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I had my RP last July 2020. November saw the urologist about Trimix injections. He started me on what I guess is a standard low dose mix to "work my way up". We all know the drill. Keep on injecting until you get the result without going overboard and taking a trip to the ER.
First dosage mix was 8.9 Mcg Prostglandin (PGE-1 aka Alprostadil), 0.89 Mg Phentolamine Mesylate, 24Mg/Ml Papaverine. I worked all the way up to 70 units (0.70ml) injections and while the pecker was getting about to full size the hardness wasn't there yet. And it ached a bit, but not too uncomfortable. After reading a lot on this website I talked to the urologist and asked for a higher dose.
First thing he said was "let's do the penile implant! Sorry Doc, wanna try other dosages first and work through the options. Doctors make more doing the surgery than prescribing.... I am not ready yet to go the implant route.
So he prescribed a new Trimix of 20Mcg Prostglandin, 2Mg Phentolamine Mesylate, 30Mg/cc Papaverine (I am taking the details from the actual prescription receipts for both prescriptions literally). Doc warned me to go slow etc... once again. Started with 20 units (0.2ml) and today tried 60 units (0.6ml). Same thing--almost hard enough but no go, plus this time I got a pretty painful ache that makes me not want to try go to 65 or 70 units. I did massage the affected member after injection to spread the Trimix around, as well as injecting slowly as recommended here in comments.
I believe I am injecting correctly, plus had a good trial run with the doc at the beginning in the clinic and he was ok with my technique
I checked out wedgewoodpharmacy.com (recommended here on FT--once again to newbies, there is a lot of info here. Spend time to read as much as you can) and it gives a very good description and information on injections. PGE-1/Alprostadil can cause the ache/pain so they suggest switching to a Bi-Mix. Or I could go Quad mix and add Forskolin with a reduced amount of PGE-1.
I intend to talk to the pharmacy first as they seem to manage ratio/mix info better than the doc, then talk to the doc for a new trial prescription.
My question to those with more experience (and I know this is not a request for medical advice simply recommendations for discussion with medical professionals) are:
1. Is Forskolin and a Quad Mix worth a try given that the mentioned doses of Trimix have not quite gotten me to the desired result? Plus gave me the painful ache today.
2. Consider adding VIP after trying a Bi or Quad mix? This is getting in to the realm of Pentamix.
3. Atropine is the other element Wedgewood (appropriate name for this topic, eh?). Any suggestions on this to be added?
Basically my problem is pain induced most likely from PGE-1/Alprostadil in the amounts I have tried without getting over the "finish line".
Any suggestions or comments would be greatly appreciated.
As an aside. If I had known about FT before or after my surgery I would have been much better prepared pre and post surgery. Using a VED is a good idea before surgery, and certainly afterwards. Understanding injections and other options from the beginning would have been helpful too. Be informed on injections, pitfalls, benefits, difference options etc...
Thanks for any comments! I very much appreciate this website and the info/help available.

one question if you don't mind me asking. how was your ED before the RP?

I used to use viagra before getting it on. 50-100mg tablet. Generally worked but I did need a boost to get going. Was using it for maybe 5 years prior to the RP. Tried Cualis but it would give me a headache.

You're still pretty fresh from your RP surgery so things are likely still changing. Have a bit of patience before you come to any conclusions or make any major decisions. I started on Edex 20s. Initially they weren't enough. Now they would be too much.

Thanks for the info Bldoink! I talked to the pharmacist and he said they also make a Quadmix with 0.1% Atropine. I’ll ask my doc to try that. They said atropine helps w rigidity and I would drop back on amount injected to start again so should avoid the ache.