Does the Pump really bring it all back?

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Regular Member

Date Joined Nov 2005
Total Posts : 113
   Posted 7/1/2009 11:16 AM (GMT -6)   
I have posted before about my Radical prostate nerve sparing robotic surgery from this last January 2009. The Doctor prescribed .25 mgs Viagra daily,along with the Kegels. I was wondering (I'm asking you guys, not the doctor on this question) if anyone with the same typee of surgery as I had, has used the pump to help with the blood flow, and does it really help?
Or does this device only helps with getting the limpiness to a semi, little more than limpiness state to acheive a better erection...and I used the term "erection" (VERY) loosely.

I realize that even after surgery, I am able to acheive a dry,intense orgasm with no hardness at all, but I just can not wait to acheive what I used to get, prior to the surgery, if that will ever happen at all. The doc tiold me it was a nerve-sparing surgery,but how in the heck would I know any different?

Thanks for all the encouragement about hanging in there and all, but I am still overwhelmed and frustrated over not getting another opinion about my low-grade cancer, that I could have lived without all this drama.

Some people say on this site that the nerves grow back at the rate of 1/8" - 1/2" per month. Is this true, and does this pump help with this?

Regular Member

Date Joined Jun 2009
Total Posts : 292
   Posted 7/1/2009 11:35 AM (GMT -6)   
My doc says the pump preps the tissues for the real thing.
He also said that cutting a section out of the urethra shortens things down stream a bit as it is all stitched together. The pump helps stretch things out there too.
I look at is as just one arrow in the quiver. One that speeds the process a bit.
If nothing else my wife says I no longer look like a little kid.
Diagnosed at 54
PSA 8.7
Biopsy 1/7/09
4 of 6 cores positive, one at 90%
Gleason 3+4=7
Neg bone scan 1/15/09
One shot Lupron Depot 1/27/09
Tax Season
RP 4/29/09
Neg lymph nodes, postive seminal vesicle, 1 positive margin
Gleason 3+4=7 with tertiary 5
Catheter out at 2 weeks no nighttime incontinence
Pad free week 5
PSA 6/6/09 <0.1

Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4848
   Posted 7/1/2009 12:49 PM (GMT -6)   

Rap a rubber band around one of your fingers till it turns purple/dies and falls off smhair

If you allow blood to flow to the finger it wouldn't have died.

Your penis won't die if you don't use the pump, but it'll be happier if you do.


Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.

Cajun Jeff
Veteran Member

Date Joined Mar 2009
Total Posts : 4119
   Posted 7/1/2009 1:41 PM (GMT -6)   
Unhappy:  Hang in there.  I hear you frustration.  Been there as most of us have.  The pump will help bring the man back out.  It is not the real reaction that you are hoping for.  I understand that.  I am almost 9 months out and still no natural erection.  I ust the pill and VED (pump).  Things are getting a bit better each day.  I have spoken to the Dr. about my frustrations of this as well.  We are going to investigate injections next.   Hope this helped.
Jeff T Age 57
9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable
 ED- 5 mg Cialis daily, pump daily,

Regular Member

Date Joined Nov 2008
Total Posts : 122
   Posted 7/1/2009 2:51 PM (GMT -6)   
I am nearly 4 years post open nerve sparing RP and stil get no natural erections.  I figure that wil be perminant.  I still use the pump for maintenance and tri-mix regularly with great results.  I can't tell you about nerve regeneration because it hasn't happened for me, but I do know that the pump helps in keeping things the proper length and size.  There are many of us who still have active love lives with good erections via pills or shots.  While natural was my 1st choice, injections work very well for me and my wife. 
I wish that I could tell you that you will be back to natural erections soon but we all know that it may or may not happen.  Just know there are options out there that make a good 2nd choice.
Best of luck to you and all of us that deal with ED daily.
Dx PCa age 54. Jly 05- PSA 8.1 Sept 05- PSA 10.7
Sept 05- Biopsy  9 of 12 cancerous, Gleason 3+3=6, T2
Bone scan and cat scan showed hot spot on hip bone.
Oct 05- bone biopsy, ouch.  benign , no cancer in bones.
Nov 05- PSA 15.4 Nov 18, 05- Nerve sparing open RP at Huntsman Cancer Center, by Dr. Robert Stevenson. 100% continence at 3 months. ED- Tried the big 3 pills with no results. Feb 06-Started VED, worked, but painful with constriction rings. May 06 started Trimix injections.
ED appears to be perminant but doing great with Trimix.
PSA remains undetectable.

