopsy report and she sent us to the Rt professor (both- national hospital in our city).

This is how the health system works in Romania... I don't believe they are treating patients who don't need treatment on national health insurance...

Anyway, when a cancer is threatening your life... you just want to be on the safest possible side... All the doctors, different disciplines, said the same thing, even the young urologist that we saw last time.

Thank you for all the details, we are reading it ... more than once... :)

Nice one with the stairs... we live on the 10th floor... :) ... i'll go with him just as an excuse to exercise :D

Edited by member 15 Sep 2025 at 17:39 | Reason: Not specified

User

Posted 15 Sep 2025 at 20:05

Originally Posted by: Online Community Member

Hi ralu.

Thanks for the clarification. You didn't mention Pn1 earlier, which led to us querying the need for salvage radiation treatment. Lymph node involvement justifies such treatment.

I hope your husband's PSA always remains undetectable and that the Caverject helps with the ED. 👍

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