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Long story short, 38 with chronic pelvic pain causing ED.

When mentally in the right place I can get a decent erection, and a good one with Cialis or Viagra, but when not good and pelvic pain causing lack of sensation and contracting the penis it doesn't work. Even with 15 mg cialis.

About 5monthd ago ni tried aprostadil injections viridal in the UK.

I used it at the urologists office, he oversaw it. 2.5 mg which is 2.5 units in the US.

After about 10.minjutes I developed a very painful chubby that never got fully hard.

Why did the penis ache so much and why did it not work?

Considering my ED is mostly psychological surely it should have worked as I was informed injections worked regardless or psychological barriers.

Should I try again with a higher dose? Urologist thinks 2.5 was probably far too low.

Thanks.

Never_Enough wrote: About 5monthd ago ni tried aprostadil injections viridal in the UK.

I used it at the urologists office, he oversaw it. 2.5 mg which is 2.5 units in the US.

There really isn't a direct relationship between mg (milligram) or mcg (microgram) and U-100 units or even fractions of a liter (milliliters) of an intracavernosal injection drug. At least according to my understanding. U-100 units (what we use) are 1/100 of a milliliter. I use about 15 units (.15ml) of a mix of alprostadil that contains 80mcg of alprostadil per ml. So I'm using 12mcg of alprostadil.

If your mix (what the doctor used) was, for example, 100mcg per ml then yes, 25 units (0.25ml) would equal 25mcg.

Oh yeah, micrograms (mcg) are what is generally used for alprostadil. There are 1000 micrograms per milligram (mg).

Never_Enough wrote:After about 10.minjutes I developed a very painful chubby that never got fully hard.

Why did the penis ache so much and why did it not work?

I don't know! I can make some guesses.
#1) The doctor missed the sweet spot and injected into the wrong tissues or at least a partial miss. A miss into the wrong tissues can most deifnately hurt and hurt for awhile. Also, you won't get much of an erection.
#2) You're one of those guys that just can't tolerate alprostsdil. I don't remember the percent of guys that just can't tolerate alprostadil but I think it's about 20%. Many guys get "alprostadil ache" when first using but get past that with continud use. That was me.
#3) Your CPPS is unfortunately capable of overcoming the effects of alprostsdil and you get alprostadil ache.
#4) You have a very bad leak that's too extreme for the alprostadil to work. Not likely in my opinion.

Never_Enough wrote: Considering my ED is mostly psychological surely it should have worked as I was informed injections worked regardless or psychological barriers.

Should I try again with a higher dose? Urologist thinks 2.5 was probably far too low.

Thanks.

Yeah mostly alprostadil should overcome any psychological issues but I guess there could be exceptions. You didn't get 2.5mg of alprostadil. You may have been given 2.5mcg, in which case that would be a tiny amount. It would do nothing for me. So yeah, a stronger dose could be much more effective.

bldoink wrote:

Never_Enough wrote: About 5monthd ago ni tried aprostadil injections viridal in the UK.

I used it at the urologists office, he oversaw it. 2.5 mg which is 2.5 units in the US.

There really isn't a direct relationship between mg (milligram) or mcg (microgram) and U-100 units or even fractions of a liter (milliliters) of an intracavernosal injection drug. At least according to my understanding. U-100 units (what we use) are 1/100 of a milliliter. I use about 15 units (.15ml) of a mix of alprostadil that contains 80mcg of alprostadil per ml. So I'm using 12mcg of alprostadil.

If your mix (what the doctor used) was, for example, 100mcg per ml then yes, 25 units (0.25ml) would equal 25mcg.

Oh yeah, micrograms (mcg) are what is generally used for alprostadil. There are 1000 micrograms per milligram (mg).

Never_Enough wrote:After about 10.minjutes I developed a very painful chubby that never got fully hard.

Why did the penis ache so much and why did it not work?

I don't know! I can make some guesses.
#1) The doctor missed the sweet spot and injected into the wrong tissues or at least a partial miss. A miss into the wrong tissues can most deifnately hurt and hurt for awhile. Also, you won't get much of an erection.
#2) You're one of those guys that just can't tolerate alprostsdil. I don't remember the percent of guys that just can't tolerate alprostadil but I think it's about 20%. Many guys get "alprostadil ache" when first using but get past that with continud use. That was me.
#3) Your CPPS is unfortunately capable of overcoming the effects of alprostsdil and you get alprostadil ache.
#4) You have a very bad leak that's too extreme for the alprostadil to work. Not likely in my opinion.

Never_Enough wrote: Considering my ED is mostly psychological surely it should have worked as I was informed injections worked regardless or psychological barriers.

Should I try again with a higher dose? Urologist thinks 2.5 was probably far too low.

Thanks.

Yeah mostly alprostadil should overcome any psychological issues but I guess there could be exceptions. You didn't get 2.5mg of alprostadil. You may have been given 2.5mcg, in which case that would be a tiny amount. It would do nothing for me. So yeah, a stronger dose could be much more effective.

Yes sorry 2.5 mcg... This is probably why.

I agree I doubt it's a bad leak as then surely pills or nothing wouldnt have worked better.

Same theory with the cpps.

He didnt inject i t himself he let me do it so. Maybe it was done wrong.

I'll make another urology appt and see if I can be shown again or get a doppler test to be sure.

I just took 15 mg cialis and struggled to stay fully s ashard for sex... Everything feels terribly sensitive due to stress and nerves from cpps

I think there are a couple of things at work here.
First, the ache could be the drug. I tried trimix, which contained aprostadil, and the ache made the medication unbearable. I then switched to bimix, which did not contain aprostadil, and I was fine. However, I did not get an erection until I reached an effective dose.
Therefore, maybe you need a medicine that is minus the aprostadil, and then you will need to find the effective dose. It took me months to find the right med, and the right dose.
Be patient, and I think you will get where you need to be.

