How long does your erection last - after an Injection ? At what point do i go to the hospital?

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FiftiesMale
Regular Member


Date Joined Mar 2009
Total Posts : 75
   Posted 9/22/2010 11:34 AM (GMT -6)   
(lest anyone suggest that i search and read before posting a new thread, I have searched and read a lot of posts and threads. My questions and concerns are very specific to the Subject Line of my thread.)

Are there others out there, who use Injections, who approach (or pass) the 4 hour mark, and then successfully and consistently come down OK???

I am concerned about how long it should take for the erection to decrease down to flaccid, or at least decrease down to the point where you do not have to consider going to the hospital.

I went to a (local) hospital with a priapism 4 hours after the first ‘test’ dosage (“.3”) that was administered (an hour away) at the Medical Center where i had my Prostatectomy DaVinci Surgery. It was not a fun experience, in the hospital. I was in the hospital for close to 4 hours. They first tried counter-injections to bring it down. They then did needle extraction to drain the blood. I was under a local, so I did not feel any pain, but there was discomfort, and it truly was traumatic.

I must really enjoy sex with my wife, because I have tried Bimix 3 or 4 more times (after I told myself that I would not use it again, after the priapism). I have tried the Bimix a total of 4 or 5 times.

First time, dosage was “.3” administered at the Medical Center (an hour away) where i had my Prostatectomy DaVinci Surgery (the ".3" is the standard amount that the Prostate Cancer administers to post Prostate Cancer Surgery patients who qualify for “injections”. Apparently it was way too much. By the time 4 hours came and went, I had not come down a bit. The nurse who administered it, examined me after an hour and was convinced that I was starting to come down (but that was not the case). I even took some of the Sudafed to assist (at the 2 hour mark, and again after 4.5 hours). I live over an hour away from the Medical Center, so I went to a local hospital. It has a great reputation, but it took them over an hour, close to 90 minutes, to start treating me after I had arrived there. To repeat, it was a nightmare situation, that i hope to never repeat.

After a phone call, two days later, the Medical Center concluded that the ".3" was too much for me. We scheduled a 2nd appointment for 2 weeks later, for a much smaller dosage.

Second time, dosage was “.1” administered again at the Medical Center (two weeks after the first attempt). This time, there was very little effect. The nurse asked me, and my answer was that I felt that I had achieved about 70% -75% erection in the office. Within an hour, things were totally down, and back to normal. The recommendation from the folks at the Medical Center was for me to increase to “.15 to .20” at home.

The third time, dosage was approx “.17”, at home. It was a great success. Good intercourse. However, as 4 hours approached, and things were not decreasing, I called the Medical Center . They were ready for me at the the Medical Center. I showered, got dressed, and figured “here I go again, another priapism, with the draining and everything”. However, short after 4 hours, things started to slowly go down. I actually started driving in the car (realizing it would take over an hour to get there). After about 20 minutes in the car, I realized that things were continuing to go down, so I made a U-turn, and headed back home. I was not totally flaccid until about 5-6 hours, but it did continue to decrease, until it became flaccid. I was greatly relieved.

The fourth time, dosage was about “.15”, at home. I achieved about a 90%-100% erection. Not as good as the .17, but usable. Once again, the erection continued longer that I had hoped. This time I did not call the Medical Center, but I continued to watch things. I actually did take a shower, and was ready to drive down to the Medical Center, just in case. It was around the 4 hour mark, that it slowly starting decreasing.

That was the last time. (about 2 weeks ago). We have only used Viagra since, as I debate my path forward.

So my primary questions relate to “the normal” or “the average” or maybe even the long end of “acceptable” erection duration?
Does anyone have an erection for about 4 hours? What is the duration of your erection, and how soon (after the injection) do you start to see things going down? I realize that it varies from guy to guy, but any numbers will help me get a feel for what others experience. Thanks.

Related information: My PSA was 6.2. My pre-surgery Gleason from biopsy was 4+3=7. The Robotic surgery was successful, the surgeon says he got it all, and saved both nerve bundles. There was some minor complications, due to prior surgery for hernia, and the surgeon had to take a path around the mesh that was put in during the hernia surgery. The post surgery biopsy was 4+3=7.

