How long to wait for Cialis

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dogyluver
Regular Member


Date Joined Sep 2009
Total Posts : 35
   Posted 9/6/2009 1:10 PM (GMT -6)   
My husband had open prostatecomy 8/24/09. The catheter and staples removed 9/3/09. From what I have read the the sooner treatment for ED is started the more likely success. But his dr said 6 weeks, is this too long to wait? We are willing to try once he is feeling up to it and his bladder is under a little control at this point pretty much no contol. We both know that it probaly won't be sussessful but what the heck.lso I have read that things like sitting to urinate and light pushing as if he were to have a bowel movement would help. Has any one tried this and does it help?
Another thought we could also try having sex in the shower and that way neither of us would know the difference.

lewvino
Regular Member


Date Joined Jul 2009
Total Posts : 384
   Posted 9/6/2009 1:18 PM (GMT -6)   
I had my robotic surgery on 8/12/09. The Doctor had me wait two weeks then with his penile rehab plan I was instructed to take a half doze of lavitra two times the first week followed by a full doze. I've done the two half dozes and this Tuesday evening will be the full doze. The purpose of started ED treatment soon is to get blood flowing to the penis. I would follow up with your husbands doctor and ask why the wait of six weeks.

Larry
Father treated for Prostate Cancer in 1997 with Proton Beam - Still doing well.
My Stats
Age at diagnosis 54, PSA 5.1
Biopsy 04/08 12 cores, 5 positive
Gleason 3 Cores at 4+3=7, 2 Cores at 3+4=7
Perineural Invasion Noted on biopsy

Robotic surgery 08/12/09 at Vanderbilt, Nashville TN. 
 
Post Surgery - Dr. Spared 100% of Nerves on the left side.
Estimated that 50 - 70% of the nerves were spared on the right side.
 
Final Path report
20% of the prostate Invovled
Tumor graded at T2C
Overall Gleason 3+4 (7)
Lymph Glands Clear
Positive Margin 1.8 cm in length Noted in Right Apex


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 9/6/2009 1:36 PM (GMT -6)   
Most guys experience here with their docs and ED is that they start the post surgery treatment quickly. The usual is to start on some type of the big 3 ED pills, as soon as the catheter is removed. My doc says Viagra or Levetra 3 times a week, 50mg of the first and 10 or 20 mg of the second. You know of course that the use of the pills don't guarantee an erection, but is used for the purpose of helping with blood flow into the pelvic and penile areas. This does mean no sex, until the doc says it's ok, usually at the 4 to 6 week level. At the six week level, most will start using the penis pump, to help with tissue recovery and stretching. The pump helps expand the penile tissue, helps infuse blood into the penis, spread the cavities and stretch the whole thing. Used daily, even twice daily, a good penis pump will go a long way in helping to maintain good penile health until the penis becomes functional again, with natural or otherwise erections. If there isn't any usable response within 3 months, with pills to help it along, most will go to injections. Injections are usually painless, believe it or not, and will really help the penis to regain its length, girth, and infusion of fresh blood into it. Plus, there's the positive psychological boost gained by having a normal erection when looking down, a big plus for a guy. Some studies say that injections will provide the fastest method of regrowing or regaining natural erection function, for long term erectile disfunction guys post surgery.

Now, a word of caution. When the doc says sex is ok, there may be problems in paradise. He may be one of the fortunate ones who recover function quickly, he may have to reply on pills, or even injections. Approach the first time as a learning experience. It may be successful, or a failure. There may be urination during sex issues, there may be length and firmness issues, there may be deflating during the act issues. The point is, anything can happen, so don't be disappointed, either of you, if it doesn't go right. There's plenty of time to learn what works now, and there's a couple of things to remember. First: he will learn that a man does not need an erection to have a climax. Second, women don't have to have an erect penis available to have a climax. You both may have to alter your expectations from what you have spent a lifetime of being comfortable with, but it can also be a rewarding and fulfilling time to relearn, experiment with what works, and you just might find that you have grown closer than before, with a much more rich sex life than you ever expected. It may take some adventurous sessions, with some experimentation and adjustments, but it just might end up being something that you really didn't expect to be so satisfying, for the both of you. I hope I've given you some idea of what the next few months may bring. It isn't a time to be discouraged, but a time for discovery and rediscovery for the both of you.
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 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
22 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix 30/1/20-.05ml 2X week continues
PSA's: .04 each test since surgery


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 9/6/2009 4:09 PM (GMT -6)   
Greetings, everyone.  I would ask your doc about the Cialis.  I have found from participating in this group that most doc's want patients to start taking the ED drugs fairly soon after surgery.  However, my doc was very clear - even if the drugs work no intercourse for 6 weeks.  Something about the healing going on inside.  Other doc's don't seem to have that prohibition but I would go with whatever your doc says.  David

Diagnosed Dec 2007 during annual routine physical at age 55
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 pos; 2 marginal
Gleason 3+3; upgraded to 4+3 post surgery
RRP 4 Feb 08; both nerves spared
Good pathology - no margins - all encapsulated
Catheter out Feb 13 - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 9/6/2009 4:14 PM (GMT -6)   
There are lots of ways to have sex without an erect penis.

