Post RALP ED issues; Injections?

I'm 52. No ED issues before surgery. Had RALP in December. Had lots of continence issues for months, finally started getting better. I need to wear a pad for leaking. With so much incontinence, sex has been non-existent. Nothing is working down there anyway. Wife not happy, I'm not happy. Dr. put me on cialis after surgery, but it has had zero effect. Pretty depressing. I have an appointment to learn about injections tomorrow. Not excited about having to inject myself for the rest of my life, assuming it even works. Has anyone had experience with that? Are there any other options anyone has had success with?

-Jason

Trimix seems to work well for guys like us. The actual injection part is not as bad as it sounds, just a tiny pinch. The main issue is getting the right dosage for you. Pretty much trial and error. Start at a lower dose and move up as necessary. Don't just assume that if a little dose is good, a huge dose is better. It's usually not.

Please take a look at my journey.

https://www.healingwell.com/community/default.aspx?f=35&m=3828639

No. I was skittish about the needle. Plus, I heard some plaque can buildup with the shots and cause some disfiguration (Peyronies). Is that fact, not sure. If you read some of my ED posts, you'll find out I was just like you. Then things got better. Now, 7 years out I don't need any pills. All good "down there".

Patience is the word.
From what I have read on this forum and elsewhere, it may take much longer (like a year or so) to regain function. There are exercises to help and of course (the usual) ED drugs.

Hi JRK,

I had a prostatectomy in January 2021 and was severely incontinent and lost sexual function as well. The incontinence showed improvement over the year after surgery. For example, I was using 6 heavy pads/day after surgery; 10 months later I was down to 1 light pad/day. Return of sexual function took a while longer for me, about 21 months. I did not explore any interventions for sexual function, but it did eventually return.

Post Edited (Rick I) : 3/29/2023 2:01:09 PM (GMT-8)

My urologist never mention injections and I am too shy to ask, this guy has a kind of intimidating personality that does not invite to go into intimate details. He just gives me prescriptions for 8 pills of cialis or viagra generics every six months that do not work. I would not mind to try TriMix but I do not have any idea about how to get it here.

JRK said...
Well, I had the appointment to get trained on how to inject today, but I was asked why I hadn't tried a higher dose of cialis yet. My Dr. had me on 5 mg a day, but never had me try a higher dose. So before considering injections, I am going to be doing 20 mg three times a week instead of the 5 mg on those days. We'll see what happens! Regardless, thanks to everyone for helping me feel better. I was pretty low when incontinence was so bad, and I've been pretty low about the ED, thinking that it should have gotten better by now.

Shame on that doctor. Yes, you should be taking a higher dose and possibly even using Viagra. Some have better success with one or the other. I would also be using a pump every day as therapy, keep that blood flowing.

Another major set of issues affecting erections are stress, anxiety and depression. Sometimes, treating those issues at the same time is very helpful.

Nerve sparing surgery isn't nerve not damaged surgery. I think sometimes we forget the damage can take some time to heal even though the nerves are intact.

JRK - You had surgery in Dec 2022 and we are at the end of March 2023, your expectations are pretty aggressive. My Uro provided stats from their practice that indicated satisfactory continence was 77% at 3 mo and 95% at 12 mos. ED recovery was 50% at 3 mos, 75% at 12 mos, and 89% at 24 mos. These numbers are heavily qualified based on patient surveys so take them with a grain of salt.

I had a manual ErectAid pump from Timm Medical that worked fine. Using water soluble gel (AquaGel) with it was mandatory for a good seal and lubrication. The instructions were every other day for 15 minutes, pump up and hold for 1 minute, release, repeat. It takes a while to get use to it and use properly but you can pump it up higher as you go along.

I had an issue with Viagra after 3 months so switched to Cialis 20mg which seem better and lasted longer.

One issue to ask your surgeon is if you had successful nerve sparing on both sides. I had partial nerve sparing on one side due to the cancer location then had radiation followup after surgery plus being older so all this work did not pay off for me but I tried.