I have tried all the pills, and have had the best success with Viagra. I also purchased, and have used an Osbon Pump. With Viagra, the pump, and rings, I have had 90%-100% erection, but there is the “bend” point where the ring constricts things, down near the base of my penis. Dr Patrick Walsh’s book even addresses the issue of the bend – at the point of the ring constrictor.

I am not doing this for my wife, but she had some minor complaints about the bend point, and that it made it difficult for her to achieve the sensation, for her to achieve orgasm. I get as much satisfaction in pleasing her, to the point of orgasm, as I do in achieving orgasm myself. Therefore, her satisfaction is very important to me.

I have read about the success of Injections. I was excited to try the Injections. I was very pleased, and continue to be very pleased with the results of Injection. Truly, a couple of times, there was 100-105% percent erection, and my wife and I had the best sex since before surgery.

I am left in a point of confusion. What do I do now? My biggest concern and fear is having to go to the Hospital and go through the full drain experience again.

I think that if I knew with 110% certainty that I would always come down, around 4 hours (or preferably less) then I could continue with Injections (and without any worries).
However, each time, when I give myself a shot, in the back of my head, I wonder …. Will it go down? Or will I go to the Hospital.

I really wish that it would only last about 90-120 minutes (2 hours max). but I also do want the full 100% erection. So, though the 2nd time, with only “.1” brought things down in a much faster time frame, it was not really a usable erection.

I guess I will stop here, and see what your initial thoughts and recommendations are.

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 9/22/2010 12:05 PM (GMT -6)   
I skipped through the last half hour of your post....What is normal for me isn't going to help you....Kind of think you've answered your own questions.....
 
Doing injections on a full or empty stomach will greatly influence the results....The meds fresh off the assembly line are more effective then when it's been in your refridge for a month or two....

FiftiesMale
Regular Member


Date Joined Mar 2009
Total Posts : 75
   Posted 9/22/2010 12:26 PM (GMT -6)   
Steve, I appreciate that you read (some of my post), and that you posted a reply. As much as I appreciate that you posted, your reply did not seem to address my questions. I *am* interested in *your* duration - even if it is different than mine. If 90% of people who reply, all have durations less than 2 hours - then it tells me that I am way off the chart, and i need to stop doing what i am doing. If 50% of the people who reply tell me that they have 3 hours (and some even have close to 4) - that they will tell me that *some* people do (also) have longer durations. With no details, on averages or maximum, then i am left guessing. (Yes, i have read other threads, but i am hoping that one thread specific to duration may be helpful to others and to me.

As for the freshness, and empty stomach. I don't get your point. Maybe my many details (that i posted) caused my main question to get lost along the way.

In short, does anyone else have erections that last close to, or longer than 4 hours?

And, if so, do their erections come down, consistently, without having to go to the hospital?

I am trying to figure out if i need to stop using Bimix, since my erections last close to, or longer than, 4 hours.

thanks
Age: 53
8/1/2008: PSA 6.2, GP recommended retake.
8/27/2008: PSA 5.8 (%free 12.1) referred to Urologist.
9/10/2008: DRE - non palpable. Urologist recommended biopsy
10/21/2008: Biopsy appt: 10 samples taken
10/31/2008: Biopsy results; 1 positive out of 10 samples.
10/31/2008: Biopsy Results: Gleason 7 (3+4) , no evidence of perineural invasion.
10/31/2008: Referred to UCSF
12/19/2008: Transrectal Ultrasound at UCSF
12/19/2008: Consultation with Surgeon.
12/19/2008: Surgeon concurred on Gleason 7=3+4 (per slides).
2/24/2009: Robotic Assisted Laparoscopic Prostatectomy (DaVinci) UCSF
3/5/2009: Cathetor removal.
3/21/2009Post Op Pathology: margins negative/clear, Gleason 4+3=7
4/9/2009: first post-op Ultrasensative PSA: less than 0.01
Currently taking Viagra (since March 2009), Levitra (tried Cialis).
6/2009: Purchased and using Osbon manual pump.
7/28/09: 5 month Ultrasensative PSA: less than 0.01
7/14/2010: 18 month Ultrasensative PSA: less than 0.04.

Rolerbe
Regular Member


Date Joined Dec 2008
Total Posts : 235
   Posted 9/22/2010 12:39 PM (GMT -6)   
Fifties,

Two comments: First, as one sitting on the fence of trying injections, I too, am interested in the responses you get. I was also particulary interested that there was a no-win tradeoff for you in time vs hardness. Will have to think about that.

