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Recently started injecting Trimix. I survived 2 nasty go rounds with Covid and decided I want my erections back. PCP sent me to a Urologist that was supposed to specialize in ED. He grabbed my penis, stretched me out, and very roughly injected me with 50 units of Trimix alp20/pap30/phe2. Burned like hell going in and hurt like hell for the next few days. I only got a very minor reaction in his office. The little bit of an erection was gone by the time I got home. He missed the sweet spot. I am small in girth and the 29ga 1/2" needle did not help. I did what was prescribed at home when the trimix arrived and injected 50 units. I had a 5-6 hr erection. Literally went completely flaccid finally, in the Emergency Departments parking lot. The trouble was that after a while I would (for the lack of a better term) rise and fall between painfully full to about 3/4. Eventually went from full to half, so I thought that it was not a true priapism. At the 5 hr mark is when I started to the hospital. I did not go in because I went flaccid.

Called the urologist and he reamed my ass big time for injecting too much. I calmed him down and assured him that I injected only the 50 units he prescribed. He told me that at 2hrs to take 2 Sudafed's and an hour later 2 more and ice down my groin and penis if it happened again and drop to 25 units. So... many missed targets latter (3-5 day apart) I finally hit the sweet spot with 25 units. Had another very painful erection and at 2 hrs I took 2 Sudafed's and an hour later took 2 more and started icing. Around 4 hrs I felt relief. But again, the same problem rise and fall until the erection went away and was painful for another day. Called Urologist again and he expressed concern and "was not comfortable with the length of time of the erections". Then he stated he was not familiar with other blends of trimix and referred me to an ED specialist. Waiting for the appointment I bought at CVS some 5/16 31 ga syringes. And dropped to 15 units with good success with a 3 hr painful erection and I did not have to take Sudafed, pain lasted about 24 hrs. The 5/16 31ga are much more comfortable.

So I cut it in half again and tried 7 units and most likely missed. Couple of days later tried 8 units and did not have much of an erection that lasted about 15min. Because I was exposed to a person with a fever and shakes, my appointment with the actual ED Dr, was changed to a phone visit. He offered a training visit, but he said it sounds like you have figured most of it out on your own. He also said the he thinks the pain is because of the Alprostadil and will order me Bimix when the trimix gets low. He also indicated the strength and amount of trimix was rather high and he starts his patients on Bimix and works up. He recommended starting at 10 units and working up at 1 unit at a time. He said to call him during office hours and go to the Emergency after hours with an erection that lasts more than 4 hrs.

I did call MENMD who supplied the Trimix and they said that to have the Dr order the "reversal drug" was about all they could recommend. Having been through this I am left with the impression that the ED Injections are driven for and by Money!!!

My Questions are...
1. Has anyone else run into idiot Urologists that have no business prescribing injections?
2. What should I do about reporting him?
3. Is it considered a true Priapism, if your erection falls to around 1/2 then gets full again?
4. Has anyone else had this rise and fall problem? I looked and searched the forums here and did not see anything about it. I do not know what to call it.
5. Any other advice you can send my way. I would greatly appreciate it.

Thank you R. E.

Hi Roberte45,
After a prostate surgery, and failure of pills to produce an erection, my surgeon at Kaiser Permanente, Northern VA, prescribed Trimix for me. The initial dose was about 20 ml. The response was excellent, stiff erection, but painful. I was clearly warned that I have to call emergency if it lasted more than 4 hours. After about 3 hours of erection, I got very worried and called the nurse. I was told to use ice. I did that and ran up and down the stairs . At 4 hours, most of the erection was gone. I went to lower dosages and finally settled on 8ml. Unfortunately, I lost my insurance, and had to see other urologists, who prescribed different dosages, and had to stick to certain pharmacies. Although I provided the same formula to them, but I didn't get the same erection again.
Beside that, I started to get a bend to the left side, obviously a Peyronie's. So, I am now considering having an implant.
For your questions, I didn't hear about having this rise and fall problem. Either getting a hard erection or no/soft one, depending on the dose and mix percentages.
Your urologist made a big mistake with a 50 ml initial dose. Lower dosages to start with, are safer than higher ones. If they fail, he can then go for higher ones.
In my opinion, I believe the implant is much better than injecting, and with time, most of the patients say that they are no longer having erections, in addition to scarring and peronie's.

Roberte45 wrote:Recently started injecting Trimix.............. Having been through this I am left with the impression that the ED Injections are driven for and by Money!!!

My Questions are...
1. Has anyone else run into idiot Urologists that have no business prescribing injections?
2. What should I do about reporting him?
3. Is it considered a true Priapism, if your erection falls to around 1/2 then gets full again?
4. Has anyone else had this rise and fall problem? I looked and searched the forums here and did not see anything about it. I do not know what to call it.
5. Any other advice you can send my way. I would greatly appreciate it.

Thank you R. E.

Welcome to the forum.

I'm sorry I didn't notice your post previously. I've been having major internet issues. I'm on fairly slow DSL, when it works. For the last 3 weeks it's been down more than up. Using my phone is a poor substitute. I have to sit by one particular window to have enough signal to even use my cell phone. You'd think I live way out in the boonies but not really, although we are in a ranchette neighborhood. Well, enough whining.
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Bear in mind, I'm not a medical professional of any kind. Anything I post is at best based on my own experiences and hallucinations and/or delusions at worst. Remember, internet forum advice is likely worth what you paid for it, or worse. Always ask your doctor and follow his/her advice.
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Yeah, your original doctor seems to be an idiot, IMHO. I'm glad you seemed to have survived your initial experience. No, I haven't run in to a doctor that is as ignorant as it sounds like yours was, although my original doctor that first prescribed Edex to me was certainly lacking on instructions, as in "Read the insert".

