At what point does damage occur in priapism?

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[Martin6469]

My urologist said that tissue runs out of oxygen at 6 hours, then gangrene is a real possibility (in which case amputation is necessary ), so I was advised to start heading to the ER at 4 hours. Don't wait! Maybe you'll get stuck in traffic! Maybe you'll have a flat tire! One of our FT friends said that his ER waiting room was full of COVID people and so he was much delayed!

I hit the 4-hour point only once, put my hat on, headed for the car, then noticed pressure going down, so stayed home. No damage. But don't want to sweat that again!

I was told that the oral remedy is phenylephrine, which is Walgreens' "Wal-Phed PE." It's non-prescription but behind the counter, so you have to ask for it and sign a log. The one time I used it I took 40 mg and it did not work fast. Don't depend on it.

[Hillywilly]

Thanks guys. After my last Trimix injection my erections have been a lot softer and require a lot of stimulation.

I'm a bit confused. Are you saying since your last injection erection your natural non-injection erections are degraded and require more stimulation? Or are you referring to just injection erections? How many injections have you done and over what period of time?

Should I just get an IPP or do you guys think it will get better?

I have no idea. I think at this point you'd be really rushing the implant idea. How old are you? I'm not a medical professional. It sure sounds like you need to consult a true medical professional that specializes is urology and sexual medecine.

I had strong and firm erections just two weeks ago without the Trimix now even on I’m less firm.

Why would you use trimix if you were getting strong firm erections without it?

Should I wait and see if I get better or aggressively pursue treatment? Worried if I wait and it’s a permanent damage I’ll lose girth and length.

You don't need to rush into anything. Do not rush! Any loss from lack of erections isn't instant and will take some time. If you're getting no natural erections day or night you may want to consider a VED (penis pump) for therapy.

I don't know what's going on with you. Please provide more information. Consider composing a signature with some details. Even with more information I can only speculate as a non-professional bubba. Make sure you're consulting a good doctor knowledgeable in the field.

Good luck.

Sorry, for the lack of detail still learning to navigate this site. I’m 31 years old and I started taking cialis at about 25 to help with sexual performance. After vigorous sex at 25 I injured my penis and now have a little scarring which is evident sometimes when I am in my flaccid or semi erect as an hour glass deformity. Anyways, went to the urologist last year and he did a Doppler on me and told me despite the scarring my anatomy was good and that he thought that the Ed I was encountering (my cialis wasn’t working as well as it used to) was psychological.

So he prescribed me some Trimix and I started with half of 5 units and eventually landed on results with 8-10 units. After a few times using Trimix my erection response to cialis improved Tremendously! I was getting firm erections and morning wood something I hadn’t had in awhile. So I shelved the Trimix and just used cialis for awhile.

Then 2 months ago met a girl I was really into and used Trimix with her cuz I had trouble getting it up and it worked for me great. But I used it every time we hung out and my erections would last between 3 and half and 4 and a half hours with each injection (maybe 20 injections total) so I am wondering if these lengthy erections may have caused the “irreversible” damage associated with priapism.

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[zachcrane]

I have the same issue...even at the lowest dose my erections last for hours and I have to inject the solution almost every single time.

I am having a hard time finding a dose that only lasts a few hours...my ED is psychological.

I have switched to bimix at a low dose as well and that has not resolved the issue either.

Have you had any erection issues after being erect that long on the Trimix?

Nope

[BoneBack]

In my non professional opinion, I think it all depends on how hard your erection is. I've had erecrions that surpassed the 6 hour mark but the hard on wasn't steel. I personal gauge it by if I can bend my penis. If I can't bend my dick then its steel but if I can bend it then there is some blood flow there and to me that means its coming down.

[ScrewedbyDoctors]

To prevent Piraprism to damage your penis follow these steps:
1) If the erection last for 2 hours and is painful take Sudafed
2) If it last for 3 hours and is painful then you have to inject Phenylephrine
3) If it last for 4 hours and is painful go immediately to the ER
Unfortunately in my case I wasn't informed of these steps, that is why I ended up with corporal fibrosis.
The clinic that destroyed me is Summit Male Medical in Tempe, AZ and the "Doctor" who did it is Nathan Papadeas, they have no clue about Trimix injections but yet they're still practicing.
My erection lasted for 4 hours, so yes you can get damage from a painful 4 hour erection

[willing]

Can you please share the citations or pubmed search terms you used? I also was interested in this as my erections decline gradually and push into 4-5 hours but did not find on-point citation. I've been surprised by the steady uptick in volume required (from 0.15mL to 0.30mL over about a year) and wondering whether this is due to damage from skirting the 4 hour threshold.

[willing]

To prevent Piraprism to damage your penis follow these steps:
1) If the erection last for 2 hours and is painful take Sudafed
2) If it last for 3 hours and is painful then you have to inject Phenylephrine
3) If it last for 4 hours and is painful go immediately to the ER
Unfortunately in my case I wasn't informed of these steps, that is why I ended up with corporal fibrosis.
The clinic that destroyed me is Summit Male Medical in Tempe, AZ and the "Doctor" who did it is Nathan Papadeas, they have no clue about Trimix injections but yet they're still practicing.
My erection lasted for 4 hours, so yes you can get damage from a painful 4 hour erection

how painful was painful and what was the basis of the "corporal fibrosis" diagnosis? Mine cross the 4 hour threshold but there's only mild discomfort and I can't tell whether to take it seriously or be patient

[ScrewedbyDoctors]

How painful? Scale 0 to 10, I will say 9. The pain was excruciating that's why I had to injected Phenylephrine to get rid of my almost 4 hour erection. Corporal fibrosis diagnose? Two days after that painful erection I developed a "dent" on the site of the injection and a slight left deviation.
Willing, just Google " trimix piraprism" and it will show a bunch of "medical professional" sites where they are very clear on what to do if you get an erection that doesn't go away. Unfortunately I went to "Summit Male Medical" in Tempe Arizona where they didn't warn me about painful erections, and "Dr Nathan Papadeas" was a useless piece of ....he let me leave the office with a hard on and told me nothing, the paper stated "after 4 hours erection call us"???????????WTF