Radical Prostatectomy

Archives1 · Aug 15, 2024

I had a Radical Prostatectomy surgery in September 2019. Still, I use one or two medium pads per day. I'm not using pads at night time. Slowly lay down on the bed and no leakages except one or two drops. On the other hand, I can get an erection, but I am worried that, when it is erected it bends to the upside like a curve, and also it is a bit smaller than earlier. What do I do? Is there a treatment for this? I would love to hear about yours.(This image taken from web)

Archives1 · Aug 15, 2024

I think this is called Pyronies Disease. If it is not painful or interrupts love making it doesn't always need treatment. Tildafil or other medicines for ED may help and some people use a vacuum pump which may also help. I am nine months post prostatectomy. I don't get erections without the pump. Can I ask when yours returned.

Archives1 · Aug 15, 2024

Yes this is pyronies disease and is treatable by a urologist using different methods depending on severity and individual circumstances. You can do research on various medical websites. And you can search for urologists who specialize in this although all urologists would be knowledgeable.

Archives1 · Aug 15, 2024

I have the same thing 16 months out from surgery, though it's not as radical as the image you posted. I have about a 30-degree upward curvature. I noticed my peyronie's after my penis lay limp for a couple of months post-surgery. At first, I tried Tri-mix injections, which caused a large, straight erection, but the erection wouldn't subside, and I ended up in the ER. That scared me, and I didn't take any meds for a few months, relying instead on self-stimulation to try to coax the erection back. After a while, my erection came back somewhat, but that's when I noticed the peyronie's as well as the smaller penis size. My surgeon says peyronie's is caused by scar tissue and is corrected by surgery. He also says he has seen the penis shrink in size but come back to full size after a while. I'm doubtful I will ever get back to my full penis size, and I will not submit myself to surgery again just to correct the peyronie's.

Archives1 · Aug 15, 2024

My surgeon urologist told me to immediately start using a pump and I am about to start Tri-mix - the reason, per my Dr. is that the nerves were damaged/traumatized during the RP and should eventually repair and naturally have erections, but in the meantime, if you don't USE it, you LOSE it!

While the nerves are damaged for now, he said nothing wrong vascularly, so the pump and Tri-mix get blood to the penis, while the nerves are being repaired. He said that he has seen many patients that don't do anything right away and just wait on the nerves to recover, but then do not have the length or girth they used to - which is why he suggests these other options in the meantime.

I saw a specialist Dr. for the Trimix, at the suggestion of my surgeon, but still in the same practice. He did a trial injection in the office to see how I would respond and then, based on that, gave me a range for dosage of injections at home. It definitely worked and it also subsided within a few hours. If it doesn't subside, the dosage may be too high - he said each person is different, which is why he wanted the office visit and trial run. I am still waiting on the Tri-mix to be delivered at home, as it is a compound ('Tri' mix) and only certain pharmacies will produce it. I was told to still use the pump on days that I do not use the Tri-mix, or as often as possible.

Hope some of this helps - never dreamed I would be typing ANY of this - had ZERO symptoms or issues in any category before the RP, but here I am and it beats having cancer!

+God+bless+

Archives1 · Aug 15, 2024

@iuwogeo "never dreamed I would be typing ANY of this - had ZERO symptoms or issues in any category before the RP, but here I am and it beats having cancer!"

You are so right about that lol! In my case, I may have allowed myself to remain limp for too long, hence the peyronie's and reduced size. I couldn't tolerate the ED pills, and I hated the pump and Bi-mix injections. Oh well...it's certainly not the end of the world.

Archives1 · Aug 15, 2024

@thundson1965 might have some great advice for you. I haven’t seen him around in a while though, alas.

Archives1 · Aug 15, 2024

@snow, @thudson1965 just voted up my original post on THIS thread!

Users who rated this post
Posted by: iuwogeo
plus Fist Pump (3)
thudson1965 (3)

He's around! LOL!!!

Archives1 · Aug 15, 2024

@snow Thanks for noticing - I still monitor, but sometimes my migraines are too much.

The suggestions of pills, pumps, and injections are what I did.

If pain is involved with peyronie's disease (for you or your partner) - see your doctor as soon as possible.

Most men will lose a little length and girth after prostatectomy and with age. We have to address incontinence and ED at the same time after surgery. I have read too many times where men will wait to address the ED. The solutions will not work for everyone, but definitely will not work if you don't try even though parts of it is boring and seem non-productive in the beginning and even middle.

I save many of my standard responses in text files to share as new member's ask questions.

Not a medical profession - just stating my process.

Below is a text file that I saved to be able to recount my experience with Penile Rehabilitation.

I am recounting my experience - I am NOT a medical professional.
Penile Rehab / Penile Therapy - Just my experience. In another post someone asked about Penile Therapy - I though it would be good to start a post for use to share our experience.

