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Alternative to tadalafil

User
Posted 21 May 2020 at 06:04

Hi all, it's been 12 months from my op and to be honest this have gone quite well with recovery. No incontinence from day 1 and a little bit of semi stiffness with the old guy. I take tadalafil 20mg but break it into 3 and take 1 piece daily..Have also tried taking the 20mg in one go instead of the daily but there is no difference..I also use a somatherapy pump for rehab but that doesn't do much but in the way of stiffness..In 2018 before my op I my wife passed away during a minor procedure so I have not been intimate with anybody else since then..I understand that with the use of tablets for ED there has to be some kind of intimacy for something to rise..Recently I have met someone and we have been intimate a few times but nothing rises to the occasion..Whether it's nerves or confidence or I need to move onto something else in terms of ED treatment..so my question is has anyone else had the same experience..have you overcome it..is it still early stages to expect something..what are you thoughts on such items like creams and invicorp 25 injections or should I just persevere with tadalafil and practice..

By the way Gleeson score was 3+3..t2c tumour confined and both sets of nerves were saved..

Any advice would be grateful. Thank you all..

User
Posted 21 May 2020 at 12:03
You have given tadalifil a fair chance of working but it doesn't seem to be the perfect choice for you. I would ask the doctor if you can have a try of Viagra or Levitra - you can carry on taking the tadalifil thirds on a daily basis but then if you have a Viagra, don't take the tadalifil third on the same day. I wouldn't try injections or pellets until you have exhausted all possible tablet options.

When you have tried the whole tablet, have you left enough time for it to work? None of these work immediately.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 21 May 2020 at 12:35

I was given tadafil a month before the op and to be honest wearing joggers were out of the question. It was about 3 hours previously that I took the 20mg to no avail. The consultant did explain that if you had no problem before you should have no problem at a later date also explaining that a lot of it can be in the mind and yes maybe it could be a unbeknown psychological issue that I am not aware of. I should feel embarrassed by it but I don't and maybe because I have been taking the daily 5mg for over 12 months by taking the 20mg it has upset the ballance, I do not know. My next move is to try and get an appointment withe ED nurse. 

User
Posted 21 May 2020 at 13:52

It can take a long time to get an ED referral.

You might well find your GP is happen to provide you with Sildenafil (Viaga) and Vardenafil (Levitra) to try (not at the same time). Actually, I think all the PDE5 inhibitors say not to be taken with any other ED drugs, but all urologists I've come across seem fine with taking the 5mg daily low dose Tadalafil with any others.

I would agree with Lyn - try all the tablets (PDE5 inhibitors) before going on to the injections and creams (vasolidators). Some ED clinics seem to take a totally random approach, and I have to wonder if the clinician has any idea what they're doing or how the drugs work.

User
Posted 22 May 2020 at 00:08
I can speak from experience intamacy is really tough starting a new relationship after a prostatectomy.

So few tips from someone who didnt have the opportunity of sex for a year after his op.

1) Practice on your own is essential for finding what works, you don't want to be fafing about with pills and potions that you are not confident with while trying to have sex with a new girlfriend.

2) Be up front with her about your currently limited ability's. It makes things a lot easier if they want to help you.

3) Because the pills are unreliable (especially if you are nervous) I opted for injections early on and while they take a bit of explaining they work reliably so will give you confidence.

Finally don't give up, took me a few years and 2 intimate relationships before I hit the jackpot and found my soulmate.

User
Posted 22 May 2020 at 11:56

I have also read about combining certain tablets-5mg tadalafil dailies in the morning and taking 50mg-100mg sildenafil and hour before any special event if you know what I mean. Has any taken the above and what results did they have. As far as Tadalafil goes I have had none of the classic side effects.

User
Posted 22 May 2020 at 14:31
John had daily Cialis for 4 years for nerve repair / recovery; he also had Viagra then Levitra and then Caverject for events. At first, the GP refused to prescribe both at the same time but backed down under pressure from the ED nurse. The absolute rule the ED nurse gave us was to never take the Cialis in the same evening that he was intending on using the Viagra / Levitra or Caverject or, if he was taking Cialis in the morning, to not take it if he had used the Viagra or Caverject the night before.

We were fortunate though that we had a pre-printed letter from the ED nurse to show to A&E if he had a priapism (not everyone here seems to get that) and. after the priapism incident, the urologist prescribed an antidote (on private prescription) which I know other members here have been refused.

I want to pick up on your comment about taking sildenafil an hour before an event, though. Not all men find it works that quickly - if John wants sex in the evening, he takes the Viagra in late afternoon - for morning sex he would need to take the viagra at bed time. It should always be taken on an empty stomach. Levitra works a little quicker here - about 3-4 hours. But every man is different so you might need to play about with different time lags.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 23 May 2020 at 22:36

Hi Lyn

As usual. very helpful info.  Due to a new relationship and accompanying sex life (woohoo!), I'm now trying out different PDS5s to see what suits best.  Your posting of:

"At first, the GP refused to prescribe both at the same time but backed down under pressure from the ED nurse. The absolute rule the ED nurse gave us was to never take the Cialis in the same evening that he was intending on using the Viagra / Levitra or Caverject or, if he was taking Cialis in the morning, to not take it if he had used the Viagra or Caverject the night before

was most detailed, and gratefully received.  My query is...  why?  Is it due to priapism risk, blood pressure risk, or something else?  Tis true, I would like to experiment, and any tips beforehand would be most welcomed.  For me currently, a more-or-less daily top up of 5mg tadalafil interspersed with a special day dose of 100mg sildenafil works perfectly, although I suspect 50mg Sildenafil might work equally well.  But could I take 5mg tadalafil and 50mg sildenafil daily?  That's my new target, but I'd prefer to avoid the priapism of heart failure! Next up, Invicorp 25....

