After bilateral prostatectomy: Still hope of recovering erections?

This forum has been of great help to me as a prostate cancer patient.
I'll share what has made a difference in the E.D. condition that resulted from my radical prostatectomy in the hopes that others may find the informaton of benifit to them.
At one and one half years out from surgery, nothing worked however through this forum, I read that an injectable -TRIMIX, was avaiable. It has worked well for me where the pills failed. The MA General Hospital in Boston was able to steer me to the right people for this.

Best, Robert

Here is a really interesting personal experience about how To optimize Trimix usage.
https://connect.mayoclinic.org/discussion/my-trimix-experience/

My erections hardness score is 2.

Trimix was the post surgery game changer for me!

I also believe that injectables with resulting erections are a vital component to penile rehab post surgery like Dr Mulhall and others suggest

Some doctors give their patient Cialis prescriptions immediately after surgery so that they can keep the blood flowing properly.

The second thing to do is use a penis pump to get an erection and keep the tissue working properly, It may not be stiff enough to her relations, but it keeps the tissue healthy.

The next thing to do, if you can’t get an erection right away, is try using either bimix or Trimix Injections directly into the penis to get an erection. It does work for most people. Not really painful for most as the needle is very thin.r

If all else fails, you can get an implant. That allows you to get an erection at he push of a button.

You might be able to search YouTube for conferences where urologist discuss this.

I am in a similar position. 53 y.o., 13 months post RARP, maybe a 3-4 with Cialis. You can try injections, but they are finicky and I found it difficult to dose right. Nerves may still recover, specialist wants to wait 24 months before doing an implant. In the meantime, Cialis, VED, and stimulation to prevention fibrosis.

Yes there is hope for recovery as long as there was adequate nerve sparing and no vascular damage during the RP. There are many men on this forum and other forums that have reported ED recovery by 24 months...with some taking longer. As the previous posters have stated, penile rehab, Cialis, Trimix are all important to keep blood flow going to prevent Fibrosis and the dreaded penile shrinkage. If you are getting night erections that is a good sign.
Post RP two years ago I was doing all the rehab stuff, had night erections, and could get erections of a 2 with Cialis. Three months later erections improved to a 3 with Cialis and a 4 with Trimix. At 6 months night erections went away and erections became worse with Cialis and even Trimix yielding only a 3. By 12 months penile shrinkage was obvious in the Vacuum Erection Device so went to a Sexual Medicine Urologist who diagnosed severe Fibrosis on one side of penis likely a result of surgical nerve/vascular damage.
He said no real treatment for that and recommended an implant. Went to a high volume implant specialist and am now 4 months post implant. The point of this story is that men need to stay focused on penile rehab as it helps with recovery of a healthy penis AND better prepares you for an implant if things go south.
While I would never have gone with an implant if Trimix had worked, at this point even if I could (obviously I can't) , I would not go back to Trimix as the implant is definitely superior, works as advertised, was paid for by Medicare, and no one even knows you have it unless you tell them.

@topf
If you are considering an implant down the road and are seeing shrinkage, get a traction device to keep things stretched out. I did my implant at 16 months cause things were getting worse in a way that would complicate the implant procedure by waiting 6 more months. 4 months of traction did the trick and absolutely no loss when compared to things prior to RP surgery.

There’s a 2023 presentation out of Stanford University that’s titled “Penile Rehab: Optimizing Recovery of Erectile Function after Prostate Cancer Treatment.” They talk about things to do before and after surgery: https://youtu.be/aRp1NXjPGLE