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Timing of post-surgery ED rehab

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Posted 3/27/2012 1:27 AM (GMT 0)
As a Canadian and a new member I have been reading posts and seeing that many of you were taking Viagra or Cialis post surgery for ED quite soon. My Dr. did not prescribe this right away.I am wondering if this is something that US Dr.s do .It makes sense since what we use we will keep but what we don't use we lose. It was not until I started complaining about ED after about a year that I got response.My prostatectomy was in 2009 and even last year my surgeon said "It's way too soon to think a bout sex-you had a big proceedure plus radiation and HT-give it time". But from what I read here alot of you "got back in the game" pretty quick.Any Canadians out there have any thoughts on this.I'm even considering an implant-any thoughts on this?I have tried the manual pump with the ring but not too much satisfaction.I have an understanding wife thru all of this but regaining our wonderful and satisfying pre -surgery sex life would be something we both desire. Still in love after 37 years of marriage.It seems like every man's dread and that's what I was dealt. I am searching for hope.I just turned 65 and my wife is 10 yrs younger.

(added a subject - 142)

Post Edited By Moderator (142) : 3/26/2012 8:37:05 PM (GMT-6)

Posted 3/27/2012 2:34 AM (GMT 0)
There is no "standard" for penile rehab. My uro is well-known, and has years of open surgery behind him, but does not promote it. I asked, and he prescribed to usual routine, but it waited for my request, about 7 months out from surgery.
Posted 3/27/2012 2:48 AM (GMT 0)
My Uro does not believe in any of the rehab med concepts.  My surgeon does and started me on Cialis 5mg nightly 4 days after catheter removal.  There does not seem to be any proven evidence or studies to say it helps, but the logic makes sense.  Get bloodflow to the tissue.

From what I understand of how it theoretically works (read Dr. John Mulhall's book) if you have gone 3 years since RP plus HT and Radiation, starting the protocol now is not likely to change your status.  The theory is to get bloodflow in that first year to keep the tissue happy until it is able to respond with or without meds.  By now, if you believe in the protocol and believe the tissue degrades without it, then the degredation has already occurred.  Plus you have the added insult of both RP and Radiation.

Sorry to be the bearer of not so good news.  That's just what I have learned through discussions with a number of docs.

Posted 3/27/2012 4:05 AM (GMT 0)
Nicka,

Thanx #142 for clearing that up.I have been worried to try the MUSE up until now but if alot of men are injecting and it's only a suppository I think I will try it.Anyone have good results with the MUSE and is it expensive? said...

Moved this over to your own thread since it was buried in an other persons thread...

And welcome to the Wonderful World Of Penile Re-Function.

On the MUSE side ... I've used MUSE lots of times in the past 3 years before starting in on Trimix about a year ago. It worked OK for me. At 1000mcg levels can give a 1 hour erection. (comes in 250, 500, 750 and 1000mcg). The lower levels are not really appropriate for 100% ED patients like those from RRP surgeriy, but your Doc will no doubt start you on 250 or 500 just to be safe. even tho it might not do much (or give some level of achiness or burning as has been mentioned).

I've kept up my own MUSE prescription even tho I use trimix 3 times a week. But I just dissolve MUSE pellet in bacteriastatic water to make 6 weak 300mcg urethral splooshes out of two pellets (so you get 18 shots from a 6 pack). I use that for daily rehab usually on non-trimix days so that I essentially get some kind of wood every day of the month. Good blood flow for sure -- much better than pills.

And yes it is stupid crazy expensive at over $300 per 6 pack if you have no insurance pay. On Medco it is $90 for 3 6-packs on their 90-day plan -- not too bad. (Your doc can write you a 90 day prescription -- which I urge you to ask him for if possible -- since the big Medco-like companies that administer prescriptions cannot just take a 30 day and turn it into a 90 day mailer ... and its a nuisance to go back and get a new one.). I have no idea how they handle this for Canadian prescriptions.

Have at it ... and then maybe go after Trimix when you are done with MUSE.

J
Posted 3/27/2012 6:08 AM (GMT 0)
The longer you go without erections after surgery, the more likely you are to suffer permanent erectile tissue damage, called atrophy, which is actually scarring of the erectile tissue. If this happens you may never get natural erections back and you will have a hard time responding to ED medications. The idea behind ED rehab is to keep the erectile tissue healthy, while waiting for the nerves to recover from the trauma of the surgery.

But you are where you are, so there is no sense in not trying what’s available. You have the MUSE; give it a try and see what happens. By the way you are less likely to experience penile pain from the MUSE since you are farther out from your surgery. The nerves are more sensitive to the medicine when they are traumatized. If the MUSE doesn’t work try pills and if they don’t work, definitely try injections. I would try all these before moving on to the penile implant.

However, I’ve read that penile implants have the highest satisfaction of any of the ED treatments. They generate 100% rigid erections in 5 to 15 seconds. The downside of course is the operation, but most men tolerate the procedure well. Complications are infections (in about 2% of patients) and mechanical breakdowns (in about 15% over 10 years).

Best of luck to you.
Posted 3/27/2012 7:38 AM (GMT 0)
i was started on pills 4 weeks after surgery. I've read of some who started before surgery. I was told it was critical to get blood flowing asap.
Posted 3/27/2012 2:53 PM (GMT 0)
Thanx everyone for the replies-I am feeling encouraged to try the MUSE-and if necessary the Trimix .It looks as tho penile rehab doesn't exist in Canada.Sometimes I get the feeling that they want us just be satisfied that the cancer is gone and no need for sex life. Enough of my pity party tho.We're all in the same boat.
Posted 3/27/2012 5:39 PM (GMT 0)
My Canadian ( New Brunswick ) urologist/surgeon was quick to get me started on Viagra and then Levitra - both free samples from him but unfortunately both ineffective. This was about three months after surgery. At six months he prescribed Trimix which worked like magic and I have been happily using that for over a year now.
Hope you can find a solution to your problem - it is wonderful to have our sex life returned to almost normal again !
Posted 3/27/2012 5:55 PM (GMT 0)
I have no complaints about the treatment I've been offered for ED. Like Brit, my Canadian uro/surgeon started me on the daily cialis not long after surgery. Lots of free samples from him as well as a prescription, but it didn't seem to help and I was shrivelling away.

He also got me into an ED specialist after about 6 months where I started on trimix/bimix. (He also does implants) Trimix hurt to much, but the bimix worked really well to the point where I don't need it anymore.

 

Posted 3/27/2012 11:31 PM (GMT 0)
Wow my Canadian comrades u have some amazing results.Thanx for the info!!EH??LOL
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