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I am 53 and had a nerve sparring radical prostatectomy three months ago. For penile rehabilitation, I take 5 mg of tadalafil daily, tried a
VED that I didn't really care for, and am now injecting Trimix 3 times per week along with the daily tadalafil. I started with 15 units of Trimix and the base of my penis certainly firmed up but not so much at the head. Increasing the dose to 3 units has made my entire penis hard until I lay down on my back. Then, the head starts to soften up pretty quickly. Is this normal and I just need to keep increasing the dosage until the head continues to stay hard while I'm on my back? I'm new to Trimix and any feedback from folks who have already experienced this, and found the solution, would be appreciated. Thank you in advance for the feedback.

Welcome to the forum!

I'm not a medical professional of any kind. Anything I post is at best based on my own experiences. At worst it based on hallucinations or delusions. Internet forum advice is likely worth what you paid for it, or worse. Always ask your doctor and follow his/her advice.

You don't say what your mix is, strength wise. The volume of your dose means nothing without knowing what the mix is.

If you're confident on your injection technique then yes, an increased dose would seem a logical step. However, you need to follow your doctors guidelines.

I'm guessing you have some venous leak going on too. Hopefully you can find a dose that is able to overcome the leak.

I frequently recommend using a novelty/sex shop silicone cock ring. You'll have to experiment to find which ones work best for you. Expect rejects. The correct ring may help. They do for me.

If your RP was only 3 months ago you can expect changes to how you respond to any and all ED therapies.

Good luck.

Post RP Lost wrote:I am 53 and had a nerve sparring radical prostatectomy three months ago. For penile rehabilitation, I take 5 mg of tadalafil daily, tried a
VED that I didn't really care for, and am now injecting Trimix 3 times per week along with the daily tadalafil. I started with 15 units of Trimix ...

I was 62 when I had a nerve sparing radical prostatectomy three years ago. For penile rehabilitation, I took (and still take) 20 mg of sildenafil daily, tried a VED that I didn't really care for, and began injecting 15 units of Trimix (when my wife said it was OK to have sex) seven months after surgery....

I have no idea if Trimix would have been effective for me three months after surgery. The healing of the nerves and their ability to function is perhaps involved in your current response to injections. Since my RP in October 2018, I have regained increased rigidity in my erections to the sildenafil. In early 2019 I had practically zero response to the 100 mg "challenge dose", and now my nocturnal erections from the 20 mg dose is about 80% firm. Until recently, I was capable of maintaining a 10-20 minute grand erection with Trimix, but feel I need to increase my dose above the 15 units (my Trimix strength is listed below).

My trimix is 22.5 / 0.83 / 8.3. I was / am surprised that I can have a good erection until I lay down on my back. Then it starts to fade. If I go back to a standing position it comes back pretty strong. I know my nerves, and blood flow to my penis in general, still have a lot of healing to do, but was just curious if the laying down and losing a lot of an erection was normal post RP or if I just need to keep upping my dosage by 1/2 unit until it stays hard. Zero margins and my first PSA test came back as undetectable so I am extremely grateful. I also really appreciate all the advice / personal experiences that others have shared on this site concerning their prostatectomies and what they experienced. While everyone is different, the best advice is typically from someone who's been there, done that.

Post RP Lost wrote:My trimix is 22.5 / 0.83 / 8.3....I was just curious if the laying down and losing a lot of an erection was normal post RP or if I just need to keep upping my dosage.... Zero margins and my first PSA test came back as undetectable....

Yeah, that's a starter mix leaving plenty of room for upward adjustment. I'd keep adjusting up until you find happiness, of course with your doctors supervision and approval. If you find you need a fairly large dose you should probably increase the strength of your mix but you aren't to that point yet. You could even try a stronger alprostadil mono-mix since you aren't complaining of alprostadil ache. However, not all doctors even prescribe mono-mix and it's a bit harder to find a compounding pharmacy that dispenses it.

I don't think it's "normal", post RP, to lose an injection erection when lying on your back.

Remember I have absolutely no medical credentials so my diagnosis is total BS, but losing it when laying on your back sounds like possibly a mild venous leak. However, if you weren't experiencing any issues before the RP I'm probably wrong as I don't think the RP would cause a VL. But what the hell do I know!

Your condition may continue to improve for a couple of years. You may even eventually regain full function or close to it.

Having zero PSA is very good foe sure. It appears I have something lurking somewhere as my PSA hangs at .02 or .03 but it's been steady for a long time.

I'd consider the novelty cock rings with the potential VL. I'd consider it anyhow as it helps me use a lower dose.

Good luck.

I’ve had the exact same problem with trimix…I still have my prostate but have been injecting for a little over a year. Position always affects me greatly. I can set up on my knees or stand and keep a rock hard on with 20 units of my dose posted on my signature. Lay down and immediately start to soften up usually at the head first. As long as I’m being stimulated I stay hard but increased dosage hasn’t helped this. As I increased dose it just left me semi hard for much longer after needed. And many sleepless hours waiting for it go go down. I’ve become very frustrated with the injections inconsistency and will be going for an implant ASAP. For now I’m dealing with some severe BPH and will be having an aquablation early next year and then proceed to an implant as soon as I heal.