Regular Member

Date Joined Oct 2005
Total Posts : 489
   Posted 7/2/2009 8:06 PM (GMT -6)   
I am just a month behind you from surgery (but I had open surgery).
Up to now all I can say is Thank God For The Pump as it has been the only game in town for me so far (and am doing all the meds too).
<< insert plug for the Encore battery powered model here >>
It is hard to say if it has helped speed things along or not.
I do think it is certainly preparing Mr Sleepy for the day when he will awaken since I can see the tumescences are full but not yet hard without the pump.
Just gotta get those outflow valves to CLOSE darn it.
So give it a try. And yes they are real hard erections (but usually don't last very long even with a couple of rings/bands). But more than long enough for a lot of good clean fun.
Do some searches for Encore or other brand names and you'll find a lot more discussion about it.
Age 58, 195lbs, 6'4", 57 at DX, PSA Aug2008 7 4 ... June2007 4.7 (BPH + LUTS)
Biopsy Nov2008 1 of 12 cores 5%, Gleason 3+3 - Sona showed 140+ cc (110 grams post op) prostate size.
02/03/09 open RRP surgery , Nerve sparing both sides, 1 day in hospital, Day 4 first BM,
Pathology Report: All margins clear - No Invasive spread - no change in Gleason score.
02/18/09 Cath out, passed a 1cm STONE within hours.
03/06/09 Started Levitra 20mg / Viagra @ 100mg / (04/01) Cialis -- no real effect (thru 06/2009).
04/01/09 PSA <0.1 - Stone Was Oxalate stone -- X-ray Kidneys @ next PSA).

Veteran Member

Date Joined Feb 2008
Total Posts : 1858
   Posted 7/2/2009 10:35 PM (GMT -6)   
Starting with the nerve question the answer I believe is no. Think about the nerve pathways in the spine. It does not take much to permanently damage them. Likewise if a limb is cleanly severed and reattached much care is taken to graft the nerve ends and even then it is hit and miss about how much use is regained. If the extent of your cancer requires the severing and removal of the nerves in the region of the prostate then there is no pathway for the signals that control erection so that's it. Grafts joining the severed nerves have been tried (sural nerve graft) but thes have not been very successful. It is true that the severed ends can grow slightly toward each other but the growth is very, very small. So far as the vacuum device is concerned its purpose to to prevent the penis from atrophying. It's a case of use it or lose it. Thick of it as exercise. Much like muscles that will waste away if not used the sacs that inflate the penis will waste and lose their elasticity and ability to properly inflate.
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)
PSA February 09 <0.01

Regular Member

Date Joined Dec 2008
Total Posts : 377
   Posted 7/2/2009 11:38 PM (GMT -6)   
Basically I tried the VED after my prostatectomy, but I could never get the thing to give me a decent erection.I always felt I was strangling my penis at the base.  Some say to shave your pubic hairs to get a better seal, but I hated the thing. I went directly to trimix injections which had a much better, natural feeling erection. 9 months out oral meds still dont help me, its trimix or nothing.
my age=52 when all this happened,
PSA went from 1.9 to 2.85 in one year, urologist ordered biopsy,
First biopsy on 03/08, "suspicious for cancer but not diagnostic"
Second biopsy on 08/14/08, 2/12 cores positive for Prostate Cancer on R side, 1 core=5% Ca, other core = 25% Ca, Gleason Score= 3+3=6 both cores,
Clinical Stage T1C
Bilateral nerve sparing Robotic Surgery on 09/11/08, pathological stage T2A at surgery,
No signs of spread, organ contained,
3 0's in a row now, 9 months out
Incontinence gone in early December '08,
ED remains,  still taking daily viagra for penile rehab, uro said try oral meds and then trimix for sex only now, Peyronie's Disease a problem now

