Article: Penile Rehabilitation after Surgery

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James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 1/5/2009 1:17 PM (GMT -6)   
www.cpcn.org/arch_0069_penile.htm

I ran across this today and it contains some good nuggets of info, including confirmation of the use it or lose it theory of ed rehab, confirmation of the usefulness of the top 3 ed drugs for rehab, some surprising info about a study of Levitra nightly, injections for speeding rehab confirmed , and some more good ed info. With links to the original studies. Worth the read, IMO
James C. Age 61
Co-Moderator- Prostate Cancer Forum
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 Nerve sparing open Retropubic Radical Prostatectomy
9/26/07 Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
Post Surgery PSA's: 3 mts-.04, 6 mts.-.04, 9 mts.-.04, 1 Year-.02.


DJBearGuy
Veteran Member


Date Joined Dec 2008
Total Posts : 714
   Posted 1/5/2009 9:01 PM (GMT -6)   
James,

Thanks, that's a very interesting website. Now if only the insurance companies would accept this.
DJ

Age 53
PSA 2007 about 2
PSA 2008 4.3
Diagnosed September 2008.
Biopsy: 6 of 12 cores positive
Gleason 4+3 = 7
CT and Bone scan negative
Da Vinci surgery at City of Hope December 8, 2008
Radical prostatectomy and lymph node dissection
Catheter removed on 7th day, replaced on 8th day, removed again 14th day following negative cystogram
pT2c
lymph nodes negative
microscopic margins
next PSA 1/22/08


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/5/2009 11:48 PM (GMT -6)   
Great Post,
This is also applicable for those undergoing hormonal therapy. Sex just doesn't happen for most of us, and when you are on intermittent HT (IHT) the hope is that you get it back. I know one advocate who is very strong in the subject ~ Kathy Meade. I have all of her contact info, and articles if anyone is interested.

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Extra Prostatic Extension (EPE)
Bilateral seminal vesicle invasion (SVI); Stage pT3b, N0, Mx
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (September 17 '08): <0.1 ~ Undetectable!
 
You can visit my Journey at:
 
STAY POSITIVE!
 
 


Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 407
   Posted 1/7/2009 10:54 AM (GMT -6)   
Thanks to the link to the article. Interesting that the research excluded the study of Cialis. If it was discussed, I've missed it. My surgeon prescribes Cialis (together with MUSE), almost exclusively (as compared to the other options).


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

 


joedaquail
New Member


Date Joined Jan 2009
Total Posts : 4
   Posted 1/7/2009 11:22 AM (GMT -6)   
James C. Thanks for the tip on the article. Found it very enlightening & useful. Have been on 50 mg of viagra for 3 months, and so far, nothing. Have been taking orexis also, to see if it will help. Will go in for my 6 mo check-up next week, and this forum will help me ask questions. Thank you. Have just discovered this forum, and love it! finally found those of which I share my prostate surgery concerns.
joedaquail

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 1/7/2009 1:18 PM (GMT -6)   
joedaquail, welcome to the club, and hope you hang around. You'll find almost everyone has a story to tell and an opinion to give, so there's a wide range of ideas... tongue
James C. Age 61
Co-Moderator- Prostate Cancer Forum
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 Nerve sparing open Retropubic Radical Prostatectomy
9/26/07 Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
Post Surgery PSA's: 3 mts-.04, 6 mts.-.04, 9 mts.-.04, 1 Year-.02.


tnuh
New Member


Date Joined Jan 2009
Total Posts : 3
   Posted 1/7/2009 5:41 PM (GMT -6)   
I have tried Viagra, Cialis, and Levitra and so far nothing. I have had. and used the Osbon Classic for many years (15+) with success, and no problems with it. However since my move to a new home, it has been lost , and I must acquire a new one.
My question: I see many advances have been made, and two or three new companies have appeared. In the purchase of a new device, I want to make the correct decision the first time. The cost negates buying just to try. I am seeking opinions from users of the top of the line models, or industry leaders.
What is the opinion of users of the Osbon Classic vs. the Bonro Vacurect systems.
I do not have any prostate problems. My problems stem from several spinal surgeries, and a internal spinal electrical stimulator. Any input would be greatly appreciated.

