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Hi All

I'm 36, from UK, suffered with ED for 20 years if you can imagine (yes since I was 16). It's been brutal. But I've somehow got here. I bit the bullet around the age of 25 and understood that I needed to take pills any time I wanted to have sex so I started on taking sex shop viagra rubbish. Then a few years later I decided to get serious and tried shockwave treatment, first Gainswave in the US which I was encouraged by but then realised that the improvement was only the result of the tadalafil troches that I was taking every other day. I would have happily continued those, they sorted out everything for me but gave me mild stomach discomfort, flushing and other symptoms.

I then went through the medical route in the UK. I tried regular Sildenafil and Tadalafil but the side effects were worse with the larger doses and too unpleasant to deal with long term. I then repeated the shockwave therapy which without the tadalafil troches did absolutely nothing. I then tried Vitaros cream into the Urethra. It worked ok at first but not really well enough to keep going. Then I tried Muse pellets, same result as Vitaros and now I am entirely reliant on Penile injections. I think I'm up to 40mcg now to achieve a real solid erection.

Also, when I did the first shockwave treatment in the US with Gainswave I had a P-Shot. Again, this was also in conjunction with the shockwave and the tadalafil so I really don't know if it did anything at all but I don't think so.

I've tried massage, some hypnotherapy, fucking chinese leaf teas from Chinatown, rolfing, different kinds of pumps and penile traction devices (Soma erect, penemaster, etc) so pretty much everything.

I'm now being seen by David Ralph at UCLH on the NHS. I'm excited to be under his care but it looks like the direction we are moving in is towards an implant.

I want to make sure I have explored absolutely every possible alternative before I pull that trigger. I will push for a surgery date anyway as the NHS wait time is huge and look to explore all other final options before then so time-wise that works out for me in that sense. The long wait time will serve and not hinder me.

I have now found that the pills are not working so well. Last year I took tadalafil and there was absolutely no reaction. I will test all medications again (Vitaros, Muse, pills) just to be certain but I now need to look at other options.

What else should I consider?

I have already undergone NPT tests twice, they seem to indicate that there is a physical issue, although I do wake up with good erections half the time but then they immediately die down.

I have had numerous blood tests for testosterone etc and all seem to be in range according to NHS (however a private company queried this so I will look to retest).

I have also undergone a doppler test on the vein function but it was terrible as the practitioner and I were having an argument whilst he was doing it. (Thats NHS for you!) I cannot recall what the results were and the feedback I remember was not clear.

I would like to repeat the NPT and doppler tests one more time for good measure. But I have also heard of the following:

Cavernosography and cavernosometry - Does anyone know anything about these and how they compare to Doppler Ultrasonography?

Venoligation or Sclerotheraphy and embolization - I believe that these are meant to address venous leak and is vascular surgery does anyone have any experience or insight into these?

Penile revascularisation - I understand this is used to increase blood flow into the penis and is again vascular surgery. Again anyone with any info or experience would be a great help.

Other than that the only other thing I have heard of is Stem Cells. It has been suggested to me that this would need to be neutral cells and would be perinatal cells (placenta, umbilical cord cells etc). However, this is understood to be very experimental.

Other than that I don't know of anything else.

Any recommendations or anything I've missed? This is the last year I'm prepared to have with a dysfunctional dick. After twenty years and even longer having issues with my dick I'm done. I want to meet a girl in bar and kiss her and not feel ashamed to have her grope me. I want to take someone in the heat of the moment and not have to sneak away to the toilet to jab my cock. Im tired of fighting to get the prescription from the doctor and find a pharmacy that has it in stock and remember to take it out with me everywhere I go and enough with me on vacation.

So this is the last year, this time next I'll either have a long term solution either from a procedure or medication or Im getting an implant for the rest of my life.

Just to break this down into bitesize:

Investigations performed;

NPT x 2
Doppler Ultrasound
Numerous Testosterone Blood Tests

Procedures tried:

P Shot + 6 x Gainswave sessions + daily Tadalafil troches
18 x shockwave sessions
Rolfing
Hypnotherapy

Medication Tried:

Sildenafil (side effect issues)
Tadalafil (side effect issues)
Vitaros (reduced efficacy)
MUSE (reduced efficacy)
Alprostadil injections (Very effective but limited to just two in 24 hours and short erection life)

Home Treatments:

Penis Pumps
Traction & Extension devices

Spiritual Work:

Prayer, sacrifice and generally appeasing the gods. No luck there either.

Looking over the treatment modalities that you've tried, my only recommendation would be to consider Trimix or Quadmix, of which, Alprostadil is one component ingredient. That said, only try it with eyes wide open, knowing that Trimix and Quadmix have a very real side effect of inducing Peyronie's Disease, which is a permanent, unnatural curvature of the penis due to the buildup of scar tissue. This condition happened to me after not too many uses and to my understanding, has happened to many other men as well. From personal experience, Viagra, Cialis, Levitra...helped me for a few years until it became an issue of diminishing returns and later, only very minimally effective. VED and extension devices will have no effect on libido or the ability to have or maintain an erection and will only be effective in slightly lengthening or straightening your glans. I feel that at this point in time, the different vascular procedure perhaps show promise, but lack any large, quantitative persuasive results. In my opinion, the rest of the treatments you mention, hypnosis, Rolfing, shockwave, P-shots...are akin to snake oil and there are a 1001 hucksters out there ready to capitalize on men's vulnerabilities and desperation. I have an implant now but encourage you to network here with other men suffering with ED and perhaps find something that will help your particular ED. Best of luck!

