post sugery penile therapy

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austin99
New Member


Date Joined May 2011
Total Posts : 4
   Posted 5/7/2011 7:50 AM (GMT -6)   
 
I am 52, I had a divinci nerve sparing surgery on 3/29/11 that well except Ed problems. No signs of life yet. What is confusing me is the treatment for it till he comes around on his own. My doctor’s Physician assistent handles penile rehab in my doctor’s office he put me right on trimax in jections 3 xs a week works well but there is a little pain. When i went to see my main doctor (in same office) for my first psa test (.05) he seen that i was on trimax injections and said that all i should be using now is ved and muse injections. Said that trimax injections can do damage. But his asst. says that just trimax injections alone 3x week work best so I’m really confused any light u can shed on this would be great. 

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5823
   Posted 5/7/2011 10:39 AM (GMT -6)   
Sounds early, my doc told me just you pump for therapy, when things start happening . go for pills, last thing was injections. Havent done injections getting very good results with pills 18 mos post op , one nerve
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

davidg
Veteran Member


Date Joined Feb 2011
Total Posts : 4093
   Posted 5/7/2011 11:12 AM (GMT -6)   
I was started on pills before they even wanted me to get an erection as the urethra was healing.

By penile rehab I was always told by everyone just to use it a lot. Alone and with my wife. Not sure why they didn't give you pills first. I thought the injections were the next step.

I can tell you that regardless of starting point, there seems to be uniform trend towards weekly changes in this process. A process that according to many can take up to 2 years.

It's definitely early for you so hang in there.
40 years old - Diagnosed at 40
Robotic Surgery Mount Sinai with Dr. Samadi Jan, 2011
complete urinary control and good erections with and without meds
Prostate was small, 34 grams.
Final Gleason score 7 (3+4)
Less than 5% of slides involved tumor
Tumor measured 5 mm in greatest dimension and was located in the right lobe near the apex.
Tumor was confined to prostate.
The apical, basal, pseudocapsular and soft tissue resection margins were free of tumor.
Seminal vesicles were free of tumor.
Right pelvic node - benign fibroadiopse tissue. no lymph node is identified.
Left pelvic node - one small lymph node, negative for tumor (0/1)

AJCC stage: pT2 NO MX

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3746
   Posted 5/7/2011 5:51 PM (GMT -6)   
When they put you on HT, after a month or two, you don't even read the ED threads anymore..

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 5/7/2011 8:31 PM (GMT -6)   
My uro/surgeon uses the pills first, pump added, then discusses shots. Seems to be his routine.

austin99
New Member


Date Joined May 2011
Total Posts : 4
   Posted 5/7/2011 10:58 PM (GMT -6)   
thanks everyone for your help relly lost here.  my doc told me pills wont work till nerves heal cause they work with nerves. don't know what to belive and dont know what u mean by
(replace this text with your code)
ht thanks mike

Woodworker
Regular Member


Date Joined Apr 2010
Total Posts : 90
   Posted 5/11/2011 12:47 PM (GMT -6)   
My order of treatment was, Pills first, Pump second, Injections third (I use BIMIX too much pain from TRIMIZ. RIght now they have me doing all three. Pump and oral meds daily, injections twice a week. An implant is starting to look good
Age : 56
Diagnosed 3/29/2010
5mg Cialis daily
PSA 2.7; Gleasen (3+4) Biopsy 2 cores of 12 25% positive
DaVinci surgery 6/25/2010
Returned to work: 7/12/2010
Post Surgery
Final Biopsy report
5 slides of 35 were 2% positive for cancer
Clear Margins
Final Gleason (3+4)
Incontinence: None
ED: 5mg Cialis Daily
Just started on BIMIX. First results were very good

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 5/11/2011 1:14 PM (GMT -6)   
Austin, early use of the pills are strictly for blood flow, not for sexual response. The thinking is the pills will open up thbings and let more blood flow into the groin and penis, speeding healing and keeping the tissue healthy. You doc is right about nerves and the pills, but that's only part of the equation. Early on, most ED specialists suggest the combo use of pump and pills, almost from the time that the catheter is removed. The injections normally start around the 3 month mark, but there are a couple studies suggesting that early use of injections provide the faster rehab of the nerves. In any case, anyone concerned with regaining function should be using the minimum of the pump early on, but optimum would be pump and p[ills together. Pumping up, holding for a minute, and releasing , then repeating for 5 or 10 times, twice daily, without applying the rings will really help you starting out.

