Posted 7/5/2009 1:27 PM (GMT -6)
Hi to all my fellow brethren whose gone through this horrific ordeal with the Radical surgeries,and now dealing with post-op limp,non-erected,and dry semen orgasms....I concur,which is very weird!
This pump thing all sounds reassuring but does this this really work for post RADICAL Prostatectomies? I do have insurance that did cover the cost of this pump called "RECLAIM" .
I only used it once. By using it more....will this help?

My Surgery was last January. Viagra is too darn expensive for me to afford. ( $16.00 each 100mg pill) My Doctor told me NOT to order from India or other countries, because you might not get what you think your getting. My insurance does not cover this medication.

Am I blowing the chance to recover ( rock hard erections...possible? ) from this terrible surgery by not using both the pump or the Viagra for the future? Is there scientific proof that these actually do worK?

Everyone is different. As far as the doc told me,this was a nerve-sparing surgery. Thanks!
Posted 7/5/2009 2:11 PM (GMT -6)

I use a very professional off-shore pharmacy and pay less than $2 each for either 36 Hour Cialis or Viagra 100mg  generics.  I've used them for a long time.  They take a credit card, the pills arrive in two weeks via registered air mail, and I've never had any issues.  They offer a 10% discount for returning customers. The pills work very well. 

 I don't believe you need the full 100mg for the daily use, and I cut mine into 25mg quarters with a pill cutter.  I've used both the Cialis generic  (preferred by my urologist) and the Viagra generic, and both work very well.  The Viagra seems to work a bit quicker.  I go back and forth a bit, either the daily 25mg Viagra, or the Cialis 36 hour taken every other day.

Email me:  NetLinkDigital@hotmail.com   and I'll attach a copy of my last invoice to the return email.  I have no financial interest or any other conflict in providing the name of the pharmacy.

I do believe that use of the daily ED meds and the pump are both very important.  The pump in particular is a pain and an insult to your sense of masculinity, but I believe it has an important purpose.  You hear more and more of urologists adopting this post surgery "penile rehabilitation protocol" of pump and daily ED meds.    Having read all the posts in the seven months since my surgery, I would use the pump daily instead of 3 x weekly, if I were to do it over again  (Thank God, that's not a possibility).

The whole idea is to keep the area flush with fresh blood to help the nerves heal, not just once in a while, but all the time.

There is a lot of psychological baggage associated with performance, and the pump helps you get past that.  For me, the pump always provided a sure thing.   That may well be the third part of the rehabilitation, regaining the confidence you once had.  Anxiety will kill any unassisted erection.

Testosterone level might also be an issue.  Blood can be taken at the same time as the psa test.  Insurance covers the test, and even if it doesn't, it's not very expensive.

 


Post Edited (KeyWestPirate) : 7/5/2009 1:15:50 PM (GMT-6)

Posted 7/5/2009 2:34 PM (GMT -6)
unhappy- funny you should ask about effectiveness of pumps, etc.  I happened across a research study article today that addresses this issue.  Short version, yes.  If you have a pump, at the minimum you should be using it- twice daily each day.  This study also says there is moderate improvement in early use of penile injection drugs to speed recovery.  Here's an excerpt of the conclusions and the full link follows:
 
