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Erectile dysfunction : Combo approaches ?

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Posted 1/11/2011 11:01 AM (GMT 0)

Hi,

I had RP a year ago. The tumor had gone a bit extra-capsular. Doctor told me he could preserve one of the 2 nerves.

Doing OK in general (PSA still undetectable, so I can't complain much) but I have a real case of ED. I do get something that look like the beginning of an erection but I am miles away from being able to have sex.

- Without help, I would rate my erections (as compared to before RP) at 10% to 15%.

- I took a 5mg pill of Cialis for a few months.  The 5mg dose improves things at may be 25% to 30%.

- Once in a while, I took a full dose of Cialis. Not much noticeable improvement over the 5mg dose....

- Viagra at full dose gets me to perhaps 40% (or 50% if I am optimistic). So Viagra works much better than Cialis but still so far away....

- Tried MUSE alone. A bit ridiculous. It just got my (very little) erected penis a bit harder

- Tried the pump. Well, that does get my penis at full length but, like a kid balloon, the instant I remove it, pffffuuuiiitttt, the "erection" is gone.

- Been trying to use the constriction rings to block the blood from going out. This seem to require a manual dexterity I don't possess.

MY QUESTION:

Are there any MEDICAL contra-indications to using combo approaches ?

a- Viagra + MUSE : that seems to make sense: Viagra gets it up and MUSE gets it harder

b- Pump + MUSE : that seems to make sense too: The pump gets it up and MUSE gets it harder. But for some reason, I don't dare go that route...

c- Viagra + Pump : that seems to make less sense as both work in the same direction

d- Viagra + MUSE + Pump : why not ?

TIA

=========== 

59 years old

No ED problem before surgery

Gleason 7, PSA 6, positive DRE

Posted 1/11/2011 11:19 AM (GMT 0)
Welcome to the site.

The ED pills didn't do much for me and I hated the side affects.

Have you considered TriMix injections? They work well for me and many others here.

Posted 1/11/2011 11:41 AM (GMT 0)
Thks :-)

No I have not tried the injections. Kind of turned off by having to use a needle....

Did they work much better than MUSE ?

=========

My question is really about using two (or 3 !!!) approaches at the same time. Are there contra-indications ?

Have you tried TRIMIX with a pump ?

Thks again

Posted 1/11/2011 3:57 PM (GMT 0)
Welcome to HW. Sounds like the injections will get you there, if you are looking for firmly erect and usable. Yes, there's that initial fear of putting that needle "There!', but the whole deal is overblown, once you do it. It is virtually painless, there's techniques that can make it easy to do, and the results usually are outstanding. It does take some experimenting to find the right dose for you, but that's the fun part. smilewinkgrin Plus if it is used properly, it can easily turn a rope into a stick, if you know what I mean...

I would not recommend using trimix with a pump, as in pumping after injecting. The trimix works so well, you should never need a pump. We do use a pump or our hands for what we call a plumping technique, which is to get the penis about 20% erect, just enough blood to make it swell and thicken, but not get erect. We do that, and using a constriciton band or even a rubber band, place it on the penis. This gives us a larger, fuller target, to easily tell when we have got the tip of the needle in the cavity. Think empty balloon collapsed and balloon with some air in it. Same thing here. Then after injecting, we keep the bands on for 3 to 5 minutes, which holds the drug in the penis, allowing for maximum adsorption by gently massaging it. . This way the drug doesn't get out of the penis, like it does now when you pump and release. Without the bands, the blood will carry the drug out before it can become adsorbed.

Ok, to answer your questions. Some people and doctors use Muse and pills together. However, it is most peoples experience here that Muse is probably the most ineffective method of combating ED, as well as being very expensive. Any use of the pump without the bands is just wasted effort, if the valves still won't keep the blood in the penis. If you can use one of the pills, then a pump to finish the job (which may or may not be recommended by your doctor- ask) , and if it will stay erect without the bands, then that is one method you could use. Lots of doctors say not to do this, to use one or the other. But if you got to use the bands, then you might as well do that without the pills. Definetly do not us the pump and injections, including Muse. Hope this has helped you some. Others may come along with their experiences.
Posted 1/11/2011 4:41 PM (GMT 0)
I had my RP in 1996, and have used viagra since with good results until the last year or so when It worked until actual penatration and than go down within a min or two. Like you the thought of sticking a needle in was not pleasant to think about, but a couple of weeks ago I tried it for the first time and it was amazing! You don't feel the needle at all!! I am using a 31 gauge 5/16" syringe.
Posted 1/11/2011 4:47 PM (GMT 0)
Hi Pete,

I was so against Trimix because of fear of the needle, now one yr later I am so glad I made the jump. It truly works every single time and its far cheaper that getting online Generic ED pills

Note: Use an Auto-Injector, you will never see a needle enter your skin, its a foolproof way to get the meds exactly where you want
Posted 1/12/2011 4:33 AM (GMT 0)
Ok !

