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New Member

Date Joined Jan 2009
Total Posts : 12
   Posted 1/2/2009 9:15 AM (GMT -6)   
Talk to me to about this. My doctor suggested I try this before surgery to see what it is about. Then I will use it after the surgery. What should I expect?

Regular Member

Date Joined Jun 2008
Total Posts : 407
   Posted 1/2/2009 9:37 AM (GMT -6)   
I've been using MUSE for the past couple of months.  I started post-op, though - not before surgery.  I can't say it's helped, or not - I think it's too early for me to tell.  I take it in combination with Cialis - three times weekly.  There have been no negative side-effects for me, as far as I can now say.

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; 12/08: 0.0


Regular Member

Date Joined Nov 2008
Total Posts : 122
   Posted 1/2/2009 9:20 PM (GMT -6)   
JonH, Welcome to HW.  I tried MUSE early on after my open surgery.  It wasn't very effective for me.  I was able to get a slight erection that lasted for a short time but it also made Mr. Happy ache quite badly.  As you read more posts on this subject you will find that there are nearly as many reactions to different treatments for ED as there are men on this forum.  You just have to be patient and try a few different treatments until you find the one that works for you.  As you can see from my profile I now use trimix injections which work very well for me and my wonderful wife. 
Good luck.
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.

New Member

Date Joined Sep 2008
Total Posts : 2
   Posted 1/4/2009 6:49 PM (GMT -6)   
JonH, I have limited experience with MUSE (6 times), but my observations are:

It’s a vasodilator, so it should work with or without nerve sparing, or any sexual stimulation. Initial studies reported 65% success, but clinical studies found it’s only effective for 30% of men.

At 7 weeks post surgery I was given 250 mcg in the doctor’s office, which produced some enlargement, but no rigidity. More than I had achieved with cialis alone, but nothing useable. I tired 500 mcg at home, but that still wasn’t sufficient for intercourse. 1000 mcg worked for me.

In terms of technique, you have to urinate before using MUSE, to provide lubrication to dissolve the pellet. You should not use any other lubricant on the applicator, as that will interfere with absorption. You need to stand or walk around for 10 minutes, to increase blood flow while establishing an erection. Piano suggested temporarily using a constriction device, to prevent the drug from leaving the scene until it’s done its job. Vivus, the MUSE manufacturer, markets Actis, an Adjustable Constriction Loop, but a rubber band would do.

MUSE does need to be kept refrigerated. It’s pricey ($40/dose retail), and can be painful (aching in the penis, testicles, and groin, that last several hours), but with the right dose, I found it to be effective. I also noticed that an erection doesn’t diminish after orgasm.

Using MUSE is a bit of a procedure. Fortunately, I am blessed with a very supportive wife, who doesn’t mind the process, as the results are worth it.

iefbr14 - David, NH
Age 59, at Dx 59.
Type 1 diabetic since age 31
PSA: 6/26/05, 1.92
PSA: 6/21/06, 2.98
PSA: 9/24/07, 2.89
Biopsy:10/31/2007, prompted by DRE, results normal
PSA: 5/20/08, 4.71
Biopsy:06/03/2008, positive: Gleason 3+3=6; stage T1c; either 10% of 1 core (out of 19), or 5% of 2 cores, or 25% of 1 core, depending on which pathologist you believe.

da Vinci surgery: 10/21/08, Dr. John J. Munoz, Catholic Medical Center, Manchester NH
Post Op pathology: Stage pT2c NX MX, Gleason 3+3=6, Margins negative, 44 grams
catheter out: 10/28/08, dry from day 1
PSA: 12/4/08, 0.01
ED: 10/28/08 5 mg Cialis, every other day
12/12/08 250 mcg MUSE produced some enlargement; 500 mcg about the same
12/28/08 1000 mcg MUSE appears sufficient

Father died of prostate cancer in 1980 (age 59)
Brother had successful da Vinci surgery in 2006 (age 53)

Regular Member

Date Joined Nov 2008
Total Posts : 299
   Posted 1/4/2009 7:30 PM (GMT -6)   
My Urologist prescribed it for me but said that very few men have much luck with it, which was my experience. It did give me that aching pain but only a slight erection. I would still try it because not every guy reacts the same to it. If your insurance covers it and it works, it is by far the easiest way to get an erection when Viagra, Cialis or Levita don't work.

Age 60
RPP May 21, 2008
Gleason's 4+5 = 9
Incontinence completely over after 8 weeks
Right Side Nerves spared
ED being treated with Edex or Caverject Injections
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