I have reas some postings that seem like some of the guys here are doing or have been instructed to do a lot more than just pop a viagra before attempting sex. I guess all doctors handle this different, but is there a more active protocol than what I have been prescribed, or should I try this for awhile and then discuss again with my doc if things don't work. I don't see him again until May 5th.
Yes, you are correct in your observations about many more active protocols for penile rehabilitation, and also correct that doctors do handle it differently. Unfortunately, sometimes we need to educate our doctors, which can be a tricky assignment, but it usually pays-off to be an "empowered patient."
Dr. John P Mulhall, MD, is an incontinence and impotence expert from Memorial Sloan Kettering in NYC. He presented at the recent (Sept, in Los Angeles) 2009 National Conference on Prostate Cancer that patients need to be proactive with their doctors about attending to sexual/penile rehabilitation early. He says that it can be an awkward subject and many doctors do not properly address it with PC patients, and visa versa. This may cause long term problems for the patient because his studies show that erectile function (EF) success falls off sharply if treatment is delayed, especially beyond 6-months.
Even most of the basic post-RP programs I've heard of don't merely advise taking a PDE5-inhibitor (any of the big-3, which you also listed) and trying to have sex. On the contrary, the most common programs I've heard of are much more rigorous in that they prescribe regularly (several times a week) taking a pill (or half a pill) and then deliberately work to achieve climax, typically advising to attempt this in the morning when the male body is most rested and commonly achieves natural morning erections.
I suggest reading more on Dr Mulhall's work by going to the website www.pubmed.com
, which is an online library of medical research papers run by our National Institute of Health. Enter into the SEARCH window this string (without quote marks, but with the capitalized AND) “timing of penile rehabilitation AND recovery of erectile function”, and you will likely be taken directly to one of Mulhall's paper abstracts. The paper's concluding statement reads: "These data suggest that delaying the start of penile rehabilitation after RP is associated with poorer outcomes for EF [erectile function]."
Your doctor does not have a very aggressive penile rehab program, as you have already noted & observed from readings. You might want to take matters into your own hands (so to speak)!