In the modern era of early prostate cancer detection, erectile dysfunction after radical prostatectomy is becoming an ever more important topic of discussion. A major advance in the preservation of sexual function after radical prostatectomy was the development of the nerve-sparing procedure by Walsh and colleagues. More recently, the concept of penile rehabilitation after surgery has generated substantial interest. Central to discussions of penile rehabilitation after radical prostatectomy is evidence demonstrating significant fibrotic changes in the corpus cavernosum after a prolonged period of penile flaccidity. Despite the theory that hypoxia is the inciting factor in these fibrotic changes, the exact etiology of this process remains unknown. Even in the absence of a mechanistic explanation, however, many practitioners are using some type of erectogenic treatment after radical prostatectomy in an effort to enhance the return of sexual function.
Several studies have been published evaluating the efficacy of various pro-erectogenic agents used for early penile rehabilitation after radical prostatectomy. The limited data regarding intracavernosal injections and VCD suggest that an increased percentage of treated patients experienced a return of natural erections compared with patients who received no treatment. However, no studies to date have included an adequate placebo control group, and the number of subjects evaluated has been limited. Longer, prospective, randomized, placebo-controlled studies will be needed to confirm the utility of these treatments in improving long-term sexual function after radical prostatectomy.
Contemporary studies evaluating the chronic use of oral PDE-5 inhibitors suggest a beneficial effect on endothelial cell function among men suffering from erectile dysfunction due to a variety of causes. Limited data suggest that this effect might be seen among post-prostatectomy patients, suggesting a possible role for these agents in enhancing the return of sexual function in such individuals.
On the basis of data accumulated thus far, it is reasonable to discuss the implementation of a “penile rehabilitation” program with patients undergoing radical prostatectomy. Preliminary data suggest that such therapy might positively influence the ultimate outcome with regard to sexual function. Patients should be aware, however, that the exact benefit imparted, as well as which treatment regimen would be most effective, will remain highly controversial until better data become available.
Main Points
  • Patients are typically counseled that it may take up to 2 years for return of maximum sexual funtion after radical prostatectomy.
  • Although the relative hypoxia thought to be associated with penile flaccidity may contribute to erectile dysfunction after radical prostatectomy, the etiology of post-prostatectomy erectile dysfunction appears to be multifactorial and is incompletely understood.
  • Several studies have been performed to evaluate the effect of artificially induced erection after surgery to prevent permanent damage, with modalities including prostaglandin E1 injection, vacuum constriction devices (VCD), and phosphodiesterase type 5 (PDE-5) inhibitors.
  • The limited data regarding intracavernosal injections suggest that an increased percentage of treated patients experience a return of natural erections compared with patients who receive no treatment.
  • Although it is not certain that the early use of VCD will improve overall return of erectile function, data suggest that fibrotic changes leading to penile shortening and possible venous leakage might be minimized.
  • The global improvement in endothelial cell function observed with chronic sildenafil treatment suggests a possible role for PDE-5 inhibition even during the period of neuropraxia after nerve-sparing radical prostatectomy.
 
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

Posted 7/15/2009 1:59 PM (GMT -6)
Hey James and Jeff --

Yesterday I got my pump but didn't get to road test it until today. I thank you both for the help and advice you gave me about it, especially Jeff. It was relatively simple to use and yes, it got me hard although I don't have the length I had before my surgery. I haven't used the rings yet but will attempt that this evening. Nonetheless, I was HAPPY to see that my poor penis COULD get hard from the pump, and I'm very happy about it. I know that, with a little practice, and finding the right size ring or rings, I can be sexually active again. I also know I'm not going to have the rigorous erections I had when I was 20 or even 50, but SOMETHING is better than NOTHING. For the first time since my surgery on April 15, I feel that there might be light at the end of the tunnel! I'll let you know how it goes from here. I'm really grateful to you guys! I have my 4-month check-up on August 11th.

Age: 62
Diagnosed prostate cancer Nov 2008, Gleason 7 score
Robotic Surgery on April 15 at Hackensack Medical Center, with Da Vinci Robot
Post-surgery Gleason score went down to 6 -- yay!!
First PSA after surgery -- 0.02
Rarely using pads now, but sometimes I do
Viagra treatment hasn't worked for me at ALL
Posted 7/18/2009 9:30 AM (GMT -6)
Yo Tim,

Glad you are about to get back in the saddle.

One thing from my experience is, even tho you can get a pretty good erection with the Pump, due to the swivel point caused by the rings, i have never been able to get a satisfactory position when in plain missionary position. Kind of amazing how STIFF you really have to be for that to work properly. So I have always positioned from the rear (like spoons). That works well. But also I have only climaxed this way once -- all other times I have had to finish off manually. I have always (at least in the last few years even before surgery) had a tough time climaxing inside in any position, so I guess it has carried over, post op -- so your mileage may definitely vary.
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 size 140+ cc (110 grams post op).
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 oblong STONE within hours.
03/06/09 Started Levitra@20mg / Viagra@100mg / (04/01) Cialis@20mg -- no real effect (thru 07/2009).
04/01/09, 07/07/09 PSA <0.1 - Stone Was Oxalate stone -- X-ray showed no additional stones.
Next up (so to speak) -- MUSE(1000mg) -- on 08/07/09.

Posted 7/18/2009 10:51 AM (GMT -6)
Thanks Jim for the info. I haven't gotten that far yet. I'm still experimenting with the pump but not the rings. I'm still trying to figure out how long to use the pump in any one session. I tried using the battery powered head but it was definitely too strong for me, so now I've begun using the manually powered one which is easier to control. What I'm not sure about is, once you've pumped to a level you're comfortable with, how long do you leave your penis in the vacuum tube before releasing the vacuum? I've been leaving it in there for about 15 seconds, release the vacuum, wait for about 30 seconds or so, then pump again, and so on. Anyone have advice on this?
Posted 7/18/2009 11:35 AM (GMT -6)
Tim: Wow I have never kept mine in the pump for 30 min. My therapy is usually 10 to 15 min.
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,

