Question:
From a previous posting I notice that Roger in our group mentioned that his
Uro did not want him to use the pump. Roger goes on to say that he doesn't
know why but would ask his doc on the next visit. I am interested if any
others have been advised against using the pump by their Uro. I would also
be interested to learn of peoples success with the pump. Not only erectile
response but ease of use or otherwise. How long does it take to pump up?
Are the motorised versions better than the manual ones? I would also be
keen to hear from people who find the pump completely useless and for what
reasons. When replying could you please advise if you had RP or radio
therapy and how long ago and what nerve sparing was achieved in your case.
Answer:
I had a nerve sparing RP at age 67 about a fifteen months ago. (Age can
be important because the risk of impotence increases with age. At my age
my urologist told me the chances were 50/50. Patrick Walsh and his
crew at Johns Hopkins claim to do about 10 percent better.)
My urologist first suggested Viagra as giving a more natural erection
than the pump, but when Viagra didn't work, he had no objection to my
trying the pump and arranged for me to meet a salesman for the Timm
company who explained its ins and outs. (Excuse the unintended pun.)
Because of my HMO I had to run
around in circles a week or so before I finally got it authorized, but
they did cover it. Ordinary Medicare covers it, but it is not
extremely expensive as medical devices go.
The Timm company provides a help number and they give advice freely if
you are a registered user, and that help is generally helpful. (What
else?
We've been using it since about a couple of months after RP. It
requires a bit of dexterity in use, but not an enormous amount. They
advise a week or two of "training" runs before attempting intercourse.
The manual version works fine unless you have some physical problem with
arthritis in your hands or serious problems with coordination. You
probably don't need the motorized version. It is hard to do any serious
damage with it, and I've never had a problem. (I have seen a few reports
of people who have had them.) You have to get a good seal for it to
work, and for me at least the gel they provide does that. If it doesn't
they recommend shaving the relevant area, but I haven't had to do that.
Since the pump can produce what looks like a very impressive and ego
building erection, you should avoid giving in to that.
They advise stopping the pumping when the penis just begins
to lift off the floor of the cylinder. Also, after the ring is on the
penis, it should not look too stretched out. You may feel some pulling
sensations as you pump, but you should stop well before you have any pain.
After the training period, it took me about five minutes to "get it up",
but it can vary from a couple of minutes to ten minutes, particularly if
I don't have a good seal. I've never failed.
The scariest part is when the ring snaps on your penis. It doesn't
really hurt but it does come as a shock. The Timm unit comes with four
rings, with two different sizes and two different degrees of flexibility.
The sizes have nothing to do with penis size but regulate how tightly the
ring fits and whether or not it keeps the blood in your penis. You can
even use combinations of rings, as described in the instructions that
come with the unit. It may take some experimentation to find the right
ring or ring combination. I found even the more flexible large ring too
tight, but when I called them about it, it turned out they had yet
another size which was a bit less tight. (Again let me say this has
nothing to do with penis size.) I've been using that. I had
some problem catching part of the scrotum under the ring, and while it
didn't really hurt, it did make it hard to concentrate on what followed.
But with some care in positioning, one can generally avoid that.
Timm provides a tape showing how to do it, which is definitely X-rated.
The demonstator gets a very dramatic erection;. If yours doesn't live up to that
don't pay any attention. Penis length is not particularly important for
your partner's satisfaction and if anything the girth will probably be too
large.
The erection it produces is not like a normal erection. First of all,
the penis gets quite engorged and is probably larger than a natural
erection can produce. This can create some problems for your partner
particularly if she is not sufficiently aroused. Also the penis is not
as stiff as you remember and flops about some, so it may require some
guidance for penetration. You should be well lubricated from the gel,
but your partner may need some lubrication also.
Your penis may also feel cold and sensation may be
dulled a bit. However, except for the initial penetration, it ought to
be quite satisfactory for your partner. If she had (multiple) orgasms
before and you work at it, she can have them now.
How well it will do for you may
be another matter. But after all you've faced possible death and your
prostate may have been removed, so you can hardly expect things to be
just as they were. But the experience should be satisfactory enough so
that you will want to do it. The ring allows the erection to persist for up
to half an hour, but you shouldn't keep it on longer than that. There
is a simple procedure for removing the ring, but on occasion, it has got
caught in pubic hair, and I've had to work a bit at getting it off. The
salesman told me that I could pump up again and put the ring on if I
waited five minutes after it came off. On a few occasions where I felt
initially I had not got it on properly, I did do that, but for us at our
age, half an hour is more than enough time.
For most men, it takes 3 mos to a year before erections return, if they
are going to, and it can take up to two years. (In my case although I
had some initial stirrings early on, it is over a year before I began to
get what might approximate a natural erection, even briefly.)
Viagra may not be
effective initially but its effectiveness may increase over time.
Meanwhile the pump is always available as a tried and true aid.
One thing that I didn't realize before my surgery was the importance to a
man (at least to me) of having erections, even apart from sex. Normally
a man has several spontaneous erections at night. It is a normal
biological function. I found that when I lost this function, my mind and body
missed it, and it was depressing. It took me a while to come to terms
with that, and I'm not sure I have even yet.
