Firm erections

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Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 3/7/2008 8:51 AM (GMT -7)   
I am several months post-op and using the vacuum pump along with viagra for my rehab.  I have tried using the constriction rings but cannot acheive an erection suitable for penetration. Does this improve with time or is this what to expect from the pump. Anyone out there with a similar experience?
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C 


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4461
   Posted 3/7/2008 9:22 AM (GMT -7)   

bootheel, I am 5 1/2 months post surgery and having the same troubles.  I can only manage an almost usable erection using the pump.  The rings have to be very small to work at all.  Are you using the smallest ring that you can possibily get on?  It seems you have no veinous control, hence no ability to retain the blood in the penis.  Veinous valve function must come before/or with the ability to get erections, so we can keep it erect when it does happen.  It seems that some of us will take longer to regain what is lost in both areas.   You are at the 1 1/2 month mark, which is way too early to see return of function in the majority of cases as posted here.   There's an occasional report of very early erections, but more to the norm is from 6 to 18 months for recovery.  Your using Viagra and the pump is a good start at rehabilitating.  Keep pumping up twice daily, if possible, without rings to achieve blood flow and infusion in the penis, until recovery is complete. 

What type pump and rings are you using?  Some people have had to use 2 rings of the same size to acheive a firm enough erection for sex.  Of course, you still have the penile injections to try.  Most start trying them at the 3 month mark.  Most men respond positively to some form of them, even if they have no veinous valve action yet.  It's been said here that the best treatment for recovering function of the veinous valve control of the penis is first injections, then the pump, and last Viagra in order of effectiveness.  The chemicals artifically activate and close the valves, providing good therepy by retoning and stimulating the nerve memory of using them.  Hope this can help in some way. 


James C. 
 
Help support the forums so they can support you:  http://www.healingwell.com/donate 
 
Age 60 
4/19/07   PSA 7.6, referred to Urologist, recheck 6.7 06/05/07
7/11/07   Biopsy- 16 core samples, size of gland around 76 cc. Staging pT2c
7/17/07   Path report:  3 of 16 PCa, 5% involved, left lobe , GS 3/3:6. 
9/24/07   (Open) Retropubic Radical Prostatectomy performed 
9/26/07   Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
10/15/07  ED- begin 25mg Viagra nightly, Fully continent
11/15/07  1st Post-surgery PSA-0.01
01/14/08  Caverject started/stopped, aching and pain , Bimix started
02/04/08  Bimix X 6 tries, .1mL, .15mL, .2mL, .3mL, .4mL, .5mL, success at .5mL
3/24/08   ED- 6 mts.-continue 50mg Viagra and pump-no change-no response


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 3/7/2008 9:43 AM (GMT -7)   
bootheel,

I was able to get an erection firm enough for penetration with the pump after about a couple of weeks of use but you have to find the ring that will hold the blood. It does get better with time. After about a month of using the pump twice a day everyday for rehab I got fed up with the discomfort of the ring and the limpness of the erection. I then went to injections which give me an upright firm erection. The only thing that the injections do not give me that I had before surgery is a firm penis head. The shaft is just as firm but the head is soft.

Tamu
Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3
Da Vinci on 11/01/06, Catheter out on 11/13/06
56 Years Old
Post Op Path, Gleason 3+3, Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06, 6/25/07, 1/8/08
No more pads as of 1/13/07
Began injections in April '07
 


Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 3/7/2008 10:15 AM (GMT -7)   

Thanks Tamu and James C.  I guess everything is normal at this stage of post-op.  The Doc never told me about the valves.  It makes better sense to me now.  I have gained a wealth of knowledge through this forum and really appreciate it.  It has made my journey at lot more tolerable.

 

Joe


Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C 


Lungman
Regular Member


Date Joined Jan 2008
Total Posts : 276
   Posted 3/7/2008 11:36 AM (GMT -7)   
I am now 6 mos post op and am experiencing gradual reduction of venous leak. At first, the erection would be a passing event, not usable at all, then over the last 3-4 weeks, there has been an increasing firmness to the erection, at times approaching pre-op condition. I started using bi-mix with promising results, natural feeling, well worth the needle stick, which is practically painless. The Viagra works, but the facial flushing is sometimes uncomfortable. The venous leakage has shown definite improvement, hang in there, from what my MD and the nurse in the ED clinic have stated, it lags behind the rest of the anatomy in full recovery, just keep trying, it will get better. I go for my 6 month PSA next week, am both nervous and anxious!!

