Urology/ED

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Question
Hi Dr.
I'm not sure how to start but will try.  I saw Urologist in Feb this year for ED.  I was prescribed 5mg Cialis for daily use and it seemed to help.  I had vericocele microsurgery in mid-July.  Two days after the surgery I had sex with my wife, without taking cialis for three days.  Now i think i'm cialis dependency and psychologycally ED but not sure.  I noticed that when i was on business travel i did not taking any cialis but still having morning wood everyday.  For example, my last business travel was for from 9/2 - 9/4.  I stopped taking cialis on the night of the 9/1 and still having morning wood every day from 9/2 - 9/4.  Is this consider psychologycal ED?  Now I'm back home and back on cialis daily again.  I'm so afraid that I will not able to have erection without it.  BTW, my wife didn't know I'm on Cialis daily.  I'm not sure what to do.  i want to stop taking it but so afraid. Please advise.  Thank you so much for your help.

Answer
Sako:

Since cialis has a long half life and stays in the body for quite a while, you can't draw any conclusions about psychological or non-psychological ED.  Dependence on Cialis would strictly be psychological as there is no physical dependency issues with Cialis.  However, the underlying problem can get worse.  

The presence of morning erections indicates a more normalized function.

Remember that this started by having an ED problem that was resolved with Cialis.  The Cialis has worked, but clearly you will return to your previous state of erection function if you stop the cialis long enough.  Now its a choice.  Talk to your urologist if you have further questions.  The fact that you are anxious about possible dependency suggests a higher than average anxiety level.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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