I would like to hear from you that have had invasive bladder cancer and a total cystectomy. My husband had surgery July 21, 2008. Since he has had total ED. We have tried Viagra with no success. Our medical insurace lacks, and doesn't offer many pills per month so I don't know if it's a matter that he needs to take them more often then we have been given pills to to realize a difference. During stimulation I think I've notice a bit of a difference but nothing that would even be close to any sort of erection. It seems to be the same with or without Viagra. I know he feels his quality of life has changed but he has never been one to complain. He has just recently turned 51, and prior to surgery ED was never a concern.. with his libdio, I always assumed it would never cease and he would be a dirty old man! He does experience an orgasam but says that it's just not the same. I have recently ordered a penis pump from Augusta and I am still waiting for it to arrive. He is not one who will take the lead in trying to help himself as he has always been the procrastinator. I know that it is important to start therapy early or he may lose his ability forever..if there is any hope at all? I have never asked the surgeon if he was able to spare the nerves but I do remember him saying prior to surgery he would try. I also know that the cancer was invasive but thank goodness it didn't make it into the muscle and we were told surgery went well and he has a good prognosis. We no longer are seeing the Doc who did surgery because we were not happy with his follow-up and have since choosen one that is best in the field at the UW Hospital. My husband is still young and I know that his sexual ability is very important to him even though he tries to downplay it. My question to you men and the partners of these men is what has been your experience and what kind of time frame am I looking at. Please send me tips and suggestions to get thought this time.