Should I consider daily ED drug therapy prior to surgery?

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HD_Rider
Regular Member


Date Joined Apr 2011
Total Posts : 416
   Posted 5/10/2011 10:25 AM (GMT -6)   
Hey folks,
 
I'm about a month out from my scheduled RALP surgery.
 
I attended my local Us-Too chapter meeting last night and the topic of discussion was ED rehabilitation.  One of the subjects that came up was starting a daily regimen of ED drugs prior to surgery as this will increase and maintain blood flow to tissue, thereby hopefully reducing healing times and improving chances of retaining / restoring erectal control post-op.
 
I've read a lot about the use of ED drugs here on the forum and it seems to me they certainly can't hurt.  I've never used any ED drugs before so I don't have a clue if one is better than the other.  However, from what I've read it seems that Viagra is more of a wham-bam single use drug whereas Cialis and Levitra are better suited for long-term daily use.
 
Should I consider starting a daily regimen of Cialis prior to surgery?  It's difficult to get an appointment with my urologist and I'm not scheduled to see him again until June 1st.  Do I just order a month or two of 5mg generic Cialis from ADC or should I consider seeing my regular family doc and getting some samples of the competing brands that way?
 
Any advice would be appreciated.
John (HD_Rider) - Wichita, KS
Age: 49
PSA: 3.5, 6/07
PSA: 4.5, 3/11
Biopsy, 12 cores: 04/13/11
Dx: 04/19/11
Gleason: 7 (3+4) (primarily on right side with <5% on left side)
DaVinci: scheduled for 06/09/11, hoping and praying for the best

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7084
   Posted 5/10/2011 10:33 AM (GMT -6)   
I would always talk to at least your GP before taking anything at all prior to surgery. There is quite the list of contra-indications (at least there were for me), and you don't want to suddenly create a problem that leaves you suspect for being surgery-ready.
 
That aside, if the doc clears you, at least you can test them for side effects and the like.
 
I use Cialis daily (5mg).
DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4849
   Posted 5/10/2011 10:59 AM (GMT -6)   

If you have a spouse of GF - I'd think you wouldn't need to use any meds...Guess you could combine the meds and the spouse..

Be sure and ask your surgeon about stopping any meds well in advance of surgery.


Gleason 6
Veteran Member


Date Joined Mar 2011
Total Posts : 876
   Posted 5/10/2011 11:01 AM (GMT -6)   
I'd check with your GP or Urologist first, too. I have heard that it is good to get an idea of which product you like the best and also to have a baseline for after the surgery. I have been thinking trying them first before my procedure also. Interesting thought about the blood flow.
Age 61
PSA 4.3 9/10
PSA 5.5 2/11
PSA 7.1 3/11
Template Biopsy 6 pos out of 40 3/25/11 GS 6 (3+3)
CT bone scan neg
6/18 areas positive - 2 in left base, 4 left apex. 6/40 cores pos. 33cc.
Stage T1C
Meeting with Dr. Wehle @ Mayo 5/4/11

Roadracer
New Member


Date Joined Sep 2010
Total Posts : 18
   Posted 5/10/2011 11:17 AM (GMT -6)   
Always a good idea to check with your surgeon, urologist or GP about any meds before surgery. I expect your support group reviewed the studies at NYU and Baylor where use of Viagra (and MUSE in the case of the Baylor work) before surgery resulted in better recovery of erectile function post prostatectomy. If not, Google Viagra before prostatectomy and they will pop up. Good luck from a guy who still suffers from ED three years post Davinci. I needed Viagra before surgery but it didn't work after. Pump worked but geez! How off putting can you get!

Road racer
Oct 2007 - PSA 7.0
Nov 2007 - Biopsy Positive in three cores - Gleason 7 (3+4) - Age 64
Jan 2008 - RLRP @ Henry Ford Hospital in Detroit
Post-op, Gleason 7, T3a/N0/M0 Microscopic positive margins
Apr 2008 - PSA <0.01
Aug 2008 - PSA <0.01
Dec 2008 - PSA <0.01
Mar 2009 - PSA <0.01
Sep 2009 - PSA <0.01
Jan 2010 - PSA= 0.09
Apr 2010 - PSA <0.01
Jul 2010 - PSA <0.01
Jan 2011 - PSA <0.01

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/10/2011 11:18 AM (GMT -6)   
I don't see the point of doing that prior to surgery. Sure wouldn't do it without your doctor's consnet. If you don't have any ED issues now, don't see where it would help you prep in anyway for what you may or may not have for ED issues after surgery.