Posted 7/18/2009 11:50 AM (GMT -6)
Jeff, re-read the post. I left it in the tube for about 15 SECONDS and then waited about 30 SECONDS before pumping again, LOL!
Posted 7/18/2009 12:23 PM (GMT -6)
Thats a bit better I think. Actually I stay in the tube a couple of min deflate then pump again. I was thinking when I read your post... "YOU DA MAN" lol
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,

Posted 7/18/2009 1:57 PM (GMT -6)
Tim, my routine is to pump up to a very firm condition, add the rings, then do the shower-shave routine, and remove the ring after that.  That usually takes me 20minutes or so.  I will pump up and hold a minute or so a couple more times after that, and at night I pump , hold for 3 minutes  and release for 3 to 4 times.  Once you get the penile tissue stretched back to normal, you should be aggressive with it, you want to expand as far as safely possible and hold for some time, to get the most benefit from it.  The 15 secs/ 30 secs is fine to begin, but you will find yourself going longer as you adapt.  After all, the purpose of the pump to to provide an erection, and the safety limit of keeping the ring on is 30 minutes during intercourse, so anything up to that will be safe and ok.  Pumping becomes a chore quickly and takes dedication and determination to keep going for months, if it takes that long.  I'm going on 20 months, and its no erotic thrill, believe me...lol  My suggestion is 'pump stiffer, hold longer each time, use the ring to keep it up"  Just my suggestion, of course... turn


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

Posted 7/18/2009 3:14 PM (GMT -6)
How long did you guys have to wait to do these things of magic? It has been 5 weeks from my surgery and I still go through 4-5 diapers a day I am hopeing this will get better soon as I want to achieve these magic times you speak of. At 48 I hope to have some good years left. It has been 5 weeks and it seems like light years and I am not a star wars fan so I have no idea what a light year is but it seems like a long time. I have not checked with my insurance but since they will not cover Viagra I am not planning on them to cover a pump. I guess I will have to watch my email for a do you want to add inches spam mail to show up. Please any advice I will look at This forum is now my sports section since I do not need to think of baseball anymore
Timmy77
48 yrs old
Robotic RP
6-15 2009
Surviver

Posted 7/18/2009 4:24 PM (GMT -6)
Timmy77, the continence is a seperate issue, of course.  Usually the path of recovery is remove the cancer, get the pants dry, then get the sex life going again.  There's no reason why you can't combine pants and sex, of course, although it may be a little messy.  Several of the guys here still experience involuntary urination during sex, either foreplay, intercouse or both.  Ones resuming an active sex life wear a condom, or use a ring to sut off the flow of urine during sex.  At 5 weeks, you are almost ready to start searching for the magic.  I started at 6 weeks with the pump and Viagra.  Even though insurance will not cover Viagra, most will cover paying for a pump.  Ask your doctor for the forms.  In my case, I had to pay a deductible, which would have been $200, on a $550 pump, so I chose a different route.  I bought a 'works the same and just as well' cheaper model that is medically safe. Several of the guys here buy it.  Here's the link, $79 for the manual, but $84 ewith a dollars off offer for the battery operated model. 
 
 
In closing, just because you still leak doesn't mean you can or need to put off the ED recovery.  It may be messy, but early use of a pump will go a long way with having an earlier recovery in ED, in most cases.  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

Posted 7/18/2009 6:44 PM (GMT -6)
Timmy, I didn't start using the pump until a few days ago, and I'm almost 4 months out from my surgery on April 15th. I had incontinence problems, too...sorry friend, but it just goes with the territory. Embarassing and even humiliating, yes, but it's also normal after this kind of surgery. The GOOD news is that it DOES get better, especially if you do the Kegel exercises faithfully. I only use the pads now if I'm going out to dinner or church, or a semi-formal event, and that only as precaution because, as many of the guys here can tell you, somtimes coughing or laughing or sneezing can bring on a "squirt." I'm not as young as you are and you will probably heal faster and easier. For me, the ED medicines didn't work but the pump shows real promise so I'm not as depressed as I was. Try it when you're ready. If it's painful, then stop and wait until you heal some more and try it again. Hang in there, friend!

Forum Information

Currently it is Sunday, October 21, 2018 1:20 AM (GMT -6)
There are a total of 3,013,620 posts in 330,038 threads.
View Active Topics

Who's Online

This forum has 161940 registered members. Please welcome our newest member, cia_b_333.
169 Guest(s), 2 Registered Member(s) are currently online.  Details
Girlie, Homeboy