Second, and talking only from my reading here, maybe you need to drop down from Bimix to just one of the two ingredients in the mix. Maybe that would give you better control of the time vs hardness dilemma.

Good luck. Will follow your success with more than a passing interest!

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 9/22/2010 12:40 PM (GMT -6)   
"I skipped through the last half hour of your post"

Steve, there was no need to be rude to the guy. He's asking a very legitimate question, and he was explaining it the best he could.

Fiftiesmale - I can't answer your question, never been on ED drugs, let alone injections. But there are plenty of guys well versed in this, including JamesC, one of our moderators.

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, on Catheter #21, will be having Ileal Conduit Surgery in Sept.

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 9/22/2010 2:11 PM (GMT -6)   
Well, as a matter of fact,...... confused Last night I wanted to make sure that I would be able to successfully complete the full act, so I used .25cc/ml of trimix, rather than my usual .15cc/ml. I had a full useful erection up to the 3 1/2 hr. mark, and it was still at least 1/2 erect at 4 hrs. I was told by my doc and have read several places that if the erection has subsided close to 1/2 way at the 4 hour mark, then it isn't a big danger of serious injury to the organ. I don't sweat it as much anymore if I hit the 4 hr. mark and it has subsided that much. By the 5 hrs it had subsided back to 1/4 erect and finished the job sometime after I went to sleep.

Now then, I think I read somewhere you used bimix, and I have been talking about trimix. smilewinkgrin As you probably know, trimix will result-usually- in a harder erection using less drug. So the dangers of priaprisms are somewhat greater with trimix. I do use bimix, also, to sorta rotate things. I normally have to use .30 cc/ml of bimix to achieve something near the same result that I do with trimix. I will admit I have more failures with bimix, failures being described as not firm enough for satisfying intercourse. Of course, it's each guys idea as to what is satisfying. To me, I want to be firm enough to easily penetrate and stay inside. The bimix erection allows for penetration, but makes it more difficult to stay inside, as it is a 'softer' kind.

As the guys have said, like everything PCa wise, it is very much an individual thing as to how long and how much we use of the drug. I notice you say you are using Viagra with the bimix. That's something I won't do, myself, as they really are acting against each other. Viagra acts to increase blood flow to the area, including the penis, and bimix acts to close down the valves inside the penis- to hold the blood in. Just how it affects only the ones that keep the blood in the penis is beyond my knowledge, but using the pills and the drugs seem counter-intuitive to me , at least.

Back to the question, I have had close to 4 hour erection, both with trimix and bimix, but only one time actually felt any danger. That was the first time, with a much larger than needed dose of Caverject. Since then, I can approach the 4 hr. mark often, the only result is 3 hours of erection that I can't use, and a sense of aching until it goes down finally. It sounds as if you may be approaching a successful system for it. If you want my opinion, I'd not do the Viagra with the drug. I'd experiment a little more, changing the amount of bimix you use slightly, maybe a half a point at a time. Sounds like you are close, but need to work on the 'fear factor' some by having a few good experiences. Some things to consider- the age of the mix, whether it has been refrigerated all the time you had it, your injection technique, maybe try the pre-plump method, with less drug and work your way up that way. People seem to have better control of it and have more consistent results if you can eliminate some variable, which this method does, by making sure the same dose is kept in the penis to be adsorbed every time. One thing I don't think has been asked or answered. What is the ratio or strength of the papaverine and phentolamine in the bimix?

I'm sure others will weigh in with their ideas. Hope this helps.
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RRP, Path: pT2c, 110 gms., all clear except:
Probable microscopic involvement of the left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09- Uh-Oh
ED continues: Bimix .30cc & Trimix .15cc PRN

Post Edited (James C.) : 9/22/2010 2:16:03 PM (GMT-6)


FiftiesMale
Regular Member


Date Joined Mar 2009
Total Posts : 75
   Posted 9/22/2010 2:20 PM (GMT -6)   
James,

Correction. I did *not* use Viagra with the Bimix. When i posted my information, i indicated that i use both, but I should have clarified that i do not combine them.I have used Viagra on off-days, when i was not using Bimix. Typically, our week tends to be about twice per week (intercourse, or sex of whatever nature). So, there is always a gap of a few days in between Viagra and Bimix. The folks at the Medical Center highly cautioned against combining. The folks at the Medical Center also confirmed what you said, that Trimix would have an even stronger affect on me. So, with the .3 Bimix causing problems, she said "Let's stay away from Trimix".

