Post-DaVinci ED treatments

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New Member

Date Joined Dec 2010
Total Posts : 2
   Posted 12/6/2010 6:09 PM (GMT -6)   
Hello, I am new to this forum. I had single nerve sparing Da Vinci surgery on July 12,2010. I had very little incontinence issues. I stopped wearing pads after roughly 1 month. However, I recently started treatment for ED and was wondering what others experience with this issue has been. I had some ED before the surgery needing 10mg Levitra on occasion but not always. Maybe half of the time. Post-surgery I started an every other day dose of Levitra/Cialis (used both) about the first of September. It has no affect at all on its own. I recently acquired a pump. It creates an erection, but not one suitable for intercourse and only if used on a day I take Levitra or Cialis. It has virtually no effect if not used in combination with the oral medication. I just acquired the quad-mix and gave myself my first injection over the weekend. Dose was .08 with limited effect until I used the pump in combination about 20 minutes after the injection and then the result was only comparable to the pump/oral combination. I achieved a partial erection that would not sustain without pumping. (The Nurse practitioner gave me .06 in the office and that actually worked slightly better than my home injection before I used the pump). I know this is just the start of the process but wondered what others had experienced.

PSA 3 + 4 (pre and post surgery)
Pre-Surgical Staging pT2a
Biopsy 10/12 positive
Cancer Volume 30%
Left Nerves removed, right side spared
Post-Surgical Staging pT3 N0 M0
Da Vinci 7/12/2010 - Dr. Richard Sarle
3 month PSA = undetectable

Veteran Member

Date Joined Nov 2007
Total Posts : 598
   Posted 12/6/2010 6:43 PM (GMT -6)   
I assume you are not using a constriction ring with the pump? If you were, you would certainly have a very good erection for sex.
You should be pumping at least once a day for 10-15 minutes to keep penile tissue healthy. Until you regain nocturnal erections, you need to continue using a pump for therapy.
What does your doctor say about staying on oral meds? Remember, they are usually used for blood flow and healing, not for inducing erections. Is this what your doctor told you?
You should be ********** or having sex to orgasm every day.
The injections will be great once you find the proper dose. Be careful about using an injection while you might have any oral drugs in your system, but I assume your doctor has already talked to you about that.
What you are doing, sounds pretty standard protocol for the ED treatment. the injections tend to jump start normal erectile response, so don't give up on them. i am curious about the quad mix. Did your urologist prescribe it? Where did you go to get it?

As hard as it is, remember that patience is the key. You will probably notice a boost of improvement at 9 months and again at 12 months. Many men find a jump in improvement after two year mark as well. You are doing well, i think. keep us posted.
Paul ED website for PCa guys

46 at Diagnosis.
Father died of Pca 4/07 at 86.
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
Pad free on March 14 - (10 weeks.) Never a problem since.
ED - at one year, ED is fine with viagra.
Two year PSA - undetectable!

Veteran Member

Date Joined Jul 2009
Total Posts : 504
   Posted 12/6/2010 6:51 PM (GMT -6)   
Hi DaMookR,

Your daily Cialis/Levitra is for recovery, not for an erection suitable for intercourse. At best you will get increased blood flow to the area and the beginnings of nocturnal erections. At this stage they are working

Injection therapy ( for me) has been very effective, I have had 100% success with Trimix. It is of paramount importance to get the procedure right. There are many many posts on how to plump and constrict during the injection process. Or head on over to Franktalk and see some of the docs there

Also note that Cialis or Levitra work against the success of Inj therapy. The oral drugs work to increase bloodflow to the penis, blood flow is what flushes out the Rx in the injection

The idea of the pump early in your recovery is to prevent atrophy, use it daily as therapy , you should have rings that help keep you erect after you have pumped up

at 5 months I was just starting Inj therapy, oral ED meds did not work then, i used the VED daily for therapy

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 12/6/2010 6:58 PM (GMT -6)   
Damook, welcome to HW, can't answer your question, but glad you found us.

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Cajun Jeff
Veteran Member

Date Joined Mar 2009
Total Posts : 4119
   Posted 12/6/2010 7:22 PM (GMT -6)   
DaMookr, Welcome here and hope you get the help your looking for. I am 2 years our and can tell you the injections are GREAT when you have the dose figured out. As others have said. Use the pump for therapy to get size back.:) Some guys have found that using the rings with the pump was gooe enough for successful sex. The rings will keep you hard enough. I did not like using the rings. Wife did not like the rings either.