Thanks, G

User
Posted 23 May 2020 at 23:03
If you are getting erections with tadalafil you are not suitable for invicorp.

If you can get erections with 100mg sildenafil for events, what's the point of going to 50mg sildenafil daily?

I assume you do not fall into the group of men who suffer visual disturbance with sildenafil - regularly not being able to drive would put John off using it every day.

I dont understand what you are trying to achieve.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 24 May 2020 at 07:12

It’s all a weird science. I now 5 yrs on just need the daily Cialis and a durex  cock ring. I can’t explain the difference between ring and no ring , but it turns a 90% into a 100%.
They say not to mix drugs as they have to , and essentially it’s unsafe for all the reasons you describe. If something is gonna work then it will despite mixing. I tried Invicorp privately having had zero success with Caverject but I ensured I dropped the Cialis. It was truly brilliant. Back to pre op even if shorter yet fatter from all the pump use. However it got me so hard each time it gave me a tiny bit of incontinence. The erection went soon after sex but was back for a second round a while later normally.

Edited by member 24 May 2020 at 07:34  | Reason: Not specified

If life gives you lemons , then make lemonade

User
Posted 24 May 2020 at 07:31
I forgot to add that on the occasions I tried upping doses or mixing slightly then there was no real effect for me. For example I’d go on a date night and add another 15 mg of Tadalafil thinking it would make things even better , but it rarely did tbh. Not noticeably. Have you used the cheap durex ring yet ?? And keep pumping every day.

If life gives you lemons , then make lemonade

User
Posted 24 May 2020 at 14:42

Originally Posted by: Online Community Member
I can’t explain the difference between ring and no ring , but it turns a 90% into a 100%.

Two effects.

The cock ring exerts pressure on the veins draining blood from the corpus cavernosum, reducing the draining, so you can build up more blood in the corpus cavernosums.

If it's a vibrating ring, the extra stimulation generates additional arousal, both to the brain which may increase the arousal back down the erection nerves, and also via a spinal arc reflex, bypassing the brain and direct to the erection nerves.

User
Posted 24 May 2020 at 15:47
I used the pump every day for about 6 weeks post op and about twice a week now. With not having a partner I suppose it is hard form to get aroused. I've met someone now so whether it's nerves or something like that I don't know. I'm still taking the tadalafil and there is some movement especially when you DIY..not the hardest but work in progress..one thing that I have noticed the orgasms are more intense that before..I'm open to any advice that anyone has..
User
Posted 25 May 2020 at 19:08

I have been on the usual websites and are there any recommendations on which cock ring to buy. I've never used one just never had to until now.. do the vibrating ones stimulate and arouse you more or do the normal ones work just as good..

User
Posted 25 May 2020 at 20:35
I’d ditch the vibrating ones with a new partner. They can honestly make such a difference. The tablets you take need stimulation to work. For a lot of men and certainly myself , visual stimulation and a partner is key. I’m not very good at masturbation these days. If you go to Lovehoney.co.uk they do a cheap starter set of rings. You get three for about £10. I wish I could link you and will try. They are NOT tight at all and really easy to use , but just enough pressure to stop the flow of blood out of the penis. A real game changer for many.

https://www.lovehoney.co.uk/product.cfm?p=34881

If life gives you lemons , then make lemonade

User
Posted 25 May 2020 at 21:28

I think that you have hit the nail on the head with visual stimulation. I lost my wife in 2018 just after being diagnosed. So since the op in May 2019 there has been no one until the last couple of weeks..I'm trying sildenafil next instead of Tadalafil and a ring so hopefully get some life back into the old fella. I was told by the ED nurse that you can lack confidence and nervous with a new partner even without feeling it.

User
Posted 25 May 2020 at 21:58
Well for us communication was everything totally. I would honestly open up fully to this lady so she understands the depth of your problem which isn’t your own fault. Yes she may run but I doubt she will. If the pressure is off for you to get an erection and perform then it’s way more likely to happen in my opinion. And loads of ways to skin a cat yeh. If you offered her an hours massage and then oral sex she would bite your hand off probably lol. Best wishes to you and your new relationship. I hope it works out.

If life gives you lemons , then make lemonade

User
Posted 25 May 2020 at 22:07
Yep it really is a tough but exciting time being back in the ring with a new partner post RP.

Regarding stimulation I find for a given hardness you need several magnitudes of stimulation more to achieve the same result as prior to RP. You also need more to keep it up. The Durex cock ring helps get it harder and keep it that way so is a real help.

User
Posted 25 May 2020 at 23:16
My mum died about a year after dad had his RP. When Dad met his new partner, he told her early on that he needed caverject and it didn't put her off. Sadly, she died in 2018 but dad has found another new lady and she doesn't seem phased by the ED solution either.

It is his twinkly eyes.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 26 May 2020 at 06:34

Yes got to be up front, if you aren't they will find out anyway!

I think caverject is useful rather than a pump and construction rings. I found the latter is a real passion killer in its use and the point at which you need to use it. Whereas the injection can be given quickly and the results are really natural.

Pills are hit and miss so you risk failure which reinforces the mental anguish. 

 
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