The mix that I use, stays in the Refrigerator until about 20 minutes before use. The Bimix at the Medical Center, i do not know if it just came out of a Refrigetor, nor how old it is/was.
Age: 53
8/1/2008: PSA 6.2, GP recommended retake.
8/27/2008: PSA 5.8 (%free 12.1) referred to Urologist.
9/10/2008: DRE - non palpable. Urologist recommended biopsy
10/21/2008: Biopsy appt: 10 samples taken
10/31/2008: Biopsy results; 1 positive out of 10 samples.
10/31/2008: Biopsy Results: Gleason 7 (3+4) , no evidence of perineural invasion.
10/31/2008: Referred to UCSF
12/19/2008: Transrectal Ultrasound at UCSF
12/19/2008: Consultation with Surgeon.
12/19/2008: Surgeon concurred on Gleason 7=3+4 (per slides).
2/24/2009: Robotic Assisted Laparoscopic Prostatectomy (DaVinci) UCSF
3/5/2009: Cathetor removal.
3/21/2009Post Op Pathology: margins negative/clear, Gleason 4+3=7
4/9/2009: first post-op Ultrasensative PSA: less than 0.01
Currently taking Viagra (since March 2009), Levitra (tried Cialis).
6/2009: Purchased and using Osbon manual pump.
7/28/09: 5 month Ultrasensative PSA: less than 0.01
7/14/2010: 18 month Ultrasensative PSA: less than 0.04.

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 9/22/2010 2:30 PM (GMT -6)   
Fifties,  I have been using a 0.5 dose of bimix for about a year.  The erections last anywhere from 30 min. to an hour.    You need to be aware of the fact that bimix is just a general term and the composition may vary with different pharmacies.  For example,  my bimix is much stronger tham James'.  My bimix dose contains 20 mcg of PGE-1 and I mg of phentolamine.  I tried a weaker trimix dose that contained 30 mg of Pap, 1mg of Phentolamine and 10mcg of PGE-1.  The trimix didn't work very well.  So,  when comparing with others, just be aware of the different possibilities.
 
Carlos

Diagnosed 2/2008 at age 71, PSA 9.1, Gleason score 5+3, stage T1c.
Robotic surgery 5/2008, LFPF at 6 wks.,nerves spared, stg. pT2c, N0, MX, R0, Gleason 5+3
PSA <0.1 at 26 months and at all tests since surgery.

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 9/22/2010 2:37 PM (GMT -6)   
I realized I failed to answer part of your question. Normally, my bimix erection will last from 1 to 2 hours, subside by the 3 hr mark, and is more of a hit or miss deal, as far as getting what I call a 'suitable' result. Even using the preplump method, I still have failures once in a while, but the above figures are the average for me. You seem to be in some better phase of recovery as me (if the pills are helping), as I have absolutely no valve closing action happening naturally. One way to judge yours is to use a penis pump and pump up full, release and see how quickly, or better, how slowly your pumped up erection subsides. In my case, it does so as soon as the vacuum is released, hence no valve action yet. (if ever confused mad )
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RRP, Path: pT2c, 110 gms., all clear except:
Probable microscopic involvement of the left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09- Uh-Oh
ED continues: Bimix .30cc & Trimix .15cc PRN

FiftiesMale
Regular Member


Date Joined Mar 2009
Total Posts : 75
   Posted 9/22/2010 2:38 PM (GMT -6)   
I pulled out the receipt, and this is how it reads:

1 PAPAVER/PHENTOLA 30/1/ML INJ 10 COMPO? (?=one more character after the O, that is either an M or an N).

can anyone help me translate that - to what you are referring to? :-)