If you continue the trimix, then I wouldn't be using the pump on the same day. I'd discuss the issue of the injections and pills being used together if that is the recommendation.
James C, 64, Kingsport, E. TN
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% inv, lf. lobe, GS6
9/07: Nerve Spar. open RP, Path: pT2c, 110 gms., clear except:
Probable microscopic involvement-left apical margin -GS6
3 Years: PSA's .04 each test until 4/10-.06, 9/10-.09, 12/10-.09, 2/11-.08, 5/11-.08
Bimix .30

austin99
New Member


Date Joined May 2011
Total Posts : 4
   Posted 5/11/2011 2:56 PM (GMT -6)   
thanks for the great replys guys. what i wanna know if there is anybody that the nerve sparing operation, and got back to normal erections and if so how long did it take or is it just a pipe dream

lowandslow
Regular Member


Date Joined Jan 2011
Total Posts : 122
   Posted 5/12/2011 9:40 AM (GMT -6)   
I am 7 weeks post surgery, nerve sparing. My erections end up the same as pre surgery with more stimulation than before. I have long term circulation issues so pre surgery means enough to do the job, but not like I was 20. I was told pump first, then pills. I haven't used the pills due to the Plavix and metropolol I am on. I've never received a clear answer as to effects of plavix and viagra from any of the 4 doctors I've asked. I used the pump twice and found it.......annoying.
Age 48
PSA 4.1 No symptoms
Diagnosis 1/12/11
RRP 3/14/11
Gleason 7 (3+4)
T2c
Margins clear
Seminal Vesicles clear
Lymph nodes clear
Prostate 69.5 grams
Organ confined
9% involvement

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 5/12/2011 9:48 AM (GMT -6)   
austin, approaching 4 years, it's been a pipe dream for me. BUT, a large but, there's a bunch of guys here who range from erections while still wih the catheter to those regaining it at almost every month from then to years later. There's no way to determine before hand what it will do to you, sorry, just not possible. The docs can cite stats for you, but there's no real facts they can tell you. You roll the dice and takes your chance. Sorry.
James C, 64, Kingsport, E. TN
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% inv, lf. lobe, GS6
9/07: Nerve Spar. open RP, Path: pT2c, 110 gms., clear except:
Probable microscopic involvement-left apical margin -GS6
3 Years: PSA's .04 each test until 4/10-.06, 9/10-.09, 12/10-.09, 2/11-.08, 5/11-.08
Bimix .30

Ausboy
Regular Member


Date Joined Mar 2011
Total Posts : 92
   Posted 5/12/2011 5:08 PM (GMT -6)   

Austin

I had 8 week follow up yesterday, both with Uro and sexual health doc.

two differing opinions on treatment shocked

sexual health doc - take ciallis 5mg daily, use pump for first three months

if you want then go to injections, he recomends you do will help and work well once you master it.

Uro - use pump (should have started confused ) take ciallis 5mg dailly, wants to start injections now, said thats why he sent me to other doc? I asked why inject now he exlained it helps with blood flow to entire penis both inside and outside the body and pump only works on outside bit. He said use it often wether for sex or not, the more use the better for recovery. goodluck

latest PSA 0.03 woohoo tongue


age 49, dx 21-01-2011 PSA 5.6
12 cores all positive >80% in some, Gleason 3+3=6, T2B
RALP 10-03-2011, post OP pathology, Gleason 4+3=7 and 1% 5+4=9
Prostate 50g, 48mmx40mmx40mm, largest tumor 48mmx34mmx24mm, extensive PIN also present, EPE left apex .2mm, perineural invasion, clear margins closest was .7mm, lymph nodes not checked.
path stage pT3A Nx Mx R0
post OP PSA ? 11/5/2011 - 0.03

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 5/12/2011 5:16 PM (GMT -6)   
austin,

i had a non sparing op, but due to difficulties, the right side was left "as is" and noted as being "damaged" on my surgical report, yet i have never had a single day of ED. as james properly stated above, its a roll of the dice, no way to predict, you have a handful like me on one end with no ED problems, and all the way to guys like james and others, that had nerve sparing ops that still have ED years later. if the surgeon is predicting or bragging ahead of time, all he is doing is guessing and hoping.

