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Side Effects (incontinence and ED) One Year out

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Posted 4/29/2018 5:45 PM (GMT 0)
Hi Everyone, I had my prostatectomy last May so am approaching my one year mark. The surgery went well and I'm undetectable with a good prognosis, was Gleason 3+4 and PSA was in the 5-6 range. So I'm quite happy with my outlook in that regard (which is the most important thing!) However, at 11 1/2 months I'm still having a of leaking and still need a small bad just in case (sneezing pressure on my bladder produces some small leakage.) So not a huge deal but I was hoping to be completely dry. Am I far enough along that I probably won't improve much, or is there still some possibility of becoming completely dry? With regards to ED, I am able to get a reasonable erection in most cases with 100 Mg of Viagra, but don't have any meaningful (or very useable!) erections with the meds. Do I have any change of this getting noticeably better after the one year mark? I've heard that usually the recovery maxs out at 18 months so am still hoping... I had nerve sparing surgery so fingers crossed. In any case, I feel myself lucky given everything, but thought I'd get folks thoughts on these remaining issues. Thank so much! James
Posted 4/29/2018 6:55 PM (GMT 0)
James, welcome to the forum

I did pretty well in the ED DEPARTMENT with daily Cialis after about 2 months. But I had continued improvement for about 2 years, so I’d say you could improve .

Re the leaking, I think most of us get a minor squirt once in a while on exertion, like a sneeze, lifting weights, etc. I can’t say if this is it for you, but keep,doing the kegels, maybe ask your Uro. But everyone is different
Posted 4/29/2018 7:13 PM (GMT 0)
Thanks Pratoman! Appreciate your feedback, good to know your ED improved over 2 years! Appreciate your response.
Posted 4/29/2018 8:20 PM (GMT 0)
Welcome to HW.

It's possible to get some small improvements, but likely you're about where you're going to be. Stress incontinence is likely to be with you for awhile. Shouldn't get any worse. kegels, walking helps.

You might see some more improvement in the ED department - as with all good things practice makes perfect. You might try the daily Cialis for awhile. That works well for some.

Keep up the good work,
Andrew
Posted 4/29/2018 8:50 PM (GMT 0)
On the ED, I was about 9 months post surgery when I gave injections a try. I only did them a few times, but they seemed to awaken some of the nerve cells as things remained better after I stopped the injections.
Posted 4/30/2018 12:37 AM (GMT 0)
Hi, James -

Yes, both the continence and the potency may still improve. At MSK, they found that some men continued to improve 3 and 4 years after RP. It will probably never be what it was, however. Do your erections get any firmer when you use trimix?

/www.ncbi.nlm.nih.gov/pmc/articles/PMC4605865/
Posted 4/30/2018 1:24 AM (GMT 0)
Hi Allen, I actually haven’t tried injections but might consider them. Viagra tends to work in most cases but I may consider daily cialis given folks posts here. Hoping for gradual improvement so I’m a little less dependent on meds.
Posted 4/30/2018 3:24 PM (GMT 0)
Regarding ED, I think you have a good chance for further improvement. Personally, I've improved a lot at 18 months after surgery. At one year, potency was marginal with drugs. My doctor claims many of his patients will regain effective function at the two year mark. So, hang in there.

I regained continence right away, but I've read that where you are at one year may be as good as it gets. I'm no expert though.

Good luck.
Posted 4/30/2018 3:31 PM (GMT 0)
Thanks so much, encouraging to hear about the potential for ED improvement. I can live with where I'm at in terms of the incontinence - its pretty manageable with a very small pad.
Posted 4/30/2018 5:04 PM (GMT 0)
The various PDE-5 inhibitors available on the market are all different drugs and work in slightly different ways—they are not simply different brand names for the same drug. So, tadalifil (drug in Cialis) might work differently, and possibly better, for you than sildenafil (drug in Viagra) has worked. Many doctors will start patients on one of the drugs and say something like, "Try this. If it doesn't work or you have issues, come back and we can try another one."

