Injection Effectiveness

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Regular Member

Date Joined Aug 2008
Total Posts : 328
   Posted 1/5/2009 7:42 AM (GMT -6)   
Started with the injections and have some questions and concerns, and this is the only place on earth were I can ask and get answers. I have tried the injections 3 times where as instructed by doctor to fill to 1.0. Each time it gets hard with assistance on manual intervention while standing up. Once I lay down or stop with the manual intervention is goes limp. Has this happened to anyone else. Both my nerves were sparred. Here are my questions:
- Why does it go limp so fast?
- Does it mean I need to inject more? Or Is this the best it will get :(
- Will it get better overtime with more injections?
I wont lie I thought this is was going to be an instant fix, awkward but would work and am very disappointed and scarred with the results. I hope I am not alone and it will get better.

Age Dx 37, 7/2008
First PSA : 4.17 5/2008
Second PSA After 2 weeks of antibiotics : 3.9 6/2008
DRE: Negative 5/2008
Biopsy : 6 out 12 Postive all on right side, Gleason 7 (3+4).
Bone Scan/CAT Scan: Clear 7/2008
Cystoscope: Normal 7/2008
Prostate MRI: Normal 7/2008
Da Vinci Surgery 7/2008
PostOp: T2c (On Both sides), margins clear, seminal clear, nodes, clear. Gleason 6(3+3).
First PostOp PSA 9/2008: <0.01
2nd PSA 12/2008: <0.1 (Different Lab then 1st)
3rd PSA 3/2009

Paul in Pa
Regular Member

Date Joined Sep 2008
Total Posts : 23
   Posted 1/5/2009 8:00 AM (GMT -6)   
Read my thread "ed injections question" as well as searching the forum--there's lots of info here.

The technique James C describes in that thread (pump till slight erection, ring, injection, penile massage, ring off) worked very well for me although others in the thread had the opposite result. Standing will always make you're erection better--gravity is your friend in this regard. You may need to use a ring to maintain an erection if the injection doesnt do it alone. I also use cialis 5 mg daily. I have also found that if your erection is close but not perfect lots of lubricant can help you get started plus squeezing at the base of the penis with a penile ring in place will give you that extra firmness you need to get started plus choosing positions where you are standing or kneeling can help.

Good luck!
53 years old
DX 4/08
Radical Prostatectomy 7/29/08
PSA 14 at diagnosis
Gleasons 3+4
Path good--all in gland, nodes negative, margins clear
Nerves spared
Still with some incontinence/pads
Some rare erections with viagra, one good enough for penetration

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4463
   Posted 1/5/2009 8:57 AM (GMT -6)   
shu93, thanks for the post. You raise a good question. I suspect you may be like me in this regard. Or at least partially. I have 2 problems. First, the nerves haven't recovered to trigger an erection. Second, if or when they do, at present my vienous valves in the penis, which are activated by the same nerve impulses, don't close to hold the blood in, thereby creating an erection. One requires the other, I suppose. Now I have good results with injections of Trimix, using the mentioned pump, ring, massage technique. The advantage in this method is it holds the drug in the cavities long enough to allow for tissue absorption, resulting in a much better response, especially in chemically operating those veinous valves. Keeping a ring on for 2 minutes after gentle pumping and massage , then removing lets the drug work rather than just flowing going back out of the penis and into the body and blood stream before it can be adsorbed. I get the same flow back results when using a pump without a ring, as soon as the vacuum is released, down it goes. Until Things start working to trigger the valves to hold the blood in, I will have to continue with the pump and ring technique. I suspect this is happening to you- your veinous valves definetly aren't working yet, therefore the blood or the drug isn't staying in the penis. In the drugs case, it is not staying long enough to be adsorbed by the tissue. When the injections work properly, you should get erect and the hardness can be felt back into the abdomen as far as you can feel with your fingers. The penis tissue and penile muscles inside the body is probably close to half or greater length as the exterior, so all of the interior will be affected by the drugs, resulting in an erection that goes deep into the body. That's why the pump and rings alone are usually a disappointment to men, the erections stops at the ring, creating a still soft attachment. tongue

Another issue that can cause rapid failure of the injection response is not hitting the target inside the cavities of the penis. I have found that when I miss partially or completely, I can stimulate and erection, which will leave as soon as I stop. That's a possibility to look into. One good thing about the pump and ring deal, is the target area is much larger, by comparison to a fully flaccid penis. I can feel a definite reduction of resistance to the needle when I get into the cavity, and it is much less painful that it was before for me. Do some experimenting and see what works best. It usually takes a bunch of times to dial in what you need, even then you will have an occasional failure, probably. smilewinkgrin
James C. Age 61
Co-Moderator- Prostate Cancer Forum
4/19/07 PSA 7.6, referred to Urologist, recheck 6.7
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 Nerve sparing open Retropubic Radical Prostatectomy
9/26/07 Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
Post Surgery PSA's: 3 mts-.04, 6 mts.-.04, 9 mts.-.04, 1 Year-.02.

Regular Member

Date Joined Jan 2009
Total Posts : 27
   Posted 1/5/2009 9:23 AM (GMT -6)   
I have used Caverject/Edex for a decade. One nerve set spared. Partial erection. When I first started injections I used one half of the 10 mg dose. Over the years I have had to increase the doseage to 90 percent of the 20mg dose. You probably , in conjnction with your doctor, have to increase your dose. Too much can cause a painful erection so you have to increase your dose carefully! Hope this helps!
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