Penile Injections don't always work for me

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dotcom
New Member


Date Joined Mar 2018
Total Posts : 10
   Posted 3/6/2018 11:47 PM (GMT -6)   
I don;t have Prostate cancer, but this is the only thread I found that is talking about Penile Injections. I have performance ED, so doctor prescribed me injections. I'm using 30 g, 5/16 inch BD needles with Inject Easy injector. First several months, everything was OK and I was getting erection after injection. But last couple of months , maybe only 30% of injections work good, other times - no erection at all....
What can be an issue?

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4157
   Posted 3/7/2018 6:04 AM (GMT -6)   
May I suggest www.franktalk.org

It's a site that deals specifically with issues such as yours.

Jim
Forum Moderator-Prostate Cancer. Age 62 (71 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Everything continues to function normally. PSA: 6 mo: 1.4, 1 yr: 1.0, 2 yr: .8, 3 yr: .5, 4/5 yr: .2, 6-9 yr: 1. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1

Everton
Regular Member


Date Joined Jun 2017
Total Posts : 91
   Posted 3/7/2018 6:07 AM (GMT -6)   
Dotcom welcome to the site. As i have not used this method yet, I would think you would be better to talk to your Urologist. It is possible the dosage needs increased. I have also had prostatis which in my case stopped an erection until it was cleared up. There will be other guys along the have used this method and will chime in.
Age 59 when DX
DX Nov 2016
PSA 350
Start Lupron every 3 months
Jan 4 PSA 10.3
Feb 4 PSA 0.60 Feb Testosterone 0.2
Nov scan shows Bone & Lung Mets
Dec radiation to hip
Jan Biopsy 12 samples all positive
Gleason 9 ( 5 + 4 )
Jan Start chemo 6 times 3 weeks apart, Apr 21 done
Docetaxel with Predisone
March start Zometa
April 4 Turp
PSA June .018 Sept .016 Dec .058

JeffM
Regular Member


Date Joined Nov 2017
Total Posts : 67
   Posted 3/7/2018 9:47 AM (GMT -6)   
Hi dotcom,

I second Jim's reco of franktalk.org. There is even a subforum for injections.

You didn't mention what you are using, but I assume trimix. Have you refilled your prescription or are you still using the same vial from several months ago. If the same vial, it may be losing some of its potency. Have you adjusted your dosage at all since you first started?

Jeff
DX August 2017, Age 52
PSA 6.3 (3.8 a year earlier)
Biopsy 3 of 12 cores positive, 5%, 5%, 20%; Gleason 3+3=6
MRI PI-RADS = 4
Robotic Prostatectomy - 10/30/2017
Final pathology G7 (3+4), pT2cN0, approx. 30% involvement
Pad free 10 days after surgery, now 100% continent
40 mg/day sildenafil; Trimix ~2-3days/week
PSA @ 3 months=0.02

dotcom
New Member


Date Joined Mar 2018
Total Posts : 10
   Posted 3/7/2018 11:51 AM (GMT -6)   
I'm using mix of Papaverine , atrophine and ... i forgot the name....
The problem is not with dosage, as sometimes with the same dosage I have perfect erection for 2 hours or so , and sometimes nothing (and this is with medicine frm same bottle))

JeffM
Regular Member


Date Joined Nov 2017
Total Posts : 67
   Posted 3/7/2018 12:24 PM (GMT -6)   
Must be quadmix as it is the only one containing atropine, I think. My guess is the failures are due to not getting the medication fully injected into the cavernosum.

Do you alternate sides for the injections and do you track the results from one side to the other? I'm curious if you are getting better results on one side or the other. Have you ever tried using just standard 31g, 5/16" syringes rather than the auto injector? They're really not that hard to use once you get some practice. I've never used one but I've heard some say that the auto injectors can make it more difficult to pinpoint the injection site to make sure you miss blood vessels and ensure it is injected into the cavernosum.

Jeff
DX August 2017, Age 52
PSA 6.3 (3.8 a year earlier)
Biopsy 3 of 12 cores positive, 5%, 5%, 20%; Gleason 3+3=6
MRI PI-RADS = 4
Robotic Prostatectomy - 10/30/2017
Final pathology G7 (3+4), pT2cN0, approx. 30% involvement
Pad free 10 days after surgery, now 100% continent
40 mg/day sildenafil; Trimix ~2-3days/week
PSA @ 3 months=0.02

dotcom
New Member


Date Joined Mar 2018
Total Posts : 10
   Posted 3/7/2018 1:11 PM (GMT -6)   
Yes, I used different sides, I injected when penis is flat or a bit erect...... same mixed results....
Yes, i'm useing BD ultra fine II 30g 5/16" syringes that I insert into Inject Ease (it's kinda semi-auto-injector).
Maybe I inject too shallow or too deep...hell knows....told it to doctor, he said that he has no idea why it's happening....

