Upcoming Prostatectomy - Best Practices

[HelloMallo]

Dear all,

I am scheduled for a radical prostatectomy. As I know many of you have had the same, I'm hoping for the advice and wisdom from the group. Of course, I will also speak with my doctor about these topics, but I think I will have better questions for him if you all share experiences first. Thank you in advance.

1. What can / should I be doing BEFORE surgery to improve my recovery after surgery? Kegals ahead of surgery seem clear. What about anything else. Would it help to start cialis BEFORE surgery? Would it help to start pumping BEFORE surgery?

2. After surgery, I have read on this site a good deal of information for actions that can be taken to increase odds of regaining spontaneous erections and to avoid/minimize loss of penis length. Again, I'm looking for your wisdom.
How quickly should one start cialis? Immediately? Only after catheter is removed?
Vaccuum pump (right after catheter comes out?)
Injections?

I would very much like to do whatever I can to maximize my chances of success. Again - thanks for your advice.

[bldoink]

1. What can / should I be doing BEFORE surgery to improve my recovery after surgery? Kegals ahead of surgery seem clear. What about anything else. Would it help to start cialis BEFORE surgery? Would it help to start pumping BEFORE surgery?

Yeah, do your kegals. I'd consult with your doctor on the preoperative Cialis idea. If you're currently getting good erections I doubt pumping before RP surgery would do much good.

2. After surgery,... How quickly should one start cialis? Immediately? Only after catheter is removed?
Vaccuum pump (right after catheter comes out?) Injections?

As soon as possible AFTER approval by your doctor. I'm thinking the pump might be a bad idea before your urethra is TOTALLY healed. Don't forget, it's been severed and then reconnected. I don't think I'd want to be stretching on it before it's totally healed. It isn't totally healed when the catheter comes out. They used to do a pressure test but I don't think they do that any more.

Good luck.

[silver daddy 1960]

Hi
I too had my prostate removed 12 years ago (Robotic radical prostatectomy) and still undetectable but what I want to say is "talk to your Dr about your concerns regarding your erection and sex". Do not let, getting your spontaneous erection back, get in your head. Which from my experience, it sure can mess with you. Bldoink is correct, you need to heal before pulling on anything, but the Dr will tell you when its ok to get off with a softy (well also wet) and get you set up with a VED, pills or injections. There is a lot more that can be said (I am not a Dr and can only speak from my experiences), but I want to wish you well and PM me if you have any questions.

[backup2014]

Ten years out from RPS. Stool softeners four days before surgery. If not I promise you the last thing you will be worried about is a boner. I’ve never used a VED since RPS. Didn’t want to risk popping off a tube from the pump in my nutsack. Some guys skate through this procedure with no issues. I on the other hand was in the hospital five days after surgery. Mainly because I couldn’t crap. I was in terrible pain. As the other guys have said leave the pumping alone for a few months. As always ask your doctor when you should resume pumping. Good luck, don’t think the first month is your new normal. Let your body heal.

[bldoink]

Dear all,

I am scheduled for a radical prostatectomy. As I know many of you have had the same, I'm hoping for the advice and wisdom from the group. Of course, I will also speak with my doctor about these topics, but I think I will have better questions for him if you all share experiences first. Thank you in advance.

You may find this thread useful if you haven't already viewed it:

https://www.franktalk.org/phpBB3/viewtopic.php?f=14&t=23904

[Erwillian]

I had RARP in 2020. I wish the Dr had been a little more forthcoming about the possible implications. Prior to that I was using daily Cialis. "Nerve Sparing" is a goal. Even though the surgeon was very careful (mine took six hours) I don't think they can actually see the nerves.

The decision to do the surgery was to get it out of there (I was stage 3). Radiation was an option, but that can certainly damage other things. Still *very happy* I made the surgery decision. No evidence of cancer (PSA levels) four years out.

After the RARP nothing worked. I tried injections (for me that was very easy) but I am one of those guys (maybe 30%) that has a painful reaction to the Aprostadil, which is the primary driver in TriMix. Doppler ultrasound confirmed the issue as well.

Finally found a doctor I liked and had the implant a couple of weeks ago. I seem to be doing well. BTW, I did the VED for a week prior with the Dr's okay.

Three takeaways:

1. Get your head around the possibility that you *may* ultimately need an implant after RARP, even though some guys come through it with zero issues.
2. Penile atrophy is very real, even though a lot of urologists downplay that. If a guy doesn't have regular erections (including morning wood) that will likely happen. There is stuff you can do to reduce that and it will help if you go for the implant in the future. Read up on that. Dr. Clavell is great source. Do be aware: there is a considerable difference of opinion between urologists on this whole subject.
3. Don't procrastinate.

I am happy to fill you in on my experience with the RARP, or answer any specific questions, if you PM me.

[ftwabeck3533]

Dear all,

2. After surgery, I have read on this site a good deal of information for actions that can be taken to increase odds of regaining spontaneous erections

Another thread.....viewtopic.php?t=23130