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 margin
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, 2/11 1.24, 4/11 3.81
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 9/10

Mike H
Regular Member


Date Joined Jan 2010
Total Posts : 72
   Posted 5/12/2011 7:25 PM (GMT -6)   
Austin,

Doesn't make a lot of sense to me. I started about a month after surgery on 25Mg of viagra daily and I've had great resuslts.

Check out the video from Dr. Mulhall at Sloan Kettering in NYC. Like alot of the guys here I get my Viagra from ADC for under $1 a pill in quantity.

Good Luck,

Mike

www.youtube.com/watch?v=ie8NkOu2VNA&feature=channel
8/12/09 Diagnosed at 49 years old. DOB. 6/11/60

12/2/00 PSA was 4.9

5/5/03 PSA was 5.4 - Biopsy Negative

6/10/09 PSA hit a all time high of 6.9

7/23/09 Biopsy Positive. 10% cancer in 1 of 12 cores. Gleason 3+3=6.



10/29/09 Surgery at Memorial Sloan Kettering Cancer Center, NYC
11/25/09 Catheter Out (4 weeks)
99% continent the day the catheter came out
Wore the pads for 2 weeks to be safe but had minor drips at most.
12/16/09 First PSA (7 weeks) < .05 Undetectable

Post Surgical Pathology:
Gleason 3+3=6
Tumor confined to prostate
Seminal vesicles not involved
Bladder neck not involved
Surgical margins free of tumor
Lymph nodes not involved

6/16/10 6 Month PSA < .05 Undetectable
1/5/11 12 Month PSA < .05 Undetectable

Post Edited (Mike H) : 5/12/2011 9:48:01 PM (GMT-6)


austin99
New Member


Date Joined May 2011
Total Posts : 4
   Posted 5/13/2011 3:15 PM (GMT -6)   
thanks again, watch that video wanna fly down there! my doc says pills wont work yet cause but u know what im gonna try them tonight i got some 100mgs should i that whole thing or 1/4. try a 50mg weeks ago just got a headache this is relly bumming me out

Mike H
Regular Member


Date Joined Jan 2010
Total Posts : 72
   Posted 5/13/2011 5:47 PM (GMT -6)   
Austin,

Where are you from? Where did you have your surgery.

I did 25 mg every day and on the 7th day they wanted me to take a full pill. I was getting stiff with the 1/4 pill and was afraid to take a full one. My doc said thats great news - just take a half. I'm at the 1.5 year mark since surgery, and I take 1/4 every day and 1/2 when I want to be with my wife. A 1/4 dose will get the job done but it's takes a little more time and effort so I just go to the 1/2 dose. I've never taken a full pill.

Click on the link to the left and e-mail me. I can send you my number if you want to discuss further.

Mike
8/12/09 Diagnosed at 49 years old. DOB. 6/11/60

12/2/00 PSA was 4.9

5/5/03 PSA was 5.4 - Biopsy Negative

6/10/09 PSA hit a all time high of 6.9

7/23/09 Biopsy Positive. 10% cancer in 1 of 12 cores. Gleason 3+3=6.



10/29/09 Surgery at Memorial Sloan Kettering Cancer Center, NYC
11/25/09 Catheter Out (4 weeks)
99% continent the day the catheter came out
Wore the pads for 2 weeks to be safe but had minor drips at most.
12/16/09 First PSA (7 weeks) < .05 Undetectable

Post Surgical Pathology:
Gleason 3+3=6
Tumor confined to prostate
Seminal vesicles not involved
Bladder neck not involved
Surgical margins free of tumor
Lymph nodes not involved

6/16/10 6 Month PSA < .05 Undetectable
1/5/11 12 Month PSA < .05 Undetectable
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