thanks
Age: 53
8/1/2008: PSA 6.2, GP recommended retake.
8/27/2008: PSA 5.8 (%free 12.1) referred to Urologist.
9/10/2008: DRE - non palpable. Urologist recommended biopsy
10/21/2008: Biopsy appt: 10 samples taken
10/31/2008: Biopsy results; 1 positive out of 10 samples.
10/31/2008: Biopsy Results: Gleason 7 (3+4) , no evidence of perineural invasion.
10/31/2008: Referred to UCSF
12/19/2008: Transrectal Ultrasound at UCSF
12/19/2008: Consultation with Surgeon.
12/19/2008: Surgeon concurred on Gleason 7=3+4 (per slides).
2/24/2009: Robotic Assisted Laparoscopic Prostatectomy (DaVinci) UCSF
3/5/2009: Cathetor removal.
3/21/2009Post Op Pathology: margins negative/clear, Gleason 4+3=7
4/9/2009: first post-op Ultrasensative PSA: less than 0.01
Currently taking Viagra (since March 2009), Levitra (tried Cialis).
6/2009: Purchased and using Osbon manual pump.
7/28/09: 5 month Ultrasensative PSA: less than 0.01
7/14/2010: 18 month Ultrasensative PSA: less than 0.04.

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 9/22/2010 2:50 PM (GMT -6)   
Bimix consists of 2 chemical/drugs. First is Papaverine and is usually prescribed as such: iIn 1 ml of sterile water, 30 mg. of it (papaverine)is added, Then 1 mg of phentolamine is added, hence the bimix. This is for one ml. Most preescriptions are for a 5ml vial, so the 1ml is mixed at that concentration (X 4 more) to make a 5ml vial order.

Woah here now! You said 1 of papaverine and 30 of phentolamine? Check that again, that is totally backwards to the 'standard"
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RRP, Path: pT2c, 110 gms., all clear except:
Probable microscopic involvement of the left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09- Uh-Oh
ED continues: Bimix .30cc & Trimix .15cc PRN

Post Edited (James C.) : 9/22/2010 2:53:54 PM (GMT-6)


Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 9/22/2010 2:52 PM (GMT -6)   
Fifties,  I believe that translates into 30 mg papaverine, and 1 mg of phentolamine.  That would be a weaker bimix than mine.  Mixes that contain PGE-1, whether bimix or trimix, are stonger than those that don't.  I have had ED problems for 20 yrs and need the stongest mixes.  Nothing else works at all.  Good luck.
 
Carlos

FiftiesMale
Regular Member


Date Joined Mar 2009
Total Posts : 75
   Posted 9/22/2010 2:55 PM (GMT -6)   
I wonder if the first "1" is referring to this "one" prescription

1 PAPAVER/PHENTOLA 30/1/ML INJ 10 COMPO? (?=one more character after the O, that is either an M or an N).

because in the middle it has 30/1/ML (see above)
Age: 53
8/1/2008: PSA 6.2, GP recommended retake.
8/27/2008: PSA 5.8 (%free 12.1) referred to Urologist.
9/10/2008: DRE - non palpable. Urologist recommended biopsy
10/21/2008: Biopsy appt: 10 samples taken
10/31/2008: Biopsy results; 1 positive out of 10 samples.
10/31/2008: Biopsy Results: Gleason 7 (3+4) , no evidence of perineural invasion.
10/31/2008: Referred to UCSF
12/19/2008: Transrectal Ultrasound at UCSF
12/19/2008: Consultation with Surgeon.
12/19/2008: Surgeon concurred on Gleason 7=3+4 (per slides).
2/24/2009: Robotic Assisted Laparoscopic Prostatectomy (DaVinci) UCSF
3/5/2009: Cathetor removal.
3/21/2009Post Op Pathology: margins negative/clear, Gleason 4+3=7
4/9/2009: first post-op Ultrasensative PSA: less than 0.01
Currently taking Viagra (since March 2009), Levitra (tried Cialis).
6/2009: Purchased and using Osbon manual pump.
7/28/09: 5 month Ultrasensative PSA: less than 0.01
7/14/2010: 18 month Ultrasensative PSA: less than 0.04.

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 9/22/2010 2:57 PM (GMT -6)   
The way I read his sentence is 1 mg papaverine/30mg phentolamine/per 1 ml/Inject in a 10ml vial Compound, if I read the shorthand right. That ratio is completely opposite mine. If true, you need to recheck your pharmacy and see if they have mixed up the proportions. That could really make it hard to know what is the correct dose to use.
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RRP, Path: pT2c, 110 gms., all clear except:
Probable microscopic involvement of the left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09- Uh-Oh
ED continues: Bimix .30cc & Trimix .15cc PRN

FiftiesMale
Regular Member


Date Joined Mar 2009
Total Posts : 75
   Posted 9/22/2010 3:03 PM (GMT -6)   
so if we add as a variable, how successful the surgery and HEALING has been, then a lessor dosage may be required, from one guy to the next.

if, and i do *not* know that this *is* the case, but if my surgery and healing have gone well, then i might not require as much as - say someone who lost one or both nerve bundles?

that is good news.

