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Second attempt with Viagra

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Posted 1/10/2014 3:28 PM (GMT 0)
I told my surgeon on Wednesday that my local urologist had given me a script for 100mg of Viagra. At 8 weeks I'm still not having much movement but the Viagra did allow us to have some fun last weekend. I was able to perform for the first time following surgery and it felt good. My surgeon said to keep trying but not to expect too much for another 4-6 months. He said it take those nerve bundles time to heal and recover from the shock of surgery.

Last evening we tried again. This time was a bust and I felt like I had a flat tire. I wasn't stiff enough to penetrate and was frustrated. My understanding retired RN wife said I'm pushing the envelope and to just let nature take it's time. I guess Viagra doesn't work all the time. It's really my second time taking the drug. Never had any ED issues prior to surgery.

What say you guys? Thanks for your help.

Tailwinds.......Berk
Posted 1/10/2014 3:45 PM (GMT 0)
I say hooray for you. If you are at that point @ 8 weeks you are months to years ahead of most your age. Shake it don't break it , however.
Posted 1/10/2014 3:59 PM (GMT 0)
Three suggestions:

Viagra is very sensitive to food effects. If you take it on a full stomach is it much less effective. Most guys do better if they take it before supper. They claim it lasts four hours but you are better off if you take it on an empty stomach five hours before you need it than you are three hours after taking it on a full stomach.

ED after nerve-sparing surgery often continues to get worse for several months after surgery then starts to get better four to six months out. You need to be patient.

Performance anxiety is a mood killer for men. Now that you've had a failure you will be more anxious next time and that won't help. What you can do is to talk to your wife about pleasurable things you can do if you can't achieve an erection. Sex toys help. That will mean that failure to achieve an erection doesn't spoil the party and it will take some of the pressure off of you, making you less anxious and more likely to succeed.
Posted 1/10/2014 5:12 PM (GMT 0)
Peter,

Thanks for the suggestions. You're correct. I took the Viagra after a big meal. First time I tried it, my stomach was empty.

Berk
Posted 1/11/2014 2:11 AM (GMT 0)
Viagara and Cialis only worked about 25% of the time for me. I basically gave up on them preferring to enjoy orgasms (for me and my wife) without the frustration of having to worry about lasting. Also, I found a major reduction in sensitivity with the pills basically spoiled the party for me. I felt like I was using a wooden brush to clean out a pipe.
Posted 1/11/2014 11:49 AM (GMT 0)
It may seem like my mantra on every ED subject, but have you used VED and a cock ring to achieve and maintain an erection until you are fully healed? Inkhorn
Posted 1/11/2014 11:57 AM (GMT 0)
Do it in the morning. Take a viagra when you wakeup, it shows effect. I actually find better effects when i stand up, rather than lying on my back. I get a hardon but no staying power. I'm working on it!
Posted 1/11/2014 2:43 PM (GMT 0)
is there any difference between Cialis Viagra or Levitra
how about a consumers guide here
Posted 1/11/2014 3:54 PM (GMT 0)
NP,

Go have a look at the inserts for the three. You'll be swimming in paper.

Realistically, I don't know enough chemistry to understand them, so they go in the recycle bin.

High points:

The side effects are very different (they are often discussed here). I suspect that the SEs have more to do with choices than anything else. I can't deal with the blue vision I get from Viagra, and have some eye issues that make it less than ideal. The Cialis gives me a slight backache, but I have one already anyway, so ...
Levitra/Staxyn had no specific SEs for me, and I will take them when the doc offers samples (getting to be a rare event these days). There is some mention in the various summaries that Levitra/Staxyn should not be taken with lupron or prolia, don't remember which, but my onco doesn't think the risk is significant.

How you can take them varies. Full / empty stomach, timing.

Viagra/Levitra/Staxyn have a shorter life in the system, while Cialis remains in the system for more than 24 hours, so if taken daily, builds up in the system.
Cost & coverage vary with insurance companies may vary.

I expect you'll find hundreds of threads with details -
Posted 1/12/2014 1:51 AM (GMT 0)
Yes, Viagra should be taken on an empty stomach, since food (especially fatty food) reduces the effectiveness of Viagra by as much as 50%. Preferably wait 2 hours after your last meal. Also, Dr. Mulhall says that Viagra maximizes in the bloodstream 1 hour after you take it. So, bottom line: Finish dinner by 6, take Viagra at 8, bedtime at 9 :)

Also, adrenaline (which is produced by your body when you are anxious or stressed) reduces erection outcomes. So, if you are anxious or stressed about the possibility of not getting an erection, you are almost guaranteed not to get one.

