ED

Ya know, if I am impotent after the surgery, at my age nearly 67, does it really matter? my wife and I have had a really good life, we have loved each other for 44 years so far, we get on real well together, and although we chased each other around the house when we were young,(and not so young) things change as you grow older, I am really fortunate that I have an understanding partner, who says all she wants is to have me by her side for as long as possible.... so I am happy.

That is a great atitude Mal! and Congrats on having such a wonderful life partner!

Great and correct attitude. I'll be thinking of you on July 30. Keep us posted you are amoung friends.

Hey Mal,

You asked "does it really matter?" Yeah it does. For ML and me it matters a lot. We too have the best realationship we have ever had since PCa and a part of the improvement is the experience of overcoming impotence together. This is a couples disease and all of our closest relationships have been affected. We have to get well together - in all aspects of our lives. We will never give up our sex life and we won't have to as long as we work together...

Jim

---

Age 73. Diagnosed 11/03/06. PSA 7.05. Stage T2B Gleason 3+3.

The choice is different for everyone. With all the complications, I can certainly see why it would be desirable for some to leave sex in the past, it would certainly make for less heartache in a lot of cases.

For better or worse, though, I love (still using present tense) sex and m*sturbation, and desperately want to get back to something resembling normality in that area.

---

____________________

Prostate cancer diagnosed: May 15, 2006 (age 40)
Gleason score: pre-surgery 3+3=6; post-surgery 3+4=7
daVinci radical prostatectomy: July 25, 2006
size of tumor: approx 1.1 inches; negative margins from surgery

- number of pads/day at 3 months after surgery: 3 to 5
- number of pads/day at 4 months after surgery: 1 to 2
- number of pads/day at 6-12 months after surgery: 0 to 1

- 1st post-surgery PSA: 0 (Nov 2006); 2nd post-surgery PSA: 0 (Feb 2007)
- 3rd post-surgery PSA: 0 (May 2007); 4th post-surgery PSA: 0 (June 2007)

The search for timber: took Viagra/Cialis approx. every other day, ErecAid once a day, injections. Peyronie's diagnosed 7/5/07. Now on Cialis, L-arginine and pentoxyfylline, ordered to be celibate for 6 weeks.

- PGE1 batting average: .364 (4 for 11)
- Bimix batting average: .200 (2 for 6)
- Trimix batting average: .500 (1 for 2)

"Lost in the valley without my horses, no one can tell me what my remorse is..."

Mal,

What matters is always relative.  To have love and then to lose it I believe matters, at least for me it does.  To have anything between two loving people and lose it has impact.  It will matter.  The question is just how much.  I went into my battle with PCa with the attitude that I wanted to get rid of the cancer and get my life back to as close to normal as possible.  My choice of treatment, doctor and focus of recovery were all driven toward that end point.  My wife and I have become closer over the years and we are better lovers now then at anytime in our lives.  I would not let PCa take that away from us and that is why I am using injections as they give us back what had been taken from us for a period of time.  Now I am beginning to get back some normal erectile reponse.  I would encourage you to not accept that PCa will take away from you an important part of your life. 

Tamu

Wow! I love your positive attitude, it's so inspirational.

Best of luck to you.

AEG

I'm 6 weeks post Da Vinci, using 100 mg viagra with disappointing results. Very depressed and not a little bit angry as my dr (I believe) gave me a more hopeful picture, particularly if I had 100% nerve sparing, which I did. My question is: Can I reasonably expect any improvement at this point, with or without medication?

Puget,

Your Doctor failed to tell you that most patients BEGIN (Not HAVE) to see recovery signs anywhere from 3 months to 12 months post op.
A small % will have earlier/faster recovery but, that's not the norm. Recovery takes up tp 2 years, sometimes more. Relax, take the meds, keep a positive outlook and consider other measures until you know how much function you will eventually have. These days are hard. Just hang in there and see what time brings. Be well.

Swim

---

 

Thanks, Swimom, this is new informatin to me.  My dr is very "taciturn," and doesn't really explain much.  He mainly just cites statistics, usually with reservations.  (Great surgeon, but . . .)  Your advice is reassuring.  Hopefully, I'll see some gradual improvement and maybe the "real thing" at some point.  Thanks again.

one more question, if anyone has any experience or insight:  Is it possible to recover function over time without the aid of drugs or devices?  It would be nice to be "natural" again.

By the way, my distress over this particular aspect doesn't diminish my recognition that I'm very lucky in that the CA was confined to the prostate and I'm not having much trouble at all with continence.  I guess I'd just like to be whole again in all respects.

Puget,

Physicians seem a little shy to offer information these days....  I don't think that its just their heavy schedules.  I think partly they want you to benefit from staying positive while prepare you to fight if your recovery rate is slower than some.  Social comparison available on the internet probably has stampeded a patient or two.... to something that resembles a threatening posture to the physician.

As to your question about devices and drugs, my understanding is that without the meds and utilizing a vacuum device, most heal but it takes much longer and can decrease possible eventual erection quality.  There are strong arguments for starting injection therapy after two or three months, too.
Swim and Tamu seem to have some of the best information in this area.

I personally advise that you start vacuum device "daily exercises" ASAP (after week 6).  This is not about pleasure or relationships.  It is about keeping tissues healthy (not atrophied) and encouraging those nerves that were spared to work together as a coordinated team again.