Let me re-address my original question, in a different way:

If it were you, and certain injection values kept you quite firm till close to, or even slightly past the 4 hour mark, what would you do?
and what if, you consistently came back down, from hour4 to hour6, would you be comfortable with that?

This is all new to me, and i have always held that "4 hour" mark as sacred. Like don't mess with it. Don't get anywhere near it. Is it true that the 4 hour mark is sacred and should be avoided at all costs?

In fact, on my first occasion, it lasted over 5, and things were so "impacted" or "compacted" that the counter-injections did not loosen things up, so that is why they used multiple needles to drain things. Not fun.

thanks,
Age: 53
8/1/2008: PSA 6.2, GP recommended retake.
8/27/2008: PSA 5.8 (%free 12.1) referred to Urologist.
9/10/2008: DRE - non palpable. Urologist recommended biopsy
10/21/2008: Biopsy appt: 10 samples taken
10/31/2008: Biopsy results; 1 positive out of 10 samples.
10/31/2008: Biopsy Results: Gleason 7 (3+4) , no evidence of perineural invasion.
10/31/2008: Referred to UCSF
12/19/2008: Transrectal Ultrasound at UCSF
12/19/2008: Consultation with Surgeon.
12/19/2008: Surgeon concurred on Gleason 7=3+4 (per slides).
2/24/2009: Robotic Assisted Laparoscopic Prostatectomy (DaVinci) UCSF
3/5/2009: Cathetor removal.
3/21/2009Post Op Pathology: margins negative/clear, Gleason 4+3=7
4/9/2009: first post-op Ultrasensative PSA: less than 0.01
Currently taking Viagra (since March 2009), Levitra (tried Cialis).
6/2009: Purchased and using Osbon manual pump.
7/28/09: 5 month Ultrasensative PSA: less than 0.01
7/14/2010: 18 month Ultrasensative PSA: less than 0.04.

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 9/22/2010 3:09 PM (GMT -6)   
Fifties,  I read the 1 as meaning 1 ml dose.  So, on a single 1 ml dose you have 30 mg/ml papaverine and 1 mg/ml of phentolamine.  I would just call the pharmacy to clear it up.
 
Carlos

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 9/22/2010 3:17 PM (GMT -6)   
yeah, it could be read as 1 prescription of papaverine and phentolamine at a 30/1 ratio per 1 ml sterile water. I guess there's enough confusion to check back and make sure what it really was compounded as. Depends on how you try to read it. Now I'm unsure and confused.

If it were me, I wouldn't confortably keep having 4 horu erection that subsided in 5 to 6 hours. There's other ways of doing things, and it will take trial and error on your and your doctors part to find it. The suces or failure is very individualized. I came out of surgery continent in 2 days, fully revoered and never regained erections. Others come out incontinent but with them, others with neither and other both dry and erect. There is no norm , average, or standard that can be sued to predict what you will do, other than to look for signs of what it happening with you. The fact that you can use pills to achieve some kind of erection is good news, it may mean a longer recovery time to get ovder the ED. It can take up to 3 years or more for some mento regain any semblance of ability. It may take that long for you. We cna't really say.
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RRP, Path: pT2c, 110 gms., all clear except:
Probable microscopic involvement of the left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09- Uh-Oh
ED continues: Bimix .30cc & Trimix .15cc PRN

FiftiesMale
Regular Member


Date Joined Mar 2009
Total Posts : 75
   Posted 9/22/2010 3:30 PM (GMT -6)   
I just spoke with the Pharmacist, and he confirmed that it is: 30 mg papaverine, and 1 mg of phentolamine.

I asked his thoughts about the "4 hour" mark, and his response was stay away from it, completely.

He suggested, that if .15 or .17 is keeping things too close to, or over, the 4 hour mark, then i should throttle things downward. He suggested trying .12, .13. (since the .10 in the Medical Center) was not really usable. He said that my "window" of usability is very narrow.

thank you ALL for your posts.

