Injections influence on later implant

[Ibfuelish]

Just an experience of mine… injections never really worked for me, but I tried, I altered the dose, alternated injection sites… etc, all that is fine… if it works for you then great.. but here’s a warning… each time you inject, you create minor trauma to the corpora… this creates scarring, over time, and I mean a rather short amount of time, this scarring will become sufficient enough to affect the quality of the outcome of an implant procedure… peyronies can limit the outcome, scarring can limit the outcome, etc. recognize the event horizon for when it’s time to switch to procedure that will give you confidence, reduce the work required to get erect, and get you back in the game.

[Tilitely]

How long have you been injecting? I’ve heard stories of people injecting over a decade without any issues,
The minor trauma thing is interesting to me because, your literally putting the tiniest of holes in something has the ability to heal, I understand people may react differently than others especially when using strong mixes. But everything related to ED has some minor or major side effects, I’m almost convinced viagra has contributed to rabid increase to my vision weakening along with crazy head aches. This is the main reason I’ve switched to injections, I’m curious to hear others input on the trauma claim, besides the obvious scaring, but theres got to be a point where your like I need to stop this before the scaring gets to bad.

[TwoStep]

https://meeting.neaua.org/program/2022/36.cgi

Title: Previous use of intracavernosal injections is not associated with higher rates of intraoperative or postoperative inflatable penile prosthesis complications: A large multi-institutional analysis

[Sean762]

There's a good bit of information stating the potential for papaverine in particular to cause increased scarring.


Here are some of the links I found in a quick Google search with quotes from the articles below each:


https://www.sciencedirect.com/topics/me ... -injection


"Papaverine is a nonselective PDE inhibitor and was the first described agent for intracavernosal injection. It is less effective as a single agent than alprostadil and carries a higher rate (emphasis added) of priapism and penile fibrosis."


"Phentolamine is an alpha-adrenergic antagonist that acts by inhibiting the postsynaptic alpha-1 receptor leading to relaxation of the penile vasculature. Unlike the other intracavernous agents, phentolamine has significant systemic side effects, including hypotension, tachycardia, gastrointestinal upset, and nasal congestion."


https://pubmed.ncbi.nlm.nih.gov/2724447 ... e%20reason. And the linked article this references: https://www.sciencedirect.com/science/a ... 4717413450

The pH analysis of papaverine-phentolamine and prostaglandin E1 for pharmacologic erection - PubMed
Although papaverine-phentolamine preparations are being employed for pharmacologic erection programs across the nation, their chemical properties have not been described in the literature. We found that the pH of papaverine-phentolamine solution in all concentrations tested remained less than 4.0. A …
pubmed.ncbi.nlm.nih.gov

"Abstract

Although papaverine-phentolamine preparations are being employed for pharmacologic erection programs across the nation, their chemical properties have not been described in the literature. We found that the pH of papaverine-phentolamine solution in all concentrations tested remained <4.0. Attempts to buffer the solution resulted in a precipitate at a pH greater than or equal to 5.0. The pH of prostaglandin E1 was <5.0 but could be easily buffered to pH 7.4 or even 10.75 and remained stable. The effect of an acidic solution on corporal connective tissue and smooth muscle meshwork is unknown. We believe that buffering by blood will lead to the precipitation of papaverine-phentolamine and may cause primary intracorporal scarring. Extravasation or improper injection into the subcutaneous tissue exposes the mixture to blood and may secondarily result in additional scarring for the same reason. Therefore, prostaglandin E1 may be a more appropriate agent for penile injection."


https://www.auajournals.org/doi/10.1016 ... %2940585-4 mentions that after a year of use of Bi-mix, 57% of men had nodules in their penises from the injections. Granted, the injection frequency played a part, but the article fails to divulge just how often the injections were used per week in the first place.


https://urology.ucsf.edu/sites/urology. ... nswers.pdf


"Injection Medications And Mechanism

Q7. It seems that there are several different medications suitable for injections. What are they and what

are the differences?

A7. Each of these medications will work to help you achieve an erection. You should always consult

your physician to discuss which is best for you. Some of the medicines currently in use include the

following:

1. Papaverine is available at a relatively low cost and is stable at room temperature but is less

effective than the other medications and may have a higher tendency to cause scarring (fibrosis).

2. Papaverine plus phentolamine (Bimix) is more potent than papaverine alone, but with the same

potential side effects such as priapism (see Q19 for definition) and scar tissue formation.

3. Alprostadil rarely causes priapism, but with its use, pain is more common. (Alprostadil is also

known as prostaglandin E-1 or PGE-1. In powdered form it may be called Caverject or Edex."

https://bladderclinic.com.au/conditions ... unction-ed

"Penile scarring:
Repeated injection over the same site can result in local scarring and fibrotic changes resulting in curvature of the penis (Peyronie’s disease).
This is more common when papaverine is used."