I'm taking a 20mg Sildenafil pill once a day (wait, there's a caveat) per Surgeon's recommendation following robotic prostatectomy in Oct 2018. This Rx has had no impact on my ability to achieve strong erections. May 2019 URO prescribes the wonder drug Trimix and, bingo, my sex life is back in full force. Now the question, what is the approach I should take in managing these two medications? I have opted to forego Sildenafil on days I inject Trimix (about 3 times a week). Is Trimix a replacement for Sildenafil with regard to penile tissue health?
ED Management: Trimix vs Sildenafil - Erectile Dysfunct...
I think you have it exactly right. The sildenafil should be taken daily except on days when injecting. You should check with your doctor about how close they can be done together. The concern is an erection that lasts too long. If I take a sildenafil in the a.m. I will inject sometimes later that day after the sildenafil has dissipated (half life of 4 hours), and I will inject about half of my normal dose of trimix.
Remember that you need to 'help' the sildenafil (for that matter, the trimix also) and manipulate/play/masturbate to get the blood into all the tissue. I don't think just taking sildenafil by itself is sufficient. The combo of alternating is exactly what my urologist directed me to do (and he was a sex rehab specialist, not my PC surgeon).
I have a stronger dose so my Uro said to use Trimix twice a week. I also take Viagra a couple of times a week. I use a vacuum pump and I jelq ever day. I don't know if I will ever be able to get a natural erection again but the exercises coupled with the meds has allowed me to maintain my length and girth.
Mark ... my goals are (1) Remain cancer free (2) Overcome ED by not requiring a "treatment" to achieve an erection strong enough for intercourse. I feel helpless, yet quite positive in achieving goal #1 (prayer and positive attitude are my enablers). To attain the second one -- it may be in my hands (pardon the pun). Is frequent (i.e., daily) manipulation a critical activity? I have not been timing my penile rehab exercises with intake of the Sildenafil, maybe I should? I'd really like to understand why my body reacts so well to Trimix and not Sildenafil. Obviously I am getting great blood flow and strong 30 minute erection, with small dose (15 units/0.15ml) and minimal physical stimulation with Trimix. And no venous leakage. Which brings me to my final thought. Where does "nerve sparing" and/or "nerve healing" fit into the equation?
I think the answer is that the effect of sildinefil works primarily through the cavernosal nerves. If the telephone lines are down, you to do not get a message through. The TriMix via needle goes to the spongy tissue where it directly promotes blood flow to fill the spongy spaces and make an erection. Are they additive? Possibly. There are no studies and little research on non-human animals
There is no one way to achieve or manage this, however, I think you have it right. If Trimix gives you a firm erection for intimacy, then that will definitely be your go-to. On the other hand if you are looking to preserve penile tissue and prevent atrophy there are several ways to achieve that. 1.) using your injections several times per week to induce an erection and get that blood flow in your penis regardless of sexual activity 2.) daily sildenafil 3.) vacuum erection device used therapeutically. A lot of men feel vacuum devices are cumbersome and don't produce the best erection for intimacy and that is fine as your trimix is achieving that for you, but adding a vacuum device to be used solely as therapy may be helpful. Think of the vacuum device therapy as an exercise and taking your penis to the gym. 10-15 minutes of creating an erection and releasing in an up and down motion just like repetitions with weights for any other body part.
So glad you got the trimix to work well for you. I have good luck with the bimix, trimix has prostaglandin, which causes pain for me. Taking 5mg tadalafil daily. Your injection and the viagra work differently. The injection is a local reaction, causing increased blood flow and swelling of the smooth muscles in the penis. Keep taking both, as the viagra is working behind the scenes. I also have found that besides these, and the vacum pump, sretching my penis in the shower-start at the base and move to the head quickly and multiple times helps with blood flow and has increased my semi firmness episodes. (I know that sounds like I am just playing with myself, but at this point, I am trying everything to get back in the game... ) point is, use every trick you can to keep your member active and filling with blood until the nerves have their time to repair. Good luck to you .
Well .... had my first post intercourse challenge with prolonged erection. Tried to walk it off, maybe not the right approach. About two hours after injection the "problem" resolved itself. What causes extended erection time?
the dose caused it.
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The pharmacist said no ED drugs when using TrIMix injection.