'saving your sex life' by dr john mulhall

Sophie: I think that if you use the "seach feature" at the top of these pages, you will see surprisingly quite a few posts from men who have had non-nerve sparing surgery and are able to get erections adequate for intercourse. Although the number is not as high as we would like, it does occur. But more importantly, the injections such as Bimix do work excellently and let virtually anyone have good sex again. Although it sounds repulsive, the injections are painless and provide a long interval for sex. I was on them for over 6 months and they were very effective with no problems or pain. Ask your doctyor to start out with "Bimix" since it doesn't contain the component that is known to give the ache that many men complain about.

But even with nerve sparing surgery, the odds are not 100% and it does take quite a bit of time to heal.

Good luck.

Bill K. from NJ

Sophie: Yes, regardless he needs time to heal. My surgeon stated not to try anything for 2 months. But believe me, bimix will have a 85 % chance of working just fine and if it doesn't there is always the more potent trimix. Just a little information on the injections and what I found helps.... I was a little nervous about injecting myself so I had my wife do it. My doctor gave me the finest needles (31 ga. and only 5/16 inch long). So all my wife had to do was to find the proper area at the 10 or 2 o'clock position and push all the way to the needle's hub. That was it. no blood, no mess. The little discomfort was only from the alcohol remaining from the swab. Took about 3 seconds. Erections were excellent and lasted for well over 1 hour. The cost here in New Jersey was about $3.00 per shot and you get the meds and needles in a kit at a compounding pharmacy. I am sure that there is one near you. I had a 15 minute drive to mine and I got enough for about 25 lovemaking sessions from one prescription. My doctor called in the perscription and by the time I got there, it was ready. He will give you the first injection and go over the technique.....We couldn't wait to get home and try out my "newly revived friend"! It is so simple. Keep it in the refrigerator until you need it. Once the syringe is full (in my case, just literally a few drops) let it warm up to room temperature before injecting. If it is too cold, you feel discomfort during the injection. If you are nervous, you can always get the self-injecting tool at the pharmacy for a few dollars more. That is automatic and it does everything by just pressing a button. Keep a simple chart on how much you inject and the results so that you can fine tune the amount to keep it at a minimum. The amount is kind of trial and error until you find the ideal doseage. They tell you to alternate sides and rub the area with a swab for a few minutes. Then "voila", like magic.

As my ED specialist told me...."don't worry, we will be able to give you erections again, we have many ways of doing this today". IMO there is no doubt that you will be having good lovemaking with your hubby again in a few months.

I hope that I didn't get too personal or graphic. But I just wanted to explain that it is so simple, inexpensive, and painless that you folks shouldn't worry about this aspect at all. But for now he must heal.

Good luck.

Bill K. from NJ

Age 58 ..PSA 3.3, free PSA 21% May 2011, Biopsy: Gleason 3+4. Davinci surgery in July 2011.
Downgraded to Gleason 3+3, 10% involvement, 67 grams.
Immediate urinary control, however, severe ED for over 1 year.
Used VED pump and 5 mg. of Cialis for over 1 year after surgery.
Used Bimix weekly for over 6 months starting at 6 months with good results.
Natural erections by using 5 mg of Cialis started at 15 months. "Mental erections" started at 2 years.
Now, no problems with ED at age 62.
All PSAs tests now <0.015.

Thanks, BillK. We are at 10 weeks out, and his next uro appointment is at 16 weeks.

My husband is dreading anything to do with rehab. i did buy him a VED recently and he uses it, but won't give me any report on whether its working. A week after i gave it to him I got the courage to ask (after him emphatically telling me he doesn't want to talk about it a couple days earlier), he answered, "i guess so." and sounded down. Its a pretty painful subject for him, but it's very difficult for me to worry so much and have no one to talk to about it ( except this amazing group)

Before Pca I always had my husband to talk everything over with. But now there are so many things I can't talk about without really upsetting him. He is comfortable listening to his doctor and doing exactly as she advises. He doesn't understand my stress, uncertainty, and questioning if its the right course of action.

Thanks for the reassurance that the shots are easy, and the tips on using them. I do know a good compounding pharmacy near us. I hope that we will be using it soon.

I called his doctors office and asked if he could go to the ed clinic before his 16 week appointment. I am so embarrassed being pushy, but I feel that waiting too long could be detrimental. And it might be weeks after his appointment before he could get in to ED clinic, and it's likely he will be starting treatments, maybe radiation and HT and I'd like to get a program going. Before my husband has no motivation or interest in sex

ashleynfld101 said...
Thanks Bill from this wife too:)
That was a very helpful and insightful post!
Hubby is 12 months post-op (and still on lupron) but I am wondering why his Urologist hasn't even mentioned any of this to us....

some are shy.
some are uncomfortable with the conversation.
some make assumptions that it's not important to you.
some won't talk about it until you do.

Andrew

OK: Please remember that you really don't have to go as far as visiting an ED clinic. The injections are very mainstream and surprisingly most urologists know all about them. But if your doctor is not helpful, or interested, then by all means go.