MrGimpy mentioned another sight. I second that location. You may want to go to and register. It is free and deals exclusevely with ED and recovery.

Shoot me an e-mail if you have questions. My e-mail is open.

Cajun jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
Only issue at this time is ED

Regular Member

Date Joined Feb 2008
Total Posts : 108
   Posted 12/6/2010 8:27 PM (GMT -6)   

Some men claim that they have achieved a full recovery within weeks after surgery; others say that it took them 18 to 24 months before they had a full recovery.  Others say that they have a good enough recovery that with the aid of the ED pills they have a fully successful erection. 

For me, I tried every option available (i.e.: pills, pump, shots, etc…) and finally ended up getting a penile implant which ended up being the best choice for me.  I am letting you know this because I want you to know that regardless of which type of recovery you end up with, there is usually a treatment out there that will allow you to have a near normal sex life going forward.

If things end up being like they were for me, where you do end up with ED and all the other options available are not a successful option for you, there is still hope.

With a penile implant I now can function like when I was a much younger man.  I can perform whenever I chose, wherever I want and as often as I wish.  I don’t have to worry about filling a prescription or taking a pill and waiting for it to take effect.  I don’t have to detract from an impromptu moment by having to take along my equipment or getting it out and getting pumped up before hand (and dealing with a truly abnormal feeling erection).  In order to react to the moment, I no longer have to go to the refrigerator to get my meds and needles, prepare the shot, making the injection and then waiting for things to work.  Within a minute or so, I can have a full erection anytime I wish.  For me, it is like I have regained my manhood.

My wife of 37 years used to call me “Ever Ready Ted”.  Now I am living up to her expectations!!

I wish you the best as you move forward with your recovery and hope that you have the best of results regardless of which method works for you..



Diagnosis Results – Oct 31, 2007;
•Age – 53 (turned 54 in Nov 2007)
•PSA is 3.83
•Gleason's Grade - 3+3=6, T1C

Surgery Dec 11, 2007;
•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
•Latest PSA, .04
•ED treatments: Levitra, Cialis, Trimix, Erect Aid pump, Penile Implant on 3/12/2009

New Member

Date Joined Dec 2010
Total Posts : 2
   Posted 12/7/2010 9:58 AM (GMT -6)   
Thank you everyone for your responses. First, to Veteran Member, my Nurse Practitioner prescribed the QUAD-MIX. I purchase mine from Universal Compound Lab in Troy, MI "". They do mail order. I believe it is a combination of Forskolin, Papaverine HCl, Phentolamine Mesylate, Prostaglandin and can be blended in different strengths. Also, I do have the constriction rings with the pump but they are hard to get used to. My Nurse Practitioner said I do not have to use them when I am just using the pump for rehabilitative purposes. Just keep pumping as need to retain the size. New question, "Should I discontinue the use of ED orals or should I use them only on days when I am not using injection therapy? I know not to use Cialis because it stays in the system longer than Levitra or Viagra, but I thought it was ok to use the later two on days when there is no injection. Is this right or wrong? MrGimpy,"thank you" for the reference to "frankTalk" I will check it out. Mostly it is helpful for me to hear how the process has worked for others. My surgeon was great but we did not have extensive discussions about ED before surgery. This helps me try to put things and perspective.

Born 1960
PSA History 2.1 - 5/2009; 3.7 – 12/2009 – 4.6 4/2010
Diagnosed with PCa 5/4/2010
Pre-surgery scores: Gleason 3 + 4, Staging T2a, positive 10/12 cores
DaVinci Surgery – 7/12/2010
Post-Surgery scores: Gleason 3 + 4, Staging T3a N0 M0, Cancer Volume 30+%
Left bundle removed, Right bundle spared.
Incontinence – No issue. Off pads in 4 weeks (started Kegel’s 6 weeks before surgery)
Erectile Function – Work in progress. Levitra, Cialis at 6 weeks, little effect.
Erect Aid pump at 4 months, some improvement, works better with orals,
Started Injection therapy 12/1/2010 – QUAD-MIX
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