Injections - OK to use for how long?

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Im_Patient
Veteran Member


Date Joined Aug 2009
Total Posts : 665
   Posted 8/24/2009 11:24 PM (GMT -6)   
My first post
I'm hoping to get a few guys to weigh in on this. It is about 17 months after my prostatectomy. Doc says she did a good job sparing the nerves. However, I am not getting erections quite well enough for intercourse using anything (Viagra, Cialis, pump) other than injections. I have used both caverject and bimix, both have worked just fine, so I am continuing to use the bimix since it is less expensive. During one brief discussion with the doc on the subject, she mentioned that I would not want to use the injections as a long-term solution. I didn't ask why but plan to. I believe her opinion is that if the erections don't come back in some amount of time, prosthesis would be a better solution. But I am curious, are there longer term injection users out there? The primary drawback that I am aware of is potential Peyronies problems, I have seen a bit of that but not sure if I can blame that on the injections or not. Your experience with long term use?
Thanks
---------------
Gleason, 4+3; PSA, 7
Robotic Prostatectomy, nerves both sides spared, post surgery analysis confirmed 3+4 Gleason,
cancer contained, no penetration, lymph nodes clear
PSA consistently <0.1 since surgery

Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 598
   Posted 8/25/2009 6:31 AM (GMT -6)   
I have a friend who used injections for many years - about ten years, I believe. But I'm sure frequency is also a factor. Not sure this helps, but I, too, am curious about the long term use of injections. how long is too long?
Paul
46 at Diagnosis.
Father died of Pca 4/07 at 86.
10/07 PSA 5.06 (Biopsy 11/07 1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC www.roboticoncology.com
Saved both nerve bundles.
Path Report: Stage T2cNxMx
-Gleason (3+3)6
Pad free on March 14 - (10 weeks.) Never a problem since.
ED - at one year, ED is fine with viagra.
One year PSA - undectable!

ED Website: www.FrankTalk.org - frank discussions of Erectile Dysfunction - check it out.


Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 8/25/2009 9:08 AM (GMT -6)   
I have been on Bi-mix for about 18 mos. with no ill effects. I inject once weekly. I do have a slight curvature but it was from the surgery and has not progressed.
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C
4/16/08- Started Bi-mix injections 
5/15/08- 1st Post-Op PSA 0.07 Undetectable
8/11/08 -2nd Post-OP PSA 0.02 Undetectable
8/15/08- No more pads as of today  Whoopee!!!
11/13/08- 3rd post-op PSA 0.02 Undetectable
03/02/09- 1 yr. post-op PSA .09 Undetectable
05/13/09   PSA .18 (ouch)
Started IMRT June 13, 2009
Completed 37 treatments July 31, 2009 (66.6gy)


hb2006
Regular Member


Date Joined Nov 2008
Total Posts : 299
   Posted 8/25/2009 9:31 AM (GMT -6)   
My experience has been after six months of Trimix and Edex, I have significant curvature. My urologist confirmed Peyronies but didn't think it was caused by injections. However, if you go to the Peyronies web sites and forums, guys will swear there that the injections caused it.

I have stopped the injections and am now on the VED Protocol for 26 weeks to try and get back to being totally straight.
Age 60, PSA 2007 4.1, PSA 2008 10.0
Diagnosed April 2008, Biopsy: 6 of 12 cores positive, Gleason 4 + 5 = 9
CT and Bone Scan negative, Open surgery at Shawnee Mission Medical Center May 21, 2008
Right side nerves spared, Radical prostatectomy and lymph node dissection
Cather removed on June 3rd, totally dry on July 9th, pT2c, lymph nodes negative
PSA Sept 28, 2008 0.00, PSA Jan 22, 2009 0.00, PSA June 29, 2009 0.00
ED Status- Currently using Trimix, Levitra daily for increased blood flow.
Noctural Erections have completely returned on a nightly basis, same hardness as before.


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 8/25/2009 10:06 AM (GMT -6)   
I have been using either Trimix or Bimix twice weekly for 20 months, with no problems of any kind. No sign of Peyronies so far (knock on wood)
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
22 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix 30/1/20-.05ml 2X week continues
PSA's: .04 each test since surgery


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 8/25/2009 4:06 PM (GMT -6)   
Obviously Peyronnes is the big potential side effect. The drugs themselves are nothing serious.

If you take and unscientific poll of the posters to the this forum, the Peyronnes link could be questionable, as most literature also concludes. Perhaps some men have a pre-dispositon to Peyronnes. Who really knows ?

