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Message from a Patient: Delayed Return of Erections
(Dr. Catalona wants to share this message he received from a patient.)

I am approximately 18 months post nerve sparing radical prostatectomy.

My erectile function is just now beginning to return to near my pre-operation level. I was able to achieve penetration and go to completion using a 20 mg Cialis dose for the first time last week.

I’d like to share a suggestion from my experience: Patients should learn about using a vacuum pump and/or a "cocktail" injection to allow sexual activity after an RRP.

I began my post radical process of attempting to recover erectile function by taking Viagra three times per week with sexual stimulation. While I was able to achieve a "soft off" this way, it did not produce any noticeable erectile function.

Nine months post surgery, unhappy that I could not achieve an erection and concerned that not having an erection would produce long term atrophy, I tried both the vacuum pump and a “cocktail” injection.

Both methods have pluses and minuses.

The cocktail produces a great erection, but also produces discomfort and lasts up to three hours.

The vacuum pump is hard to manipulate successfully; the ring is a bit unwieldy; and the erection is harder to maintain.

But in both cases, the ability to have sexual success is a great cure for the frustration of not being able to produce an erection and also made me feel like the atrophy problem was being addressed. I was at least actively doing something that felt like it was working.

Post radical prostatectomy patients should be encouraged to use these methods for both psychological and potential physiological reasons.

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