Question:
After just over 3 years post rrp, I have had no luck with Viagra, Levitra, Cialis, or Muse. Not much help from injections, either. Have tried Papaverine, then papaverine with regitine, and very little luck. I did have slight success with alprostadil, but not sufficient for performance. I'm now at the point of seriously considering a penile implant. (And all this after: "We were able to spare the nerves.") Have any readers of this board had a penile implant, and, if so, what has been your experience? How long did recovery take? What are you most pleased about with the implant? What are you most disappointed about? I'm guessing that most of the prospects for answering my question(s) have probably gone on with their lives and no longer access this board, but I thought it might be worth a try. Thanks for any help anyone can give me!
Answer:
I'm glad that you asked the question. I am at 15 months, and still haven't resumed erections with either of the 3 ED drugs. I did have success with Edex, but it caused other complications and I had to stop using it. Haven't tried bi-mix, but may. My urologist keeps wanting to do the implants, and I've not been willing to do that yet. You might check the implant group on Yahoo..several there talk about theirs. There is certainly some things that are apparently different when you have the implant, but most seem pleased with it. Did you try the vacuum? Hope all goes well.
doj
Answer:
Regarding injections, it is important to find the right combo and the right dose. The drug that really did the trick for me is a Tri-Mix made by a local compounding pharmacist, with these components:
PGE 1 @ 5.9mcg/ml
Phentoamine @ 0.65mg/ml
Papavine @ 17.6 mg/ml
The urologist detemined the correct dose by a process he calls titration. He started me out, in his office, by demonstrating to me and my girlfriend how to do the injection. His injection was 0.1cc, which gave me a 50% erection for about an hour. He then instructed me to increase the dose by 0.05cc on each subsequent injection, until I got a 100% erection that lasted at least 15 minutes but not more than 2 hours. He said if I did not get satisfactory results upon gradually increasing to 0.5cc to call him. So, I increased to 0.15cc, and got an 80% erection, and finally increased to 0.2cc which gives me a very full erection that lasts from 15 minutes to two hours, depending on how aroused I feel. I've been successfully using this dose for the last seven months, with my girlfriend doing the injections, alternating injection sites from one side of the penis to the other. Following each injection, I compress the injection site with an alchohol wipe for at least five full minutes, which is thought to reduce the probability of future scarring (Walsh's recommendation). During this five minute period, we continue with our foreplay.
I use the injections about once per week, and use the vacuum device between injections. Intercourse is not as easy with the vacuum device, but it works fine for masturbation and for maintaining the erectile tissues. I also received in-office instruction from a manufacturer rep for the vacuum device.
According to my urologist, if the various types of injections had not worked, the next step for me would have been to check out the local vascular system. And then, if the vascular system cannot be made functional, he considers implants.
Answer:
Thanks, doj and All_Sevens, for your replies.
doj, I would think 15 months post rrp is a little early to consider an implant. Since an implant is irreversible, I'd give all other alternatives every chance to work. I've pretty much run the gamut on alternatives after 3 years of frustration.
All_Sevens- Thanks for your help. You're pretty much suggesting I take my own advice that I just gave to doj.
I've tried .15 CC of papaverine/phentalomine, then .3 CC, with no results. Next attempt will be probably .45 CC. If that doesn't work, my doc says go to 5, but if .45 doesn't help, I don't believe .5 will. However, I'll probably go for the tri-mix before implants. I have the vacuum device, but it doesn't provide much feeling. Oddly, I used a 20 mcg of Edex about 6 months after surgery, and it worked pretty well. Now, even 40 mcg of Edex is a very temporary fix, lasting for probably five minutes. I keep working with it to keep it active, so hopefully something will work. Until about 10 months ago, I had not tried further injection therapies, but had relied on the pump and the hope that the ED medications would help. So far, the only thing I can really count on is frustration. I do appreciate your response.
Answer:
Thanks, doj and All_Sevens, for your replies.
doj, I would think 15 months post rrp is a little early to consider an implant. Since an implant is irreversible, I'd give all other alternatives every chance to work. I've pretty much run the gamut on alternatives after 3 years of frustration.
All_Sevens- Thanks for your help. You're pretty much suggesting I take my own advice that I just gave to doj.
I've tried .15 CC of papaverine/phentalomine, then .3 CC, with no results. Next attempt will be probably .45 CC. If that doesn't work, my doc says go to 5, but if .45 doesn't help, I don't believe .5 will. However, I'll probably go for the tri-mix before implants. I have the vacuum device, but it doesn't provide much feeling. Oddly, I used a 20 mcg of Edex about 6 months after surgery, and it worked pretty well. Now, even 40 mcg of Edex is a very temporary fix, lasting for probably five minutes. I keep working with it to keep it active, so hopefully something will work. Until about 10 months ago, I had not tried further injection therapies, but had relied on the pump and the hope that the ED medications would help. So far, the only thing I can really count on is frustration. I do appreciate your response.