Updated June 29, 2022 - Prostatectomy Sept 2020 age 55; Male Urethral Sling Surgery Sept 2021

My penile rehabilitation.

1) tadalafil (generic cialis) 10 mg daily (started day catheter was removed)

2) Bathmate HydroXtreme penis pump - started at week 9

3) Trimix penial injections - started at 6 months (doctor wanted to start sooner, but I needed more time to mental adjust to inserting a needing into my penis).

At 9 1/2 months, I have some natural erections using daily 10 mg tadalafil (generic cialis purchased using GoodRx (prescription required)). I use the Bathmate HydroXtreme penis pump 3 to 5 times a week (extreme has a hand pump) (link below). I started Trimix penis injections at 6 months. Using Trimix once or twice a week, I was able to have an erection without Trimix starting around 8 months after prostatectomy. I still use the Trimix once a week (March 2021 to Sept 2021).

At 9 1/2 months, I am incontinent leaking about 20 ounces a day (4 pads a day).

The longer version of above :

1) Just after treatment (prostatectomy) Daily cialis is about getting blood flowing to the penis. It took 3 months to notice any firmness about 50%. I use GoodRx to find a good price - a grocery chain store pharmacy had the best price for me.

2) My urologist recommended the Bathmate penis pump. Unless you have a firm pelvic area, you will want the Bathmate with the hand pump - HydroXtreme. I went from 5 1/4 inches before prostatectomy down to 4 inches, then back up to 4 3/4 inches after using the Bathmate pump for 3 months.

The Bathmate HydroXtreme pump is more about penile rehabilitation than producing an erection to constrict (ring to hold erection) and try to use for sex.

I sit on the corner of my tub with cups of warm water to fill the cylinder (about 100 degree). The instruction are to pump for 3 minutes, massage for 2 minutes (I use shampoo plus conditioner to reduce friction), and repeat twice for a total of 3 times 15 minutes.

The Bathmate uses water in the cylinder and seems to work on girth more. I am not looking to get bigger than I was, just to restore my pre prostatectomy size.

Bathmate website - sign up with your email to get 20% to 30% off.
Get the Xtreme because of the hand pump. I purchased the comfort cushions to reduce the chance of pulling a testicle into the pump (very painful). The size of the cushion ring goes with the size of the pump.

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YouTube search for instruction - note - most are not using the pump for rehabilitation. Sign into YouTube with a gmail account to see adult versions.

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I also purchased the Vacurect. I used it a few time with the rings, but the ring to hold an erection was to constricting. I also used it a few times for blood flow (pump 2 minutes, release 2 minutes). I prefer the Bathmate.

3) Trimix injections - I had a difficult time starting and using these. I was shaking inserting the syringe at first. Do NOT use an auto injector - it was not the thing for me to do. I had to stop for a while because I was putting too much mental pressure on myself to use the Trimix when I was not ready.

I also had concerns about using Trimix for every erection or orgasm. I would use Trimix, then not feel like trying for an orgasm for 5 days. That was okay. After 6 weeks on Trimix, I noticed on the days trying for an orgasm without Trimix that my erections were getting firmer and at 8 weeks of using ( month 8 ) I was getting to 90% hard.

Trimix is ordered from a compounding pharmacy. It comes in a 5 ml bottle. My initial does of 0.15 cc or 0.15 ml produced a 6 hour erection. Some member in the Facebook group (link below) also reported that they had to return to the doctors office. Make sure you get your initial dose in the morning so that if there is a problem, you can return to the doctor. After 4 hours, I contacted my doctor - I took 4 30 mg Sudafed (the 4 hour pill not the 12 hour pill).

I found that 0.05 cc gave me a 4 hour erection in the beginning. You can prefill a few syringes. I found that adding an extra 0.05 cc for storage. Before use, you shake the syringe and squirt out the extra trimix. (Trimix is compounded and needs to be shaken before each use for better results.)

Trimix tips
0) Trimix is stored in the refrigerator or freezer
1) comes in a 5 ml vial
2) make sure the order comes with 20 to 40 syringes
3) Ask the doctor to include the "Undo" injectable or pills so that you do not have to go to the emergency room.
4) Have 30 mg generic Sudafed tablets on hand (After my 5th time injecting, I started taking FOUR 30 mg Sudafed tablets after one hour.)
5) I found eating and drinking 32 ounces of water worked better than the Sudafed at deflating the erection. Part of it is that I am taking my attention away from the erection. I will watch an hour of Television.

I signed up for too many Facebook Groups and had to select a few that were more suited for me. Some groups as new members join will trigger PTSD for reliving the post prostatectomy trauma, sadness, and anger of the side effects of prostate cancer and prostate cancer treatment.

Facebook Groups - these are Prostate Cancer Groups that are for members only - you have to join the group and your messages will only appear in the group and not on your Facebook home page.