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User
Posted 09 Sep 2020 at 07:57

Those of you further down the track - can you please help me track progress in recovering from ED? I had nerve-sparing RARP six and a half months ago, and while I still can't get erections sufficient for penetrative sex, I am getting nocturnal swelling (not really erections) that are almost up to full size but not at all firm. And I can have orgasms, with momentary full hardness at the "moment of truth" but can't sustain an erection. My wife is very supportive and we have become inventive about staying connected and making love in an erectionless way. Am I on track to be able to "get it up" in a relatively natural way within the next few months?

I am generally very fit, 62 years old, had full erectile function pre-op. I do regular penile rehab exercises - VED about 5 times a week, daily pelvic floor exercises with supervision by a physiotherapist. Cialis did nothing for me so I stopped a couple of months ago. For now I am assuming it's just an exercise in patience and (pardon the pun) flexibility. I'd love to hear how your experience of the onward journey can illuminate mine.

User
Posted 09 Sep 2020 at 11:01

Hi, 

Six months isn't that long.

I thought I detected improvements and tried to let it come back itself but in reality it was very slow and reached a certain not too great point and hasn't improved.

A doctor said your penis extends and flushes through several times at night and it's better to try to stimulate it, or words to that effect.

I bought a £30 pump after nearly 3yrs and it made an immediate difference to the size and shape but it didn't really improve my ED.  I don't have full ED but it's a limp affair and needs a lot of coaxing.  Gravity also helps a lot, if I stand I can get a full erection with some coaxing.  It's a bit of a false erection I think as I find if I strain on the loo it gets harder so it's down to weight of blood.  There are various other effects depending on how I lie.

Orgasms will occur with no erection at all.

One advantage is the dry orgasm.   Although for some there is some urine leakage as a final punishment.

At 6 months try everything as much as possible.

 

User
Posted 09 Sep 2020 at 11:19
The Durex cock ring will probably solve your issues. What you describe is pretty much exactly what I had. I tried everything and that little bit of squishy rubber solves everything for me.

It has the following benefits:

Allows natural erections to "progress" from a relatively flaccid state through foreplay

Traps your cock at the point of peak erection so helps with erection anxiety which of course becomes a self fulfilling prophecy

Help stop pissy orgasm

User
Posted 09 Sep 2020 at 12:26

Just to emphasise, cock rings (such as the Durex Pleasure Ring) are completely different from the pump constriction rings. Cock rings apply pressure just on the veins draining the corpus cavernosum, and once the corpus cavernosum gets near full girth, it will in any case take over doing that and close off the veins draining it. The pump constriction rings are much tighter and will close off the blood supply too.

User
Posted 09 Sep 2020 at 12:29
Just keep doing what u are doing with rehab. I would agree that daily 5mg Cialis is best taken at night. It will be doing its magic and in time you will improve vastly I hope. Admittedly it took over 2 yrs for me , and I use daily Cialis and a durex ring , but I get fully totally hard without fail now. You do lose length over time with atrophy and your internals readjusting etc , but the use of the pump regularly has made him nice and thick which ladies prefer tbh I hear. I used to squirt a bit here and there for a year or so but never do now. Orgasms back to full strength also. You are early days as others have said so just have faith and keep creative with the Mrs in lots of ways. I always said to my wife that we may be missing an erection , but are having fantastic , fun , adventurous sex with props that the neighbours would envy lol.

Good luck

If life gives you lemons , then make lemonade

User
Posted 09 Sep 2020 at 15:39

Mish

Pre surgery I could hang a towel on my erection, I have often wondered if guys who fully recover get erections that stand to attention. Quite often guys who get a pre op size swelling complain that the base of the penis has no strength.

Early days for you but never give up.

Thanks Chris

User
Posted 09 Sep 2020 at 18:37

Hi,

I'm 10 months post-op and have had significant improvement ED wise only in the last month or so. You describe "momentary full hardness at the moment of truth". When that happened to me it was a lightbulb moment.. something to build on so keep going and enjoy trying. 

Regarding PDE5 inhibitors, I have tadalafil 20mg on prescription and haven't stopped taking them (even when I didn't see the point). I have tried sildenafil a few times but I'm undecided as to whether it does much for me so will continue experimenting anyway. 

Hope this helps. 

Kev

Edited by member 09 Sep 2020 at 18:53  | Reason: Not specified

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User
Posted 09 Sep 2020 at 08:58

I think you are on track.

What dose of Cialis did you have?

Cialis (Tadalafil) is one of four PDE5 inhibitor drugs. These work by amplifying the arousal nerve signal that arrives at the penis, and give you a better erection that you would have had without it.

They also improve the blood flow in the flaccid penis, which helps protect the penis during the period of no or few erections. (A penis needs regular erections to maintain health and prevent shrinking.) Cialis is particularly good at this because it's long lasting. The 5mg daily low dose or 20mg twice weekly will give continuous dosing, i.e. continuous protection. (All the other PDE5 inhibitors are too short lasting to be able to do this.) For this reason, you probably should continue taking it unless it's causing you side effects - the benefits are not just for erections. Also, you will have moved on in a couple of months, and a PDE5 inhibitor may work better for erections now.

However, for erections, you might need the event dose drugs, which would be 20mg Tadalafil or 100mg Sildenafil (urologists mostly recommend trying the max dose of PDE5 inhibitors when aiming for erections during penile rehabilitation). If you do this and you're on the 5mg daily Cialis, I would suggest you skip the daily tablet when using the event dose tablet.

