Post-Op therapy - ED meds vs pump vs both

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New Member

Date Joined Apr 2009
Total Posts : 14
   Posted 6/9/2009 6:17 AM (GMT -6)   
Hi all,
I'm 8 days post Davinci and am getting my Foley out on Thursday (yay!).  My surgeon is going to recommend both Cialis and a pump for "getting the blood flowing again".  My question is, do they both operate under the same principle or are they in fact different and symbiotic ways of providing the needed therapy?  In other words, are both considered better than one or the other?
Another question is how long ED meds are typically used for therapy?  My insurance does not cover the medications and they are VERY expensive.  I will be given some free samples but likely not enough to cover my therapy duration.
I have purchased and received an order from ADC, but am leary of using the offshore meds for anything but recreational purposes (hopefully) in the future.  Is this concern valid?
Thanks in advance all!
Age 40
Diagnosed at age 40 (March 2009) as a result of routine physical
Family history - Father diagnosed and treated at 64, one of his brothers at 70, maternal uncle at 60
PSA 19.14 (first PSA), pre-op PSA 3.93 (second PSA)
1st DRE - abnormal - 1cm nodule -  2 subsequent DREs by 2 different surgeons showed some firmness on right side, no nodule
14 biopsy cores - 1/4 positive on left, < 5% malignant, 3/7 positive on right, 10% malignant, 3 cores of nodule showed no malignancy
Gleason 3 + 3 = 6
Cat Scan - negative, believed to be prostate confined
Bone Scan - negative, no distant metastasis
Davinci RP performed 6/1 by Dr. Jean Joseph at Strong Hospital in Rochester
great wife and 3 young children (ages 4, 6, 8)

Veteran Member

Date Joined Feb 2008
Total Posts : 655
   Posted 6/9/2009 6:37 AM (GMT -6)   

Hi Dave.  There are lots of guys here who have used the pump, but my doc has not suggested it so I don't have any experience with it.  My doc prescribed cialis post surgery and gave me some samples.  When I was able to get a fairly firm erection just days after getting the catheter out, I didn't take them - big mistake.  Please do what your doc prescribes and take the meds.  I found that I never got more than about 80% and when I started taking the meds I was back to presurgery firmness and size. 

As to ADC, I am on my second order with them and the pills work exactly the same as the name brand.  At least for me, I am very satisfied with their product.  I have had both name brand cialis and levitra as well as the ADC version of both.  I can find no difference between the two.  The cialis tends to stay a little longer and the ADC version does as well.  The levitra works for about 24 hours for me and so does the ADC version.  Iwouldn't hesitate to use them.  Why pay the $12 per pill for the name brand stuff.  I just ordered 120 levitra and 60 cialis and with shipping the bill was about $190.  So that is about $1 per pill.  ADC does charge $25 per order for shipping so you don't want to order just a few pills. 

I am 15 months post surgery.  My doc said to take them for 2 years.  We'll see what happens after that but even if I have to continue to take the pills, I have come to the conclusion that it is no big deal - you just do what you need to do. 

Dave, sorry you have to be here with us but glad you have found this group.  You will find many guys and gals who have been where you are and are glad to share their experiences.  Please keep us posted on how things are going. 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
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me

Regular Member

Date Joined Nov 2008
Total Posts : 299
   Posted 6/9/2009 9:32 AM (GMT -6)   
I have had the same experience with ADC. Haven't found any difference with Levitra whether I got it from ADC or a script from CVS Pharmacy, except that it's a lot cheaper.

You definitely want to get and use a pump for awhile. The pump prevents shrinkage and will get you back to your pre-surgery size quicker.

Lots of guys on here, continue to use both for months/years after their surgery.
Age 60
PSA 2007 4.1
PSA 2008 10.0
Diagnosed April 2008
Biopsy: 6 of 12 cores positive
Gleason 4 + 5 = 9
CT and Bone Scan negative
Open surgery at Shawnee Mission Medical Center May 21, 2008
Right side nerves spared
Radical prostatectomy and lymph node dissection
Cather removed on June 3rd, totally dry on July 9th
lymph nodes negative
PSA Sept 28, 2008 0.00
PSA Jan 22, 2009 0.00
ED Status- Currently using Trimix, Levitra daily for increased blood flow.
Noctural Erections have completely returned on a nightly basis, same hardness as before.

Veteran Member

Date Joined Apr 2009
Total Posts : 990
   Posted 6/9/2009 9:46 AM (GMT -6)   
Overall my impression is that the pharmaceutical industry in India is fairly well regulated. Indian patent law for drugs allows manufacturers to make generic versions of drugs still under patent although they must pay a royalty. The only royalty examples I have seen are a percent of the selling price much better than a fixed amount per pill. My guess is that what ADC offers for sale is legitimately manufactured product, not garage bootleg. I don't understand how it can be shipped to the U.S. so there might be a slight chance of seizure if customs changed policy
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3 + 4 = 7
CAT scan 1/09 negative, Bone scan 1/09 negative

Robotic surgery 03/03/09 Catheter Removed 03/08/09
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7
At 6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4463
   Posted 6/9/2009 9:48 AM (GMT -6)   
RE: ED Drugs. You will want to read this thread if you haven't already:

Using ED Drugs for long periods of time may be required, and if so, normally causes no harm to someone, except in the The same with using a pump- no harm for long term use. Both are very beneficial for ED recovery. If neither of these singly or in combo are working after 6 months or so, most men should consider adding injections to the mix. Using a pump once or twice daily, small doses of Viagra nightly, or the other 2 or 3 times weekly along with the injections maybe twice a week is not uncommon for longterm ED sufferers. None of them should cause any harm, except for some cases of piraprism (SP) with injections.