Do not worry so much about the few drops of urine, even when it works a few drops may come out in place of semen, you will never know it. If you normally do it in a shower then fine, if you are asking him to do something different because of the urine then the Psychological impact may limit his erections

At 5 months all is way better in the Sex dept than before I had surgery, but thats with a Trimix injection, imagine your husband lasting for 2 hours straight, any place, any time.

The 1st few months were tough, but once the incontenence passed, my mental outlook toward sex changed light night and day and I was ready for the Trimix

In the meantime, a VED will keep him in shape, the Cialis will stimulate blood flow to promote healing, he should also be taking some L-Arginine to increase blood flow. Walking helps greatly at increasing bloodflow to that area as well
Stats:
Age: 52
PSA (2008)=1.9
Biopsy on Jan 09, 2009
One (1) out of twelve (12) cores was positive, plus external nodule found
Gleason Score = 3+3
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, under .0


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 9/6/2009 4:17 PM (GMT -6)   
CPA, the reason for the 6 week wait is to allow the uretha to fully heal. Intercouse ( erect Penis) will cause the uretha to stretch and possibly could tear the newly reattached uretha and cause all kinds of problems
Stats:
Age: 52
PSA (2008)=1.9
Biopsy on Jan 09, 2009
One (1) out of twelve (12) cores was positive, plus external nodule found
Gleason Score = 3+3
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, under .0


dogyluver
Regular Member


Date Joined Sep 2009
Total Posts : 35
   Posted 9/6/2009 8:33 PM (GMT -6)   
I really want to thank everyone for the replies. I will call his dr tomarrow to see why the wait on Cialis I understand the no sex for 6 weeks not the treatment.
 

geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 9/6/2009 8:46 PM (GMT -6)   
At six weeks I really couldn't get enough of an erection for sex but with manual stimulation I could have an orgasm with some urine leakage. I could pleasure my wife in other ways than penetration. We just put down towels and had what fun we could. Then we slept naked in each others arms.

I am still not dependable even with ED drugs, but making love has many dimensions. Focus on the positive of what is there for you both rather on what is missing. Sometimes ED takes a long time to abate.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads


Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 407
   Posted 9/8/2009 9:43 AM (GMT -6)   
dogyluver said...
My husband had open prostatecomy 8/24/09. The catheter and staples removed 9/3/09. From what I have read the the sooner treatment for ED is started the more likely success. But his dr said 6 weeks, is this too long to wait?
Is there a reason you don't trust your surgeon's/physician's advice?  No two men share similar situations/surgeries - and your physician/surgeon knows your husband and health history.  If this were me I'd follow the professional advice.

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 (1/2 light pads per day)

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; 4/09: 0.0

 


dogyluver
Regular Member


Date Joined Sep 2009
Total Posts : 35
   Posted 9/9/2009 7:09 PM (GMT -6)   
It's not that I don't trust the surgeon, (I basically don't trust dr's but that's another story.) It's just that all that I have read mentions starting penile rehab. shortly after the catheter is removed. He did not give a reason it's just what they do 6 weeks and not a minute sooner I don't know if the dr ahs tht rule so that the patient doesn't try or what. I just want some sort of normal a life as possible.  The doctor said "Oh, don't worry we have an ED clinic down the street"
I'm sorry but our insuranc won't cover that because even though the oral meds are given for a medicinal reasons, it's still not covered. It doesn't matter if you have a drs referral or not.
 

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 9/9/2009 7:34 PM (GMT -6)   
dogluver, your husband had major open surgery only 16 days ago, way too soon to making sexual attempts, he strongly needs to listen to his dr/surgeon. Six weeks is a pretty standard min, has nothing to do with the catheter coming out or the staples being removed. He just went through a complex surgery, has had his plumbing re-routed, the six weeks is to allow healing deep inside, especially around the bladder neck to the urehtra. There are complicated sutures and internal stiching, that take time to heal properly. That's why they put him on a "don't lift xxx weight" limit too. There be plenty of time later to work on any ED issues, but right now, its time for healing.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20%, Contained in capsule, 1 pos margin
2009 PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/09 2nd corr surgery, 8/9 cath #7 - out after 38 days


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 9/9/2009 8:41 PM (GMT -6)   
dogyluver, is it possible you are confused about the terminology used in describing the Erectile Dysfunction part of recovery? Almost every surgeon will have a 6 weeks restriction on any strenous activity after surgery, including max weights to be lifted and including abstaining from sexual intercourse for 6 weeks to allow for healing. The ed therapy we discuss here, that is started as soon as the catheter is removed is using the pills only, to help keep the tissues healthy and the blood infused in the pelvic and penis area. Using the pills won't cause an erection by itself, it still takes either mental or physical stimulation. So the pills are for blood infusion, not for initiating sex. There will be a time when the doctor will release your husband to renew your sexual life, probably in 6 weeks. Even then, the erections needed for intercourse may be missing, maybe for months, but again, you may be one of the lucky couples who start right back up. I hesitate to mention it, but don't want you to be really disappointed if he is unable to regain his erections immediately. Wait the 6 weeks for intercourse, and maybe call the doc back and ask for samples or a prescription of any of the big 3 in ED pills- Viagra, Levetra, or Cialis.
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 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: ED- 50 mg Viagra 3X week, pump daily,
Bimix-30/1/20-.20ml 2X most weeks continues using plump and ring technique
PSA's: .04 each test since surgery

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