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Regular Member

Date Joined Sep 2009
Total Posts : 35
   Posted 9/18/2009 5:41 PM (GMT -6)   
We know that we're jumping the gun a little, but hubby and I would like to know which oral meds seem to work best for E.D  treatment.  I'm not sure why the sugeon waits 6 weeks, when most start after the catheter is removed. Hopefully that won't effect anything but not counting on it. The information that the original dr. gave us is outdated (2005). He goes for post op on 10/08/09 and first PSA.
April 09 PSA 3.2
May 09 DRE enlarged prostate
July 09 PSA 5.2
July 09 Biopsy 5 out of 12 malignant
Gleason score: Primary 3, Seconary 4 Total 7
August 24, 2009
Radical Open Prostatectomy Andocarcinoma of the prostate
% of 4 and/or 5: 1-25%
% of 3    76-90%
Androgen deprivation effect: Negative
Apical involvement: Positive
Apical marginal involvement: Negative
Extraprostatic extension (EPE): Negative
Margin: Negative
Bladder Neck Shave: Negative
Areas of involvement: Right and Left lateral, posterolateral and posterior and left anterior apex and mid prostate
Principle area of involvement: Right and left lateral, posterolateral and posterior apex and mid prostate
Focality: Multifocal
Volume: Medium(100 Sq mm)
Ejaculatory Duct: Negative
Seminal vesicles involvment (SVI): Negative
Vas deferens N/A
High Grade PIN: Positive
Neuroendocrine differentiation: Negative
Pathologic Stage: pT2c NO MX

Elite Member

Date Joined Oct 2008
Total Posts : 25355
   Posted 9/18/2009 6:07 PM (GMT -6)   
Don't feel bad, Dog, my uro/surgeon was old school and wouldn' do a post surgery psa till a full 3 months after surgery, he feels the one sooner are subject to much change/error. He also had no intention of even discussing ED issues to the 3 months appt, but I fooled him, because I didn't need any meds or help. Good luck to you.
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  38 days, 9/14/9 - met 3rd rad. oncl., agreed to start radiation, does not rec. HT at this time, mapping on 9/21/9

Veteran Member

Date Joined Mar 2009
Total Posts : 739
   Posted 9/18/2009 7:08 PM (GMT -6)   
Hi Dogyluver,
Same old story different blokes, different strokes, we are all different, I tried Viagra and Cialis both seem to have the same response.  Plenty of hot flushes, not alot of action, until the 9 month post surgery mark, when things started to change.  I have been using mainly the cheaper brand now called "Manly" from, work out very cheap, compared to the norm, and I think work just as good.  Matter of fact I am thinking soon of going off meds to see if I can achieve it on my own, that to me will be the altimate. 
Dont be scared to order thru the "" I have never had a problem.
Cheers and Good luck.....................Kev
Age 51yrs
DX 11/11/08
6 out of 8 cores positive 3 X 60% / 3 X 10%
Gleason Score 3+4=7
Stage T1c
Robotic Surgery 24/12/08
Upgrade Gleanson Score 4+3=7 Gleason Differential 60%/40%
Stage T2c
Three small foci total volume <10%
Neg Margins and Nodes
Nil - Extraprostatic Extentions
Dry less than 1 week.
ED- taking Meds- Its been 9 mnths now getting some action ! yah
PSA 1/09  .03
PSA 2/09  .03
PSA 5/09  .03
PSA 9/09  .03
"Everyday in Everyway I get better"

Veteran Member

Date Joined Jan 2009
Total Posts : 2211
   Posted 9/18/2009 7:32 PM (GMT -6)   
My guess is that each of us have had a different reposnse to the meds, so I would try what the Dr. suggest and then you can switch if needed. Levitra gave me less of a headache than Cialis and I have never tried Viagra. Listen to your body and you will figure the right one for you. Be well and hope all continues to go well for you and you family.
Dx with PCA 12/08 2 out of 12 cores positive
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margins not involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only
 started ED tx 7/17, slow go
Great family

Veteran Member

Date Joined Apr 2009
Total Posts : 990
   Posted 9/18/2009 7:51 PM (GMT -6)   
most docs start with viagra but that may just be be because it has been around longer. I have a better resp[onse to cialis. Ask your doc for samples. Some don't do this but others hand them out like candy on Halloween
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

Regular Member

Date Joined Jun 2008
Total Posts : 407
   Posted 9/18/2009 10:40 PM (GMT -6)   
You're jumping the gun. First be concerned about successful surgery and leave the sex concerns until later, because that stuff isn't quite as important. Go with the urologist's suggestion and if you don't have confidence in the urologist change now.

Age:  60 (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; 9/09: 0.0


Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4818
   Posted 9/19/2009 2:29 AM (GMT -6)   
And since there basically only 3 drugs to choose from - it won't be hard (pardon the pun) to find the one that works best for your hubby.

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.

Veteran Member

Date Joined Feb 2008
Total Posts : 655
   Posted 9/19/2009 7:33 AM (GMT -6)   

Greetings, dogyluver.  My doc says he starts his patients on cialis or levitra - whichever has the least side effects and works.  If neither of those 2 work, then he has them try viagara.  He says viagara works differently than the other 2.  Both ciailis and levitra and their generic equivalents I get from all day chemist work fine for me with minimal side effects. 

My doc gave me samples of both cialis and levitra.  You might ask when you have your appointment.  If you are ordering from all day chemist you probably need to allow at least 2 weeks to get your meds. 

