Post surgery erectile recovery.

Posted by neilaus @neilaus, Sep 21 3:02am

My surgery was 3 years ago and was nerve sparing and apparently successful given my continued insignificant PSA tests since. My recovery period was quite long and uncomfortable but ultimately physically and emotionally very successful, with regular reviews with my surgeon and a supervised pelvic floor exercise regime that has enabled a continued 90% avoidance of urinary leaks.

My only incontinence risk event are when I’m sexually aroused and heavy cough or flatulence without first consciously clamping my pelvic floor muscles.

Ok ..erectile loss was pretty much total for 6-9 months and has never really returned in terms of being naturally erect enough for penetration. My doctor recommended the use of a penis pump and prescribed 5 mg of cialis daily for about 2 months, then changed to 20 mg when ever I desired an erection. Later I was switched to Viagra 50 or later 100mg for use when I described an erection.

The 20 mg cialis gave limited but barely useable results. The 100mg viagra allowed a greater result but not lasting and gave me significant blocked nose and flushed face effects.

Finally I was prescribed Quadmix injections on an as needed basis (never more than every 2 days) which remains fully successful @ 40 units. My sex life is restored.

A recent YouTube specialists video alerted me that I had never been properly guided in the use of the penis pump as an ongoing therapy rather than a precursor to producing an erection for sex. Similarly the medications were always presented as a precursor to sex rather than a therapy.

Question .. would it be beneficial even at this stage to perform regular penis pump therapy as an aid to erectile health? Should I retry the cialis 20mg with the pump therapy?

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spino | @spino | Sep 24 7:36am

In response to @neilaus I am now out 3.7 years from nerve-sparing RALP. There has been continued recovery in erectile function for me past three years. I do recommend penile therapy with a vacuum pump, although I find it a hassle to make time for it. I use a non-medical grade pump (electric, rechargeable) that will automatically cycle. It is not the maximum vacuum that helps, but rather the repeated cycling until significant muscular tension is reached (for a maximum of 10-20 minutes.) I do not use the penile therapy on days I have intercourse to avoid overuse of those muscles.
I used trimix for years, keeping careful logs, because I had an adverse reaction to sildenafil and tadalafil (and for a long time it had no positive effect either.) However, my urologist encouraged me to try again from time to time and last year I began to tolerate sildenafil successfully and get some positive result. My wife and I both prefer the experience without the injection, although we were grateful to have that option before. The problem I experienced was that the injection provided engorgement but not arousal. In fact, I would say it decreased sensation.
So while I still have some (varying, extending up to 24 hours) adverse reaction to sildenafil, that has provided our current best solution, especially when I make time to do the penile therapy on days without sexual intimacy.