I will continue to trial, but at lower numbers i guess.
Age: 53
8/1/2008: PSA 6.2, GP recommended retake.
8/27/2008: PSA 5.8 (%free 12.1) referred to Urologist.
9/10/2008: DRE - non palpable. Urologist recommended biopsy
10/21/2008: Biopsy appt: 10 samples taken
10/31/2008: Biopsy results; 1 positive out of 10 samples.
10/31/2008: Biopsy Results: Gleason 7 (3+4) , no evidence of perineural invasion.
10/31/2008: Referred to UCSF
12/19/2008: Transrectal Ultrasound at UCSF
12/19/2008: Consultation with Surgeon.
12/19/2008: Surgeon concurred on Gleason 7=3+4 (per slides).
2/24/2009: Robotic Assisted Laparoscopic Prostatectomy (DaVinci) UCSF
3/5/2009: Cathetor removal.
3/21/2009Post Op Pathology: margins negative/clear, Gleason 4+3=7
4/9/2009: first post-op Ultrasensative PSA: less than 0.01
Currently taking Viagra (since March 2009), Levitra (tried Cialis).
6/2009: Purchased and using Osbon manual pump.
7/28/09: 5 month Ultrasensative PSA: less than 0.01
7/14/2010: 18 month Ultrasensative PSA: less than 0.04.

mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 673
   Posted 9/22/2010 3:43 PM (GMT -6)   
FiftiesMale said...
(lest anyone suggest that i search and read before posting a new thread, I have searched and read a lot of posts and threads. My questions and concerns are very specific to the Subject Line of my thread.)

Are there others out there, who use Injections, who approach (or pass) the 4 hour mark, and then successfully and consistently come down OK???

 
I was having 3-4 hour erections on a continually reducing dose of standard trimix...starting at 0.100 mL and ending up at less than 0.025 mL over a course of 5 or so months. I also had one ER visit for priapism. I almost had a couple more ER visits...sudafed helped me after first ER visit each time...or maybe it was just time to come down.... I think everyone responds somewhat differently. Sometimes it takes a remix of ingredients and certainly some patience in trying to get the right chemical combination and right dose, IMO.
I stopped trimix injections and now levitra works just by itself.
Hope this helps. Tried to answer specifically to your "approach or surpass the 4 hour mark".
 
Good luck.
 
Mike

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 9/22/2010 3:52 PM (GMT -6)   
Fifties,  Mike mentioned using sudafed to help the erection go away.  My uro's instructions say:" If you experience an erection lasting more than 2 hours, take 30 mg of Pseudoephedrine once and apply an ice pack.  If your erection does not go away within the next hour, contact your physician or go the emergnecy room immediately."  Hope this helps.
 
Carlos

Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 9/22/2010 4:05 PM (GMT -6)   
I write this as an ex-injector. Although I had good results with bimix for over a year, gave up for various reasons, none to do with erection quality or duration.

I settled on a dose of 0.2ml of my bimix (10/1 ratio). Although I never had a solid erection still at four hours, it was still partly erect, although clearly subsiding at that point. As I recollect, it used to take about 6 hours to get back to fully flaccid.

I had erratic erections at first and most of my failures happened then. One factor that lead to consistent results for me was to apply some constriction at the time of injection and for three minutes afterwards. I used a few office rubber bands doubled over round the base, but a pump ring should be equally effective. Theory: it forces the drug to hang around while it does some good.

The usual advice if the erection lasts too long, is to reduce the dose. So I suggest trial your 0.1 dose again, but this time with constriction and see what happens.

If you can remove the "erratics" that will allow you to fine-tune the dose for a balance between erection quality and duration.
Pre-op:
Age 63 at diagnosis, now 65.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Operation:
Non-nerve-sparing open surgery on 7 March 2008.
Two nights in hospital; catheter out after 7 days.
Post-op:
Continent; no pads needed from the get-go.
Pathology showed organ confined and negative margins. Gleason downgraded to 4+4=8.
PSAs:
6-week : <0.05
7-month: <0.05
13-month: 0.07 (start of a trend?)
19-month: 0.09 (maybe)
25-month: 0.2 (yes, bummer)
27-month: 0.2 (not up; glad about that)
ED:
After a learning curve, Bimix injections (0.2ml) worked well. From 14 months, occasional nocturnal erections. At 18 months, "graduated" to just the pump.

