Ability to achieve erection
Trimix - 33.3%
Vacuum Pump - 33.3%
Cialis - 0.0%
Viagra - 33.3%
Boston Medical - 0.0%

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S Mark
New Member

Date Joined Nov 2008
Total Posts : 12
   Posted 11/6/2009 2:36 PM (GMT -6)   
I am currently injecting Trimix .5ml.  Only achieving about 60% erection but I have a significant curvature of the penis no matter which side I inject. I am very careful to milk after injecting but still getting the curvature. The erection is pretty much un-usable even without the curvature.
Any suggestions, maybe a vacuum ring?  Over two year post RRP and still impotent, very disappointing.
Age 58, PSA 14.3 Biopsy - 4/07 62 cores , Gleason 3 + 3
RRP 5/07   Nerves spared, but carved up a little.
2 year PSA <.01 (undetectable)
 Trimix injections

Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4849
   Posted 11/6/2009 3:24 PM (GMT -6)   
What does your surgeon say?

Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.

Regular Member

Date Joined Oct 2007
Total Posts : 300
   Posted 11/7/2009 9:17 AM (GMT -6)   
I am about 2 years post op and have the curvature.  I noticed it when I started having erections.  It has not progressed.  There is a condition called Kelami's or urethal manipulation syndrome sometimes caused by the catheter after surgery.  It usually does not progress.  Also, the uretha is stretched after the prostate is removed and it is reattached.  As long as it does not
progress, I would not be too concerned.  As far as the tri-mix,  that is a pretty big dose.  Maybe Jim C.  will chime in and give you some advice about the injections. I use bi-mix.  I usually use a vacuum pump with the restriction ring for some fullness prior to injecting.  It keeps the medication trapped and makes it more effective.  Just a thought.
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
Gleason 7 (3+4)
1 positive margin (.3cm)
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)

Regular Member

Date Joined Jul 2006
Total Posts : 202
   Posted 11/7/2009 10:00 AM (GMT -6)   
I experienced some curvature when I tried the injections.   When I stopped injecting the curvature disappeared.
Since the injections aren't producing a usable erection, I suggest stopping them, at least for awhile, and see if that helps with the curvature.
Don't lose hope on the ED.  I'm a bit over 3 years out from surgery and believe I'm still seeing continuing improvement.  Starting to experience nocturnal erections for the first time since surgery.
PSA 5/22/06: 5.6
DaVinci surgery: 9/14/06
Gleason: 3+3
Organ confined, clean margins.
Both nerve bundles spared.

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4463
   Posted 11/7/2009 10:14 AM (GMT -6)   
S Mark: Here's a method several of us have found to be effective when having trouble achieving erections with bi mix or trimix. See if this works for you, if you haven't already tried it. Yes, I agree, also, that .5ml of trimix is a massive dose for most, this method may be something you can use to reduce the amount needed. Hope so anyway.

"Are you getting the tip of the needle into the cavernous cavity? I had a problem at first, using 1/2 inch needles of going on thru the cavity and out the other wall, into the tissue in the center of the penis. This caused some really sharp pain. What's your technique for injecting- do you fluff up the penis a little, maybe stretching or milking blood into it, to fill up the cavities with blood beforehand. Several of us here have to do the pre-plump deal, with a pump and ring to get the cavities to expand enough to allow for the needle to hit the target in the right place. Use the pump to get about a 1/4 erection, apply a penis ring, then inject. Gently massage the penis to spread the drugs and keep the blood in the penis. After about 3 minutes, when enough time has passed to ensure the drug has adsorbed, remove the ring and continue the gentle massage until erection is achieved. Lots of question thrown at you, but trying to help by pointing out things that may be continuing to the painful experience. A thought- maybe try the 31 ga, 5/16 inch needles with the pump and ring method to see if that helps. I'd look really closely for any signs of plaque or calcium buildup as the first thing that comes to mind.
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
24 mts: PSA's: .04 each test since surgery, Bimix .3ml PRN or Trimix .15ml PRN

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