Low Dose Cialis and Penile Rehab Therapy

I was 70 1 year ago when I had RARP. Both sides were spared. No SRT afterwards.

I am 61. Couldn’t spare the nerves, unfortunately, my cancer cells were too close to my nerves. I have been cancer free for five months. Now dealing with ED issues. Searching for the best VED that would work for me.

I may be an outlier...

After surgery, my urologist put me on a 5 mg daily Cialis, been on it for 11+ years.

My surgery was nerve sparing. It was probably around the 12 month point I regained function. Initially there was issues with urine leakage but it resolved by itself.

Under the use it or lose it philosophy I did a lot of self simulation, aka masturbation.

I did not do kegels, no vacuum pump.

What's different:

Orgasms are dry.
Greater physical and visual simulation to achieve an erection.

What's not different,

Orgasms are pretty intense.
No change that I notice in size or girth.

The UCSF has a pretty good PRT guide - https://www.ucsfhealth.org/conditions/erectile-dysfunction#:~:text=Our%20approach%20to%20erectile%20dysfunction,highly%20skilled%20care%20with%20compassion.

An involved partner in the process is invaluable, mine is a sexless marriage so PRT has been a solo effort.

Another example of an outlier, never lost my libido while on ADT.

Kevin

How common is the use of injections as part of penile rehab (not for intercourse, but to help with recovery)?

I just learned that many specialists recommend to start Cialis before surgery (and probably more so in my case since I was on Bicalutamide 50mg/day for four months). Did anyone do that?

Not-just-for-ED:
A new study finds erectile dysfunction medications associated with significant reductions in deaths, cardiovascular disease and dementia.

"These medications, such as Cialis and Viagra, are believed to offer cardiovascular benefits through improved blood flow, lowering blood pressure, enhancing endothelial function, and providing anti-inflammatory effects...”
https://www.utmb.edu/utmb/news-article/utmb-news/2024/11/19/study-finds-erectile-dysfunction-medications-associated-with-significant-reductions-in-deaths--cardiovascular-disease--dementia#:~:text=%E2%80%9CThese%20medications%2C%20such%20as%20Cialis,inflammatory%20effects%2C%E2%80%9D%20said%20Dr.

My recovery has been similar being 19 months from my surgery. However, I have lost length and girth. Feels as if the doctor had to pull my urethra up too far to reattach to my bladder. It feels tight when I get an erection as if it wants to grow further but cannot.

I definitely believe in those findings. My husband was prescribed samll does of Cialis a month ago as part of pre-op by his surgeon and his BP went down to normal level. His BP was not very high but his cardiologist insisted that he takes low dose of Valsartan. Now that he is on Cialis he was able to discard Valsartan which was actually effecting his BUN (kidney function). We are very happy about this effect of Cialis.

I am 78 years old and endured cyberknife radiation. I have started using the Osborne Erectade VED. Works well. Use plenty of lube every place it recommends. It does work. Wife comments on the extreme rigidity increase.

I’m 10 months post surgery, believe surgery only spared part of nerve . I’ve tried pumps , Trimex and now Bimex , only a few times out of 50 attempts did I get an erection barely hard enough for penetration. I have no feeling or sensation of pleasure, do I need to be more patient for my body to repair the nerves , I’m considering implant in the fall but not if I can feel any pleasure to hopefully have an orgasm, very frustated

My doctor put me on 5mg of Cialis and 3000mg (3g) of L Citrulline supplement a month before and has stated he wants me to continue them for at least a year after surgery. As I've documented here many times I've not had a single instant of ED (nor incontinence but that has nothing to do with the meds). I had mostly nerve sparing surgery and he feels I likely won't need these things later down the road but wants to be safe. I'm with him, I want my things to work too.

For the incontinence, it's pelvic floor after pelvic floor, don't overdo it but don't under do it either. Keep working those muscles, instead of only doing Kegel's try doing squats and kettlebell swings and other weighted exercises engaging the floor on the muscle engagement, releasing after. It'll wear your pelvic floor out but goes much further than kegels alone.