I have not suggestion for reporting the doctor.

In my humble non-medical opinion it's not a true priapism emergency if your erection is rising and falling as it is likely changing blood during each cycle.

I haven't experienced rise and fall cycles such as you describe. However mine can revive after starting to deflate upon a change of position or stimulation.

My advice would be to keep at it and continue to perfect your technique. It sounds like you still lack some consistency in that department.

Everything is driven by either sex, money or power, except for those few driven by divine love.

I'll do my best to answer any questions I can. Private message me if you wish.

Good luck.

AST2123 wrote:......
In my opinion, I believe the implant is much better than injecting, and with time, most of the patients say that they are no longer having erections, in addition to scarring and peronie's.

AST2123,

I'm sorry you haven't had an ideal experience. Injections aren't for everyone. I think they work best for those whose ED was a direct result of prostate cancer treatment rather from some other underlying and possibly worsening affliction. You would seem to fall into the ideal group, unless you're one of those that can't tolerate the pain that alprostadil causes some men.

If you're getting bending with a full erection that would be something to be concerned about and should certainly consult your doctor over. I've noticed that the few times I've partially missed the perfect spot or gave an insufficient injection dose, I can get one bending to one side or the other. However, my erection is always essentially straight with the proper dose and injection technique. I've always bent to the left a tad, even when flaccid. But yes there is a risk of scarring and/or peronies with injections. Fortunately, many men, myself included, have had long and satisfying runs with injections. I'm at 9+ years with no signs of diminished results or side effects. I'm not aware of studies where "most of the patients say they are no longer having erections, in addition to scarring and peronie's".

Injections are quite clearly not for everyone for a number of reasons. Implants are clearly the preferred and or better choice for many men. If an implant is your choice it isn't my place to try and talk you out of it.

I am NOT a doctor and this is an issue best handled by a qualified urologist. But having read your description I can’t help but think that you might be better served by using BiMix instead of Trimix. The difference is that BiMix doesn’t have the prostaglandin and THAT is what most commonly causes that dull ache.
If you are using 7 units of this Trimix you are probably in range of being able to use BiMix. An added benefit of BiMix is that it doesn’t require refrigeration in the same way Trimix does.


Ask your urologist if you could try BiMix instead.

GoodWood wrote:I am NOT a doctor and this is an issue best handled by a qualified urologist. But having read your description I can’t help but think that you might be better served by using BiMix instead of Trimix. The difference is that BiMix doesn’t have the prostaglandin and THAT is what most commonly causes that dull ache.
If you are using 7 units of this Trimix you are probably in range of being able to use BiMix. An added benefit of BiMix is that it doesn’t require refrigeration in the same way Trimix does.


Ask your urologist if you could try BiMix instead.

Hi - GoodWood is giving you good advice! After my prostatectomy my Uro started me on Trimix and I had 3-4 hr erections, fully hard and very painful. I don't remember the initial dosage but I continued to cut the dosage in half but I was still experiencing painful erections for 2+ hrs. The burning sensations didn't not allow me to enjoy the erection. Out of frustration and anxiety, I stopped injecting TriMix and gave up. A few months later I had an appointment with my Oncologist and he asked me how the injections were working. I explained the situation and he suggested BiMix. I started using BiMix and it was like a miracle. There was no pain, erections lasted 1-2 hrs max and sometimes less, and my cock was a little more pliable which made it feel more natural. I'd definitely suggest talking to your Uro about BiMix! It doesn't guarantee ti will work for you but based on your post, it sounds very similar to my situation. Best wishes and feel free to reach out to me via Private Message if you would like to discuss further.

Jeff

Thank you All for your input. I am still having trouble finding the sweet spot. I think it is because I am so small in girth when flaccid, I do not have a big target area. It also does not help that I am a big-time grower. Anyway the next time I inject will be 12 units. Feels like I am almost there with dosing. As soon as I get dosing better nailed down I will call and ask for the offered "training visit" and for the ED Dr to order the Bimix for me. Hopefully I can schedule the office visit just after the Bimix arrives. I am sure they have seen small penis's before and will be able to guide me much better than the first Urologist.
I at first assumed that the extended pain I was feeling was because of the overly hard erections after not having them for 5 years. Now I think it is the Alprostadil, because no matter what I do it is painful to the point of distraction even when I do not become erect (missed attempt). The pain drops to an ache, but can continue up to 48hrs.
As for a Peyronie's go, I already have a slight bend to the right. My SO moved at the wrong moment... and my penis slid fully out and missed the V with the next up stroke. Another problem with being small. Because it is only a slight curve I have not mentioned to a Dr. I will bring it up the when I see the ED Dr.
I think I will post another question asking for help with advice for injecting small penis's.
Thank you and I do appreciate your advice. Finding this site and your advice has been a godsend. I was about to give up. Not only because of the way it hurts both injecting, during my erection, and then after going flaccid. But a poor Dr. R

Roberte45 wrote:Thank you All for your input. I am still having trouble finding the sweet spot.

I sent you a PM. Check the upper right of the page.