Expect that perfect erection and it will eventually return.  Stay positive.  Be patient.

Your friend,

C^Cedar
ICTHUS!

Puget,
Don't get too discouraged after just six weeks. My Doctor told me it might take one to two years to regain function. In Dr. Walsh's Book (2nd edition) he says it might take up to four years. Keep a positive attitude (I know it's not easy!!!) and like Cedar said, do your exercises. Good Luck!
Best,
Mike

---

June 2005 - Age 53 PSA 4.8 at regular physical
October 2005 - After several rounds of anti-biotics, PSA 5.2 at Urlogist
November 2005 - Biopsy negative
July 2006 - PSA 5.9 at regular Physical
October 2006 - After several more rounds of anti-biotics PSA 8.1
November 2006 - Second biopsy - Positive
December 2006 - Gleason (3+4=7), Tumor T1c, CT Scan and Bone Scan Negative
January 2, 2007 Robotic Prostatectomy, University of Rochester Medical Center - Tumor confined but larger than thought, only one nerve able to be spared. Margins clear.
February 2007 - Three to four pads a day, no erection with viagara.
March 2007 - Down to two pads a day, had first intercourse with Erecaid pump and bands, otherwise still flat tire.
April 2007 - First Post-Surgical PSA 0.02 and a great relief! Down to one pad a day. Still unable to achive erection without pump.
May, 2007 - Still one pad a day, even try a smaller pad on occasion. Slight improvement on the ED.
July, 2007 - Six Month Post-op: PSA 0.04 still Non-Detectable. One small pad/day for a few drops only! No change in ED.
"If patience is a virtue, I feel like the most virtuous guy on the planet!"

Thank you, Cedar! I'm scheduled to conference with the team nurse today, and I'm going to raise the additional treatment options you suggest. My periodic calls to the MD staff haven't been all that informative. Maybe I need to be more proactive. Anyway, thanks again. I don't know what I'd do without this forum . . .

Puget,

Through the postings on this forum it is obvious that the interim treatment of prostate cancer caused ED has no commonality in the medical community. While some urologist encourage a penile rehab program and interventions others just shrugged their shoulders and say you have to wait. Just as it is with taking control of the process to determine the treatment you are going to choose for PCa you have to do the same thing with the ED. There are intervention steps while the nerves that have been traumatized are healing. ED drugs, vacuum pumps and injections all address the issue. As to the drugs the statistics that I have seen indicates that they provide an erection reponse for PCa caused ED in only about 30% to 40% of the men. The vacuum pump along with the ED drugs increases the success factor and in most cases it provides an erection good enough for penetration. You just have to decide if the quallity meets your acceptance. Penile injections have a high success rate and produce an erection very close to those that occurred before treatment. Of course the deterrent is to get past the fear and sticking a needle in your penis. There are the lucky ones that get their erections back in weeks but for most of us we are looking at several months if not over a year. There is no justifiable reason to have to go without the pleasure and intimacy of sex for that period of time. If you are motivated enough and you have an urologist that wants to help you then you can get erections and have as normal a sex life as possible while the nerves heal and respond. I have followed the course with the different intervention steps and I am now extremely happy and have peace of mind using injections. I am now approaching eight months since surgery and beginning to get some unassisted erectile reponse. I have started cutting back on the dose of my injections because it is taking less now due to some normal response to stimulation. My urologist believes that the injections can be helpful in getting the nerves to kick in sooner.

Good luck and take control.

Tamu

---

Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3

Thanks to all of you who have offered information and support. Like most of us, some days I feel pretty down, and turning to our "reluctant community of necessity" offers the best support there is. I did talk to my dr's team nurse today. Finally, I think I cut through the platitudes and got some honest advice and reassurance. She also said that for the vast majority of men, 6 weeks is way too early to expect a significant improvement. As Swimom advised, they don't begin to really look for any meaningful improvement during the first 3 months. She told me to stay on 100 mgs of Viagra for another six weeks. At 12 weeks (just about the time I see the surgeon again), they will re-evaluate. She says she sees nothing in my situation to cause any concern and that there is no reason (but no guarantee) that I shouldn't slowly regain function over the next several months. She sees good signs. The fact that I am almost fully continent indicates that the body is healing. Also, I had noticed that my scrotum and penis felt cool to the touch but after increasing to 100 mgs, that seems to be resolving, indicating that blood flow is increasing. Also, since I am experiencing some engorgement with 100 mg is an indication the nerves are beginning to respond. This is the most complete discussion I have had with my medical team, and it wouldn't have happened unless I was motivated to raise all these issues following all of your comments and advice. I love all of you!

1st time post! Glad I found you all! DaVinci radical prostatectomy 2/2/07. Down to one pad a day for about a month now. Still no erections, lots of sensation though. Tried viagra, alot of pressure in my head.(wrong head) Trying Cialis for the second time tonight. 1st try, no pressure in the head(either). Have a very supportive girl, makes me orgasm almost daily. Don't miss the mess, still feels wonderful.
Want to try the shots, afraid of side effects, what is that stuff? Uncomfortable at the thought of walking out of the doctors office with an erection too...
Whew! Nice to talk about this stuff, hard to explain to friends...