JeffM
Regular Member


Date Joined Nov 2017
Total Posts : 67
   Posted 3/7/2018 1:22 PM (GMT -6)   
Yeah, that's why I suggest skipping the injector and try it manually with only the syringe. That way you can control the needle exactly and only inject the meds when you know it's fully inserted.

Jeff
DX August 2017, Age 52
PSA 6.3 (3.8 a year earlier)
Biopsy 3 of 12 cores positive, 5%, 5%, 20%; Gleason 3+3=6
MRI PI-RADS = 4
Robotic Prostatectomy - 10/30/2017
Final pathology G7 (3+4), pT2cN0, approx. 30% involvement
Pad free 10 days after surgery, now 100% continent
40 mg/day sildenafil; Trimix ~2-3days/week
PSA @ 3 months=0.02

dotcom
New Member


Date Joined Mar 2018
Total Posts : 10
   Posted 3/7/2018 1:34 PM (GMT -6)   
JeffM said...
Yeah, that's why I suggest skipping the injector and try it manually with only the syringe. That way you can control the needle exactly and only inject the meds when you know it's fully inserted.

Jeff

I tried it, it worked 1 time, but I'm really scared to inject with injector sad
btw, the solution I have contain:
chlorpromazin 1.923 mg
papaverine 17.5
atropine 0.23 m

JeffM
Regular Member


Date Joined Nov 2017
Total Posts : 67
   Posted 3/7/2018 3:09 PM (GMT -6)   
Chlorpromazine? Are you sure about that? I didn't know what that was so looked it up and it's an anti psychotic! If you're injecting that into your dick, it's no surprise you're getting strange results haha.

The drugs that I'm aware of that are used for ED injections are Papaverine, Phentolamine, Prostaglandin E1 and Atropine. They are mixed together in different combos and strengths to create bimix, trimix and quad mix.

Jeff
DX August 2017, Age 52
PSA 6.3 (3.8 a year earlier)
Biopsy 3 of 12 cores positive, 5%, 5%, 20%; Gleason 3+3=6
MRI PI-RADS = 4
Robotic Prostatectomy - 10/30/2017
Final pathology G7 (3+4), pT2cN0, approx. 30% involvement
Pad free 10 days after surgery, now 100% continent
40 mg/day sildenafil; Trimix ~2-3days/week
PSA @ 3 months=0.02

dotcom
New Member


Date Joined Mar 2018
Total Posts : 10
   Posted 3/7/2018 10:27 PM (GMT -6)   
I also did a research about it and found:
Chlorpromazine is an aliphatic phenothiazine that is indicated for the treatment of a variety of conditions ranging from nausea anxiety, schizophrenia, and hiccups. Chlorpromazine was discovered back in 1951 and it was quickly adopted by the mental health society because it has very powerful effects on numerous neurotransmitter channels. It was considered the greatest advancement in psychiatric health in the 20th century. An alpha1 adrenoceptor blocking agent which forms one of the elements of Chlorpromazine’s psychiatric profile is what made this medication a natural subject in the investigation of its efficiency in the management of Erectile Dysfunction, surprisingly substantial data has proved that it is very effective in managing Erectile Dysfunction and reducing the side effects from Phentolamine. You can also combine it with other treatment agents to form even more powerful medications.
https://absoluterx.com/erectile-dysfunction/

Chlorpromazine has been shown to be a useful substitute for phentolamine when used in combination with PGE1 [ 22]; 163 patients followed for a 2-year period had the PGE1/phentolamine mixture substituted for PGE1/chlorpromazine, with no difference in response in 156. In another study, 148 of 175 men (85%) responded fully to a combination of papaverine and chlorpromazine [ 23]. A mixture of papaverine, PGE1 and phentolamine was just as potent when the phentolamine was substituted with chlorpromazine. The advantage of the alpha-blocker chlorpromazine over phentolamine is the reduced cost of the drug.
http://onlinelibrary.wiley.com/doi/10.1046/j.1464-410x.1998.00600.x/full

I;m going to Ontario Men's health clinic and they have very good reviews

JeffM
Regular Member


Date Joined Nov 2017
Total Posts : 67
   Posted 3/8/2018 6:13 AM (GMT -6)   
Interesting. I wasn't aware of that, thanks for posting your research.

I guess you could try a more traditional trimix with papaverine, PGE1 and phentolamine to see if that gives you more consistent results. Other than that, I'm out of ideas. Suggest you post over on franktalk.org. The guys over there may have more suggestions.