Lawnman wrote:I think there are a couple of things at work here.
First, the ache could be the drug. I tried trimix, which contained aprostadil, and the ache made the medication unbearable. I then switched to bimix, which did not contain aprostadil, and I was fine. However, I did not get an erection until I reached an effective dose.
Therefore, maybe you need a medicine that is minus the aprostadil, and then you will need to find the effective dose. It took me months to find the right med, and the right dose.
Be patient, and I think you will get where you need to be.

I think in the UK we have one without aprostadil, but it's not easy to get.

Yes it's called invicorp and contains Aviptadil + Phentolamine.

People mentioned it causes less pain.

Lawnman wrote:I think there are a couple of things at work here.
First, the ache could be the drug. I tried trimix, which contained aprostadil, and the ache made the medication unbearable. I then switched to bimix, which did not contain aprostadil, and I was fine. However, I did not get an erection until I reached an effective dose.
Therefore, maybe you need a medicine that is minus the aprostadil, and then you will need to find the effective dose. It took me months to find the right med, and the right dose.
Be patient, and I think you will get where you need to be.

Question regarding the aprostadil ache that we both had.

Did you still get a full erection even if painful through it?

I could bear some pain so long as I achieved a full erection, what I don't want is the nonsense I HD on my first trial.

My test injections in the urologists office were 100 % aprostadil and caused some aching. My ultimate prescription was for Trimix which contains aprostadil It caused less aching but still some level of pain for the first few pokes. It now causes hardly any aching.
As for why you didn’t get fully hard. My non professional opinion is dosage and lack of any mental or physical stimulation. Before you get too discouraged I would keep titration going at home and add some stimulation while the drug is taking effect, eg foreplay or porn. Good luck.

The previous replies are all good info. I agree with them.

I’ve used shots for a long time. I’m one of those guys that never got over the ache from the prostaglandin. But my dose became really large over the years as my venous leak got worse.

Many guys experience that ache but it goes away over time. Mine didn’t. Over time you will figure out if it goes away for you.

The reason you didn’t get an erection is most likely one of two things: you missed the spot or the dose is too small.

Do you have the medication and syringes at home? I would experiment at home to figure it out, or at least get more information. I don’t think another doctors visit is needed yet, but follow the advise your doctor gave you of course.

Read through the posts on the injection section of this forum. You’ll see a number of descriptions of how to inject. In short, don’t inject the head or the base of the penis. You want to inject in the main body of the shaft. Don’t inject the top or the underside. You want to inject the side of the shaft. If imagining the face of a clock, 2pm-4pm, 8pm-10pm. Switch sides from left to right with each injection. Most say to only inject every other day. I press the spot for about 30 seconds immediately after I withdraw the needle to prevent getting an internal bruise from the injection. Some of us are OK with injecting on consecutive days. Follow your doctors advice.

If it were me I would try the beginning dose one more time being mindful of injection technique. Just to make sure the cause wasn’t bad injection technique.

If I got poor results from that first shot, a day or two later I would inject again but a larger dose. Increasing the dose each time. How much to increase? Once again, follow your doctor’s advice but if I had very poor response I would increase my dose by 25%. If I had a decent but not good enough result I would increase the dose by 10%. Keep going every other day until you get a satisfactory response. Keep your doctor informed.

I find that taking daily cialis helps quite a bit. It seems to help me get part way there so the shot doesn’t have to do all the heavy lifting. I also find a decent cockring helps slow venous leak and I am harder for longer when I use one.

Here's my experience with Trimix. I know it's not straight Aprostadil.
But I think I can relate.

My test run was 5 units in the doctors office.
It got me a nice chubby for 2.5 hours. I did not use any stimulation. But it was the coolest thing to have a nice chubby that lasted 2.5 hours.

My first injection (for sex) was 10 units. Which was adequate for sex. Again an amazing experience. Considering I struggled for 10+ years with ED.
My second injection, I missed not even a chubby. But I did notice my penis ache for 2 days.

I haven't missed since. But I did slowly up my dosage to 20 units. I did notice aching I'm assuming from the medicine. But could also been from a solid 2+ hours of erection.
After several months and consistent 2-3 hour erections, I worked my dosage back down to 10-12 units. And don't have any ache.

My urologist wants me to cut the dosage even more, but honestly, I'm afraid the erection won't last and my wife will get pissed.
Note: all she wants is a reliable erection. When I had trouble with my erection, she stopped wanting sex for weeks at a time.


My advice to you is not to look at it as a bad experience, but a learning experience.
Over the past nearly two years of using injections. I've had to tell my wife 3-4 times the injections work. Maybe not with exact precision. (for example, a couple of times it took 20-25 minutes to start working). She doesn't want to hear about it. She just wants it to work.
It took 3-4 times to get the dosage and to figure out that I could continue sex even after ejaculating.

Musson wrote:My test injections in the urologists office were 100 % aprostadil and caused some aching. My ultimate prescription was for Trimix which contains aprostadil It caused less aching but still some level of pain for the first few pokes. It now causes hardly any aching.
As for why you didn’t get fully hard. My non professional opinion is dosage and lack of any mental or physical stimulation. Before you get too discouraged I would keep titration going at home and add some stimulation while the drug is taking effect, eg foreplay or porn. Good luck.

Thanks. I thought the erection was achieved with injections mechanically though for why it's used for the scans.

Agreed though 2.5 mcg was probably too low.