I guess the vote is for the injections... cool

I am surprised by how confident all of you are about this method. After going through a series of disappointments, I am a bit cautious.... What the hell, I may try it at one point.

And I will try it before trying any combo approach.

 

This said, I am thinking (perhaps uselessly) two steps ahead: nobody has a clear answer to the purely medical side of a combo. Is there any danger in one of the combinations ?

Ex:

- the pressure of the pump is tough on the penis, even at low pressures. So adding the stress of MUSE or the injections (or Viagra) may be too much ?

- MUSE and Viagra may interact....

etc.

 

Posted 1/12/2011 2:26 PM (GMT 0)
Hi Pete,

My Dr told me about the oral Ed meds canceling out the Trimix effectiveness

From my own experience, Trimix works every single time why bother wasting a good Viagra when it would not add anything even if the Dr was only speaking from what he read
Posted 1/12/2011 2:33 PM (GMT 0)
The injection process worked for me too! Only other thing to consider is an implant. You may want to visit franktalk.org. This sitemdeals with ED. There is some great info there.

Cajun Jeff
Posted 1/12/2011 3:19 PM (GMT 0)
I have used Viagra (50mg) and Levitra (20mg) together with no adverse side effects or drug interactions. An ED doc I spoke with told me I was wasting my time combining.

I don't do this all the time, and can't claim any major additional effect from both versus Levitra alone (Viagra alone doesn't do enough), but subjectively I think its a little harder. Maybe just placebo effect. But with reasonably low per pill prices from ADC, even if its just placebo, its worth the extra confidence.

Good luck.
Posted 1/13/2011 3:50 AM (GMT 0)
Pete N:

Getting back to one of your queries:

b- Pump + MUSE : that seems to make sense too: The pump gets it up and MUSE gets it harder. But for some reason, I don't dare go that route...

My observation:

On Pumping after MUSE -- I have tried that at the tail end of a MUSE session when things are going down and I want to get it back up again.
What I notice is that because Alprostadil/Prostaglandin stimulates the nerves in the penis (especially near the glans), when you pump up to a good useful hardness level you can get some uncomfortable pain in the glans due to the added pressure on the sensitized nerves..

For me I can get thru it by pumping up to that level and leaving for a bit then releasing back a little and then pump again again .. each time is less pain til I can tolerate it and snap on the rings.

But if the MUSE did not do much what dose did you use? 500? 1000?? PCa/surgery folks should use 1000mcg dose probably -- if they can tolerate it.

On pumping in general you should probably head over to FrankTalk.org .. lots of details on what to do and do it right etc.
Posted 11/23/2015 6:09 PM (GMT 0)
My prostate was removed in March of 15. I have used Cialis with some success, but I have now moved on to the trimix injections. The injections work well. I can stay hard for about 60+ min and orgasm more than once. Even though the injections work, I don't feel the fullness I once had. I was wondering if anyone has ever injected and then used the pump? Was there any issues and did it make you thicker?
Posted 11/23/2015 6:57 PM (GMT 0)
Hello John, welcome to the forum.

We have had some guys who combine a VED (pump) and injections but I don't think most guys who have combined them stay with the combination long term. Some guys use the pump to get half-way there before they inject to make for a larger target when they are injecting. I have heard the theory that using a pump after you inject has some possibility to cause an injury -- the idea is that the injection may cause a temporary weak spot in the tunica albuginea that might bleed or scarify under the pressure of the vacuum pump. But I dunno.

What you might try (if you don't already) is using the pump for a few minutes on the nights when you don't inject. In theory the pump helps the stretchy bits stay stretchy and can help reduce/reverse the shrinkage. I did that for several years and it seemed like it helped.
Posted 3/22/2017 10:19 PM (GMT 0)
Hey there all,

I am relatively new, Anyone recommend a pump, VED? I am currently on Muse for ED, 500Mcg, or Viagra 100 mg, Need something to assist with those. I am looking at the Vacurect from Bonro Medical, seems to be good, Any thoughts?

Thanks in Advance?

Vitaminguy
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