Also, Dr. Mulhall says that for the average patient, ED due to prostate removal gets progressively worse during the first 3 months. So, some guys are lucky and can get erections naturally or with Viagra during the 2nd month (I wasn't one of those lucky ones) and then lose their ability to get erections until full recovery begins several months later.

Even if you fail to get good erections naturally or with Viagra, injections generally work great. At first it is distressing to stick a needle into willy, but the outcome it generally excellent.

More details on these topics are covered in Dr. Mulhall's book (link below in my signature).

-Gedman
Posted 1/12/2014 3:27 PM (GMT 0)
Gedman,

Thanks for the information and link to the book. I'm going to concentrate on my recovery and wait for my body to recover before pushing the envelope to perform again.

Tailwinds......Berk
Posted 1/12/2014 4:12 PM (GMT 0)
Berk,

Just remember that tissue will atrophy if unused. You'll want to achieve a reasonable erection at least 2x per week for at least 10 minutes so that your tissues stay healthy while your nerves recover. I started injections at 11 weeks post-surgery, but my doctor said I could have started as early as 6 weeks.

Even if you aren't going to push the envelope for awhile, I still recommend the book (or videos, if you can't get the book) linked below - simply so you can get a better understanding of why ED occurs and what options exist for addressing it.

-Gedman
Posted 1/13/2014 12:01 AM (GMT 0)
Berk,

May I make a somewhat strange suggestion based upon my own current physiology? I exhibit venous leakage. If I am laying down either prone or on my side or back, I am unable to maintain a decent erection with 100mg of Viagra. Now here is the strange part. I get a very hard erection that seems to stay hard if I am standing up. I have not tried anything yet with the Mrs, but it works for me by myself. I have every intention of trying sex with me standing. I go with the flow!
Posted 1/13/2014 12:24 PM (GMT 0)
clanda I am six weeks out and can get an errection sitting up or standing but not on my back
what is venous leakage
Posted 1/13/2014 1:21 PM (GMT 0)
No Patience,

Think of it this way: The blood goes into the penis through the arteries and leaves through the veins. If the veins don't close well (leaks), you can't get a good erection and it's called venous leakage. Apparently gravity has something to do with allowing a better erection when standing, or in your case standing and sitting, but not work lying down. The venous leaage can be due to scarring, previous lack of use, etc. There is no cure. You just have to try to deal with it. In my case, I think that is by standing up.
Posted 1/13/2014 1:22 PM (GMT 0)
From here.

That site said...
What Is a Venous Leak?
Your penis must store blood to keep an erection. If the veins in the penis cannot prevent blood from leaving the penis during an erection, you'll lose your erection. This is called venous leak.

-Gedman
Posted 1/13/2014 3:03 PM (GMT 0)
We've had a couple of guys who said their venous leaks got better with continued rehab. The veins are designed to be flattened by the pressure of the erectile tissues. A venous leak is a relative thing -- it is when the blood leaks out as fast as it comes in. If you improve the blood flow or you increase the pressure of the erectile tissues on the veins then the blood supply can catch up. I don't know if exercising the tissues makes the veins more flexible (and easier to squash) or if rehab can improve the other two factors (the blood supply and the elasticity of the erectile tissues that press on the veins) but guys with venous leaks do sometimes get better.

So, clanda is right, there is no cure but sometimes the problem diminishes or goes away.

The only positive about a venous leak is that men who have them are unlikely to wind up in the emergency room if they inject a couple of units too much trimix. Personally, I'd be glad to run that risk.
Posted 1/13/2014 5:22 PM (GMT 0)
clanda did you self diagnose yourself with this ? it sounds technical
I see you had your surgery a couple of months ago , couldn't it just be
your still getting better jeez
Posted 1/13/2014 5:44 PM (GMT 0)
No Patience,

Good question. The ED problem actually developed in the past few years...long before my RALP. Now having said that, I had all but given up on things before RALP but since then my eyes have opened to all the possibilities. Until I starting researching into venous leakage (on a self-diagnosed basis) I had no idea the position, ie standing up might make a difference. I learned that when my uro gave me my first and only (so far) injection of prostaglandin and I had a very painful erection where standing would kill me but laying down on my back would allow the pain to go away. So at least after a few hours I could stand again. According to Dr Mulhall's writing, that shows that I do have venous leakage. So I experimented with 100mg of Viagra, which years ago used to work for me, and lo and behold, still did, if I stayed upright. That's the story.
Posted 1/13/2014 6:24 PM (GMT 0)
will trimix injection overpower that issue ?
Posted 1/13/2014 7:33 PM (GMT 0)
No Patience,

It might for you. Each of us is different. The injection only worked for me standing up. It is certainly worth trying for you. Good luck.
Posted 1/13/2014 7:49 PM (GMT 0)
So now we know the origin of the expression he's a stand up guy.

LupronJim
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