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Penis health after RP

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Posted 9/20/2017 7:31 PM (GMT 0)
Do we even discuss this on this site? The cancer cure is hell of a lot more important for sure. I am reading that you need to keep blood flow to your cells in your penis. Is this true? Only 6 weeks post RP and my therapist has me using a suction pump daily. I have NO NERVES and challis/viagra is useless. Thought penile injections of Trimix would be my choice. Wife does not care if it ever gets hard again. Well had first injection at URO office today 30 units of trimix. Excruciating pain for 2 hours. Doc says that is common in 30% of men. It ain't worth it. Don't like the pumping. trimix is out. An Implant wouldn't cause blood flow, would it? Do I even need blood flow. At this stage with the diaper rash on my scrotum an constantly sore penis I am ready to get it all cut off.

Post Edited (oldbeek) : 9/24/2017 10:36:14 PM (GMT-6)

Posted 9/20/2017 8:15 PM (GMT 0)
Give it some time, you're only 6 weeks out. I'm surprised your doc/therapist is being so aggressive, the normal protocol is to prescribe low doses of ED meds, and then wait for the nerves to heal. It could be 12-18 months.
Posted 9/20/2017 8:16 PM (GMT 0)
I'm almost a year from my surgery, and about 75% of my nerves were spared. I haven't followed a steady rehab program, but saw a specialist in early August and trying to give that area more attention. I do get a response from the drugs. The specialist would like me to use a pump as a back up to the drugs, but I haven't bought one yet.

I think the pump will help exercise the tissues in your penis, but I don't know what an absence of nerves means for you in the future. I thought injections might be your answer, but I've heard finding the right dosage is the key.

I was pretty swollen and bruised for at least a couple of months after the surgery, and I didn't want to touch myself much until about 3 months had passed. Everyone is different though. Do what makes you feel comfortable.

There is a discussion group site called Frank Talk. It has a lot of information about injections and implants. You might want to take a look.
Posted 9/20/2017 8:22 PM (GMT 0)
Oldbeek,

Don't cut it off just yet and don't give up on the injections. The "tri" part of the term trimix comes from the three drugs that are all in the mix. The one that causes some guys pain is the one called alprostadil (or sometimes prostaglandin). The usual formulas for trimix have a tiny little bit of alprostadil compared to rather larger amounts of papaverine and phentolamine but it is still the alprostadil that does most of the heavy lifting -- it produces a response at much lower concentrations than the other two drugs. But you can get a mix called "bimix" that doesn't have any of the pain-inducing alprostadil. Usually, guys who can't handle the alprostadil ache can get bimix to work for them.

Here's a fact sheet from the UCSF medical center that contains (among other things) some information about bimix: Successful Self Penile Injection - UCSF Department of Urology
Posted 9/20/2017 9:22 PM (GMT 0)
Thanks for the answers. Will look into bimix. Important thing is today PSA is<.01
Posted 9/23/2017 8:24 PM (GMT 0)
Oldbeek, sorry you're dealing with this but glad your PSA is <.01! Have appointments with both surgeon as well as radiation oncologist next week because one option is RP. If I go that route maybe we could start an "RP at 75" group.
Posted 9/23/2017 9:46 PM (GMT 0)
You can go for bimix, but the alprostadil is really the most effective part of the mix. You can also try reducing the dose. Or you can have the compounding pharmacy make up a trimix with half the concentration of alprostadil. There's also an expensive transurethral pellet called MUSE.

I'm glad your doctor is starting you early - that is certainly the best protocol because penile tissue atrophies quickly without blood supply. The daily ED meds (taken at night) may help give you night time erections that preserve tissue. The daily pumping also maintains blood supply.
Posted 9/24/2017 12:31 AM (GMT 0)
I,m on what they call super trimix. My uro told me to take 2 extra strength tylenol just before injecting. Seems to work for me, very little dicomfort, before i had alot of discomfot, hope this works for ya.
Posted 9/24/2017 6:56 PM (GMT 0)
The pump brings blood into the spongey tissues, which is important to keep them healthy. Don't stop using it. I haven't tried injections, not ready for that yet.

Without nerves, I don't think you'll be getting any spontaneous erections in the future.

Hope your doctor finds the right mix for you.
Posted 9/25/2017 2:30 AM (GMT 0)
VED pump does nothing for me. It just give my penis a bit of fluffiness which does not lost once penis pulled out. It disappears in 30 seconds orl less. I pump it up until I start feeling pain.
I am almost 11 months post RP and lost 2+ inches of length and lots of girth. Pump can not get any of lost length for me. I am wondering if every other day is enough or it should be a daily routine?
Also, TRIMIX can not get any of length back. It gives me erections but my penis looks like when I was 10 or 11 years old. I did not practice sex in that time, nor sex is possible now.
Sex is non existent for me, orgasams also.
MK
Posted 9/25/2017 4:31 AM (GMT 0)
Sorry to hear your failures. I was sent to a physical therapist immediately after RP. She put me on the pump daily. I was healing fast so she said have the URO get me a Trimix script. before my 6 week appointment. She has been the greatest support in this mess. Has my incontinence nearly under control at 7 1/2 weeks. My son and I worked our pointing dogs up and down mountain sides for 3 hrs today. Logged 3 miles.
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