Randy
Pre-Op PSA 9.9
1 of 12 cores positive, Gleason 3+3
DaVinci on 9/5/2007
Post-Op Gleason 3+6, Negative Nodes and Margins
Less than 1% of prostate involved with CA
3 Month PSA 0.004
Incontinence resolved 9/15/2007, one day after cath removal
ED showing significant improvement, more notable over last month
with Viagra 100 mg.


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4461
   Posted 3/7/2008 11:41 AM (GMT -7)   
Thank you for the information.  You're the first one I can remember who reported in detail the whys and whens of recovering the valve function.  That gives me great hope and comfort that my time will also come. 
Good luck on your next PSA check. also.
James C. 
 
Help support the forums so they can support you:  http://www.healingwell.com/donate 
 
Age 60 
4/19/07   PSA 7.6, referred to Urologist, recheck 6.7 06/05/07
7/11/07   Biopsy- 16 core samples, size of gland around 76 cc. Staging pT2c
7/17/07   Path report:  3 of 16 PCa, 5% involved, left lobe , GS 3/3:6. 
9/24/07   (Open) Retropubic Radical Prostatectomy performed 
9/26/07   Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
10/15/07  ED- begin 25mg Viagra nightly, Fully continent
11/15/07  1st Post-surgery PSA-0.01
01/14/08  Caverject started/stopped, aching and pain , Bimix started
02/04/08  Bimix X 6 tries, .1mL, .15mL, .2mL, .3mL, .4mL, .5mL, success at .5mL
3/24/08   ED- 6 mts.-continue 50mg Viagra and pump-no change-no response


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 3/7/2008 3:01 PM (GMT -7)   
Takes about 6-9 months for the average man to "begin" seeing decent results. Hang in there..well, be patient.


Swim
 


montee
Regular Member


Date Joined Mar 2007
Total Posts : 315
   Posted 3/7/2008 8:30 PM (GMT -7)   

Like everyone said above, just have to have patience.  My wife and I had our second penetration sex last week since surgery,  The 1st was Cialis assisted a few months ago, but I couldn't take the side effects of legs aching for a couple days like you had the flu, plus the erection was painful.  This last time was natural.  Sure don't like the idea that things have gotten smaller, but I guess that is just another side effect along with the dry and the fact that it seems the libido is not what it was.

My wife and I am sure all the wives of the guys on here are saints as this disease and operation effects all of us and what use to be taken for granted.  I am truly blessed by the wife God sent my way.

Have a good weekend.

Ron


diagnosed sept 06
gleason 3+4=7, right lobe only
psa 4.7  (psa rose 1 point per year for 3 years, urologist said still under 4 and no concern.  If I can find out about PSA velocity, why didn't he know!)
Told not to have surgery at Dana Farber as cancer had already penetrated prostate, in seminal vesicles, would have positive margins. Would only treat with radiation and HT
RP Emory Atlanta December 2006
Path-negative margins, negative lymph nodes
negative seminal vesicles, multifocal perineural invasion, both lobes involved
40% gland involved
gleason 3+4=7
Fully continent 2 weeks post catheter removal
1st psa April 2007-<0.04
 6 Mos PSA <0.04
9 mos PSA still <0.04
12 mos PSA still <0.04


Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 3/8/2008 3:28 PM (GMT -7)   
Your'e right about the wives. they truly are saints. I am very patient and know that everyone is different on the potency issue. Right now I am concentrating on the incontinence being a month and a half post-op. I'm down to about 3 to 4 pads a day. I can make it almost all night without going. The kegels help especially doing them getting in and out of the car. I see in your bio that you had capsular penetration. I had one positive margin about .3cm from the cut line. Although it was classified as T2C, I am still anxious about my first PSA in May. Your .04 PSA 12 months out gives me hope.

Joe
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C 


StrictlyInc
Regular Member


Date Joined Dec 2006
Total Posts : 353
   Posted 3/8/2008 5:26 PM (GMT -7)   
I find using the pump takes a lot of practice. I can get somewhat suitable erections if I use two rings rather than one.

Injections work better for me.
____________________

Prostate cancer diagnosed: May 15, 2006 (age 40)
Gleason score: pre-surgery 3+3=6; post-surgery 3+4=7
daVinci radical prostatectomy: July 25, 2006
size of tumor: approx 1.1 inches; negative margins from surgery

- number of pads/day at 3 months after surgery: 3 to 5
- number of pads/day at 4 months after surgery: 1 to 2
- number of pads/day at 6-18 months after surgery: 0 to 1

- 1st post-surgery PSA: 0 (Nov 2006); 2nd post-surgery PSA: 0 (Feb 2007)
- 3rd post-surgery PSA: 0 (May 2007); 4th post-surgery PSA: 0 (June 2007); 5th post-surgery PSA: 0

The search for timber: took Viagra/Cialis approx. every other day, ErecAid once a day, injections. Peyronie's diagnosed 7/5/07. Now on daily Cialis, L-arginine and pentoxyfylline. Peyronies has stabilized and significantly reversed.