Trimix has been fantastic for me and I'm 69 years old with Quadruple Bypass surgery 6 years ago.I would think it would be even better for someone considerably younger.

Get a injector called Inject-Ease and you excuse yourself for 1 minute to a separate room and be ready to go.....so easy


Also,a big plus is that you will be able to last 3 times longer than her last partner...she will be amazed....

Looks like you've tried most everything. Lots of nasty side effects from some too. If you are done chasing a solution, the implant is a good option. Most of us guys have walked a similar road. For me, the implant not only gave me my confidence back but took me out of depression.

I endorse trying some injection, e.g. TriMix.

As to shockwave, it looks like the only thing you have tried is Gainswave. If this is the case, you have NOT tried real acoustic shockwave with a device such s the Urogold of the Storz Duolith SD-1. Radial shockwave, such as what you did, has absolutely no scientific basis for working. Real shockwave has dubious science but there is at least a healthy debate as to its effectiveness. I have spent about $8,000 on shockwave and I cannot vouch for its effectiveness, but like you, I am trying everything that has any genuine hope (not a guarantee, but a hope) of helping.

(Notice that I specify the Storz model because they sell both cheaper radial shockwave and $60-100,000 real shockwave devices. The scam is to advertise these ineffective radial devices as shockwave and confuse the public with the more well-researched acoustic shockwave.)

tobenormalagain wrote:Looking over the treatment modalities that you've tried, my only recommendation would be to consider Trimix or Quadmix, of which, Alprostadil is one component ingredient. That said, only try it with eyes wide open, knowing that Trimix and Quadmix have a very real side effect of inducing Peyronie's Disease, which is a permanent, unnatural curvature of the penis due to the buildup of scar tissue. This condition happened to me after not too many uses and to my understanding, has happened to many other men as well. From personal experience, Viagra, Cialis, Levitra...helped me for a few years until it became an issue of diminishing returns and later, only very minimally effective. VED and extension devices will have no effect on libido or the ability to have or maintain an erection and will only be effective in slightly lengthening or straightening your glans. I feel that at this point in time, the different vascular procedure perhaps show promise, but lack any large, quantitative persuasive results. In my opinion, the rest of the treatments you mention, hypnosis, Rolfing, shockwave, P-shots...are akin to snake oil and there are a 1001 hucksters out there ready to capitalize on men's vulnerabilities and desperation. I have an implant now but encourage you to network here with other men suffering with ED and perhaps find something that will help your particular ED. Best of luck!

That's very interesting regarding the Trimix or Quadmix and peyronies. I currently have pretty good results from the Alprostadil alone so there isn't really much sense me using another injectable with more risk. I also heard those products need to be refrigerated?

The injection is the best option I've found so far but I've been taking it for 6 years and no longer want that hassle every time. It kills my confidence to meet someone new in a bar as I know I'll always have to prep the mix and run away to inject. Then it doesn't last all that long if you want to go again.

jwjwjw wrote:Trimix has been fantastic for me and I'm 69 years old with Quadruple Bypass surgery 6 years ago.I would think it would be even better for someone considerably younger.

Get a injector called Inject-Ease and you excuse yourself for 1 minute to a separate room and be ready to go.....so easy


Also,a big plus is that you will be able to last 3 times longer than her last partner...she will be amazed....

Yeah I do already have good results from Alprostadil already but I'm currently single and I'm looking to progress away from "in the moment" applications. Even my ex expressed disappointment when I would interrupt intimacy to go and inject.

How long have you been using the Trimix? Did you have any issues with peyronies as mentioned above?

Old Guy wrote:Looks like you've tried most everything. Lots of nasty side effects from some too. If you are done chasing a solution, the implant is a good option. Most of us guys have walked a similar road. For me, the implant not only gave me my confidence back but took me out of depression.

Yes I know an implant is looking likely but I just need to ensure I have no remorse when I look down at the bandages around my dick the next day. In mid 30s it's a pretty big decision.

And yes the depression is hard. Having this in your youth is devastating. But I just count myself lucky that i live in a time where there are options and pretty decent ones. What did they do 50 years ago!!

CanGetItUpButNotOff wrote:I endorse trying some injection, e.g. TriMix.

As to shockwave, it looks like the only thing you have tried is Gainswave. If this is the case, you have NOT tried real acoustic shockwave with a device such s the Urogold of the Storz Duolith SD-1. Radial shockwave, such as what you did, has absolutely no scientific basis for working. Real shockwave has dubious science but there is at least a healthy debate as to its effectiveness. I have spent about $8,000 on shockwave and I cannot vouch for its effectiveness, but like you, I am trying everything that has any genuine hope (not a guarantee, but a hope) of helping.

(Notice that I specify the Storz model because they sell both cheaper radial shockwave and $60-100,000 real shockwave devices. The scam is to advertise these ineffective radial devices as shockwave and confuse the public with the more well-researched acoustic shockwave.)

I tried Gainswave in the US and a lot of shockwave treatments in the UK at two of the leading andrology clinics here. I recall they both used Storz machines but I can't recall which models. I expect they would have been the higher quality ones.

I felt I got more from the Gainswave and that's likely because of the tadalafil troches.

Im curious to find out which machines they had now!