Impotence

[Auman]

Fifteen months since my surgery. No leakage but impotence has been a major major consequence. Pills are of no help. My PA wants to talk about devices.

Any advice from the community would be welcome.

[Tall_Allen]

What kind of penile rehab have you done, other than pills?

[Auman in reply to Tall_Allen]

None. That’s basically gist of my post. What is available besides devices? From your reply it appears I’m unaware of other alternatives.

[Tall_Allen in reply to Auman]

It's not too late to start a rigorous program of penile rehab - daily pumping, ed meds, trimix. Get Mulhall's book:

amazon.com/Saving-Your-Sex-...

He found that some men could regain some function with penile rehab even years after RP:

ncbi.nlm.nih.gov/pmc/articl...

[Handdrummer777]

Tall_Allen is absolutely correct. A vigorous program of penile rehab is essential to preserving and strengthening your sexual function -- AND saving your libido in the process.

Prolonged absence of erections not only deprives penile tissue of enough oxygen, it also deprives libido of the necessary positive einforcement that only repeated erectile success can give it.

The pump is a vital tool in the early-to-middle post-RP period. By hook or crook you want erections to resurrect as early as possible.

From the middle period (1 yr onward) where some erectile function is beginning to return, you should also be able to greatly benefit from two new FDA devices, one of which, Giddy, is sponsored right here by Darryl our administrator. The other is Xialla.

Vigorous penile rehab, like Tall_Allen recommends.

Make it so, #1.

Good luck! and keep sharing and asking questions.

[Handdrummer777 in reply to Handdrummer777]

Trimix also. It does work.

[RonnyBaby in reply to Handdrummer777]

Am I mistaken or did you (in the past) have your own solution that you were promoting on this site ?

If so, what ever happened to the concept ?

thxs ....

[Handdrummer777 in reply to RonnyBaby]

You're not mistaken. For eight months I've been freely offering instructions for the Loop device, which has enabled me to save >80% potency coming out of ADT this month.

Nobody asks for the instructions. I don't know why. Maybe they don't believe me when I extoll the virtues of the Loop, at least as it's worked for me. (RT completed 1 yr ago).

Anyway, it might be of some help. Drop me a message and I'll get the instructions out to you.

[RonnyBaby in reply to Handdrummer777]

I'd be interested in seeing what its all about.

Thanks.

Can we / should we private message ?

Not sure how to do that.

[Handdrummer777 in reply to RonnyBaby]

Sorry to miss your query -- to do a private message, just go to the two overlapping caption balloons on the activity bar when you first open your homepage. Be happy to work with you on that.

[Handdrummer777 in reply to Handdrummer777]

Just go to "A big hello..." scroll down aways and there's the link.

I'm going to be dickish and dare you to try the Loop and tell me it doesn't help at least somewhat.

[Uxp_d in reply to Handdrummer777]

All good advce,never give up, keep trying,

[RonnyBaby]

The concept of penile rehab is not new, but the approach to it has changed in the fact that there is now a protocol to try to keep the 'engine running'before and after the treatment phase. It is certainly more visible in the USA.

Those of us in the rest of the world (internationals) have noted that the USA leads the pack in the best practices approach to PCa.

Those that get an RP tend to have a different experience than the radiated ones, based on what I've heard and read.

I'm seeing an ED specialist (in Canada) and have been for about 6 months.

The 'injections' are only partially effective. Therefore, I am faced with surgery, a vacuum device, a new way of facing genital sex (non erection) or doing nothing at all.

The pills don't do anything for me either, while the side effects seem somewhat strange and perhaps risky, as well.

I am undecided as to what to do (I was radiated to the max) but I do have a pump that does work (I don't like it much but I can get hard). The surgery is too invasive (IMO) but at least it can make the spontaneous part of sex more natural (pumps take at least 5 five minutes and are cumbersome).

There is some good news in all of this. I still have sensations - can climax (dry type) and get partial erections without any assistance.

We'll see what happens.

What I think I'd like to do is poll some of the forum members to see if they had a positive experience with the surgery / implant(s).

[Auman in reply to RonnyBaby]

Thank you. This is good information. I had an RP but most of what you've experienced, as "some good news" is the same for me, dry climax. I did wake up one morning with a surprise. Other than that one time, nothing for the last 15 months.

My preference was injections but your experience with them doesn't sound promising. I have not heard from anyone else on the subject of injections or pumps either.

I'm trying to stay optimistic since, right now, I don't seem to have a choice other than stay positive.

[RonnyBaby in reply to Auman]

Eternal hope, as they say.

I did consider a combo of an injection and some type of constricting ring. It is a possibility, but unlikely.

A reaction to injections is scored on a scale of 0 - 4 but better understood as 1 - 4.

0 means nothing happening (not a candidate for treatment)

1 means some blood flow into the penis (not a good sign - a maybe at best)

2 means (semi) erect but not hard enough for intercourse (a candidate for successful treatment and/or potential improvement to a 3 ) could take up to 20 shots to come to a conclusion.

3 means hard enough for intercourse but not fully erect - potential to become a 4

4 means fully hard and erect - as good as it gets - the objective (within reason of course)

Something to consider - in some patients, there is a healing that occurs from getting 'trimix' injections.

It's like going to the gym. Some patients can get better outcomes over a longer term.

I was a 2 for most of the treatment phase, so I figured I could get a 'semi' on demand.

Ad a ring and presto.

There is a cost of about $200..00 a batch (4 or 5 doses I think) and you need to get past the needles.

I was told that the auto/self injectors are not recommended - maybe even dangerous.

That leaves me undecided.

I'll be consulting a surgeon in a few months, so I have some homework to do.

[cpcohen in reply to Auman]

Auman wrote:

>>>

My preference was injections but your experience with them doesn't sound promising. I have not heard from anyone else on the subject of injections or pumps either.