- PGE1 batting average: .364 (4 for 11)
- Bimix batting average: .706 (12 for 17)
- Trimix batting average: .500 (1 for 2) Grand total 17 for 30 = .567

"Lost in the valley without my horses, no one can tell me what my remorse is..."


uncledan
Regular Member


Date Joined Aug 2007
Total Posts : 120
   Posted 3/8/2008 9:34 PM (GMT -7)   
I have been using the pump about 3 months now. I have just been told to use it daily. My doctor also said to use Viagra about every other week. I see others on here that are using the pill daily. Not sure what is going on.,but my surgeon and my Uro both said a pill every other week. Any comments. I agree that the erection are not what they used to be, but they are usable, using the smallest ring. Six months past surgery and there is no hope with out the pump at this time, pill or no pill. Thanks for letting me vent, Uncle Dan
Age 68
DRE negative, 10 - 06 PSA 5.44, 01 - 07 PSA 6.47
5 - 07 CT and Bone scans negative, 05 - 07 Biopsies, 2 of 6 positive
Gleason Score (3+4) 7 Stage T1c
08 - 14 Da Vinci RAP, five hours surgery
Some right nerve and all left nerve removed,
8 -16 Negative margins, Encapsulated, 50% left side
Lymph nodes 2 R & 1 L - Negative, R & L seminal vesicles - Negative
Gleason changed (4+3) 7 so it was closer to 8 than 6
Sixth month PSA 0.04 Previous PSA 0.00 Occasional stress drip
Results are improving while using pump. Pills no help


Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 3/9/2008 7:35 AM (GMT -7)   
Hi Uncledan,
I use the pump twice daily since the cath was out, also 50mg Viagra daily per Uro's orders. You can ask your Doc about that. Also I hear from some of the guys that the shots really help on the rehab. I plan to start them about 3 months out. Just a thought.
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C 


geon
Regular Member


Date Joined Oct 2007
Total Posts : 103
   Posted 3/10/2008 9:01 PM (GMT -7)   

:-)  I am 13 months post op.  No natural erections. Some stirrings at times, feel great and promissing, but as I look down there is nothing there.  I have run the gambit sparing implants.  The injections are the best and I do that every third day with good erections with stimulation usuall during foreplay and it last about two hours without pain.  On the VED.  I have not tried intercourse with the VED erection because it is too painful.  Two high tension rings barely holds the erection suitable for intercourse for five minutes.  Slipping the rings off the vacuum tube onto the penis is not a joy.

From other sources I have been led to believe that retention rings from 'Silicone Island' is much more enjoyable as there is no pain and the flexibility of silicone seals the penis better from blood release.  I have ordered but have not tried - but looking forward to it.  $6.00 or so for a set of three and available from adult sites.

Marc


64 years old 100307; healthy; active,
married 41 years, good strong erections before surgery.
DaVinci Prostate Removal February 5, 2007
2/12 samples malignant.
Catheter removal 2/13.
Viagra 25mg every other day from 2/14 to 5/12.
Tried Viagra 100mg on occasion-no erections.
Incontinence almost gone after three months.
No pads, occasional  dribble.
Lavitra every other day 5/12 to 7/22.
Muse 1000mcg - no help (50% at best).
Cialis twice a week 7/25 to 11/6/07.
Vacuum pump daily/twice a day 8/2 and going - no help.
Begin Trimix injections, two low dose per week, 11/05/07.
Currently, vacuum pump and low dose Trimix twice per week each.
Trimix in office - 0.10cc.  Low dose set at 0.05cc
First drug induced erection 10/8/07....Wow!
Natural erections - 0 as of 10/25/07.
PSA's, three to date undetectable.  Thank God!
 