I would sure advise having all the pre-surgery "normal" sex you can stand prior to surgery, as even with the best results, it will never be the same for you, as it is now.

Good luck

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

HD_Rider
Regular Member


Date Joined Apr 2011
Total Posts : 416
   Posted 5/10/2011 12:59 PM (GMT -6)   
Thanks everyone for the sound advice.  I feel very lucky to have found this forum.
John (HD_Rider) - Wichita, KS
Age: 49
PSA: 3.5, 6/07
PSA: 4.5, 3/11
Biopsy, 12 cores: 04/13/11
Dx: 04/19/11
Gleason: 7 (3+4) (primarily on right side with <5% on left side)
DaVinci: scheduled for 06/09/11, hoping and praying for the best

tvwohio
Regular Member


Date Joined Sep 2010
Total Posts : 175
   Posted 5/10/2011 7:02 PM (GMT -6)   
My urologist after my surgery had wished he had started me on ED drugs or pump.
May even want to look at increasing blood flow using Vacuum Pump prior to - should help
tom
Prostrate Cancer 2001 RP 50 years old PSA 6.8 Gleason 3 + 2 40% T3bNxMo moderately differentiated adenocarcinoma RP - cancer apex area, nerve sparing not successful Bulking using both collagen and teflex unsuccessful for continence. 4 sets of strictures within 1 yr after RP - 3 manual and 1 rotorotor -9/2010 stricture - suprapubic catheter folled by Homan Laser. AMS800 1/22/11. Dry 3/9/2011

North49
Regular Member


Date Joined Feb 2011
Total Posts : 83
   Posted 5/10/2011 7:16 PM (GMT -6)   
As others have said, check with your doc first.

My uro prescribed 5mg Cialis for a month prior to surgery and I had no issues getting to to respond without the drugs, no cardiovascular disease. He said the theory is PDE5 inhibitors are beneficial to epithelial cells inside the penis and starting on them before surgery helps with their recovery post op. I think I also saw this same claim from the Memorial Slone-Kettering Cancer clinic.
PSA 5.6 - 04/2010 - DRE positive
PSA 6.7 - 09/2010
Biopsy - 09/2010 - Age 53
T2b/c Gleason 7, 4+3
PSA 8.2 - 12/2010
RRP - 12/2010
pT3a, Gleason 7, 3+4, 20% PCa
pNO
Negative margins and seminal vesicles
RP 37.3 g
No further treatment recommended.
PSA <0.01 - 03/2011 - 3 month post-op

Woodworker
Regular Member


Date Joined Apr 2010
Total Posts : 90
   Posted 5/11/2011 1:35 PM (GMT -6)   
I would check with my urologist first. However, my urologist started me on a caily dose of Cialis about 5 weeks before surgery. It is a standard approach for a lot of Urologists. I assume the goal is to get the Penil tissue as healthy as possible prior to surgery. It supposedly improves your chances of recovery.
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

Woodworker
Regular Member


Date Joined Apr 2010
Total Posts : 90
   Posted 5/11/2011 1:35 PM (GMT -6)   
I would check with my urologist first. However, my urologist started me on a caily dose of Cialis about 5 weeks before surgery. It is a standard approach for a lot of Urologists. I assume the goal is to get the Penil tissue as healthy as possible prior to surgery. It supposedly improves your chances of recovery.
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 : 4463
   Posted 5/11/2011 2:17 PM (GMT -6)   
I wish I had used the pills a year before surgery. I tried one a couple days before and was impressed with the response. , Just wish I had used them much earlier. Whether it would have speed up recovery I don't know
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

Susan R
Veteran Member


Date Joined Dec 2010
Total Posts : 511
   Posted 5/11/2011 4:08 PM (GMT -6)   
John-
Dont pay out of pocket for the ED pills, Tricare will pay for them!
Husband 39 at diagnosis 12/2010.
No symptoms, PSA 18 in 10/2010
one month antibiotic then PSA 12.6 in 11/2010
biopsy end of 11/2010 Gleason 6
Da Vinci prostatectomy 2/2/2011
1-2 pads per day
nocturnal erections within a month, and able to have sex with Levitra.
1st post-op PSA less than .05

staging: pT2aNo, Gleason 6
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