Posted 5/11/2015 12:07 PM (GMT 0)
Prpac,
If you could tell us a bit more about yourself we might be able to make suggestions about a way forward for you. From what you said in your other thread your Gleason score was 9(5+4) and the only treatment you mentioned was Lupron shots which have reduced your PSA from 29 to 0.1. It sounds like you are responding well to the hormone therapy which is good. To complete our picture of you we would want to know your age and anything you can remember about your biopsies and scans.
Most likely you should expect to be working around some sort of androgen deprivation therapy (hormone therapy) for quite a while. As Allen said, for almost all guys the lack of testosterone will squash their libido and for most guys this will cause total erectile dysfunction, even with pills. There are a very few guys who respond well enough to physical stimulation to still achieve erections even without testosterone. Very, very few. Here on the forum, with hundreds and hundreds of members, I think we may have two such guys. I'm not one of them and, chances are, you're not one either. So it is unlikely that pills will work for you.
What will probably work (if your goal is to find a way to achieve erections) is injections. Normal erections work when a horny brain sends messages via the erectile nerves to the erectile tissues which, in turn, release nitric oxide that causes smooth muscles in the blood vessels to relax allowing them to fill with blood. The pills make that last part work better. They improve the blood vessels reaction to the nitric oxide. They don't do anything if the nerves don't work (we see that after surgery) or no message is sent to start with (hormone therapy). Injections by-pass the whole brain/nerve thing and act on the smooth muscles in the blood vessels directly. They usually work for men incapable of becoming aroused.
Which leads to the next problem. Once you've got the thing erect, what do you do with it? This is a question that used to suggest its own answers but it won't any more. You'll have to have a plan. You will be available as a sort of human sexual novelty for your partner but she will have to understand that you won't react normally -- that it's not her, it's you.
Some guys remain capable of climaxing with enough stimulation. I was one of them. It's an odd process. There's no particular desire or mental arousal -- just a few minutes of strangely-unmotivated self-abuse then zap. Its more of a reflex like your leg kicking when the doctor whacks your kneecap. If feels good and you get a bit of that post-sex glow. You'd think you'd desire it but you don't. You have to make it part of the plan. Not everyone can make it happen for them and some SSRI antidepressants make it impossible but it may be on the menu.
And if you are just looking to keep the hydraulics working (penile rehabilitation) then you can watch television or read a book until the erection starts to subside (you need to stay awake to make sure it doesn't last too long) then you can throw a sheet over it and go to sleep.