5 mg cialis for nerve healing?

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Regular Member

Date Joined Oct 2008
Total Posts : 56
   Posted 11/13/2008 6:31 AM (GMT -6)   
    Its been 8 weeks since my RP surgery and I saw my dr. for the first time yesterday. He started me on 5 mg cialis for, as he said nerve healing. I asked him about trimix for my ED, but he said its is to early for that. I am not having alot of problems with incontinence
    I would like to know how much 5 mg will help towards the ED and what kind of side effects come with this.
    Also I would like know what most people are using to help speed up the  ED problem.
    I am mentally ready to have an active sex life again, and I have had a small orgasm with my wife once, but without an erection.
Diagnosed Feb 08
PSA 6.3
gleason 3+3
first biopsy 1 of 10 needles positive
surgery Sept 18 08
bone scan negative
evidence of sinus histiocytosis?
involvement of the margins identified at right and left apex and right anterior surface
also perineural invasion
no extraprostatic extention
no seminal vesicle invasion
tumor cells aggressive features of moderate to severe pleomorphism
possible radiation depending on first  PSA  Nov 12
kept left side bundle of nerves but lost some of the right side bundle

Veteran Member

Date Joined Feb 2008
Total Posts : 655
   Posted 11/13/2008 8:15 AM (GMT -6)   

Greetings, Fred.  I had RRP in Feb 08.  My doc prescribed Cialis 5 MG 1 or 2 X a week after I had my catheter out.  I didn't seem to need it - got about 80% erection 2 weeks post surgery.  I called the office, talked to the doc's nurse and she said if you don't need it don't take it.  In retrospect that was a mistake.  I should have gone ahead and taken it whether I needed it or not.  As time went on I found that I never got more than 80%.  When I had my 90 day check up, my doc said take the cialis or levitra whichever works best for you (there is a different regimen for viagra and he said we would use that as a last resort).  The cialis worked fine and so did the levitra and I was back to 100% with either.  I hope over time that I may not need it but as long as it works, use it. 

The only side affect I had with levitra was a stuffy nose and flushed face.  The cialis didn't seem to cause the side affects but you can't get generic cialis.  However, I probably would have paid the higher USA price, but after I had taken 10 doses or so of the levitra, the side affects seem to have gone away. 

By the way, I ordered generic levitra from alldaychemist and it works fine at about 10% of the cost of what you pay in the USA. David


Age 55
Diagnosed Dec 2007 during annual routine physical
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 positive with 2 marginal
Gleason 3 + 3 = 6
RRP 4 Feb 08
Both nerves spared
Good pathology - no margins - all encapsulated - Gleason 4 + 3 = 7
Catheter out Feb 13 - wore pad for couple of days - pad free Feb 16
Great wife and family who take very good care of me

Regular Member

Date Joined Feb 2008
Total Posts : 308
   Posted 11/13/2008 9:05 AM (GMT -6)   
I took 50 mg of Viagra every other day after surgery and then after a few months I only took it when I had sex. That was a mistake on my part. My incontence is almost corrected at 8 months but I started back taking Viagra almost every other day now and it seems to have an effect on that issue. I am again doing my kegels and walking and exercising more. I still feel that I am healing in that area.

I have had side effects with the Viagra. I have had great success in the ED department with it at times and have had no effects. If I take it after a big meal no matter how long I wait , nothing. I have had headaches, flushing feeling and muscle aches and pains some 24-48 hours after. Mostly in my back, butt and legs. This goes away like a switch was turned off for some reason.

Diagnosed @ 53 years old now54
DRE normal , 2004 Biospy negative - 2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
PSA @ surgery 6 
Bone and Ct scans negative
clinicaly Staged at T1C - Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008
University of Chicago,Hospital stay 30 hours -
Catheter out in 7 days 
normaly expected leakage
Post Pathology T2C, Gleason 7, 10 % of both portions of prostate
Seminal vessels clear, fat tissue clear
single positve margin measureing less than 1/2mm 
Six week PSA < 0.1 , 4 month PSA <.05 Gen II test. 6 month PSA  <0.01
Urologist recomends to hold off on Radiation and watch PSA closely. Oncologist and Radiation Oncologist seem to lean to doing pre-emptive radiation.Uroligist says 50/50 chance of PSA re-occurence.  
I have decided to hold off and see in 3 months lets see in 9 months.
Next PSA January 2009.
11-08-08 (7months) starting to go without day pads, 100 mg Viagra seeing good results

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4462
   Posted 11/13/2008 9:18 AM (GMT -6)   
I started 50mg viagra generic daily with 2000mg l-Arginine at catheter removal, the pump at 2 months and injections of bimix and trimix at 4 months, for the first year, a daily regime that resulted in zero improvement, which says that each mans rehab is individualized and we can't tell you how or when 5mg of Cialis or whatever will be effective for you. Sorry, but it really is a case by case thing. I do hope you are one of the sooners rather than laters in the ED function.
James C.
Co-Moderator- Prostate Cancer Forum
Age 61
4/19/07 PSA 7.6, referred to Urologist, recheck 6.7
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
Present- 1 year: ED- Viagra, pump continues, no response- Trimix .10ml x 2 weekly continues
Post Surgery PSA's: 3 mts-.04, 6 mts.-.04, 9 mts.-.04, 1 Year-.02.

