In praise of Penis Pills before prostate cancer treatment!

It's been two days since my last radiation therapy session. I had a discharge conference with the MD and the nurse they advised me on what to expect, etc. I know that it's not the same for everybody but when did the urination problems got better for you guys? That seems to be the only problem I am struggling with right now. Thanks.

@panch0
Two or three months is all it took for my brother. I was just talking with a friend of his who started having burning when peeing after three sessions out of 20.

This doctor had him on Flomax plus a steroid. He was taking 5 mg one day 4 mg the next day 3 mg The following day down to two and then one. He said it did help, It wasn’t perfect.

I’m definitely interested if somebody else has Solutions.

@jeffmarc Thanks for the info. I'm taking 400mg of Ibuprofen twice a day now and it's not any better although drinking more water seems to help with the flow.

I already had ED (diabetes, blood pressure drugs and statin drug, 71 years of age) prior to ADT/radiation therapy. I just finished my radiation sessions 3 days ago with an additional monthly coverage with Lupron because my radiation therapy sessions outlasted the last ADT dose. I did not notice any big change in my libido and in fact I experienced an episode of dry orgasm. I would not do that again until I'm hopefully fully recovered. It was a bit painful due to the existing irritation of the urethra.

I had 28 sessions of proton radiation + 6 months of ADT. Though my libido went to zero (testosterone level dropped to 3.0), I never experienced ED. From what I was told by my medical oncologist, the key is to continue doing it, despite the “want to” not being there.

My experience of not having ED while on ADT might be related to me ramping up my resistance-training and cardio exercise programs to minimize the side-effects of ADT; that might(?) also have had the side-benefit of keeping the blood flowing “down there” as well; I don’t know. Libido eventually returned to normal when testosterone level returned to normal.

As for delayed ED following radiation treatments, some studies show that late ED may be avoided by minimizing radiation hitting the penile bulb —> https://www.icr.ac.uk/about-us/icr-news/detail/avoiding-penile-bulb-with-radiotherapy-could-save-men-with-prostate-cancer-from-harmful-side-effects

As always, discuss with your medical team.

@brianjarvis Kudos to you for being so proactive and slaying the ED gremlin. Filing your advice away if I have to go down this particular road. Thanks

My ED thoughts - 59 and married, so you know where I’m coming from (Hmmmm… 🤔 ).

I was already diagnosed as entering the first stages of ED when I began seeing a urologist for my PSA, back in 2021. Age and meds, I believe.

Mild ED for me mainly meant that I had no trouble achieving erections, I had spontaneous erections, but I did have some issues maintaining an erection. Basically, if Mr. Happy wasn’t being directly stimulated one way or another, he’d take a little nap, but always willing to jump back into it as soon as he became the center of attention again. Those days of becoming aroused, and then walking back to the bedroom, getting prepared and situated and all that, all while maintaining a full erection, were over. In the scheme of things, though, it wasn’t a big deal - adjust and keep on truckin’.

Post-surgery…immediate loss of any erection capability. It’s gone. No loss of penis length (luckily), no loss of libido (didn’t expect to), and I’m on a half-dose of nightly Viagra and use a penis pump (5 erections a day), just to keep the blood flowing, so it’s purely therapeutic.

The ED nurse at the cancer center’s ED clinic said that around 70% of men get back “close” to what they were before the surgery by around two years, but it can take as long as four years. I’m not even at four months, so I’ve got a ways to go yet.

Luckily, my wife and I are both patient. She has a chronic autoimmune disorder that stopped sex for a while when she was in her 40’s. Then she had a devastating stroke at 50 (she’s gotten back about 85% of her ability), then a heart attack in her mid-50’s, so we’re no strangers over the years to putting things on hold or adjusting ways we’re intimate to match what we’re going through. Now it’s my turn to be the bump in the road. No worries, we’ll get through it.

Right now, things between us are on pause, though I’ve been cleared by my care team to up the Viagra or to use a tension ring with the pump and “give it a go.” - we’d both prefer to wait until my bladder control is a bit better. I’m making small improvements with that, so I’m getting there…slowly.

Dry orgasm - you definitely do not need an erection to experience an orgasm, it just takes longer, because Mr. Floppy (Mr. Happy’s alter ego) makes it more difficult to stimulate those nerves at the tip of the penis, so it takes more time.

The feeling? I’d describe it as “the same as a wet orgasm, but less so.” It’s difficult to go beyond that with a description, except to say, there’s a certain physical sensation of a viscous material passing rapidly out of the penis that’s now missing.

It’s like having a piece of apple pie without the ice cream. The pie’s still pretty good on its own, but it’d be better with the ice cream.

@turtbean Thanks for telling us your story so far. The amount of detail is incredibly helpful for knowing what is likely ahead for most of us post surgery. I so prefer hearing it this way than scientific jargon. Yeah, my wife has been a long-time patient....so having me become the patient is definitely destabilizing.

I've read online a few studies and some therapists say vibration devices at the tip can help stimulate the nerves. There's a study under way to set up an more exact look. The pilot study on is here, https://www.nature.com/articles/s41443-025-01185-5

There's more out there on this. It might not help with nerve recovery, but speed up the sensation process with the nerves you got. Don't know....but might be an option.

Being patient....that seems like the most difficult thing (was going to say hardest, but dang it). I've read that patient fatigue with penile therapy is a huge problem because the recovery timeline is so frigging long. People just stop, which just means done deal and fibrosis/atrophy. But, keep at it. Apple pie still a good thing.