Thanks for being a supporting wife!  I know he appreciates it.  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

Regular Member

Date Joined Feb 2008
Total Posts : 104
   Posted 9/19/2009 3:18 PM (GMT -6)   

I agree with everyone that says; “The important thing is that I am now cancer free!”  All my post-op PSA’s have been “undetectable” and for that, I am truly thankful.


I am so happy for those men that fully recover after PC surgery, and don’t have to worry about getting an erection because all their equipment works just like it used to before surgery.  Unfortunately, for many of us, that is not the case, and we need to find a solution for that side of the side effects.  I still consider myself a man that is young at heart, and frankly I was not ready to give up on a solution that provides me with a satisfactory sex life, and a solution that will work for the rest of my life.


I used Cialis, Viagra and Levitra.  Cialis worked best, but none of them alone provided an erection that was equal to pre-surgery.  I used Tri-Mix shots, and those worked almost too good.  I eventually settled on using the ErectAid pump in combination with Cialis and that worked the best for me.   Regardless, anyone that has used the pump, the oral medications, or the shots, knows that they all come with their own issues.


Frankly, none of these solutions provided me with a solution that I wanted to use for the rest of my life.  Therefore, I eventually decided to go for the "ultimate" solution in March '09.  I decided to go for a Penile Implant.  I can’t tell you how happy I am with this decision.  This has been the only solution that has given me the ability to have an erection that feels “normal”, works “every time”, and allows me to maintain my erection for as long as I (we) chose for it to last.  I never have to worry about “losing it” any more.  It is actually as easy for me to get a satisfying erection, every time, as it used to be 40 years ago.

Pre-op Diagnosis Results – Oct 31, 2007;


  • Age – 53 (turned 54 in Nov 2007)
  • PSA is 3.83
  • Gleason's Grade - 3+3=6, T1C
  • One biopsy core (Right mid) was diagnosed with carcinoma, which was less than 10% of the tissue submitted.
  • One other biopsy core (Left apex) had a "high grade parostatic intraepithelil neoplasia” (atypical cells, otherwise called pre-cancer cells).
  • All other biopsies benign.

Post-op Results – Surgery Dec 11, 2007;


  • Gleason's Grade - 3+3=6, T2C
  • Cancer confirmed on Right mid and Left apex
  • Both nerve bundles spared, some damage to the Left bundle.
  • 30 day PSA, .01
  • 90 day PSA, .00
  • ED treatments: Levitra, Cialis, Trimix, Erect Aid pump, Penile Implant on 3/12/2009
  • Happy

Post Edited (tedgard) : 9/19/2009 3:53:17 PM (GMT-6)

Regular Member

Date Joined Jul 2009
Total Posts : 384
   Posted 9/19/2009 3:58 PM (GMT -6)   
I had started on Levitra 3 weeks post surgery with success. Haven't tried anything else yet. Levitra does give me the 'headache' I take some tylenol along with it to help lessen the headache. Also get some stuffy nose but that has been getting better each time and had mild heartburn.

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

Regular Member

Date Joined Apr 2008
Total Posts : 158
   Posted 9/20/2009 10:10 PM (GMT -6)   
Diagnosed November 2007   (43 years old )
PSA 3.9 / Gleason 6 / TC1 6 cores 1 shows 25%
Sugery scheduled 5/29/08 - City of Hope - Dr. Mark Kawachi
 "First show of the day"
 and now for the new ive been waiting for
 FINAL PATH REPORT:gleason upgraded to 3+4 T2c bilateral disease,tumor involvment 5%
extra prostatic extention:absent
seminal vesical invasion :absent
pathological staging:pTNM pT2 ORGAN CONFINED
margins free of carcinoma
usable erections ;6-6-08 with little blue pill
continence; 1 pad a day, dry at night
continence a non issue at 10weeks
 1 year p.s.a. undetectable

Regular Member

Date Joined May 2009
Total Posts : 121
   Posted 9/21/2009 5:03 PM (GMT -6)   
I get less of a headache with levitra, Viagra gives me a whopper. I do seem to get more results on one I have not been using si I would say mix them up
Dx'ed 5/08 one core 2%  out of 12  3+3 gleason
DREs all negative
PSA was in the 3-4 range then jumped to 7
I have the enlarged prostate, on the order of 100cc.  After taking Avodart for 3 months  my
PSA was cut in half.
I did Active S for a year but concluded that I didn't want a life
of biopsies and Uro meetings.
DaVinci on 6/24/09  UCI Med Center  Dr Ahlering, long surgery based on size and location
Final was 5% one side all clear, but had a huge 90 grm prostate
Now we work on pee control, ok at night but sitting is a big problem.

Veteran Member

Date Joined Jul 2009
Total Posts : 504
   Posted 9/22/2009 5:40 AM (GMT -6)   
Each of the 3 ED drugs works differently and each has its own protocol when it comes to food

Viagra for example is almost useless if you take it with a meal. Absorption is a key goal here, also note that Cialis takes a few dosages to fully build up in your system

50mg Viagra 1 hr after a meal and 2 hrs prior to the next meal works the best for me. A close second would be 20mg Levitra, benefit with Levitra is the meals can be closer in time
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

Regular Member

Date Joined Sep 2009
Total Posts : 27
   Posted 9/22/2009 8:30 PM (GMT -6)   
As they say...All the meds work differently in different people....I found low dose Cilas gave me an acid stomach...High dose was the same but worse....Viagra was ok ,but similar side effects...It did however make me very mellow/positive/relaxed/good for a relaxed sleep the following evening...Levitra high dose has produced the best erection with the least side effects...makes me mellow like Viagra,but a bit depressed the next day.....All give me a red face...They work best on empty stomach....Have to watch that I only have a small meal after...Certainly watch the alcohol...But then that's just me...You just have to experiment...
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