MUSE and oral meds...

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Regular Member

Date Joined Jun 2008
Total Posts : 91
   Posted 12/7/2008 6:27 PM (GMT -6)   
Is it "safe" (or advisable) to use MUSE along with one of the oral meds (Viagra, Levitra, Cialis) at the same time? Or, should I go with one or the other on a given night? I'm at six months post RRP and still struggling with ED. Each of these methods on its own produces very, very modest results, but not enough for intercourse.
Husband and father of two (current ages 4 and 6).
Age when diagnosed: 47 (current)
Biopsy showed cancer only on left side.
Pre-surgery PSA: 13.7
Pre-surgery Gleason: 4+3=7
Pre-surgery Staging: T2
CT Scan, Bone Scan, PET Scan: Clear
Robotic Surgery on May 28, 2008, at Barnes Hospital in St. Louis.
Right nerve bundle spared; left bundle removed.
Catheter for 8 days with infrequent "stress" leaking. Pad-free after five weeks.
Continuing ED: attempted Viagra, Levitra, and Cialis with no response. However, had SUCCESS in October 2008 using MUSE.
Bad news-
Gleason: 4+3=7
Involved 10% of prostate; all quadrants involved
Extraprostatic extension at left base and apex
Extensive perineurual invasion present.
Non-neoplastic prostate shows PIN, high grade, diffuse.
However, good news-
Bladder neck, lymphvasular space, seminal vesicles, 17 examined lymph nodes, and all margins are FREE of tumor.
Four-week post-surgical PSA = 0.1
Seven-week post-surgical PSA = .01
October 2008 PSA = 0.0
Next PSA scheduled for January 2009.

Regular Member

Date Joined Jun 2008
Total Posts : 407
   Posted 12/11/2008 2:10 AM (GMT -6)   
My Urologist/Surgeon put me on MUSE and Cialis starting about four weeks following da Vinci procedure surgery - and he does the same for many if not most of his patients who've had the surgery. The instructions I was provided by the Urologist call for me to use the MUSE one-hour after taking the Cialis - they're taken together, relatively, and not separately or on different days apart from one another. My suggestion is for you to discuss the matter with your Urologist or primary care physician and seek their advice, because they're the one's best equipped to offer specific/personal recommendations based on your medical history.

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


Post Edited (Mavica) : 12/11/2008 12:14:48 AM (GMT-7)

Regular Member

Date Joined Nov 2008
Total Posts : 122
   Posted 12/11/2008 1:34 PM (GMT -6)   
Kark,  From reading your letter and signature you may want to look into Trimix or Bimix injections.
I tried the pills with no success, had some sucess with muse but it was painful.  I have been using Trimix for over 2 1/2 yrs. now with great results.  I had nerve sparing surgery but ED seems to be here for the duration.  With Trimix, life is good for my wife an me.  Good luck to you.
Age 54 at Dx.   Currently 58
Jly 05- PSA 8.1
Sept 05- PSA 10.7
Sept 05- Biopsy revealed 9 of 12 cancerous, Gleason 3+3=6, T2 stage
Bone scan and cat scan showed hot spot on hip bone.
Oct 05- Surgery for bone biopsy.  Pathology showed benign growth, no cancer in bones. Who ever thought I would be happy to only have PCa?
Nov 05- PSA 15.4
Nov 18, 05- Nerve sparing open RP at Huntsman Cancer Center, SLC, UT by Dr. Robert Stevenson. 
Home after 3 days.Cath out at 2 wks.
Incontinence gradually improved for about 3 months to 100% continence.
ED- Tried the big 3 pills with no results
Feb 06- PSA undetectable, Started VED which worked but caused discomfort with constriction rings.
May 06- PSA undetectable, Dr. gave me an Rx for Trimx injections. They work great.  Still use VED on off days without constriction for therapy.
Aug 06- PSA undetectable 
Nov 06, May 07, Nov 07, May 08, Nov 08 - PSA undetectable
ED appears to be perminant but doing great with Trimix.

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