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Regular Member

Date Joined Oct 2008
Total Posts : 56
   Posted 11/27/2008 11:36 AM (GMT -6)   
 I am 10 weeks since RP surgery and have been taking cialis 5 mg for about 2 weeks as prescribed by my doctor. I have read on the forums about these drugs and injections that everyone takes to get an erection for intercourse and increase blood flow. I have not been able to have a usuable erection yet, even with extra stimulation from my wife. I have 2 questions. If you are using injections or drugs, and you get your first usable erection. Are you able to continue to have a second orgasm after the first one if, you still have an erection? Also, other than the drugs, what other means are best to get stimulation.
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 Apr 2008
Total Posts : 847
   Posted 11/27/2008 1:16 PM (GMT -6)   
With injections, (but no Cialis type drugs) it is possible to have two orgasms (or maybe more -- I don't know!). I find I have a usable erection that lasts for two hours -- although it declines after 30 min, it comes up again with further stimulation.

As for stimulation, I use standard musturbation to get started, but it does require a lot more than in the old days.
Age 63. Other than cancer, in good health; BMI 20
Pre-op: No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores
7 March 2008, RRP, non nerve sparing
Two nights in hospital; catheter and staples out after 7 days
Continent, no pads needed from the get-go
Post Op: Stage pT2 M- N-; clear margins and lymph nodes; Gleason 4+4=8; prostate weight: 37gm
6-week and 7-month PSAs: 0
Bimix injections working well 

Regular Member

Date Joined Jun 2008
Total Posts : 407
   Posted 11/27/2008 3:32 PM (GMT -6)   
I'm still taking Cialis three times weekly and regarding ED, there's been no improvement . . . I don't yet get to the point of having an erection.

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


Regular Member

Date Joined Apr 2008
Total Posts : 270
   Posted 11/28/2008 2:45 PM (GMT -6)   
Hi Fred,
The tone of your email suggests some great expectations in the ED department. I did not read your age, but even if you are young, you may want to take a more casual approach. As you are just 10 weeks out for most (with some exceptions) there is not a lot of recovery activity for the first number of months. In fact some of us may never recovery normally. In the mean time there are the supplimental rehabilitory things.

There seems to be a general process of using the orals for a while, the pump, and then beginning injections. All of this to rehabilitate, and to function as normally as possible. I for one had no effect from the orals. The pump helps but is not equal to presurgery. I am just now getting into the injections (six months out). As for orgasm, from experience and from what I have read those continue approximately as before surgery. With some people they are not as dynamic as before, and I have read others say they are more dynamic. I am not where I would consider myself as near normal function yet, and can only say my experience has not been equal to my presurgery days.

Regardless of all that I am content to bide my time trying to rehabilitate and see if function returns, and mostly I am very happy to have a good cancer free prognosis at least for the time being. I quess what I am saying is patience is very important in the recovery process. Blessings.

Age 61 (now 62)
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA <.04
2nd Post PSA <.1 10/30/2008

New Member

Date Joined Dec 2008
Total Posts : 10
   Posted 12/9/2008 7:39 AM (GMT -6)   
Thank you for sharing this information.

Regular Member

Date Joined Apr 2008
Total Posts : 206
   Posted 12/9/2008 12:24 PM (GMT -6)   

you are WAYYYY   early in the process ...patience  and practice wil pay off in the long run may take a year to start recovary   but  you must be patience...

Good Luck !!

April 2007 PSA 8.4 for last 6 months biopsy shows PC 3+3=6
June 13 2007 Nerve Sparing open RP / Dr. Christopher Johnson at St. Francis Hospital NY.
4 days later home for Fathers Day, and Catheter.
Removal of catheter 10 days later , incontinence not an issue, no pads used from the get go.
1 month PSA next to not detected

ED is a longer battle:
1 month out start using occasionally Cialis and 50MG Viagra to promote blood flow with no response.
3 months and 6 months PSA not detected
ED 6 months mark starting with VED therapy and being more aggressive with meds , in addition taking Folgard supplement daily.
April 2008 : 10 month out and start seeing some serious improvements with ED while using Meds and VED , can achieve erections, Mid nights erections almost on a regular basis , and uncontrolled 90 % erections spontaneously.
1 year visit on June 13 2008 woohoooo!!!

ED: With Viagra Usable erection for intercourse , AND AT 80% without any medications !!
Fully continent since removal of catheter.
PSA one year : 0.0 as of 6/13/ 2008 BIG Wooohoooooooooo!!!!

Veteran Member

Date Joined Apr 2008
Total Posts : 847
   Posted 12/9/2008 10:30 PM (GMT -6)   
From what I have read, it typically takes 18 months two years to recover natural erections, if ever. Some have taken as long as four years!

If you find the oral meds are not working and you don't like the VED, consider injections. They can give a good, long lasting erection. I started on bimix exactly one month after surgery -- my uro calls it rehabilitation, but I call it fun.
Age 63. Other than cancer, in good health; BMI 20
Pre-op: No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores
7 March 2008, RRP, non nerve sparing
Two nights in hospital; catheter and staples out after 7 days
Continent, no pads needed from the get-go
Post Op: Stage pT2 M- N-; clear margins and lymph nodes; Gleason 4+4=8; prostate weight: 37gm
6-week and 7-month PSAs: 0
Bimix injections working well 

Regular Member

Date Joined Mar 2008
Total Posts : 85
   Posted 12/10/2008 11:40 PM (GMT -6)   
When I read your post, I had to smile. At 10 weeks out, I was lucky Junior even showed up for a leak let alone an erection.

In March I'm coming to my 1 year anniversary of RRP, and I haven't seen any real erection yet. Maybe in the middle of the night he's half interested, but that's it.

As you will learn, it is not necessary to have an erection to climax. It's necessary for intercourse, but not for chocking the chicken. If you are one of those who never did that before in your life, be prepared for something new, because sooner or later, you're going to want to know it "It" is still there. It is, you just have to work a little harder to realize it.

As others have said, be patient. 6 months is nothing. A year is early and 18 months to 2 years is what my Doctor said to expect.

As for needles, it's my personal opinion that if I have to stick Junior to get his attention, it just ain't gonna happen and I'll just have to pretend I'm back in elementary school and my eyes don't cross. :))
DIAG. 2/08
PSA 6.8
LUPRON, (3 MO.) 2/28
SURG, SCHED. 3/26/08
RRP, 3/26, HOME 3/31
PSA 5/21 O.O1 UND
PSA 9/30 0.0.1
ED still there but finding ways around it.


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