New Member

Date Joined Apr 2009
Total Posts : 14
   Posted 7/5/2009 10:14 AM (GMT -6)   
I think I've had the same experience as mspt98 with my VED (Stamen Medical Systems MOS).  I'm one month post-op and use it for therapy, but can't get a decent erection with it.  I'm getting good vacuum, but it seems to only expand the tissue around the outer surface (say outer 1/8"), so the erection is much smaller and does not at all feel natural.  I also tried one of the rings the other night (largest diameter one) and it was *very* painful, especially trying to remove it. 
Right now I'm about 50% erectile ability with Cialis and I'm praying it improves.  I'll continue using the pump for therapy, but don't have hopes for using it for IC.  If he ED meds fail me, I'll be looking to injections. 
Regarding nerves actually growing, someone else posted on this several weeks back and indicated that they grew back 1/8" per month or something like that.  My surgeon insists that this is not true.  Nerves may heal, but they don't grow once they've been severed.  If anyone has a link to a medical journal article or study, which states the contrary, I'd like to see it.
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)

New Member

Date Joined Apr 2009
Total Posts : 3
   Posted 7/5/2009 11:14 AM (GMT -6)   

Veteran Member

Date Joined Apr 2008
Total Posts : 847
   Posted 7/5/2009 11:15 PM (GMT -6)   
Bobo, it's great that you are finding the pump works well for you. It also works for me, but as my wife does not like the erections it produces, I use the injections which give better erections -- for us.

I think if trying the pump, it is important not to give up too soon. There are techniques to master, like how to get a good seal, how to place the constriction ring(s) and so on. Pump without constriction at first, then when you are getting results there, start experimenting with the constriction.

I think your early sessions should be solo. You will have some failures and it's best to have those alone! When you are getting good results, then you can let it loose on your partner. :-)

Another factor is that like any other part of your body, it can take a while to return to normal fitness. And like any other fitness regime, you should start gently and build up slowly.

So I think you need a month or more of daily exercise before deciding that the pump is not for you. There are good reasons why it won't work for everyone -- poor circulation might be one. But don't give up on the pump without a reasonable trial -- it takes time.
Age 63 at diagnosis, now 64.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Non-nerve sparing RRP on 7 March 2008.
Two nights in hospital; catheter out after 7 days.
Continent; no pads needed from the get-go.
Pathology showed organ confined and negative margins. Gleason downgraded to 4+4=8.
6-week : <0.05
7-month: <0.05
13-month: 0.07 (start of a trend?)
After a learning curve, Bimix injections (0.2ml) are working well. VED also works but we find it inferior to Bimix.

Regular Member

Date Joined May 2008
Total Posts : 240
   Posted 7/7/2009 9:02 PM (GMT -6)   

I do Cialis twice a week, and I've been using the pump. I treated it strictly as a physical therapy type of thing. The more you use it, the more it stretches you out. And as I've written before, it is not a straight-line process. You'll go for weeks or months with no improvement, and then one day - bang! Significant improvement. Then you go for more weeks or months at the improved level, and then bang - more improvement. I reached the point where 11 months to the day from surgery, my wife and I had real sex - not great sex, but real sex. I am now 14 months out, and I am probably still only 85-90%, but it's a darn good 85-90%. And seems to still be getting better.

Hang in there, and all the best,
Age: 53; 52 at DX
March 2006: PSA 2.5
Dec 2007: PSA taken for insurance application. I did not see the results until late
Jan '08 - after I was rejected. Their lab said PSA 4.5.
Feb 2008: PSA 3.7.
March 2008: Biopsy. Gleason 7 (4+3) 12 cores taken. 5 on the left side were
cancerous and the 6th was suspect.
May 5, 2008: Da Vinci robotic laparoscopy at GW Hospital, Washington DC.

Post op: Gleason 9 (4+5). 15% of prostate involved. Stage: pT3a. Negative margins. Lymph node and nerve samples taken, and appeared to be cancer free.

July 2008: PSA at 7 weeks was undetectable.
August 2008: PSA at 14 weeks (3 months) was undetectable.
Nov 2008: PSA at 6 months was undetectable.
Feb 2009: PSA at 9 months was undetectable.
May 2009: PSA at 12 months was undectable.

Regular Member

Date Joined Mar 2009
Total Posts : 75
   Posted 7/8/2009 12:14 PM (GMT -6)   
Hi all. I have a couple of quick, hopefully easy questions.

I just bought a pump, and am just starting to "test" it. Per the instructions, I am not supposed to use the "rings" until i have tried testing it a few times, just to see how the erection process works. That is fine with me.

for those of you with pumps, you may not remember the first few days, and the initial issues. You may have moved on to the point where you don't even have to think about it.

my model is a manual model, with a hand pump (as opposed to the battery operated one).

