New Member

[Nugget]

Hello. I’m fairly new to Franktalk and this is my first post after a lot of reading on this site and many others.
I’m 7 weeks out from having a Radical Prostatectomy. My surgeon has recommended I take 5mg tadalafil daily to help me with my ED and from what I’ve read and heard it could be anything from 6 months to 2 years before I get any function back. I have also purchased a pump for therapy and try to use it daily for 20 mins.
Is there anything else that I should or should not be doing to help with my rehab and at what stage should I be asking about injections to help with erections. I have my next appointment with my surgeon in January.
I would appreciate any feedback.

[bldoink]

I'm not a medical professional of any kind and I'm in no way qualified to give any medical advice.

Do use that VED for therapy regularly.

I mostly used Viagra, initially at the full 100mg dose. You may need to experiment to find which PDE5 pills work best for you.

I don't think now would be too soon to ask about injections. I'd lean towards Alprostadil mono-mix if you're a suitable candidate for it.

How is your incontinence doing? Climacturia after an RP can be an issue. Climacturia is when you orgasm you ejaculate urine. This can be forcefully and copious. I had it bad after my RP.

As my wife isn't in to golden showers I undertook solo practice. I eventually learned I could kegel clamp while climaxing. This took practice and initially pretty much ruined the orgasm. Eventually I got to where I could both clamp to prevent pee and still have a satisfying orgasm. It didn't come naturally but it's a technique I learned. It wasn't a technique I mastered quickly so don't get frustrated. It's no longer an issue now and I don't pee in or on my wife. All is good.

Just be aware that it could be an issue for you during your recovery but that with practice you can overcome it. Of course if your wife is into waterworks there's no need to go solo for practice. Hopefully it won't be an issue for you at all and you wasted your time reading about it. But it's one of those things the urologist should discuss and rarely do.

[Nugget]

Thanks Bldoink.
I have noticed I do leak urine sometimes when I have an orgasm but not every time. Apart from that the incontinence is pretty good.
What is the difference between Alprostadil mono-mix and Trimix and what do you mean by if I’m a suitable candidate for it.

[BelleBite]

Hi One thing you definitely need to do is start doing kegel exercises to strengthen your pelvic floor. Ask your surgeon or urologist about learning the correct way. It's not difficult. Continue exercises even after surgery. Will help with the incontinence.

[bldoink]

Thanks Bldoink.
I have noticed I do leak urine sometimes when I have an orgasm but not every time. Apart from that the incontinence is pretty good.

With practice you can learn to control the leak at orgasm but you'll need to actually concentrate on that at the time. Practice using your kegel muscles at orgasm. You'll be able to find the balance that allows the orgasm while restraining the pee. Voiding before sex is always a good idea. And as Bellebite said, practice your kegel exercises period.

What is the difference between Alprostadil mono-mix and Trimix and what do you mean by if I’m a suitable candidate for it.

Trimix contains 3 ingredients and alprostadil (PGE1) is one of those ingredients. The 3 ingredients together are supposed to act synergistically in that the effect of the 3 drugs together is stronger than just the combination of the effects would be. Kinda like 3+3+3= 12 instead of 9. Some guys can't tolerate alprostadil very well and some not at all. Some guys initially get an ache in their penis that resolves with continued us of the drug (I'm one of those) but some just can't use it. For those that don't tolerate the drug well a trimix will have much less alprostadil. The guys that can't tolerate it at all will have to use a drug combination that doesn't contain any alprostadil, generally a bimix.

[Nugget]

Thanks Bellebite.
I have been doing my kegals now for about a month before surgery and my Physio told me I would be doing them for the rest of my life.
I’ve been very lucky in the continence way, with no need for pads anymore with no leakage since about my fifth week.

[Nugget]

Thanks again Bldoink for your input.
I’d like to be reasonably up to speed with this topic when I see my surgeon next and have an idea of a plan in place going forward.
Cheers.