The meds simply relax the muscles and valves in the penis and blood automatically flows into it and an erection occcurs. This is actually almost a "default" mode for the penis if you think about it....normal blood pressure is what pumps it up and these muscles and valves keep it from being hard all of time. "fultilt" asked about the quality of orgasms.....surprisingly they are the same in feeling and pleasure but many report that they last much longer. And that is my case too, about 3 or 4 times the duration of the old orgasms. And please understand this...your husband can get an orgasm without an erection. That is a medical fact. Only one slight drawback to medically induced erections as reported by my wife, they are not as hot in temperature as they once were, but once things start to happen everything warms up.

Don't feel embarrased at all. This is part of life. Perhaps ask your husband if you could help him with the VED. This may help spur his interest again. But he, like all of us on this forum got hit with a double wammy---cancer and ED at the same time. It is horrible for a guy to go from having perfect erections to zero virtually in one day. And behind all of this is the dread of cancer. But he will get over it and it will occur sooner is you gently push him by making things a little more interesting. Just my thoughts.

Bill K.

Sophie: If he dreads the needle; that is normal. All of my friends knew that we were doing this and they were amazed that I was able to tolerate it. There is really nothing to tolerate! It sounds 100 times worse than it is. The needle is so tiny that you have to look closely to even see it. Google 31 gauge, 5/16 inch needle. about 3 times the thickness of a human hair. It only goes in a little more that a quarter inch and very little is actually injected. Tell him that you will do the injecting if he wants and all he has to do is close his eyes for 3 seconds. He can think about all of the fun that he will have after those 3 seconds! Finally, many doctors go right for the trimix which may cause some pain issues while having an erection. The third ingredient in trimix may be problematic for some. My doctor recommended starting with trimix, but my knowledge from others on this forum caused me to simply say: "How about starting easy with bimix"? He was not offended at all and went with the bimix which worked great every time for me.

I think that you are making great progress. As we can see by reading your posts, keep working together as a team on this matter and you will be just fine.

Bill K. from NJ

Sophie,
Stick with it...
I am blessed to have a wife who at the onset did everything in her power to help me. Many will argue with me but I believe it's just as much a head thing as it is a physical thing.
I posted a couple years back about a commitment my wife made to me. "We are going to have 21 consecutive days of sex so get ready." We made it. It wasn't always the best lol but a tremendous confidence builder. You are doing the right thing for him and you.

Sophie: Trimix contains the third component (alprostadil) which may or may not cause a bad aching while having an erection. This is well documented yet many doctors seem not to take it into account. Trimix is more potent than bimix because it has this ingredient but not all men need it. In my case a very tiny amount of bimix (0.22 cc) was all that I needed but some men need larger doses and even the third ingredient of trimix. I think that you should simply explain your concerns- that if your husband has a bad first experience, he may be hesitant to continue. Again, for some reason, my doctor had me scheduled to start on a super strong dose of alprosadil and I personally think that it would have had me in the ER screaming! But I asked for bimix based upon my readings on this forum and it was a very smart move. So IMO ask the doctor if you can start out very slowly. One last thing to tell your husband---Remember that you will be injecting into a very soft penis and in that state it is not that sensitive. As a matter of fact it is not sensitive at all because the nerves are basically "sleeping". I think that it would be totally different and much more painful if you had to inject into an erection.

When your doctor writes the prescrition, the needles will be part of the "package" along with the alcohol swabs. You then bring your prescription back to the doctors office and they show you how to inject. I asked my doctor to give me the first shot and my wife watched and learned. She never screwed up and did perfectly every time. And there are varying strengths of bimix and trimix with each ingredient in different concentrations. But don't worry too much about this. Again, simply ask if you folks can start off slowy and you will be fine. And remember to keep some pseudoephedrine HCl (Sudafed®) on hand in the event that his erections last more than a few hours. This common nasal decongestant will actually help to get him soft again. The doctor or nurse should mention this "antidote" during your instruction session.

Good luck.

Bill K. from NJ

Boy !!!!!....you guys are right on when you say that UROs are disinterested, don't care, don't know...

If you ask they will respond....If you don't, they won't even then you have to dig..

PeterDisAbelard. said...
My husbands surgeon wants to hold off on injections for a while because of the NN sparing.

Ummm. huh?

Not following the rationale there. Non-nerve sparing surgery is the most likely to cause atrophy and it seems like non-nerve sparing guys would benefit most from rehabilitation.

Peter,

That is exactly what I thought. But she said because he had non nerve sparing it would hurt too much if he did it earlier than next appointment at 16 weeks post op. She wanted to meet with him at 16 weeks to discuss cancer treatment after the next psa, and then depending on the treatment talk about going to ED clinic for rehab.

The whole rehab thing is a very touchy subject with my husband. But I feel like it must be addressed now for good results. And uro is in no hurry. However i was pushy and got him an appointment. I am a little disappointed its on a day I'm out of town. I hope he doesn't bolt from the ED doctors office at first sight of the needle! I was so thankful to hear the doctor was a man.

I also am anxious for him to start because he is likely to start salvage treatment and if he's not in a routine and being successful while he feels good and has libido, It probably won't happen after treatment starts.