Good luck,
Jeff
DX August 2017, Age 52
PSA 6.3 (3.8 a year earlier)
Biopsy 3 of 12 cores positive, 5%, 5%, 20%; Gleason 3+3=6
MRI PI-RADS = 4
Robotic Prostatectomy - 10/30/2017
Final pathology G7 (3+4), pT2cN0, approx. 30% involvement
Pad free 10 days after surgery, now 100% continent
40 mg/day sildenafil; Trimix ~2-3days/week
PSA @ 3 months=0.02

PeterDisAbelard.
Forum Moderator


Date Joined Jul 2012
Total Posts : 5865
   Posted 3/8/2018 7:58 AM (GMT -6)   
dotcom:

I'd like to second the ditch-the-autoinjector idea. It sounds like you are not always injecting into the erectile chambers and there are things you can try that might help but can't be done while using the autoinjector.

The tissue inside the erectile chambers is a bit like a sponge -- a matrix filled with interconnected holes. (If you like technical terms you can call the holes "lacunae" which is a fancy-schmancy medical word meaning "holes".) What you want to do with your injection is to hit one of the holes and inject into that. If the end of your needle winds up in the matrix material between the holes it is difficult to inject and when you do inject it will sometimes form a pocket between the holes where the drugs are useless. Sometimes you can feel the pocket as a lump.

There are two ways to make sure you are injecting into the right place. Some guys pull back the plunger slightly before they push it in. If you are in the right place you will be able to draw a little bit of blood into the syringe. An easier, and less gory, way to tell that you are in the right place is to simply not push the plunger very hard. If you feel resistance then you are probably trying to inject into the interstitial tissues (outside the holes). If either of these tests tells you you are in the wrong spot you can either try again somewhere else (yes, a second stab... sorry) of you can press the hub of the needle more tightly against the skin to advance the needle an eighth of an inch and try again.

I think you can see why this would all be impossible with the autoinjector.

It is important to alternate sides. If you inject too often in the same place you can form scar tissue that increases your odds of missing the holes.

Good luck.
65 Slow PSA rise 2007-2012: 1.4=>8
4 bxs 2010-2012: 1&2 neg, 3 pos 1/14 6(3+3) 3-4% (2nd opn. 7(3+4)), 4 neg
DaVinci 6/14/12. "some" nerve sparing on left
Path: pT3a pN0 R1 GS9(4+5) Pos margins on rt
24 mo ADT3 7/12 - 7/14
Adj IMRT 66.6 Gy 10/17/12-12/13/12
8/2012-3/2015: Incont., Trimix, VED, PSA<0.015.
AUS & IPP installed 3/5/2015
Forum Moderator - Not a medical professional

dotcom
New Member


Date Joined Mar 2018
Total Posts : 10
   Posted 3/8/2018 12:32 PM (GMT -6)   
Everyone , thanks for replies!

Just curious, are you doing injection into a flat or semi-erected penis?

moeskeeter
Regular Member


Date Joined Feb 2013
Total Posts : 31
   Posted 3/12/2018 1:21 PM (GMT -6)   
I used an auto injector at first but did not have good results. When I do it manually I can feel the needle penetrate the corpus cavernosum.

oldbeek
Regular Member


Date Joined Sep 2017
Total Posts : 194
   Posted 3/12/2018 6:48 PM (GMT -6)   
Auto injector didn't work from either. I have a disecting microscope and examined the 31 g needle. The tip was bent. Went back to compounding lab with questions of why. They said use 29 ga or larger with auto inject. I can feel when the needle pops through the tunica and I get into the Casanova muscle when injecting manually. My uro also said he had poor results with auto injectors. Also go to :FrankTalk
76 very active. Physically fit. PSA 6.8 MRI Targeted biopsy 6/17 Gl 4+3 9%, Chose RP without consultation 7/28/17 RP ,16 lymph nodes & nerves removed, pT3a, pin, negative margins, EPE focal Total ED using bimix, still one pad a day, 9-18-17 psa <.1, 1-5-18 <.1 psa

dotcom
New Member


Date Joined Mar 2018
Total Posts : 10
   Posted 3/17/2018 11:02 PM (GMT -6)   
OK, 1 time did injection manually and it worked.... will see how it's going next time

25years
New Member


Date Joined Jan 2018
Total Posts : 11
   Posted 3/18/2018 3:06 PM (GMT -6)   
This may sound kind of nuts, but using my new Autoject2 I had it adjusted so the needle was 1/2inch long and it didn't work(!) so I set the next injection depth back to 5/16 inch and it worked just fine.
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