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Thread: Backsliding in regards to erections

  1. #1
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    Backsliding in regards to erections

    DH had Robotic surgery March 2018. Nerve sparing and was getting erection (using Sildenafil) after 7 months and able to have sustainable intercourse. After about a year he no longer needed the Sildenafil and was able to get and sustain an erection on his own. Now, 15 months after surgery he can get an erection but not as hard and not sustainable for intercourse. He took the medication again last couple of times for penetration but is very concerned about backsliding in this area.

    Has anyone experienced this? His next appointment is Sept with surgeon. Thank you
    Age 64 brother passed from PC age 57
    PSA 4
    12 core BX Oct 24, 2018
    3 cores positive PC rt lateral base
    Gleason 3+3, 3+4, 4+4
    Bone scan negative
    CT negative
    RALP Surgery March 9, 2018
    T Stage: T2c
    Nerve sparing both sides
    Lymph nodes clear
    Margins clear

  2. #2
    Moderator Top User HighlanderCFH's Avatar
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    There could be other reasons (hopefully temporary things) for his erections not being as hard. Since he has been able to have penetrating erections since the surgery, that suggests to me that the mechanics are able to work.

    Even if he needs occasional help with the Sildenafil once in a while, things should still be okay as the future unfolds.

    For peace of mind, maybe it would not hurt to have an appointment with the surgeon before the Sept one, or at least a phone conversation.
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Seven annual post-op exams 2012 through 2018: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  3. #3
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    There are all kinds of reasons for erection issues. Appearently your surgery was not one of them. Look for other causes. Anxiety or depression can be a cause.

    Are there new influences; medications, obesity, low activity or exercise, alcohol?
    Last edited by Another; 07-12-2019 at 02:17 PM.

  4. #4
    Have I experienced it? It was my number one struggle for 15 years.

    There are many causes and MANY solutions to ED. 3000 mg of over the counter supplement L-Arginine is a help. What is commonly known as a cockring helps. There are Vacuum Erection Devices (VEDs). many of these solutions can be combined. There are penile implants that essentially make a man bionic. One wife described it a the "new improved male 2.0"

    I am happy to have an indepth exchange with you over the forum, via private message, or even by phone. It is the one thing I know. You might consider http://www.peyroniesforum.net/index.php as a resource and scroll down to the ED section. If he has a will, he will never be beyond a solution. I am about as content with my ablity now as I was at 18 yrs old.
    Last edited by Hawk; 07-14-2019 at 02:31 AM.
    History: age 53 It took 3 biopsies (34 cores) to find 2 cores 4+4 Gleason 8
    Lap RP at MSKCC Apr 2004, age 54 All neg margins, nodes & structures. (T2a).
    Post RP PSA: <.1 until Feb, 08 (46 mos) PSA 0.1 - I then got sensitive tests -> 2008: Feb 0.06,
    May-08 0.09 - Jun-08 0.10, - Aug-08 0.10, - Nov-08 0.15
    SRT Dec-2008 ---Post SRT PSA 2009, Feb-09 0.10, May-09 0.09, Aug-09 0.06, Dec-09 .04, - 2010 Mar-09 0.04, 2011 .02, 2012 .02,
    STARTED UP Feb 2014-0.06, Jul-2015 0.10, Oct-2015 0.10, Feb-2016 0.15, Jun-2016 0.17, Dec-2016 0.25, Jan-2019 0.74, Jun -2019 0.72
    Aug 2018 Auximin scan - nothing
    Had an inflatable penile implant 2018 for ED. Best decision ever https://www.peyroniesforum.net/index...oard,56.0.html

  5. #5
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    Thank you so very much. Hawk, appreciate you sending me the link and the offer to contact you privately.
    Age 64 brother passed from PC age 57
    PSA 4
    12 core BX Oct 24, 2018
    3 cores positive PC rt lateral base
    Gleason 3+3, 3+4, 4+4
    Bone scan negative
    CT negative
    RALP Surgery March 9, 2018
    T Stage: T2c
    Nerve sparing both sides
    Lymph nodes clear
    Margins clear

  6. #6
    Senior User
    Join Date
    Jan 2019
    Posts
    464
    Simple explanation is age.
    DOB 5/1957

    PSA - 11/2010=1.9, 6/12=2.3, 12/13=2.19, 12/14=2.64, 3/17=5.29, 3/17=3.91, 6/17=3.47, 12/17=4.50, 12/17=3.80, free PSA low risk (local (Uro, “My opinion you don’t have cancer), 8/18=5.13, 10/18=5.1, 10/19 ISO PSA 56% risk cancer. All DREs negative.

    DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM <5%, Right side negative, (Uro opinion “This has been going on for a year”.... ah, more like 2 years ). Bone scan/CT negative

    2/25/19 R-LESS (Robotic Laparoendoscopic Single Site Surgery) outpatient Cleveland Clinic,

    3/6/19. Pathology - Grade Group 4 with Intraductal Carinoma
    T3aNO, GS8, 21 mm unifocal tumor 10%. -7 Nodes, - SV, - Margins, - PNI,
    - bladder neck neg., +LVI, + EPE non focal apex/mid lateral 1mm max extension, Cribriform pattern present. Decipher .86 High Risk.

    PSA 3/27/19 .03. (29 days)
    4/25/19 <.03. (58 days)
    5/25/19 <.02. (88 days)

    ADT - 6/3/19
    ART - 8/5/19

  7. #7
    Top User
    Join Date
    Aug 2016
    Posts
    1,638
    Quote Originally Posted by Duck2 View Post
    Simple explanation is age.
    Unless it was a sudden and noticable regression.
    Born 1953
    family w/PCa; grandfather, 3 brothers
    07-12-04 PSA 1.90
    07-10-06 PSA 2.02
    08-30-07 PSA 3.20
    12-01-11 PSA 5.69 Internist recommends urologist, I say no
    05-16-12 PSA 4.76 manipulate w/diet & supplements
    12-11-12 PSA 5.20, Health system changes to 3 years on testing
    03-07-16 PSA 7.20 Internist adamant on urologist
    DRE smooth, enlarged
    03-14-16 TRUS biopsy-prostatic adenocarcinoma 1%-60% across 8 of 12 samples, Gleason 3+3=6
    03-31-16 MRI pelvis w/o dye
    05-04-16 DaVinci prostatectomy, nerve sparing, Dr. Kent Adkins - recommend
    Final Path; weight 65g, lymph nodes, seminal vesicles, capsule, margin all negative, Gleason 3+4=7, Tumor volume 35%, +pT2c
    Catheter out - 16 days
    Incontinence at 6mos is minimal – no pad
    Cialis 3x/wk & Viagra on occasion
    Begin self-injection needle therapy for erections, stop after 6 due to onset of Peyronie’s
    Erections 100% - 14 months
    5-21-19 PSA <0.02, Zero Club 3.5 years

 

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