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Most effective approach to ED

User
Posted 12 Jun 2026 at 16:32

Hi all,

I appreciate this is very early days but everything I’ve read has led me to believe that the quicker you start with this, the better chance of a positive outcome. 

My husband had nerve sparing surgery 10 days ago and had his catheter taken out this morning. No leaks and feels like he has full control, so all good on that front so far. 

I’m just a bit confused about what we should be doing about the ED side of things. He has been prescribed Sildenafil 3 x per week. Should we also be asking for low dose Tadalafil and should he be starting with that asap? Is a doctor likely to prescribe this as well? 

He was referred to the ED clinic but it is a couple of months wait before he’ll be seen there. Is that too long a wait to be starting to use a pump to get the blood flowing?

Many thanks all! 

User
Posted 12 Jun 2026 at 20:35

10 days after the op is early to be using a pump in my opinion.   He's still healing inside, the urethra to the bladder.  It won't like any stress and could damage the healing which you definitely don't want.  Perhaps 2 months is a good time to wait.  I judged my internal healing by progress with the big wound in the middle of the stomach. Although it took quite a while to heal and lo and behold 9yrs later I got a hernia there.  He's got Sildenafil, that may be more natural than a pump.  It might be better to get the question to the surgeon.  There will likely be other opinions.

Edited by member 12 Jun 2026 at 20:36  | Reason: Not specified

User
Posted 12 Jun 2026 at 21:39

Hi

As previously stated I would get some advise from the surgeon.Once I had the OK I started using the vacuum pump 3 times per week as well as regular dosage of Sildanifil.I am 18 months post surgery, unfortunately,mine was non nerve sparing and so am unlikely to get natural erections.I am still waiting for my first ED appointment!

Good luck to your husband , in the case of nerve sparing surgery there is every reason to feel confident of a good recovery.

User
Posted 13 Jun 2026 at 00:16

Hi ,good advice from the above posters,no point trying to recover to soon an doing long-term damage. You are in good hands at the city, by the time you get to see the ed consultant he will have a better picture of what to offer. Assuming we are at the same hospital we have the advantage of having a Erectile disfunction clinic. 

Thanks Chris 

 

User
Posted 13 Jun 2026 at 02:04
If you use the pump too soon the blood will flow, just not where you want it! I started at about two months and it was too soon as I found out in a rather shocking way!
User
Posted 13 Jun 2026 at 11:46

Thanks everyone, solid advice! As I’m sure you guys appreciate even more than I do, he’s very anxious about that side of things and it seems like there’s some conflicting advise based on ongoing trials around what’s best and what’s not etc. But I think you’ve all answered the question about the pump so we can park that. 

How about the medication side of things? It looks like different NHS trusts have different approaches. Has anyone had a conversation with their consultant about why they may have prescribed Sildenafil v Tadalafil? Is it just a cost thing? 

colwickchris, he is indeed under The City and we feel very fortune to have the experience and expertise that’s there. His next appointment with the consultant isn’t until the end of July though so I thought I’d pick the brains of people on this forum who may have already asked the same questions. He’s very down in the dumps at the minute (I know he’s at the very beginning with this but to him it feels like a long time already), so I think half of this is about having some hope (whilst being realistic). 

User
Posted 13 Jun 2026 at 17:34

We're all different and there are debates on here about quality of life, what it is and what you'd do to maintain it.  There are those who put off treatment to extreme to maintain body functions, especially with hormone treatment.  There are those like me who put being alive above everything.  Although at this moment I put off RT that was offered as my psa is rising very slowly and is still low.    

Having had the operation he may need to be adapting to what is often called a new normal which might actually be very little change after say 6 months.   I've had no change except for about 6/10 ability ED wise without assistance. I found the pump restarted something as it was about 3/10 although it was months after the op before I started using it.  I only once took the tablets and was suspicious of them as they made me ache.  The surgeon said he'd take nerves on one side.  There are the regular blood tests which bring about their own anxiety.

A tireless, unembarrassable and knowledgeable friend is ChatGPT AI. Although it does limit how long conversations can be if you don't pay.  I don't pay and it puts you on a lower quality programme after about 20 questions then decides if you've used enough for today after a while.  Although you shouldn't believe all it says, it answers according to what you've told it and you might not have told it all it should know and sometimes they make poor assumptions.  You need to challenge it.  It also likes to flatter you so don't be taken in.  I've found it pretty good, it doesn't seem to be just scanning the internet like some do.  Search ChatGPT and open an account.  If you do it remembers your conversations so if you don't want that you need to delete them, they're listed on the side of the screen.   You can literally talk to it, you speak and click the upload arrow.

You can overdo reading this stuff but that might be after it becomes more settled.

All the best

User
Posted 14 Jun 2026 at 08:07

Opinions might vary on YouTube videos for medical advice, but I learnt a lot about ED medication from Dr Rena Malik, a Californian Urologist. Her videos discussing comparison of tadalafil and alternatives are very good. Look her up. Good luck 

 
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