I know that you asked for "thoughts" on your issues and not necessarily for people to simply recount their own anecdotal experiences, but almost invariably that's what you get here. Me? I buy the generic Cialis "weekend" pill (20 mg; remember, it's a different drug that the sildenafil/Viagra, so different mg amounts). I split the 20mg pill in half and take it every other day...so the net equivalent of the daily (5mg) pill approach. This has worked well for me for having sex just about every day. I take this approach with the pills because it's super cheap to buy the 20mg pills via an offshore mail-order pharmacy...and I've been doing this for about 9-years. I had continued improvement, btw, well past my first year post-RP.
Posted 4/30/2018 5:20 PM (GMT 0)
Wow - I didn't know you could get Cialis offshore! Can you tell me how to contact whomever can provide that?
Posted 4/30/2018 5:42 PM (GMT 0)
I buy online at AllDayChemist.com

You can buy tadalifil. Cialis is the brand name for tadalifil from a US company.
Posted 4/30/2018 6:29 PM (GMT 0)
Thanks NKinney! You haven't had any quality issues I assume? I didn't realize it was possible to bring these types of med in via mail from offshore.
Posted 4/30/2018 6:43 PM (GMT 0)
I started out (my very first order) using the US manufacturer's pills ordered through Walgreens, so I have experience with both. But I have nearly 9-years of personal (anecdotal) experience offshore with this ISO-accredited pharmacy—and there are many other HW/PC members who also buy from the same source. I've been very pleased with the quality. No issues.

I have also discussed buying offshore with my internist (haven't seen my urologist/surgeon in years) who I go to for annual physicals, and so (of course) every year we review every pill (prescription and OTC) that I take. When I told him I am using an offshore pharmacy for tadalifil, he said many of his other patients do the same.

Post Edited (NKinney) : 4/30/2018 12:48:07 PM (GMT-6)

Posted 5/1/2018 12:16 AM (GMT 0)
So I checked out the site and it says Tadalifil "not for consumption in the US" - it doesn't seem to say that for generic viagra. Do you think it is ok to essentially ignore the "not for consumption" designation? Great to see these low prices!!
Posted 5/1/2018 11:10 AM (GMT 0)
On one of my past orders they called me to verify the order details. They said in that call, "this is not for consumption in the US," to which I said, "that's right." I just placed another order a couple months ago and there was no verification call. No issue. Offhand, I've forgotten my order size; I think it was enough for about 2 years after splitting & taking half every other day. Remember that drugs have an expiration date after which there probably starts to be diminished potency.

Post Edited (NKinney) : 5/1/2018 5:14:40 AM (GMT-6)

Posted 5/1/2018 12:11 PM (GMT 0)
Great, thanks - I'm likely to move in the same direction
Posted 5/1/2018 12:13 PM (GMT 0)
Oh, one more question (sorry for all the questions) there seem to be several options for Tadalifil - can you tell me which one you've ordered?
Posted 5/1/2018 12:38 PM (GMT 0)
No problem on the questions...

I’ve ordered Cebis brand...I may have spelled it wrong here; not at home now
Posted 5/1/2018 12:52 PM (GMT 0)
I found it, thanks. Did you need a doc prescription (it asked for one)? also, doesn't take credit cards, which payment mechanism did you use?
Posted 5/1/2018 1:48 PM (GMT 0)
I have prescription, but it was not needed/not used.
Bank check direct transfer.
Posted 5/1/2018 1:56 PM (GMT 0)
Thanks, I don't think my current docs would sign-off in this case unfortunately. Good to know they'll do the deal without an Rx
Posted 5/1/2018 2:02 PM (GMT 0)
As I said, not needed/used. But to your comment, keep in mind that doctors writing prescriptions do not know if it was ever filled, or where it was filled.
Posted 5/1/2018 2:21 PM (GMT 0)
That's true. I actually just called them and they confirmed no Rx needed if you pay by eCheck the first time. I guess they used to take credit cards but there has been a systems glitch so you need to call them to process CC transactions over the phone. Given that they seem reputable I'll be OK giving them back info (thru eCheck). Thanks again for the info.
Posted 5/1/2018 2:25 PM (GMT 0)
James83,

We jumped into a lot of Qs and As, but I'd like to take a step back and offer what I would do if I were you with what I understand of your case. I sorta implied this in earlier posts in this thread, but I should be more explicit. Keep in mind that I'm me and you're you, but I'll just offer what my suggestion for next steps would be...

You said you tried Viagra with limited success, and it sounds like you are interested in trying another PDE-5 inhibitor. It sounds likely that your Viagra was under a doctor's prescription. I would go back to that doctor (either your urologist, or just go to your PCP and tell him about your RP and ED), and say you'd like to try Cialis. Ask him for some free samples (very common) and/or for a prescription. Then use the samples or buy a small quantity locally and try it. If you have issues, go back to the doc to ask for something else. Then, after you've tried it under doctor's care, look to buy inexpensive bulk via the method I suggested.

I guess to be more clear, I would never recommend anyone try a new med on their own. And, always, always tell your PCP when you go for annual checkups about ALL meds you take, either prescribed or OTC.

Hope that all this info helps.
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