Erectile Rehabilitation advice please and recovery update

Since my last post, I have had my post surgery appointment with the surgeon.

He has confirmed my opinion on the histology and feels that he has got the cancer out, which is geat news.

What was not so good was his attitude to recovery from the side effects of the surgery, he simply didn't want to talk about it and I have been left feeling that I am on my own here, particularly in the ED field.

With the help of members of the forum, I am getting the incontinence under control. I am monitoring it using both weighing my pads and the pedometer on my watch and then entering the results on a spreadsheet and averaging them weekly. Basically, the results of this give me an average mg/step/day average. To start off with the figure was 60, which dropped to 36 in the second week, 30 in the third week, 24 in the 4th week 14 in the fifth week and 15 this week. It seems to have halted this week but it has been a bit of a stressful week, so I am not too worried and from advice here this sort of thing is normal.

The ED recovery is more of a concern to me. The surgeon said that if I really insisted he would give me a prescription for Viagra at half a pill 3 times a week. Having read fairly widely on the internet management of ED recovery is very important and highly time dependent. His attitude of not wanting to have anything to do with it was really upsetting to me, particularly knowing that if something wasn't done in a timeous manner it could be permanent.

I have tried to search for a better aftercare professional in New Zealand but have come up with nothing so far. What I am doing is taking the half Viagra every second day and I have imported a Viberect device from the US. What I have found is that I am getting a tiny bit of action down there with the half tablet alone. Going on what I have read I have tried a full a tablet on a 1 off time and combined it with the Viberect and got quite a bit more, but still very mild compared to my erection before the surgery. What this tells me is that I do react to Viagra which is a good thing.

Can other people on the forum tell me what is the thinking on recovery programs at the moment? My GP is very good and I am sure will help me if he can get advice on what the latest thinking on the subject is.

Any help would be much appreciated as I don't want to damage my chances by not taking action while I still can.

Pharma, pump, and plenty of actual stimulation are the way to go. Good that you’re starting now. My surgeon prescribed 2050 mg sildenafil (Viagra) twice a week and 100 mg once a week. I don’t know if there’s any research supporting that particular pill regimen or if it’s my own surgeon’s recipe.

ED recovery seems to have less of a clear pattern than recovery of continence. A lot depends on age and degree of nerve sparing, and your function pre-surgery.

Like you, early on I found that the meds increased blood flow but didn’t produce anything close to a usable erection. But by 9 months I was occasionally getting real usable wood. It’s still sporadic, at 12 months, but frequent enough that I’m hopeful to avoid the need for implant and to have satisfactory function by 24 months.

Edited to correct senior moment: 100 divided by 2 is 50, not 20. I'm actually doing 40mg now instead of 50 -- no sense splitting those tiny 20mg generic pills.

Yes, you should do a rehabilitation plan. You're still close to surgery, so don't expect much for awhile, but something should come up soon.

As Saipan points out, pills, pump, stimulate, and time are the basic tools. for now you just need regular blood flow to prevent any atrophy. Some doctors are uncomfortable with the conversation - you'll just have to keep looking till you find someone willing to help.

You might want to consider the book, "Saving Your Sex Life" by John Mulhall. It's a good general resource. You should also check out franktalk.org - that site deals in ED information and some of our folks are active over there.

If you're getting a reaction to the pills at this point, I'd say that is a good sign and given time you should be okay.

Andrew

I recommend a book by Dr. John Mulhall, a urologist specializing in penile rehab for prostate cancer patients at Sloan Kettering. I believe it is titled "Saving your Sex Life". An excellent reference book, and available on Amazon.

If you search on his name you will find several video presentations that are also informative.

I started seeing a specialist in ED at about 10 months after my surgery. I have responded to drugs, and show improvement. My doctor says his average patient regains reasonable function between 12 and 24 months after surgery.

Do the rehab program. Good luck.

Harry,

Here is a link to a YouTube video given by an Australian doctor, Dr. Gillman, speaking on the subject of ED treatments following a RP. The treatment protocol looks to be very similar to the protocol suggested by Dr Muhall. I included a link to a talk by Dr. Muhall as well.

Dr Gillman
/youtu.be/pWyMzYp1UXg

Dr Muhall
/youtu.be/ie8NkOu2VNA

FG

Harry, keep up the good work. And, if something starts working even part way--and you have a willing partner--feel free to give it a go. Nothing succeeds like success.