I have not read of anyone reporting any less effectiive responses or unsafe meds from ADC. They sell safety certified drugs worldwide and what we get is what the rest of the world uses if they don't have access to our big name and big expensive US drug companies.

If you only do one thing of the the 3, I would do the pump, as it stretches, infuses the penile tissues by vacuuming blood into it, and keeps the penis and tissues from atrophy. Pumping gives an erection manually, used with silicone penis rings, it can be used for intercourse by some men. Pills may or may not give an erection -chemically- but is supposed to infuse the penis with fresh blood and encourage nocturnal erections. Injections will give an erection almost everytime, once you are 'dialed in' with the technique, amount and placement. If you can get an erection with injections, it will probably be the most 'natural' of what you had pre-treatment.

All of these statements are generalized, since each man here is individual and their reactions to the 3 are also individualized. Hope this helps.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
21 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months

Veteran Member

Date Joined Jul 2006
Total Posts : 686
   Posted 6/9/2009 7:48 PM (GMT -6)   
geezer99 said...
Overall my impression is that the pharmaceutical industry in India is fairly well regulated. Indian patent law for drugs allows manufacturers to make generic versions of drugs still under patent although they must pay a royalty. The only royalty examples I have seen are a percent of the selling price much better than a fixed amount per pill. My guess is that what ADC offers for sale is legitimately manufactured product, not garage bootleg. I don't understand how it can be shipped to the U.S. so there might be a slight chance of seizure if customs changed policy

I was satisfied with my generic viagra from ADC in India. however it like the US version did not agree with me from a nose congestion point of view.
Interestingly, my generic cholesterol drug (Simvastatin / Zocor) is regularly filled by my American pharmacy with a product that is manufactured in India. yeah
PSA up to 4.7 July 2006 , nodule noted during DRE
Biopsy 10/16/06 ,stageT2A
Very Aggressive Gleason 4+4=8  right side
DaVinci Surgery  January 2007
Post op confirms gleason 4+4=8 with no extension or invasion
no long term continence problems
Post surgery PSA continues to be "undetectable"
One side nerves spared
Bi-Mix for ED 
born in 1941

Regular Member

Date Joined May 2009
Total Posts : 476
   Posted 6/10/2009 11:09 AM (GMT -6)   
I have used both the pump and the pills on a regular (though not daily) basis. My understanding is that the pump creates a vacuum and draws blood from veins (not reach in oxigen), the pills supply fresh arterial blood. Used together, you are better able to keep the penile tissues streached and nurished. Pills, in addition, also supply blood to the entire pelvic area and that helps with nerve healing. It is said that the process may take up to two years... I am 12 months post-op and just now started getting usable erections from the pill alone. I was able to have an intercorse with the pump, but it is uncomfortable as the rings need to be pretty tight to maintain the erection. The most important ingridient here is patience - dont get frustrated and keep working on it.

Previous 5 biopsies over 4 years negative

PSA going from 3.8 to 28

Father died from PCa @ 78 - normal PSA and DRE

Dx Nov 2007, age 46

PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke

6 rounds of chemo (Taxotere+Avastin)















followed by RRP at Duke (Dr. Moul) on 6/16/2008

Gleason downgraded 4+3=7, T2c N0MX, one small positive margin

PSA undetectable for 8 months, then







Regular Member

Date Joined May 2008
Total Posts : 260
   Posted 6/10/2009 12:08 PM (GMT -6)   


 Same here, no problem with ADC. I use the Levitra and it works fine. As you can see in my signature my Doc started me on ED therapy right away, day after the cath came out. Pump did what it was supposed to do and the Levitra finished the longer use the pump, still buying that ADC Levitra though!

  age: 53 @ Dx, Pre-op PSA Feb 08' 5.0, April 08' 4.1
  Biopsy 5.1.08, 5 of 15 cores postive, T2a, Gleason 3+4=7
  DaVinci performed 7.29.08
  Bladder sling installed, umbilical hernia repaired during surgery.
  Path report, "cancer fully contained, margins clear".
  Cath removed 8.8.08, ED therapy begins 8.9.08
  100mg Viagra three times a week, pump for ten minutes daily
  and hold for ten minutes.
  8.16.08 switched to Levitra 20mg, immediate results
  9.15.08 Pad free at night, one thin (light) pad during the day
  9.18.08 1st Post-op PSA Undetectable Zero's....Yes!
  12.22.08 2nd Post-op PSA  Zero's still...
  Pads gone 1.3.09, finally found the courage...Thanks ya'll
          ".....tryin' to reason with hurricane season...."

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