Looking for experience with Tadalafil after RP

[gamma909]

Underwent RP in October 2018 with nerve sparing on one side. Urologist recommended, but did not push, a daily regimen of low-dose (7 mg) Tadalafil to help with ED. I considered this for a while and recently decided to move ahead and give it a try. I would like to learn from others who have taken Tadalafil what their experience has been, how long it took to observe any effect, recommendations on when to take the drug, other usage recommendations, and so forth. Thanks in advance.

[Tall_Allen]

How are you coming along with your continence? Cialis can affect that.

[gamma909 in reply to Tall_Allen]

Thanks for asking. I am making slight improvements and having regular PT helps. So although I have setbacks on occasion, the trend is in the right direction. My guess is that I will one of those men who takes 6-12 months to regain a more acceptable level of continence. I had heard that Cialis can affect incontinence so I am monitoring very closely. So far, I have not observed a difference. I asked my Urologist about this and he did not think it would be an issue. He did walk through all of the potential side effects. At the same time, I do my own research and take Urologist's feedback as just one opinion.

[Tall_Allen in reply to gamma909]

For this reason, it may be a better idea to use Cialis only "on demand" rather than nightly, with a pump used daily and trimix used intermittently to get better blood flow.

ncbi.nlm.nih.gov/pmc/articl...

[Wian in reply to Tall_Allen]

Tall_Allen,

If taken, is it advisable to take it at night instead of a daily morning dose. I thought it doesn't really matter with Cialis as long as it is taken at the same time everyday and that it remains in your system for 36 hours, also that it is not necessary one has to take it with food.

Thanks!

W

[Tall_Allen in reply to Wian]

True. Take it whenever you like - it will achieve a steady-state concentration in your blood no matter when.

[Wian in reply to Tall_Allen]

Thanks very much!

[Wian]

Hi Kurt65,

I had my Nerve Sparing RP surgery on Jan 5, 2019. I started with Cialis 5 mg 2 weeks before the surgery and then re-started 3 days after surgery. I take it in the morning everyday (Tall_Allen, is it advisable to take it at night?), so far not seen any side effect. Incontinence is much better and in control for the most part.

I'm in India at this time and do not have any resource for penal rehab before or after surgery. I reached out to a doctor in Miami and he suggested I start with this dose, and start with the pump 6 weeks after surgery. I'm due to start that this week.

Hope this helps!

- W

[gamma909 in reply to Wian]

Thanks for the reply. I continue to do research on Cialis after RP and there are a number of different studies regarding its efficacy as well as impact on incontinence. Similar to other PCa medical research I've gathered, the studies do not necessarily come to the same conclusions (e.g., one study suggests negative impact on incontinence while another notes positive impact for men aged 61-68), the sample sizes tend to be small, and dosages tend to be higher than the low-dose that you and I are taking. For me, I will see how it works out and closely monitor side effects. I also had pump recommended by my physical therapist but have not yet decided on that treatment. Good luck and good health!

[Wian in reply to gamma909]

You as well!

[MelbourneDavid]

I used daily 5mg tadalafil for about 18 months. It was the only PDE-inhibitor regime I found tolerable - even low dose Viagra gave me gut trouble and 20mg Cialis (tadalafil) on demand was similar.

A few men get back pain with tadalafil but usually it has fewer side effects than Viagra (sildenafil).

Timing didn't seem to matter with low dose daily tadalafil.

Tak8ng one of the PDE-5 inhibitors has been demonstrated to protect against scarring in the corpus cavernosum so it's highly recommended to do this while waiting for erectile nerve recovery.

Sadly my erectile nerves never recovered and pumps weren't satisfactory. I had an implant but it gets painful during intercourse, so my sex life is very much harmed. I was unlucky, but I have undetectable PSA 4 years after removal of a 20cc stage 3A cancer with no other cancer treatment, so I had a good cancer control outcome.

[gamma909 in reply to MelbourneDavid]

Thanks for sharing your experience. Agree that the most important outcome is to remain cancer free and your PSA results are great. So far, no major PDE-5 side effects and have also read that PDE-5 can help reduce scarring so I will stick with it for now. With nerve sparing on one side, I am hopeful but realistic about recovery. Right now I am more focused on incontinence - trending in the right direction but still having a big impact on my QOL. I wish you all the best and continued good health.

[Potenzguru]

It is better to take medicine at night rather than taking it mornings. I

[Roamer321]

The reason to take at night before bed is that if you have side effects you will not notice them as much. I et indigestion sometimes and minor muscle soreness. I would highly suggest you start with a pump now because that will decrease the penis atrophy.