Veteran Member

Date Joined Apr 2006
Total Posts : 1732
   Posted 11/13/2008 10:06 AM (GMT -6)   
Paul took 10mg Levitra daily for a year then 2-3 times a week, probably for life. He's recently gotten scripts for daily dose Cialis (2.5 and 5 mg) to try as a possible maint. med. 3.5 years after the fact seems a good time to just go to a maint. dose and forget planning ahead. His choice. It really doesn't matter to me what he decides. We're so used to what is our now-norm that frankly, the past had become a distant memory. I'm happy the way we are. He's healthy, I'm healthy, kids healthy. We have plenty to eat, jobs we like and a "whole" roof over our heads again....... and our daughter is moving out :>) Guess I should mention our family has grown by a soon to be son in law...whom we love dearly. Doesn't get any better than that :>)


Regular Member

Date Joined Aug 2007
Total Posts : 118
   Posted 11/13/2008 11:24 PM (GMT -6)   
My doc prescribed the pump and 10mg Cialis every other day. I asked how long this should go on, and the answer I got was "until you are back to normal". Although the pumping is time-consuming and the medicine is expensive, I promised myself to continue the regimen until I saw absolutely no improvement over time. There seems to be consensus that ED meds help with recovery if not actual erections early on. Early after surgery, I could really tell that the Cialis was improving blood flow down there at all times of the day. You should also inquire about using the pump. This really seems to help restore penis size after surgery. It also ensures that the spongy tissues inside the penis get a regular engorgement of blood which is important to prevent atrophy. Although I did not receive or require it, others here on the forum have recommended penile injections not only for useable erections but for therapy as well.

Age:45 (44 when diagnosed)
Father diagnosed and cured at age 52.
08/21/07: Diagnosed with T1c cancer
1 of 12 biopsy cores positive; 10% tissue
Gleason score: 3+3=6
PSA level prior to biopsy: 4.3 (velocity < 0.4ng/ml)
10/19/07: da Vinci prostatectomy by Dr. Vipul Patel
              Difficult surgery due to prostate inflammation.
              Both nerve bundles spared.
              Spongy erections began within 24hrs of surgery!
10/24/07: Catheter out; down to 1 Serenity pad/day next day.
              Final pathology: neg margins, no capsular penetration,
              Gleason 3+3=6, 5% tumor involvement, multi-focal.
11/04/07  First usable erection with Cialis
11/22/07  Thanksgiving - Bye-bye, pads
01/17/08  First post-surgery PSA result: < 0.008 ng/ml
03/17/08  Erection quality mostly back to pre-surgery levels with Cialis;
              have not tried without meds yet.
04/23/08  Second post-surgery PSA result: < 0.008 ng/ml
07/30/08  Third PSA: 0.01 ng/ml
11/04/08  One year PSA: 0.01
              Still taking 10mg Cialis every other day - enjoying the results
              too much to stop yet.

Regular Member

Date Joined Oct 2008
Total Posts : 29
   Posted 11/15/2008 2:34 PM (GMT -6)   
I started on the cialis, but suffered from the delayed onset of back ache.  It took me awhile to figure it out.  I now take the little blue pill with very little problems,
Age 51
Father died of prostate cancer at 73
Yearly PSA testing.
Biopsy after PSA went up .75 in one year
6 of 12 in needle biopsy where cancerous
DaVinci surgery 4/15/2008
Last PSA .008

Regular Member

Date Joined Oct 2008
Total Posts : 56
   Posted 11/15/2008 6:32 PM (GMT -6)   



How long before you discovered the backaches, and were they lower backaches? Also how much viagara are you taking a day?

Diagnosed Feb 08
PSA 6.3
gleason 3+3
first biopsy 1 of 10 needles positive
surgery Sept 18 08
bone scan negative
evidence of sinus histiocytosis?
involvement of the margins identified at right and left apex and right anterior surface
also perineural invasion
no extraprostatic extention
no seminal vesicle invasion
tumor cells aggressive features of moderate to severe pleomorphism
possible radiation depending on first  PSA  Nov 12
kept left side bundle of nerves but lost some of the right side bundle

Regular Member

Date Joined Nov 2008
Total Posts : 299
   Posted 11/22/2008 5:43 PM (GMT -6)   
I have been taking Viagra for six years prior to RP surgery in May of this year. Still in recovery mode after that which is a different story. But viagra is definitely impacted adversely by food, especially greasy fries, hamburgers, etc. It worked best for me on an empty stomach, would sometimes be good for me for over 4 hours. I could get really "up" more than once with the some stimulation.

Regular Member

Date Joined Dec 2007
Total Posts : 56
   Posted 11/24/2008 9:26 AM (GMT -6)   
I was on the 5 mg Cialis for a few months... "to get the blood flowing" was the doctor's description. It did help me quite a bit, and although I did have side effects (headache and nasal congestion), they were fairly minor at the lower dosage. I also used the pump therapy, as some of the other responders mentioned. I have also tried the 20 mg Cialis on occasion, in which case the side effects were more pronounced but so was the effect on ED.

Diagnosed Sep 2007 Age 54 Gleason 6 (3+3)
DaVinci Surgery 11/8/07 University of Minnesota
2/22/08, 8/15/08 PSA Undetectable

Regular Member

Date Joined Jun 2008
Total Posts : 407
   Posted 11/27/2008 3:40 PM (GMT -6)   
I've been on 20 mg of Cialis three times weekly since about a three weeks to a month after my surgery. I've also taken MUSE, in conjunction.

Age:  59 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (getting better, though)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0


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