When Can I Take Cialis or Viagra After Prostate Cancer Surgery?
By Dr. David Samadi
Prostate cancer surgery, specifically a radical prostatectomy, can significantly affect sexual health. One of the most common concerns after surgery is the recovery of erectile function. Many men consider using erectile dysfunction (ED) medications like Cialis (tadalafil) or Viagra (sildenafil) to help with this. Knowing when it’s safe and effective to use these medications post-surgery is essential.
Erectile Dysfunction and Prostate Surgery
Prostate cancer surgery can damage the nerves and blood vessels responsible for erections. Even with nerve-sparing techniques, erectile function may not return immediately. It can take several weeks or months and for some men, possibly up to a year or more before regaining natural erections after surgery.
This delayed recovery is because the nerves, even when spared, need time to heal. During this period, ED medications can help by increasing blood flow to the penis, preserving the health of erectile tissues, and improving the chances of regaining function.
When Is It Safe to Start Cialis or Viagra?
The timing for starting ED medications after prostate surgery depends on several factors, including your health, the type of surgery, and your doctor’s recommendations. Here are key points to consider:
Doctor’s Approval Is Essential
Before starting any medication, getting approval from your urologist or healthcare provider is critical. Doctors typically recommend waiting 4 to 6 weeks after surgery to allow the body to heal. The exact timing depends on how your recovery progresses and whether any complications, such as infection or bleeding, have occurred.
Penile Rehabilitation Program
Some doctors recommend taking tadalafil (Cialis) or sildenafil (Viagra) two weeks before surgery; however, I do not. The reason is men who were sexually functional and free of ED before surgery will not benefit more by taking these medications beforehand. The same is true for men who experience ED before surgery. What I recommend is that all men start these medications about seven to ten days after the surgery, after the catheter is removed. When the catheter comes out, taking 5 milligrams of Cialis or Viagra may bring more blood to the penis to keep its muscles active as part of penile rehabilitation. The aim is to enhance blood circulation to the penis to facilitate restoring sexual function faster.
Nerve-Sparing vs. Non-Nerve-Sparing Surgery
How quickly your erectile functioning recovers will depend on what type of surgery you had:
- Nerve-Sparing Surgery: If you had a nerve-sparing prostatectomy, such as my SMART surgery, your chances of recovering erectile function sooner are higher. In these cases, your doctor may recommend starting Cialis or Viagra a few weeks after surgery as part of your recovery plan.
- Non-Nerve-Sparing Surgery: If your surgeon had to remove or damage the nerves during surgery, regaining erectile function may be more challenging. While ED medications can still help, other treatments like penile implants, vacuum devices, or injections may be needed to manage ED.
Daily vs. As-Needed Use
Cialis is sometimes prescribed in lower daily doses to promote regular blood flow and spontaneous erections. Viagra is typically taken on an as-needed basis, about 30 minutes to an hour before sexual activity. Your doctor will guide you on which option might work best based on your recovery and personal needs.
Understanding Expectations After Surgery
It’s essential to set realistic expectations about using ED medications after prostate cancer surgery. While Cialis and Viagra can improve blood flow, they cannot wholly restore erectile function overnight. It may take several months of regular use before seeing noticeable improvements, and recovery varies from person to person.
Factors that influence recovery include:
- Your age
- Pre-surgery erectile function
- Overall health and other medical conditions
In some cases, additional therapies, such as penile injections, vacuum devices, or counseling, may be necessary to support sexual recovery.
Side Effects to Consider
Both Cialis and Viagra are generally safe when used under the guidance of a healthcare provider, but they can cause side effects, including:
- Headaches
- Flushing
- Upset stomach
- Nasal congestion
- Dizziness
Men with certain medical conditions, particularly heart disease or those taking nitrates, need to be cautious when using these medications. Always discuss your complete medical history with your doctor to avoid potential complications.
Open Communication Is Key
Recovering from prostate surgery and navigating sexual health concerns can be emotionally challenging. Having open and honest conversations with your partner about your recovery is crucial for managing expectations and reducing anxiety. Involving your healthcare provider in these discussions can help address concerns and find the best treatment options.
Conclusion
Cialis and Viagra can play an important role in restoring erectile function after prostate cancer surgery, but timing is crucial.
Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board-certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Dr. Samadi is a medical contributor to NewsMax TV and is also the author of two books, Prostate Cancer, Now What? A Practical Guide to Diagnosis, Treatment, and Recovery, and The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.