Injection questions

I'm one year post RP.  Zero club.  Stress incontinence (especially when I mention S-E-X to little Willie).  Been through drugs, pumps, MUSE, and now injections.  My Uro prescribed prostaglandin, and it works well.  And Willie may be waking up.  Couple of questions/issues:

1.  That 4 hour erection - it is only a problem if it is rock hard for 4 hours?  As long as it is "bendable" it isn't a problem?

2.  I think the drug flows downhill.  Seems to me that the site of the injection back gets harder/firmer.  Forward, not so much.  Been shooting at dead center.  My uro shot at the base.  Any advice?

3.  Still have incontinence - some during arousal, and certainly post orgasm.  I know, empty the bladder before geting started.  That doesn't cure the problem.  I'm a 60 year old widower, and PCa is bad enough, but this is a really cruel joke to play on a single guy.

Any help suggestions appreciated.

I have been on Bimix injections for almost 5 years now.  I have never had a failure or made a trip to ER due to prolonged erection.  I was concerned at first because my erection lasted  a couple of hours.  My urologist said not to worry if it has begun to soften after an hour or so, even if it has not completely gone down at 4 hours.

I actually inject in the front half.  Recently a new urologist was surprised, but told me to continue if was doing the job. Try a kegal clinch if you continue to have stress incontinence problems.

 

George – Congrats on the Zero Club and on getting your continence back (for the most part). Now it sounds like Willie is coming around. That’s great!

A 4 hour erection above penetration hardness is considered an emergency. Penetration hardness is considered to be an erection of 60%. So anything above 60% is cause for concern. My ED specialist says for penile rehabilitation you need a minimum of 10 minutes at 60% or better, that 30 minutes is ideal, and the maximum should be less than 90 minutes. For an erection lasting 2 hours you should take 4 Sudafed 30 mg tablets (regular Sudafed not the extended release) to knock it down, if it’s still up at 3 hours you should be in contact with your doctor, and if you’re still 60%+ at 4 hours you should be in the ER.

I inject at the shaft of the penis just past the mid-point between the head and the base (a little closer to the base), at the 2 o’clock or 10 o’clock positions; always changing sides each time I inject. I’ve never been instructed to shoot near the base (but never told not too either). I always massage Willie to help distribute the medicine.

Unfortunately, it is not uncommon after an RP to have leakage during sex. Peeing before hand helps, which you are already doing. Limiting your fluid intake would help - especially caffeine and alcohol. Fatigue can exacerbate the problem. You might consider using a constriction band on the base of the penis. It is supposed to be very effective controlling both foreplay and orgasm associated incontinence. Another option to look into is a medicine called Imipramine that has been used to help this condition. It is a drug used to treat depression, but one of the side effects is relaxing the bladder and causing the bladder neck to contract better. However, it is not as effective for men who’ve had a RP. Using a condom is certainly a valid option. And just so you know, urine is sterile and will not cause a yeast infection or a urinary tract infection in your partner. I know, easy to say, but hard to convince. Sorry, this has to be really hard on a single guy. Hopefully you will improve with time.

Good Luck!