Question re return of natural erections

I had full nerve sparring. Still took more then 2 years for me to get anything close to what I had before. Some folks only have partial nerve sparring but report that their erections returned almost immediately. So I think you can read from that firstly there are no guarantees and second everyone is different. 

Sildenafil did not work for me but Tadalafil did which I take once a week for maintenance rather than just before for sex. Previously I was using the pump everyday. 

So specifically how did my erections start to manifest? My penis would become more semi erect before orgasm, took a while to get to that point. Now with the Tadalafil they manifest anytime since it actually works for at least 4 days. 

Sorry that Steve is having difficulties, my first year without a proper erections was frustrating so I can empathise. Hopefully the injections work.

They often first show up as very short-lasting semi-erections in circumstances where he would previously have had erections, e.g. during the night or on waking in the morning, or during stimulation. The use of Sildenafil or Tadalafil will help these early indications appear earlier, so it's good to be testing them periodically even if you haven't found them useful for sex, providing they aren't causing unwanted side effects.

There is some evidence (although it's not overwhelming) that regular use of Tadalafil from the operation for 6 or so months speeds up recovery, because it improves blood flow to nerves damaged by the surgery, even when it's not generating erections. (There's no such evidence for Sildenafil, probably because it's short acting and doesn't generate continuous dosing.) I rather doubt that regular continuous dosing Tadalafil would help much 20 months later, but it's worth trying the largest event dose perhaps monthly as it may give you an earlier sign of things improving. You could ask for a stock of tablets with the injections, but they won't want you trying them at the same time.

Also, it's really great that he's been using the pump, because otherwise, 20 months of no erections would have done some serious damage to the erectile tissues, and they wouldn't work properly even for injections otherwise.

Edited by member 22 Sep 2025 at 07:10  | Reason: Not specified

Sadly Steve had side effects with both Tadalafil and Sildenafil, bad enough to warrant him not tolerating them

Adrian, we didn’t know about the erection grading scale (although he always got a 10 out of 10 from me!)

The whole process of the ED side of this experience has been painfully slow, partly due to the fact that Steve has never been handed back to our own Trust, because of his incontinence issue and awaiting more surgery he remains with the Trust that did the RARP, but has to go to GP for the ED issue, unbelievably our Trust never had an ED clinic until a few months ago, with a three month waiting list! We got seen last week with an appointment to go back for injection demo in four weeks.

At the appointment we were told that non nerve sparing men get prescribed injections straight away but those with nerves have to go through the various stages of tablets etc first. We will be prescribed either Viridal Duo or the generic Alprostodil, depending on availability (Caverjet no longer issued), 4 injections a month. I asked about Invicorp and quoted my research of some men having pain associated with the other drugs….she said she’d never heard of it and googled it there and then!! She said it was likely more expensive but she did say if Steve doesn’t tolerate the first drugs or they don’t work that she would try and prescribe invicorp.

I've just asked my wife what score she'd give my lovemaking. She said, "Six out of ten. Must try harder!" 😁

Edited by member 22 Sep 2025 at 22:51  | Reason: Typo