I am wondering how much pressure I should expect, or be comfortable with?
I am wondering how many times to pump (in between pauses)?

The owner's manual recommends doing a few manual pumps, just to get the air out. Sounds like i am supposed to pause for 5-10 seconds after the intial few pumps. Then, I am supposed to pump a few times, and pause. and pump a few times, and pause. I have done that. I do notice some stiffness. And, there is a bit of presssure (kind of a "tugging" sensation). The owner's manual recommends proceeding slowly (not to rush things). It also makes mention of some minor brusing, as blood is flowing into areas where it has not been in a while. It says that minor brusing will go away quickly. It also makes mention of some precautions of overdoing it, going too quickly, too intensely, that can conceivably cause bleeding or clotting. I obviously do not wish to damage myself.

I just called and spoke with the company, and the guy on the phone indicated that I should take it very gradually. Just one pump at a time, and then pause. Then one pump, and pause. And, it could be as much as 3-5 minutes before any real reaction occurs. And, in the first few days, to take it slow.

It is probably not as big of a deal as i am making it out to be.

Can anyone offer any thoughts as to what they have found to be the case, both during initial few days, and down the road once you have it down to a science.?

Age: 53
8/1/2008: PSA 6.2, GP recommended retake.
8/27/2008: PSA 5.8 (%free 12.1) referred to Urologist.
9/10/2008: DRE - non palpable. Urologist recommended biopsy
10/2008 Biopsy appt:
10/21/2008: Biopsy results; 1 positive out of 10 samples.
Biopsy Results: Gleason 7 (3+4) , no evidence of perineural invasion.
Referred to UCSF
12/19/2008: Transrectal Ultrasound at UCSF
12/19/2008: Consultation with Surgeon.
Surgeon concurred on Gleason 7=3+4 (per slides).
2/24/2009: Robotic Assisted Laparoscopic Prostatectomy (DaVinci) UCSF
3/5/09: Cathetor removal.
Post Op Pathology: margins negative/clear, Gleason 4+3=7
4/8/09: first post-op Ultrasensative PSA: less than 0.01
Currently taking Viagra, Levitra (tried Cialis).
Considering a Pump.

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4463
   Posted 7/8/2009 1:41 PM (GMT -6)   
First, the main issue with succesful pumping is lubrication.  Use plenty, make sure you get a good seal.  Second, the pubic hair needs to be clipped back, maybe to about 1/4 inch or so.  Once you are set with these 2 items, then you can begin pumping.  Since you say you spoke to a company representative, this should indicate you have a medical grade pump, with the builtin vacuum release if the vacuum gets too great.  The releif valve in it should prevent any permanent damage.  You may have the mentioned brusing for a few times beginning.  Take your time, and follow what you have ben doing.  If you are clipped back and have enough lube for get a good air seal, then your slow one at a time pump should expand the penis by pulling blood into it.  If you have no veinous valve action yet, to hold the blood in, then you will have to pump just enbough to override the blood leaking back out of the penis.  It may take more than a slow once a minute or whatever pace.  The pointof the exercise is to fully infuse the penis with fresh blood, expanding tissues and stretching the organ.  To do so will require that you vacuum in blood faster than it can run back out.  It will take some experimentation to find that point where you can do that. If you have ben usin it a couple days, for a couple sesions, then you should be ready for some more rigorous pumping.  The point is to pump until you get a erection response, then stop.  At some point you will want to be able to pump it up fully expanded. The first time or 2 it may be uncomfortable, and you may experience a common issue of the pump pulling scrotum or abdomen skin into the pump.  It will be uncomfortable for a while, but you do set the pace and you do get to decide what is acceptable for you.  There will be discomfort, even pain, but it is a part of the [process and some of it doesn't get any easier, even 2 years later.. smilewinkgrin    Any specific question , ask away...
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 Nov 2007
Total Posts : 598
   Posted 7/8/2009 1:41 PM (GMT -6)   
First of all, when you feel the sensation of the pump (it is anything but erotic) you will feel when the comfort level is reached and any more pumping would start to be painful. That's when you stop. You will feel the pressure of the suction slowly ease as your penis fills with blood and displaces the air. When it starts to feel like there is not a lot of suction, then pump once or twice more. Continue this until your penis is fully engorged. It will also probably be bigger than you remember it being! that's cause it is.