Something else you might try to improve erections for penetration is to use a cock ring such as the Durex Pleasure Ring (but not a pump constriction ring - they are for use with a pump only). The more gentle cock rings apply gentle pressure to the outside of the penis which is where the veins draining the erectile parts (corpus cavernosum) are, and very gentle pressure on these can considerably help maintain blood and increase pressure in the corpus cavernosum, giving you a firmer erection. Cock rings are available to go around the base of the penis, or the base of the penis and scrotum - both ways work, and don't need to be particularly tight. When the blood pressure increases in the corpus cavernosum, it actually takes over the role of squeezing the veins shut. (These are not the visible veins on the outside of the penis - they're a couple of layers deeper and not visible.)

Good luck.

User
Posted 09 Sep 2020 at 11:01

Hi, 

Six months isn't that long.

I thought I detected improvements and tried to let it come back itself but in reality it was very slow and reached a certain not too great point and hasn't improved.

A doctor said your penis extends and flushes through several times at night and it's better to try to stimulate it, or words to that effect.

I bought a £30 pump after nearly 3yrs and it made an immediate difference to the size and shape but it didn't really improve my ED.  I don't have full ED but it's a limp affair and needs a lot of coaxing.  Gravity also helps a lot, if I stand I can get a full erection with some coaxing.  It's a bit of a false erection I think as I find if I strain on the loo it gets harder so it's down to weight of blood.  There are various other effects depending on how I lie.

Orgasms will occur with no erection at all.

One advantage is the dry orgasm.   Although for some there is some urine leakage as a final punishment.

At 6 months try everything as much as possible.

 

User
Posted 09 Sep 2020 at 11:19
The Durex cock ring will probably solve your issues. What you describe is pretty much exactly what I had. I tried everything and that little bit of squishy rubber solves everything for me.

It has the following benefits:

Allows natural erections to "progress" from a relatively flaccid state through foreplay

Traps your cock at the point of peak erection so helps with erection anxiety which of course becomes a self fulfilling prophecy

Help stop pissy orgasm

User
Posted 09 Sep 2020 at 11:38

Thanks Peter - your frank and clear account is super helpful. What I take away is both (as I now know) it is early days AND that the recovery can stall at any point. I will maintain my diligence - as you imply, it is strange that was so natural is now a bit of work, but still worth it.

I think your point about different positions including effect of gravity when standing is more important than many people realise. My Physio recently told me to do all my pelvic floor exercises while sitting, standing and lying down and then while moving and with (as far as possible) an erection - after all the goal is to maintain an erection while moving and in different positions :-)

User
Posted 09 Sep 2020 at 11:40

Thanks for a couple of suggestions about cock rings. My VED (Vacurect) comes with good quality rings, and I am realising that first I was using rings that were too loose - it actually needs to be surprisingly tight to keep the blood in during intercourse. Will also read up about the Durex version in case it offers additional benefits.

User
Posted 09 Sep 2020 at 12:26

Just to emphasise, cock rings (such as the Durex Pleasure Ring) are completely different from the pump constriction rings. Cock rings apply pressure just on the veins draining the corpus cavernosum, and once the corpus cavernosum gets near full girth, it will in any case take over doing that and close off the veins draining it. The pump constriction rings are much tighter and will close off the blood supply too.

User
Posted 09 Sep 2020 at 12:29
Just keep doing what u are doing with rehab. I would agree that daily 5mg Cialis is best taken at night. It will be doing its magic and in time you will improve vastly I hope. Admittedly it took over 2 yrs for me , and I use daily Cialis and a durex ring , but I get fully totally hard without fail now. You do lose length over time with atrophy and your internals readjusting etc , but the use of the pump regularly has made him nice and thick which ladies prefer tbh I hear. I used to squirt a bit here and there for a year or so but never do now. Orgasms back to full strength also. You are early days as others have said so just have faith and keep creative with the Mrs in lots of ways. I always said to my wife that we may be missing an erection , but are having fantastic , fun , adventurous sex with props that the neighbours would envy lol.

Good luck

If life gives you lemons , then make lemonade

User
Posted 09 Sep 2020 at 15:39

Mish

Pre surgery I could hang a towel on my erection, I have often wondered if guys who fully recover get erections that stand to attention. Quite often guys who get a pre op size swelling complain that the base of the penis has no strength.

Early days for you but never give up.

Thanks Chris

User
Posted 09 Sep 2020 at 18:37

Hi,

I'm 10 months post-op and have had significant improvement ED wise only in the last month or so. You describe "momentary full hardness at the moment of truth". When that happened to me it was a lightbulb moment.. something to build on so keep going and enjoy trying. 

Regarding PDE5 inhibitors, I have tadalafil 20mg on prescription and haven't stopped taking them (even when I didn't see the point). I have tried sildenafil a few times but I'm undecided as to whether it does much for me so will continue experimenting anyway. 

Hope this helps. 

Kev

Edited by member 09 Sep 2020 at 18:53  | Reason: Not specified

User
Posted 10 Sep 2020 at 09:57
Thanks Kev T - I also feel like that lightbulb moment, have been feeling way more optimistic recently. Yet change remains slow, and this group is giving me courage to hang in there
User
Posted 10 Sep 2020 at 09:58

Thanks Chris! Yes, that weak base feeling is familiar. My physio is really pushing me to build muscle strength to combat that. It is slow going but I think it is helping.

 
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