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 1/8/2009 9:38 AM (GMT -6)   
tnuh, I use the Vacurect system. As a 15 months user, I must say I have come to dislike it. Maybe for it's failure to magically restore me, or from the boring repetition, but I find it not to be a very 'good' system to use. Here's why: The system uses different sized disks, with holes in the middle, that attach to the end of the pump tube. You lube it, the pump edge and your penis liberally, then place the head of the penis in the hole and pump slowly. The vacuum pulls the head, then the penis into the pump, and the disk slowly slides down to the base of the abdomen as the penis is drawn in, and the penis enlarges, sealing off the blood flow out of the penis. The result is an erection held up by the disk at the base of the penis. This by itself is ok, I suppose, but I haven't found a disk size yet that doesn't let some of scrotum be pulled into the pump thru the disk as you are pumping. This causes some problems, as you can imagine. Manually pushing the scrotum tissue back out of the disk will cause a loss of some of the erection, in my case at least. The best I can come up with is to use the disk sized a little larger than needed to hold the erection, but with a silicone penis ring on the end of the pump opening first. This way, the disk is at the base of the penis, holding back some, but not all of the scrotal tissue, then the smaller silicone ring is rolled off the pump onto the penis in front of the disk to hold the erection. Both disk and ring stays in place during use. This works fairly well, but can still be painful at times.
My basic complaint with pumps, and I think this applies to all of them, is the open end of the pump tube will dig into the abdomen during use, causing soreness and even pain, they will let scrotal tissue be pulled into the pump. I suppose they are a necessary evil. Others with different size and physical differences may have completely different take on them, though. .
James C. Age 61
Co-Moderator- Prostate Cancer Forum
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 Nerve sparing open Retropubic Radical Prostatectomy
9/26/07 Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
Post Surgery PSA's: 3 mts-.04, 6 mts.-.04, 9 mts.-.04, 1 Year-.02.


tnuh
New Member


Date Joined Jan 2009
Total Posts : 3
   Posted 1/8/2009 1:00 PM (GMT -6)   
Thanks James. Your feedback is the kind I was looking for. The problems you experience(ed), is what I want to avoid. In my own mine, this is the type of thing I imaged could happen. I was very happy with the Osbon, but dealing with several parts to the pump, was what I was trying to get away from. As far as the function of the Osbon, it is comfortable and does not pose your kind of problems. So I think I will just stay with the Classic.

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 1/8/2009 3:14 PM (GMT -6)   
Can you describe how the Osbon seems to be different than my description of the Vacurect and the scrotal problem? How does/did yours not vacuum in that scrotum parts.? I'd like to know, as I might switch if I thought it would stop that problem.
James C. Age 61
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy- 16 core samples, size of gland around 76 cc. Staging pT2c
7/07 Path report: 3 of 16 PCa, 5% involved, left lobe , GS 3/3:6.
9/07 Nerve sparing open Retropubic Radical Prostatectomy
9/07 Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
Post Surgery PSA's: 3 mts-.04, 6 mts.-.04, 9 mts.-.04, 1 Year-.02.


tnuh
New Member


Date Joined Jan 2009
Total Posts : 3
   Posted 1/8/2009 8:39 PM (GMT -6)   
The Osbon has the neoprene band that is first stretched over the edge of the tube, then a neoprene, or rubber band, your choice of size is then stretched over the edge of the tube. You then insert another rubber ring into the opening of the tube. Put a little lubricant on it for a airtight fit, then slide the penis inside, all the way to the base against your body. To get a good airtight seal they recommend trimming the hair off around the base. You then manually pump, or they have battery operated models. The tube is only about a inch and half in diameter, and when its against your body there is no room for the scrotum parts to be sucked in. It's all a good fit. Prior to releasing the vacuum, you give the rubber ring over the tubes end a little push and it will maintain an erection. It's hard for me to explain, but maybe you'll bet the picture. Look at Osbon's web site, and I think they have a video of it's operation, and you can see the parts I'm talking about. It's really not all that bad to use. I had mine 15+ years and it was still good as new. Never had a minuet of trouble with it. I could certainly recommend one. Only thing, you don't want to pump too much, because you'll have more vacuum that you need. You'll know when to stop.
Lucky for me I haven't had a prostrate problem. Mine is only spinal cord damage(scar tissue) from surgeries, 5 and a fusion.
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