I think if you listen to your body, you will have no problem. It really hurts if you are overdoing it. It does take 6-10 minutes to get an erection for intercourse. But use the pump simply for therapy for a week or so, would be my suggestion. Trim the pubic hair around the base of your penis. It helps with the suction and these days most men manscape, so don't be embarrassed at the gym.
46 at Diagnosis.
Father died of Pca 4/07 at 86.
1/06 PSA 3.15
1/07 PSA 4.6 (Biopsy 3/07 just suspicious)
10/07 PSA 5.06 (Biopsy 11/07 1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC
Saved both nerve bundles.
Path Report: Stage T2cNxMx
-Gleason (3+3)6
-totally contained to prostate,
-10% involvement in L & R Mid lobes
PSA 0 at nine months.
Pad free on March 14 - (10 weeks.) Never a problem since.
ED - Took 100mg viagra every night. for several months
Totally usable erections at 10 weeks, which disappeared over the course of a month or two.
ED bounce is what they call it. Now, at one year, ED is fine with viagra.
One year PSA - undectable!

Regular Member

Date Joined Mar 2009
Total Posts : 75
   Posted 7/8/2009 2:44 PM (GMT -6)   

Thank you both for your replies. Both good information.

Yes, my pump is a medical grade pump. I ordered it before someone recommended a cheaper one, but I am fine with having spent more. Probably the cheaper one would have been fine, but with the body part that is interfacing with the pump, i would not want to end up with a problem, wishing that I had spent more (if you know what i mean). In a similar way, I would not choose the cheapest product, or cheapest surgeon if i was going to have Laser surgery on my eyes. You only get one set of eyes, and one penis. Unlike a car, TV, stereo, cellphone, etc., it is not that big of a deal when you say "i wish that i had spent more" on the product because the one i got is a lemon. With an erection pump, or lasic surgery, I don't want to have regrets. :-)

The two times that I have experimented, I stopped when the pressure was at a level that was pushing the envelope but before things got painful. So, I will continue to see how things go.

Like James suggested, it seems like "one" pump, so far, has not been enough to keep the blood going the right direction. I have had to go with 3 or 4. Once it has started to increase in size, then i have been able to back off to one or two at a time. (do you know why they suggest the "delay" or "pause"? Is there a lag time, that following some pumping, then the blood continues to flow and fill, even after having stopped ?

I am thinking that, after I have the process worked out, that i would like to combine the pump with my pills (either viagra or levitra). I have had some fullness with both pills, but not the hardness that I wanted. So, it seems like the combination of the pills (with the internal reactions going on) and the pump (with the fullness and hardness) then the two together would be a good synergistic method. Combining the best of both worlds, if that makes sense.

Age: 53
8/1/2008: PSA 6.2, GP recommended retake.
8/27/2008: PSA 5.8 (%free 12.1) referred to Urologist.
9/10/2008: DRE - non palpable. Urologist recommended biopsy
10/2008 Biopsy appt:
10/21/2008: Biopsy results; 1 positive out of 10 samples.
Biopsy Results: Gleason 7 (3+4) , no evidence of perineural invasion.
Referred to UCSF
12/19/2008: Transrectal Ultrasound at UCSF
12/19/2008: Consultation with Surgeon.
Surgeon concurred on Gleason 7=3+4 (per slides).
2/24/2009: Robotic Assisted Laparoscopic Prostatectomy (DaVinci) UCSF
3/5/09: Cathetor removal.
Post Op Pathology: margins negative/clear, Gleason 4+3=7
4/8/09: first post-op Ultrasensative PSA: less than 0.01
Currently taking Viagra, Levitra (tried Cialis).
Considering a Pump.

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4463
   Posted 7/9/2009 8:35 AM (GMT -6)   
Well, one pump isn't gonna be enough for anyone here, I would guess.  It will take a slow but steady continued pumping action to fill and keep full the erection.  I've been at it almost 2 years and it sitll takes maybe 10 to 15 pumps to fully engorge it, then a pump every 30 seconds or so to keep it up.  Without sounding too critical, it may be that you are being too cautious.  Maybe a little more aggressive action needs to be taken.  The pump has safety device built in and can't do any major or longterm damage.  If you have already gotten one or 2 erectrions with it, then the minor bruising stage is most likely past also.  I suggest you go ahead and pump it up.  You will know wehn ti stop.  Like Paul said, there's nothing erotic about it, believe us.... smilewinkgrin
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

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