<<<

I think this Forum has a "search" capability. Search on:

injections

or

tri-mix

or

trimix

You should get plenty of hits. If you don't, "Friend" me, and I'll give you a summary of 11 years of generally-favorable experience.

The usual sequence of "fixes" is:

. . . Oral drugs;

. . . . VED (= penis pump)

. . . . . . Injections (bi-mix or tri-mix, usually)

. . . . . . . Implant

I think most docs want to wait two years before saying:

. . . "All else has failed, if you want an erection, you need an implant."

Mulhall's book "Saving Your Sex Life" is a good source for injection information.

. Charles

[Handdrummer777 in reply to RonnyBaby]

If I was in your position, despite the invasiveness of the implant surgery, I would run to get it. Most guys are thrilled with the outcome (who wouldn't be with a penis that can stay erect indefinitely)?

Talk about opps for spontaneity!

[RonnyBaby in reply to Handdrummer777]

Thanks for the message. You make a good point if you are focused on the sexual aspects of PCa and trying to figure out what to do about ED. I recall the 'loop' and asked for instructions but I guess my request got lost in the mist.

Anyway - I've got to look into this further .....

[Handdrummer777 in reply to RonnyBaby]

Loop instructions are scroll-down underneath my first post, "A big hello to everyone ..."

Hear some success stories with the AMS and/or Coloplast implants

[Handdrummer777 in reply to Handdrummer777]

Sorry I missed your original Loop instructions request!

[cpcohen]

It seems there's no "Friend" capability here. There _is_ a "private message" capability.

Do the search, read some posts, and I'll track this thread.

. Charles

[dadzone43]

Two of the members of my support group had penile implants this year. They are *very* happy with the results. One is straight; one is gay. Both tried injections first.

[Handdrummer777 in reply to dadzone43]

See? Implants kick ass! Hell, part of me wants my natural erectile ability to falter, and me not to like Trimix = I get an implant.

Meanwhile, though, I'm 69, just turned gay, have found a potential life partner, and I want lots of good, wholesome sex with him.

Waiting for my Xialla order still...

[Hidden]

I wonder if trazodone, an anti-depressant, could help with nocturnal erections. My doctor refers to it as 'traza-boner'. Careful with the dose. Here's a cautionary note on it:

sexualmed.org/risk-factors/...

Nocturnal erections are essential in maintaining the health of your equipment.

I was using trazodone as a sleep aid, as a replacement for a lorazapam prescription that the doctor refused to refill. It caused a problem with dry mouth so it wasn't good for that either but I can verify the boner effect and I'm glad I never took the full 50 mg pill.

[Auman]

Thanks. This is really good information. I appreciate the personal info as well as the drug names and resources.

After injecting how long before starts to work and is the full erection immediate? Sorry to sound so naive but I assume that the injections are at the base of the penis

Right now, my PA is recommending either a pump or injections and an implant has not been mentioned.

Anyway you’ve left me with a reading list and I appreciate that.

Thanks again.

[cpcohen]

From injection to an erection, maybe 10 minutes. The needle goes into the shaft of the penis (alternating the injection point from left side to right side), _not_ into the tip. You need to be shown where (and at what angle) to inject -- verbal descriptions can be confusing. It is possible to do it wrong, and some men take a while to get it right.

A 31-gauge needle stings more than a mosquito bite going in, but it's maybe a 1 on a 0-10 pain scale. Not something to worry about.

With my standard dose (which may be different from yours), the erection lasts, in good condition, for a half-hour or so. Unlike "natural" erections, it doesn't disappear after orgasm. (One day, I'll find out whether I'm multi-orgasmic or not, I haven't tested that yet.) It takes an hour or more to completely disappear.

The standard sequence of ED treatments (in order of aggressiveness) is :

. . . oral drugs;

. . . . vacuum pump;

. . . . . . injections;

. . . . . . . implant.

So your PA is on the right track.

Keep in touch -- you should find something that works for you.

. Charles

[Daddybearblue in reply to cpcohen]

Great information. Concise and to the point. My Surgeon took me straight to injections since my nerves were not spared. Implants will come after several months of clean PSA'S. Tri-Mix is a great alternative after no erections for several months and I am still learning about that. Injected wrong place and got nothing yesterday but they tell you these in the instructions. Was using autoinjector and plunger would not go down so I chose another but not as carefully and as the plunger was going down realized that it was different. This is a learning experience. After the dosage was corrected everything great until yesterday's experience. Thanks for your post Charles.

[David1958]

I will just add my own experience with this issue. I had RP in 2011 (age 52) and flat lined on erections and libido. I have tried every technique known to man other than having inflatable bladders installed. The ease and spontaneity are things of the past. I have used the vacuum pump (manual and electric), Viberect, tri-mix shots, and pills. I can tell you that prior to PC, I always had a thing for needles and shots. I was finally cured of that when I had to inject tri-mix into my prick. A little bit goes a long way when it comes to tri-mix. Nothing worse than a hard on that refuses to go away, and it aches. Pills do nothing for me except for the side effects. In my own case, I found all of this to be very depressing and counter productive. Yes, orgasms are possible without a hard on or penetration. This is something I found out about on my own and made this journey in ED tolerable. In the last year I had some success achieving an erection using gravity (this means you have to be standing up). It also means using a cock ring to maintain it. Using gravity means shaking the blood down into your cock while thinking stimulating thoughts. This means blood gets into not only the shaft, but also the head, something tri-mix cannot do. When it comes to orgasms, there is the law of diminishing returns. The more often you achieve them, the less intense they get. That is why I many times will get him hard just to exercise him. Not bad for 8 and a half years post surgery with PSA not detectable.