Geon


B&B's World
Regular Member


Date Joined Mar 2007
Total Posts : 120
   Posted 3/10/2008 9:38 PM (GMT -7)   
I like the title of this thread!  After one year, I am happy to report that B now has good erections, with the help of a full dose of Viagra, enough to satisfy both of us!  The vicious cycle seems to be over, and I think that the passing of time is a huge factor here.  We have been in a period of re-training. For example, without ejaculations, whatever mental excitement we had over that happenstance must be resurrected somewhere else. Without the accustomed tumescence, it distracts, and then performance anxiety checks in.  I want to say that I am comforted to find that the passing of time has taken care of much.  Finally, we are now able to keep from being so "present" ; our bodies have adapted and our minds, too.  Sex is so much in the mind, that after allowing for the physical healing, which takes time, one can get just about as ecstatic as one wants...with relaxation...and imagination...

Age 51

Gleason 3+3

PSA from 3.2 to 4.3 in one yr

Biopsy 11/06

DRE negative

4 of 12 cores positive, one lobe, less than 10%

Inflammation only second lobe

Stage T1C Clinical Dx

PSA prior to surgery: 3.9

Da Vinci Prostatectomy 2/27/07:

PCa in BOTH lobes 5-10% of gland

Gleason 3+3

Negative tissue margins

Bladder, seminal ves, vas deferntia negative

Two inguinal hernia repairs

Catheter removed 1 wk after surgery

Full continence (no pad needed) 1 wk after surgery, then intermittent drips 4 wks out

Full erection, 12th day after surgery

2 mo’s post-op, some ED after penetration

3 month PSA 0.03

6 month PSA non-existent

1 year   PSA  non-existent

Erectile function--up and running!

 


mikem
New Member


Date Joined Sep 2006
Total Posts : 4
   Posted 3/11/2008 4:14 PM (GMT -7)   
I haven't posted in quite some time but want to contribute to this dialog.
I had my surgery 6/27/06, so I am approaching 2 years. Most importantly, my PSA is still undetectable. I experienced dramatic improvement in my erections after a year, and they are still getting better. I now can have spontaneous sex, occasionally wake up with a good erection(reminiscent of the good old days) and even occasionally get some wood admiring an attractive woman.
So, be patient and practice using whatever aids work best for you. My urologist said that many of his patients experience improvement 1-2 years post surgery.

DanmanBob
Regular Member


Date Joined Feb 2008
Total Posts : 467
   Posted 3/11/2008 8:43 PM (GMT -7)   

Appreciate the information posted here.

Began using a vacuum pump about 2.5 weeks ago.  He just wants me to use it for therapy right now, so I am not using rings.

I seem to get pretty good erections, as best I can tell (hard to see when the inside of the pump clouds up, as it frequently does)....but no idea about whether or not I have the venous leakage that was mentioned, since I am not using the rings.

Erections were somewhat uncomfortable at first....not as bad now, although they do not feel anything like normal.

My next trip to the urologist is about 5 weeks away.  I will ask him then about injections.

On a different note, I have improved from 3-5 pads a day to 1 in the past month, so I am excited about that development.  Hope to be pad free SOON...........


Danman Bob
Age 57
Prostate removal November 2007
Gleason score 9, TC1
Biopsy result - 9 of 12 sticks showed cancer
Despite high Gleason score, cancer was confined to the prostate
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (1 to 2 pads a day)
Began using Osbon Erec-Aid Esteem manual pump for therapy mid-February 2008
Begain using Viagra 3 times a week December 2007 to stimulate blood flow


puget
Regular Member


Date Joined Mar 2007
Total Posts : 237
   Posted 3/11/2008 10:21 PM (GMT -7)   
Had my 9 month check up last week. My PSA was 0.02. Last September, it was less than 0.01, so I was a bit concerned. My family doc reassured me, and also asked my uro to comment. Today, I received a note from my uro that 0.02 is a great result, since my post-surgery pathology was completely negative at the margins and in seminal vesicles. He said not to worry at all and no follow-up test necessary for 6 months. I wish the report had come back "undetectable" again, but have to trust in my drs that all is well.

As to ED, it is encouraging to hear from mikem (whose surgery was one year before mine) that things continue to improve. My family doc told me last week that many drs now believe that sexual function continues to improve for 2, 3 or even 4 years after surgery. It takes a LONG TIME for those nerves to heal. He told me not to lose hope. Viagra is working well for me at this point, and even tho I have no spontaneous erections after 9 months, dr said he was encouraged that I would continue to improve over time. I hope one day, not too far in the future, to wake up with the ol' woody.
Puget
60 years old
Dx March 2007
Pre-Surgery Gleason 3+3 = 6
Clinical Stage: T1c
Biopsy: 1 in 10 positive
Da Vinci: June 7, 2007 
Post-Surgery Gleason 3+3 = 6
   Clear at margins
First Post-PSA Sept 07 = <.01 (Hooray!!)

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