The question you have to ask yourself, is a satisfying sex lile worth risking a kink in Willie, If you look at the average age of the guys on here, it probably is. That's not to say old guys don't need and want sex, but it certainly does slow down for a lot of us. It usually takes two to have sex. (grin)
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks due to anatomical issues with location of ureters with respect to bladder neck.  Try 3 tubes where no tubes are supposed to be for 2 weeks !
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)


mspt98
Regular Member


Date Joined Dec 2008
Total Posts : 375
   Posted 8/25/2009 4:22 PM (GMT -6)   
 It must be the Peyronies she's referring to. I know  I have developed Peyronies from injections. I am 11 months out, began injections almost immediately after catheter removed because I hated the VED. I did notice the curvature increasing after 6 months of use. So I have cut down to injecting 1x/wk, minimal dosage that I can get away with, take Vitamin E, arginine daily, and wear a Peyronie's extender stretching device daily.
    I would say that after doing all this my curvature has lessened a little, nothing dramatic, but a little. At least it's not progressing as it was. I was told you have to wait 2 years post-op before applying with your insurance company to pay for penile implant. I'm not sure I really want a penile implant, I'll guess I'll think about that about a year from now. For the present it's trimix or nothing...
my age=52 when all this happened,
DRE=negative
PSA went from 1.9 to 2.85 in one year, urologist ordered biopsy,
First biopsy on 03/08, "suspicious for cancer but not diagnostic"
Second biopsy on 08/14/08, 2/12 cores positive on R side, 1 core=5% Ca, other core = 25% Ca, Gleason Score= 6 both cores,
Clinical Stage T1C
Bilateral nerve sparing Robotic Surgery on 09/11/08, pathological stage T2A at surgery
No signs of spread, organ contained,
3 0's in a row now, 10 months out
Incontinence gone in early December '08,
ED remains,  still taking daily viagra for penile rehab, uro said try oral meds and then trimix for sex only now, Peyronie's Disease a problem now


apacker1950
Regular Member


Date Joined Nov 2008
Total Posts : 122
   Posted 8/25/2009 6:35 PM (GMT -6)   

I have been using Trimix for over 3 years now with no problems.  I inject at least once or twice a week and occasionally 3 times.  After nearly 4 years post open RP I still get no natural erections but the Trimix keeps my wife and I very happy.

Allan



Dx PCa age 54. Jly 05- PSA 8.1 Sept 05- PSA 10.7
Sept 05- Biopsy  9 of 12 cancerous, Gleason 3+3=6, T2
Bone scan and cat scan showed hot spot on hip bone.
Oct 05- bone biopsy, ouch.  benign , no cancer in bones.
Nov 05- PSA 15.4 Nov 18, 05- Nerve sparing open RP at Huntsman Cancer Center, by Dr. Robert Stevenson. 100% continence at 3 months. ED- Tried the big 3 pills with no results. Feb 06-Started VED, worked, but painful with constriction rings. May 06 started Trimix injections.
ED appears to be perminant but doing great with Trimix.
PSA remains undetectable.

Post Edited (apacker1950) : 8/25/2009 6:00:05 PM (GMT-6)


Rob Smith
Regular Member


Date Joined Jan 2008
Total Posts : 23
   Posted 8/26/2009 2:06 PM (GMT -6)   
Has anyone tried Tri-mix gel (not talking about Muse)?  Do a search under Tri-mix gel and a company that sells it (only with a script) will come up.  I haven't tried it, but might be willing to if it's effective.  I've done injections for 15 months now without any problems but the fear of peyroines is always in the back of my mind.  If anyone has any experience with the gel, I'd sure like to hear about it.

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 8/26/2009 5:12 PM (GMT -6)   
How big a needle do you need for the Gel ? Ouch (just kidding )
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks due to anatomical issues with location of ureters with respect to bladder neck.  Try 3 tubes where no tubes are supposed to be for 2 weeks !
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)


Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 598
   Posted 8/26/2009 9:59 PM (GMT -6)   
my buddy uses Trimix Gel. It worked well. Not nearly as potent as the injection. The erection lasted much less longer as well...about 45 mins to an hour. The injections lasted tooo long for him. Went to the hospital twice cause of them. He now uses a viagra and the gel...and that is better. Trimex gel has a great video on their site. exactly what most guys need.
Paul
46 at Diagnosis.
Father died of Pca 4/07 at 86.
10/07 PSA 5.06 (Biopsy 11/07 1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC www.roboticoncology.com
Saved both nerve bundles.
Path Report: Stage T2cNxMx
-Gleason (3+3)6
Pad free on March 14 - (10 weeks.) Never a problem since.
ED - at one year, ED is fine with viagra.
One year PSA - undectable!

ED Website: www.FrankTalk.org - frank discussions of Erectile Dysfunction - check it out.

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