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3 Months Post-RALP - Major ED!

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Posted 8/18/2022 12:45 AM (GMT 0)
My RALP was successful, and I'm grateful for that and to be out of the woods. I have very little incontinence and am also grateful for that. However...I have an awful case of ED that is seemingly going nowhere. Is this a temporary condition that I'll have to be patient with and work my way out of over time? No matter what, it doesn't work. Gah! The surgeon said that all nerves were successfully and fully spared.
Posted 8/18/2022 2:29 AM (GMT 0)
Your pelvic region had a major disturbance to say the least. You may or may not have permanent ED. However, ED recovery is measured over at least a year period. 50% of men at 3 mos, 75% at 12 mos, and so on. Men under 60 do better than those over 60.

What are you doing currently? Viagra, Cialis, vacuum pump, other? Did you have any signs of beginning ED before this adventure started? I never recovered to a level necessary to accomplish much but then I had ART after surgery which tends to mess recovery up.
Posted 8/18/2022 3:32 AM (GMT 0)
Currently I'm not doing anything -- the follow-up with the surgeon is in a couple of weeks, and he did tell me that ED problems are usually addressed at that point. I had some minor ED prior to the surgery, mostly caused by the fact that I have very low testosterone and need shots. Once I was diagnosed with PCa, the shots had to stop, and my testosterone has plummeted to about 75. Hopefully I can resume the shots. In the meantime....the mind is willing, but the flesh is weak...
Posted 8/18/2022 4:55 AM (GMT 0)
My RP was four years ago and I started my penile rehab. six weeks after surgery. Things have worked out pretty well. My Uro (in Scottsdale) told me to use the VED every day starting six weeks after surgery. I asked, every day? and he said, every day. I absolutely believe the VED coupled with almost daily Sildenafil helped me a lot. You don't want to go too long w/o erections.
Posted 8/18/2022 5:19 AM (GMT 0)
Ok, most recommend daily dosage in small amounts as therapy for blood flow where you usually need a greater dose to really get the blood flowing. The vacuum device is like an exercise tool to pull blood into the veins and do the work for you. It takes some time to get used to the procedure (search for tips) but it reminds you of what is possible. The low T problem contributes to this so you will need to address that in some manner as well. Doctors don’t like the concept so this gets to be a treatment issue. Others here have dealt with low T issues not from hormone therapy.
Posted 8/18/2022 6:15 AM (GMT 0)
Be patient! My progress was slow but continual. Took about 12 months to return to pre-surgery normalcy for me. I've read it can take up to two years for some. The spared nerves were moved during surgery and have experienced some trauma. The healing takes time. Begin your rehab with your Doctor's advice. All My Uro told me is "you can buy a pump online." My bladder let me know I started too soon!
My experience with the pump was that it is really more of a stretching device. It was not an instant erection machine. The erectile tissues need to be frequently stretched so they can fill with blood. The pump accomplished this even though it was several months before I experienced anything resembling an erection.
Posted 8/18/2022 10:02 PM (GMT 0)
I am closing on on 6 months without much results. Cialis daily, pump and viagra at least weekly. Though be careful not to mix the two drug without a couple of days of spacing. Uro has offered the trimex shots and I am ready to start next month. Why not? After 4 Covid shots, what's another prick? No pun intended. But seriously, I try not to dwell on it or I would get really depressed. Putting my faith in the 12 month milestone everyone talks about.
Posted 8/19/2022 2:31 AM (GMT 0)
After RP, I wanted to get as much blood in there as often as possible. Fortunately, Dr. Jeff Albaugh spoke at my support group meeting in Scottsdale a couple of months after my surgery. He probably stayed a good hour afterwards to answer questions. Here's a short video. Probably the most renown expert on penile rehab. is Dr. Mulhall from MSK. I have friends who were his patients. You can find many of Dr. Mulhall's videos on PR online but most are somewhat dated now. He wasn't big on the VED ten years ago but it has since been proven that a good % of the blood drawn in with the VED is in fact arterial blood. Good luck to all you guys after RP. It is my opinion that whether you have to beg, borrow or steal, get regular erections to keep the tissue healthy.
Posted 8/19/2022 2:32 AM (GMT 0)
Woops, senior moment. Here's the link:

https://www.youtube.com/watch?v=a7R4RlZ5hXg
Posted 8/20/2022 3:27 AM (GMT 0)
https://www.youtube.com/watch?v=a7r4rlz5hxg

he says radiation ED problems occur later unlike with surgery. that was not the case for me. i think this is "old" thinking or maybe just prostate snatcher BS
Posted 8/30/2022 11:06 PM (GMT 0)
3 months is not a long time - some recover after 1 year, some after 2.

There is always Trimix. Does not hurt and very effective.
Posted 8/31/2022 12:56 AM (GMT 0)
How's your testosterone levels going?
I'm on TRT due to extremely low level of testosterone below 25
Sadly while it helps my libido, diabetes and prostate problems along with low back surgery have made a full erection a rare occurrence.
I've had this ED way before my PCA
I suppose testosterone levels are something to consider.

Glen
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