I'm 71 and had an RP in mid-May, so about three months ago. The incontinence aspect is improving, down to one pad per day and none at night, and I know that recovering erectile function takes more time. That said, I'd like any input on any approaches that might help with that part of recovery.
Prior to surgery, I had no issues getting a solid erection, and often had early morning ones as well. My surgeon told me before surgery that regaining erectile function would likely be at about 80% of pre-op experience, but with the caveat that retaining that capability may or may not occur depending on any complications arising during the surgery. My nerves were spared but my prostate was unusually large, so I'm sure the nerve bundle got stretched a bit getting the gland out.
With respect to erections, I know there are two element to this. Blood flow into and pinching off the outflow in the penis are what I would call "plumbing issues." The nerve signals that control the plumbing responses are what I would call "electrical issues." It's a bit like pumping water into a tank; you can fix leaks in the pipes all you want, but if the pump isn't plugged in, the tank will stay empty!
I'm also aware that lack of use of most body parts can cause atrophy of those parts, so keeping the penile tissues "in shape" is a concern. I have a vacuum pump to keep cells from losing elasticity, etc.
Three things are often mentioned as options for post-surgery ED issues: Cialis, the pump, and implants.
In discussion with my PCP recently, he felt that doing nothing about the ED issue would not be wise in long term...the atrophy potential. He gave me an Rx for Cialis 5mg (once daily) to see if that has any effect. So far, (after 10 days) I've noticed NO effects, but not surprised by that either.
My question is this: I think Cialis is a drug that affects the plumbing aspects of ED, but doesn't do anything to address the electrical side of the issue. Am I missing something on that? Given the cost of this stuff, I'm not inclined to spend money to buy a drug that won't help the underlying issue, which I suspect is electrical.
Any insight or suggestions?