Thousands of radical prostatectomies are performed each year worldwide. Half of the patients have pre-existing erectile dysfunction (ED), while the rest expect to lose their natural erections after surgery (1, 2).
These men need medication that can give them hope and healing, and one thing they are asking is if Viagra can help them achieve an erection or “How soon after surgery can I take Viagra?”
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This discussion seeks to provide these men with vital information about the drug and help them make the right decision whether or not Viagra is fit for their condition.
What Is Erectile Dysfunction?
Erectile dysfunction is the incapacity to get an erection or keep it firm enough for sexual penetration and ejaculation. It is sometimes called as impotence, though this term is used less often.
Occasional inability to get an erection is a common experience among men, and this usually happens when one is stressed. On the other hand, frequent occurrence of ED is a sign of emotional or physiological distress.
ED is characterized by a lack of blood flow to the penis. It is the lack of blood flow that Viagra, whose basic ingredient is sildenafil, can improve (3).
What Is a Prostatectomy?
Prostatectomy is an operation performed to remove all or part of the prostate gland. Nerves damaged during the surgery can lead to the development of ED.
A nerve-sparing procedure can help reduce the possibility of nerve damage. One aspect to consider is the doctor’s competency in performing nerve-sparing surgery (4).
If the surgeon can do the procedure correctly, the likelihood of the patient to retain his erectile function may improve.
For people thinking, “when can I take Viagra after surgery,” it may not be a long wait – unless there are complications. With minor restrictions, you can return to regular activity 2 to 4 weeks after the operation.
How Does Viagra Work?
The natural substance cGMP regulates blood flow to the penis. This action, however, can be counteracted by another substance called PDE5.
When the drug sildenafil was first made, it was tested for heart disease. Unexpectedly, the researchers during that test discovered that the drug also promoted penile erection.
They investigated further and discovered that sildenafil has anti-PDE5 action. Thus, the ultimate benefit of sildenafil for people with ED is increased blood flow to the penis. But one needs initial sexual arousal for this drug to work.
PDE5 (phosphodiesterase 5) – an enzyme that breaks a phosphodiester bond.
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cGMP (cyclic guanosine monophosphate) – the second messenger of signaling pathways in the cardiovascular system.
What Are the Side Effects of Viagra?
It is crucial for those asking about “when to take Viagra after surgery” to know the drug’s side effects and interactions with other medications.
This is to protect you from any possible synergistic effect that can occur from taking other drugs while using Viagra. Also, take note that side effects from sildenafil use can be aggravated with interactions with other medications.
Viagra side effects include (6):
- Flushing
- Dyspepsia
- Diarrhea
- Indigestion
- Dizziness
- Nasal congestion
- Visual disturbances – due to swelling of the optic nerve
- Rash
- Stomach pain
- Memory problems
- Vomiting
In some patients, acute myocardial infarction and ventricular tachycardia have been reported. It must be noted that most of these side effects are due to the vasodilatory effect of sildenafil (7, 8).
That vasodilatory effect also takes place in the increase of blood flow to the penis. Because of the action of the drug involving inhibiting PDE5, dilation of blood vessels in the penis also happens.
Viagra Contraindications
Contraindications to observe include (9):
- Alpha-blockers – use with caution if a patient is using alpha-blockers. This is because of the blood lowering effects of both sildenafil and an alpha-blocker. Make sure that before using Viagra, the patient is already stable with an alpha-blocker therapy.
- Ritonavir – (CYP3A4 inhibitor). This is a potent CYP3A4 inhibitor, which means it can increase the exposure of the body to sildenafil. That is, it can increase the effect of sildenafil by about 11 times. Your doctor will recommend limiting dosage to only 25 mg. Tablets are available in 25, 50, and 100 mg doses.
Alpha-blocker – drugs that block receptors in smooth muscles and arteries. Alpha-blockers relax blood vessels leading to an increase in blood flow and decreased blood pressure.
CYP3A4 – an enzyme in the body found in the liver and the intestine.
- Nitrates (drugs with nitric acid) – medications with nitrates in combination with sildenafil can cause over-dilation of blood vessels and, therefore, can lead to a drastic decrease in blood pressure.
Alcohol – In a particular study, sildenafil did not potentiate the hypotensive effect of alcohol (10).
Overdosing on Viagra
Another essential thing to be very careful about taking Viagra after surgery is overdosing.
Overdosing on Viagra can result in a prolonged erection (priapism), which, if not treated immediately, may lead to a permanently damaged penis. If erection extends beyond 24 hours, go to a hospital, or call a physician immediately.
Overdosing on sildenafil can also cause nausea, chest pains, and irregular heartbeat.
The recommended dosage is 50 mg taken once a day. There should be no more than one administration of the drug within 24 hours (11).
Study your body’s response. If you think there is a need to increase the daily dosage, talk to your physician. Remember, there were cases of death due to excessive intake of sildenafil that has happened before.
Depending on your body’s response and your medical conditions, your doctor will recommend giving you a higher or lesser dosage to make sure that you can continue living life with satisfying sexual function.
When people start asking “how soon after surgery can I take Viagra,” they tend to be tempted by the many merchants online, which makes it easy to buy Viagra. But make sure to talk with your doctor about their recommendations and advice before you do.
