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Looking for some ED advice

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Posted 6/1/2014 1:52 AM (GMT 0)
First the good news, just had got the second post surgery PSA test and still in the zero club. Was very depressed with incontinence for a while after surgery (thanks to many on this forum for support) then things suddenly dried up at 3 months, today was my first pad free day in public!

The last item to work on now is ED. My uro seems really uncomfortable with the subject but handed out samples of the 3 basic oral meds. No luck yet, not even what my uro calls indications of fullness. Seems like my next step would be a VED, not sure as my dr does not make many suggestions.

Questions:

* Is a VED the next method to try?
* When do you make a decision to ask for Muse or tri-mix?
* Do the injections hurt?
* After 4 months is it too early to worry about atrophy of the penis if I don't move quicker on this?

Thanks for your always appreciated insight,

Steve
Posted 6/1/2014 2:05 AM (GMT 0)
Steve-

If your uro is uncomfortable with the subject, find a uro who specialized in men's sexual health. I can't emphasize this topic strongly enough.

Next suggestion: Read Dr. Mulhall's book and watch the YouTube videos (all links below).

Answers to your questions:

1. VED is not necessarily the next step. The blood drawn into the penis by a VED is not rich with oxygen, so it doesn't have the healing benefits of other methods. The right next step needs to be decided between you and a uro.

2. My surgeon begins people on injections as soon as 6 weeks after surgery, but I had to wait until 11 weeks when an appointment was available.

3. Injects hurt a bit for me. Others have described it as being no worse than pulling a hair out of the back of your hand. Either way, it is not very painful and the result of a good erection for 30-60 minutes is well worth 15 seconds for the injection. The hardest part for most guys is the psychological resistance to sticking a needle into willy.

4. You need to discuss that question with a uro who specializes in men's sexual health. My impression is that you need to get started with achieving erections by some method pretty soon (if not immediately). Dr. Mulhall's book might also address this topic.

-Gedman
Posted 6/1/2014 2:09 AM (GMT 0)
Congratulations on regaining continence. Here are my non-professional opinions:

* Is a VED the next method to try?

Use it everyday. Your insurance will probably cover it. Also use a low dose of ED med every night to get those all important nighttime erections. Maybe a higher dose once a week to see if you get a response. Remember, they only work in conjunction with inspiration.

* When do you make a decision to ask for Muse or tri-mix?

Now. Try it twice a week if the oral meds aren't working. You can taper off when the orals start to work. They do not depend on inspiration to work.

* Do the injections hurt?

No. It's an insulin-size needle. Your Uro will show you how to do it to avoid injury.

* After 4 months is it too early to worry about atrophy of the penis if I don't move quicker on this?

Atrophy starts to set in immediately after the surgery. What we don't use, we lose. But it may be reversible if you work the apparatus frequently.

If your Uro is uncomfortable about this, find a specialist in sexual medicine.


- Allen
Posted 6/1/2014 2:13 AM (GMT 0)
We are very similar in that I lost about 75% of the nerves on one side. I started oral meds right after the catheter was removed. I got absolutely no results until about month three, but even then it was not useable. I started using a VED at that point and was able to achieve an erection, but not maintain it. I tried using a "ring" to maintain the erection with poor results. At about month six I was able to achieve a useable erection with Cialis, VED, and standing to get the help of gravity. I would then put the "Vulcan Death Grip" around the base of Mr. Happy and achieve penetration. I was very diligent to use my VED with no meds at least three times a week to keep the blood flowing so to speak. By month nine Cialis alone did the trick and I was able to maintain without a grip and at almost exactly one year and since I have been able to perform without meds at all. It was a long road filled with frustrations at times, but given time and having no ED issues prior to surgery you have every reason to be hopeful.

Best of luck,
Tom
Posted 6/1/2014 3:32 AM (GMT 0)
Ragman,

You have gotten excellent answers to all your questions but there is one I can maybe clarify.

Does it hurt?

Before I answer your question I'd like you to grab your earlobe between your thumb and forefinger and give it a squeeze -- a good hard one -- careful of the fingernails we are looking to crush, not cut -- now hold it for four seconds. If you did it right it should have hurt a little bit. Not bad -- not going to change your life -- but it hurt, didn't it?

Sticking a tiny little insulin needle in your penis does hurt. Not as much as the earlobe thing but, yeah, it hurts. If you can do the one you can do the other.
Posted 6/1/2014 3:57 AM (GMT 0)
Thanks for the quick responses and good advice. Having a long overdue and in depth conversation with my wife on this topic tonight, we have read through the advice and already ordered Dr. Mulhall's book. Will call my DR Monday to set up an appointment for further treatment options and will change doctors if he is not more attuned to what is needed.

Peter - I pinched for 4 seconds and you are right it hurts, a little, I can do this!
Posted 6/1/2014 10:45 PM (GMT 0)
Pain from injecting your willy? Just a little prick. ;)

I get some achy soreness with Alprostadil (Caverject) that begins when I get an erection and then goes away for the most part after the erection subsides, although I notice some soreness for a few hours afterwards if I squeeze it. But for me, that pain is worth the gain, because upon getting the erection I can not only easily achieve penetration, but I actually feel more aroused naturally when my wife and I begin getting intimate.

I'm a year and about three months post prostatectomy. Other than what I could get with a VED and ring combination, I didn't start noticing any "indications of fullness" until about a year after surgery, and even then it's been only with a little help from a pill. I still get no natural erections.

Although I remain hopeful for significant recovery from ED, I have adapted by finding new approaches to intimacy within the context of my "new normal".
Posted 6/2/2014 4:39 AM (GMT 0)
Yapp....injection...just like a little ant stint...lol

My experience....not every time it works...sometimes it misses

 

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