FiftiesMale
Regular Member


Date Joined Mar 2009
Total Posts : 75
   Posted 9/22/2010 4:39 PM (GMT -6)   
Thank you for the updates, since my last post (Piano, Carlos, and Mikey)

Thank you all, again, for comments and suggestions.

I am inclined to continue to rotate between Viagra (and a couple of days later), Bimix around (.12 - .14).

I will let you know.

It sure is helpful to get real answers from real people.

This forum is great.
Age: 53
8/1/2008: PSA 6.2, GP recommended retake.
8/27/2008: PSA 5.8 (%free 12.1) referred to Urologist.
9/10/2008: DRE - non palpable. Urologist recommended biopsy
10/21/2008: Biopsy appt: 10 samples taken
10/31/2008: Biopsy results; 1 positive out of 10 samples.
10/31/2008: Biopsy Results: Gleason 7 (3+4) , no evidence of perineural invasion.
10/31/2008: Referred to UCSF
12/19/2008: Transrectal Ultrasound at UCSF
12/19/2008: Consultation with Surgeon.
12/19/2008: Surgeon concurred on Gleason 7=3+4 (per slides).
2/24/2009: Robotic Assisted Laparoscopic Prostatectomy (DaVinci) UCSF
3/5/2009: Cathetor removal.
3/21/2009Post Op Pathology: margins negative/clear, Gleason 4+3=7
4/9/2009: first post-op Ultrasensative PSA: less than 0.01
Currently taking Viagra (since March 2009), Levitra (tried Cialis).
6/2009: Purchased and using Osbon manual pump.
7/28/09: 5 month Ultrasensative PSA: less than 0.01
7/14/2010: 18 month Ultrasensative PSA: less than 0.04.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 9/22/2010 6:00 PM (GMT -6)   
For all the brothers, that need and depend on injectable drugs for ED, my hat is always off to you. I am not sure I would have the patience, the courage, and the natural ability to do all this experimentation of dosing. JamesC, that's why I plugged your name, you seem be our house expert on the subject, not saying of course, that others aren't well versed too in the subject. I always pay attention to these threads, as I never know, that one day I may need that knowledge and experience.

fiftiesmale - look like you have been getting a slew of good, thoughtful, and well qualified answers. I am happy on that count. It's a great community here, glad you have joined us.

david in sc
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, on Catheter #21, will be having Ileal Conduit Surgery in Sept.

TeddyG
Regular Member


Date Joined Apr 2009
Total Posts : 133
   Posted 9/22/2010 6:54 PM (GMT -6)   
Gents, including those reading and wondering,
After 15 months of waiting for nature to help, I too finally took the plunge(r) and tried Trimix. My Doc suggested the opposite approach apparently by using a very low dose to see how I reacted in the office. He wanted to try 10 ml, I squirmed and we adreed to 7ml. It got me 1/2 way there so we knew it would work. Then he sent me home with 2 syringes (teeny diabetic ones) preloaded, one at 15ml and another at 25ml. I tried the 15ml and it worked well enough for penetration but not as hard as the olden days so the next time (soon) I will try 20ml. The goal is to find the minimum dosage that works. After reading stories here and, of course the commercials on TV about 4 hours, being conservative is the only way to go. Oh, at 15ml, I was hard for about 45 minutes.
Regarding Bimix v. Trimix, my Doc does not use Bimix as he says that aching of the penis is more common with Bimix and he has had more over all success with Trimix. 
I think that I am over the "needle" thing and my spouse and I both believe that we made progress. That feels good.
Best,
Ted 
 

mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 673
   Posted 9/22/2010 7:12 PM (GMT -6)   
TeddyG said...
After 15 months of waiting for nature to help, I too finally took the plunge(r) and tried Trimix. My Doc suggested the opposite approach apparently by using a very low dose to see how I reacted in the office. He wanted to try 10 ml, Regarding Bimix v. Trimix, my Doc does not use Bimix as he says that aching of the penis is more common with Bimix and he has had more over all success with Trimix. 
Hi TeddyG,
Just wondering about the units of measurement. I know there is some variation in trimix formulation, but 10 mL seems a bit high. Most guys I think start on a standard dose of 0.1 mL.
I had a lot of pain with injections due to the alprostadil in trimix. That's what gives most guys pain. I don't think alprostadil is in bimix...that I've heard of.
 
Mike
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