whats the normal chain of events in return to normal erections?

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Regular Member

Date Joined Dec 2010
Total Posts : 172
   Posted 12/10/2010 11:22 AM (GMT -6)   
Hello everyone,
I am new to the group, 44 years old
August 2010 PSA 4.32
DRE negative
12 needle biopsy: one needle 5%
gleason 3+3
Retropubic Prostatectomy 9-28-10
gleason 3+3=6
pathology report good
5 weeks post op PSA 0.02
complete urinary control at 4 weeks post cath removal
So I am VERY happy with the first two parts of the tri-fecta; Cancer gone, and bladder control back!
 Now for my question... nocturnal erections are not stiff but "enlarged" or engourged by about 40-50% of normal flacid state.
No spontanious erections at all yet. But if I masterbate I can get about 50% firmness and about 5" length I was nearly 7" prior to surgery.
with the pump and ring can get full size and thickness/firmness. Is this the normal progression to full recovery?

Cajun Jeff
Veteran Member

Date Joined Mar 2009
Total Posts : 4119
   Posted 12/10/2010 11:28 AM (GMT -6)   
Natural, sounds like you are on your way. Everyone is different in that recovery. Some lucky guys got erections while still in the hospital, others were a slow gradual progress. Others never recover completely. Your age is an advantage.

What are you doing for recovery? Usually it is Pump (VED) , Pills (viagra, Lavitra, Cailis), Injections

Hope this helps. I would recomend that you take a look at franktalk.org it is a site that deal specificly with ED.

Good luck with your recovery.

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

Veteran Member

Date Joined Dec 2009
Total Posts : 1268
   Posted 12/10/2010 11:36 AM (GMT -6)   
Hey Natural,
I've cut and pasted a posting from the "blue" area when you sign on.  It was posted in June of this year ... I think it will address your questions:
"Here's a link to an excellent video presentation whose viewing should be required of all new arrivals seeking options for PCa treatment. A video presentation titled "Sexual Problems in the Male Cancer Patient", concerning Erectile Dysfunction by Dr. John Mulhall of Memorial Sloan Kettering and author of the book "Saving Your Sex Life." Consisting of 4 parts, total time of about an hour and a half, it contains an address to a PCa Cancer Patient group and contains of of the most through and up to date information available. Well worth the time for anyone who is contemplating their method of treatment after a PCa diagnosis. "

PSA 2007 - 2.8; 11/24/2008 - 7.6; PCa Dx 2/11/09; age at Dx 62; RLP 4/20/09

Biopsy - Invasive moderately differentiated prostatic andenocarconoma; G 3+3=6; PT2C; No evidence of Seminal Vesicle or Extraprostatic Involvement; Margins clear; Tumor identified in sections from prostatic apex. 70 gram prostate. Continent after removal of cath.

ED - Trimix works well; levitra @ 90%
PSA - 7/31/09 <0.06; 12/1/09 <0.06; 3/29/10 <0.06; 8/4/10 <0.06

Veteran Member

Date Joined Nov 2007
Total Posts : 598
   Posted 12/10/2010 11:48 AM (GMT -6)   
This recovery is a LONG process. You are doing great. Think of recovery in terms of a big improvement at 9 months to a year. At Two years, there is often another big leap. I was 47 at surgery. 3 years later, still improving. You are in great shape. Anxiety will only make it worse. Relax, invent some new sex for yourselves and have fun until erections return. You WILL be just fine. Don't worry about it. Have your tried viagra? If you have not, it sounds to me as if that might be all you need.
www.franktalk.org 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 www.roboticoncology.com
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!

Regular Member

Date Joined Jan 2010
Total Posts : 363
   Posted 12/10/2010 12:19 PM (GMT -6)   
Sounds normal or a little better. Other than the pathology it sounds like we're twins. Your path is the same if not a little faster than mine. Starting at 4 months it was usable, at 9 months out I can attain a full erection with only 20mg Levitra (generic) and a little stimulation, pill free it's 90%. I'd say you're ahead of average and well on your way to 100%

I made sure to do nightly "exercises" to remind it what it was for, keeping the blood flow is important according to most Doctors.
Diagnosed 12-09 age 55
07-06 PSA 2.5
01-08 PSA 5.5 (PCP did not tell me of increase or schedule follow-up!!!!)
09-09 PSA 6.5 Sent for consult with Urologist
11-09 Consult, scheduled for biopsy, found out about PSA from '08 (yes I was pissed)
12-09 Biopsy, initial Gleason 9 (4+5) later reduced to 8 with tertiary 5, ain't much but I'll take it.
01-10 Bone Scan, "appears negative"
03-01-10 RRP in Durango CO by Dr Sejal Quale and Dr Shandra Wilson, no naked eye evidence of spread, Vesicles and lymph nodes taken for microscopic exam.

