I am 3 1/2 mts. post surgery, have gone thru the Viagra and the pump routine, and last night did my first self-administered Caverject Impulse injection. The Doc didn't do any trial testing in the office, knowing I was capable of doing it myself. It was comical in some ways. I had had no response from the Viagra and very unsatisfing results from the pump, so we hadn't had but one semi-successful session of lovemaking since surgery. It had been successful for her, in a sorta kind of way, as we had to fight a leaking down penis the whole time. Unsatisfing for me, as I didn't get a whole lot of pleasure and no climax from it. So we approached the first injection with hope and anticipation. My Doc recommended I start with a 2.5mcg dose of alprostadil in a Caverject Impulse system, given that I had absoletely no veinous return valve control, allowing any blood drawn in from the pump to run right back out.
Since she didn't want to see me injecting my penis with a needle (not romantic enough, I suppose lol), I repaired to the bathroom, set up the syringe, and prepared to do the deed. I will admit I really faltered when I saw that little needle placed against that oh so sensative part of me. I had to gulp and force myself to make the injection. As so many have said here, the needle entered easily, and completely with little effort on my part. It just barely stung, nothing like I was dreading. My various adventures with the pump and its infernal rings have produced much more pain than this did. It was just a mental block to get past. The injection went smoothly, the plunger easily injected 10 mcg of the solution, which contained 2.5 mcg of alprostadil. I got a couple small drops of blood which easily stopped seeping. Grabbing a robe, I repaired to the recliner where I massaged my penis, trying to get as good dispersal of the med as possible. After 10 minutes or so, I began to get a response, slowly increasing in size. At 15 minutes, we retired to the bedroom and continued with foreplay, watching it continue to grow. Boy, did it look good to see a fairly firm erection again after such a long time. At the 30 minute mark, not sure how long it would last, or how much firmer, if any, it would get, we began to make use of it. At this point, it was maybe 75% firm, compared to the old days, just useable for penetration. With lovemaking it did lose some firmness, which made it a little more work to keep things going. I think the physical act of friction, gripping, and pushing overrode the veinous valve closure slightly and allowed some blood to leak back out. We struggled to keep it going, but managed to get her some pleasure of completion. We tried a couple different positions , but kept losing just enough firmness to keep penetration, so stopped for that session. I didn't get any orgasm from it. I did get lots of pleasure though, so the pleasure receptors in the penis still work. I did discover that I didn't leak urine during intense lovemaking, like I had done with earlier attempts, so that was definite plus to the experience. Hard and dry is a good thing...lol
Back in the den, watching tv, my erection regained all lost ground and more. At the hour and half mark, it was firm, nearly upright and ready to party. Sadly, we weren't. lol. At the 3 hour mark, it was still in the same state, so I took 2 Suda-fed and an ice pack, and within 30 minutes or so, down it went.
Total time of start to finish was a little less than 4 hrs, with fullest part attained at around the 2 hr. mark and maintained until taking Suda-fed. I didn't feel a lot of pain or aching during the first hour and half or so. It was there, but nothing that couldn't be tolerated, but kept slowly increasing as the evening went on. At the fullest time and beyond until I deflated it with Suda-fed, the aching continue to increase, until it was really uncomfortable at the end. Within 15 minutes of deflation, most of the ache was gone again, and in an hour, it was just a slight memory. I liken the pain and aching to a surgery I had on my hand, where the surgeon used a tourniquet at the armpit to close off the flow of blood to the arm for an hour and a half. At the end of that, my arm was really throbbing at the choke point from blood trying to get into the arm. This is what the penis ache felt, like the blood was trapped inside and couldn't get out, rather than it being pain and ache from the drug itself. That the pain and ache went away so quickly after deflation seems a good sign. I hope so, anyway. Next time, I will reduce the dose by half, to 1.25mcg and wait longer for that full, firmer erection before attempting any use of it. Most of our problems this time was not knowing just how long we would have or how hard it would get, so we didn't do as good a job of timing as we could have. So far, I am pleased with the potential of using Caverject without most of the aching and pain that some 33% of men report from using it. Once we get it dialed in, things should go much better. But even with bad timing, and not perfect results, it was gratifing and deeply satisfying to once again enjoy lovemaking with my wife. I will be doing the Caverject twice weekly as nerve regrowth and veinous valve therepy, along with continuing the 25 mg Viagra nightly routine. I haven't decided about further use of the pump for therepy yet. The thing is so uncomfortable to use, it had become a necessary evil. Any comments from anyone?
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4/19/07 PSA 7.6, referred to Urologist, recheck 6.7 06/05/07
7/11/07 Biopsy- 16 core samples, size of gland around 76 cc. Staging pT2c
7/17/07 Path report: 3 of 16 PCa, 5% involved, left lobe , GS 3/3:6.
9/24/07 Retropubic Radical Prostatectomy performed
9/26/07 Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
10/15/07 ED- 25mg Viagra nightly-no joy
10/19/07 Dry 24 hrs, pad at night just in case
11/15/07 ED-continue 25mg Viagra, no response, begin Vacorect pump-
11/15/07 1st PSA-0.01, fully continent- no pads
12/17/07 ED- 3 mts.-continue Viagra and pump-no change-no response
01/01/08 First use of Caverject 2.5mcg, successful, erections at last