03-16-10 Removal of cath' and pathology results of samples.
Multifocal carcinoma with areas of Gleason pattern 3, 4 and 5, Overall Gleason grade 4+4 with tertiary 5, Bilateral involving 21% of left lobe, 3% of right lobe, Invasion of left Seminal vesicle, Tumor focally present at left resection margin, 9 lymph nodes removed all negative, Tumor staging pT3b NO MX

04-23-10 PSA <0.04....... 06-07-10 PSA <0.04..... 08-03-10 <0.04
05-03-10 1 week without pads
06-28-10 ;-)

Regular Member

Date Joined Dec 2010
Total Posts : 172
   Posted 12/10/2010 12:21 PM (GMT -6)   
I have tried viagra and levitra couple times with no responce at all as of yet, I have read that I may still respond to it later so not to give up on the meds. I have been masterbating to achieve some kind of an erection daily and using the pump daily or every other day to achieve erections that way also....If meds do not work now for me how long till they will work for me do you think? I know there is not an absolute schedule fo rany of this but just trying to see if there is a chain of events and time line that leads to full recovery...

Veteran Member

Date Joined Aug 2010
Total Posts : 644
   Posted 12/10/2010 2:40 PM (GMT -6)   
Natural, it sounds like you are doing well. The experience of achieving fullness initially without real stiffness initially is quite common. That's why my early recover was like, and the Doc said it's normal. I'm at about 10 months post RP and it's come back a lot further since then, both in terms of rigidity, length, and duration.

I was told that practice helps, whether alone or with a partner. It seems like you are the path to a good recovery. "Keep up" the good work.

Regular Member

Date Joined Oct 2005
Total Posts : 489
   Posted 12/10/2010 10:19 PM (GMT -6)   
The gold standard indicator for early (or later if not so lucky) ED progress would be nocturnal erections. If you notice some then the nerves are doing their job and are healing.

That is one area where The Big Three ED drugs come in handy. Take one at bedtime (and probably on a mostly empty stomach by that time) or even take one during your middle-of-the-night trip to the john ( and even more empty stomach). As long as you will get back to some REM sleep you might get some. If you are a heavy sleeper you might not even realize you have them. That is a shame. The old country doctor method to tell was to put a ring of Green Stamps around the penis and if it had broken the band during the night, well, an erection must have come to town!
That was how they checked for ED in the old days. One other way to detect em would be to have your dear wife check regularly during the night ;-)

( Us mostly old guys still remember green stamps I am sure -- very weak paper savings stamps your mother collected in stacks of redeemable booklets. Not sure what would be an equivalent today. Don't use postage stamps! Too strong paper and too expensive!)


Regular Member

Date Joined Jun 2010
Total Posts : 192
   Posted 12/11/2010 9:35 AM (GMT -6)   
Sounds like you are on a very similar time line schedule as me. I had the catheter removed on June 2/10. At 6 weeks I had nothing...nada, then with stimulation from my wife, at 7 weeks I noticed a bit of swelling and a lopsided erection, maybe 10%...not much to be excited about but I was pretty happy. I bought an Osbon pump at 2 months out and used it with success to have sex. It worked but I often lost much of the firmness during the act. At 3 months out I started using Viagara (Manly) from All Day Chemist, no reaction the first time but then I learned to take it on an empty stomach and wait 1 1/2 hours, with stimulation in the shower it gave me maybe 80%, this continued to improve and at 4 months from surgery I was able to get it stuffable. Its been nothing but improvement since then. I can now have normal erections with no aids but require stimulation, it will occasionally go softer while "performing" but I can live with that. I'm not quite back to pre surgery levels but getting closer by the week. 
I often have the sensation of a nocturnal erection but when I "check" down there it seems no bigger then normal, I think this will come though. Its been a very gradual process but at 7 months out I'm a happy cancer survivor. I had open, nerve sparing surgery with a surgeon that has done many prostates.
age 56
PSA 5.5
Biopsy, both lobes PCa
Gleason 3/4=7
open RP May 18, 2010
Pathology: 15% involved, lymph nodes and v. d. clear, margins clear
June 3-10 10-12 pads/day
2 months 8 pads/day
Aug 1, 2010 5-6 pads/day
Aug 20, 2010 3-5 pads per day
Aug 16, 3 month PSA: undetectable
Sept 22, 2 pads a day
Oct 12, PSA 0.03
ED OK with no drugs Dec 2010

Regular Member

Date Joined Dec 2010
Total Posts : 172
   Posted 12/11/2010 9:49 AM (GMT -6)   
Thanks everyone! great information here for the most part! Arch please reply again with an email if u dont mind I would love to chat more with you about your progression back to normal Thanks!

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4463
   Posted 12/11/2010 9:53 AM (GMT -6)   
Natural, I do the same as JStars does. I take my pill in the middle of the night during my pee run. Works out ok, I sleep thru the side effects and have an empty stomach then. No results, but I still take it.. confused shakehead :-)
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RRP, Path: pT2c, 110 gms., all clear except:
Probable microscopic involvement of the left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09- Uh-Oh, next in Feb.
ED-total-Bimix 30cc

gold horse
Regular Member

Date Joined Nov 2009
Total Posts : 360
   Posted 12/11/2010 8:12 PM (GMT -6)   
You are doing very well it took me several months to get it right.
PSA 6/05=0.04,0.04,0.04,6/06,0.04,0.04,0.04,6/07,0.04,0.04,0.04,6/08,0.04,0.04,1/09
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