Injections after Radical Prostatectomy

[dunbar57]

I'm about to be scheduled to have my prostate removed. For those of you who've had a radical prostatectomy, how long after until you started trying injections? Same question about length of time after surgery before getting an implant.

[Motorheadrulz]

The answer is different for everyone.
I had my RPP 15 mo ago. My uro suggested that I try injections, but I waited over a year. I started on cialis, then a pump at 3-4 mo post op. The key is to be somewhat in control of your incontinence before you try anything. Pissing your pants and on your partner is not an easy thing to get over.
In hindsight, I should have tried the injections a year ago. Although I still don’t have any nerves firing, it’s far better than the pump.
I wouldn’t consider an implant until you’ve exhausted all other options and nothing worked. Others on this board may disagree, but every case is different.

Check out my other posts and read about my journey thru this bullshit. Every day should get a little better, and don’t expect fast results. And I’m impatient... just my 2 cents.

[Reggieman]

I waited 3 months before I started injections. That was a mistake. Three months without an erection allowed some smooth muscles to cease working on the left side of my penis. This caused the tip of my penis to bend to the left several degrees. In 2020 I had a total knee replacement. I was not feeling well enough for my bi-weekly injects so I postponed them for a month or more. I faced the same problem to a greater degree as more smooth muscles quit working and I developed an even bigger bend on the left side.

Lesson: Create erections by pill, vacuum for injections on a regular basis as soon as possible. Use or lose.

[Atacama]

I would agree with sooner rather than later. I think using a pump prior to surgery is a good idea. I also read a Harvard medical study about pumping within a month after surgery to keep erectile function going whether you intend to have sex or not.
As far as injections I would say the same. Give it a month to get over surgery, catheter etc. I don’t know of any reason to not try injections after surgery. Try sildenafil or tadalafil too. Most likely your doctor will advise low doses of either post surgery to keep night time erectile function while you sleep going. You need the blood flow from erections to keep your penis healthy otherwise it can atrophy. Think of it as fresh blood flow keeps tissue and the organ healthy.
My 2c from personal experience however I am NOT a doctor so follow what the doc says and keep reading posts here for more info.
Also. It is a big change in your lifestyle. It can seem depressing but not having cancer is worth it. You will find what works for you. Just keep working on all the options. Implant is a last resort and not reversible.

[bldoink]

All good advice so far. I would start pumping as soon as the doctor says it's OK. Same with injections unless you're lucky enough to retain natural erections from the start, if anybody is that lucky.

I'd also suggest you start kegels before surgery: https://www.prostatecancer.ca/Prostate-Cancer/Treatment/Kegel-Exercises and https://www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/kegel-exercises-for-men/art-20045074. However, maybe not: https://www.renalandurologynews.com/home/news/urology/prostate-cancer/kegel-exercises-after-prostate-surgery-called-into-question/

Like many men, aside from incontinence during recovery, climacturia will likely (not always) rear it's head. A bunch of solo practice can help overcome that problem. It did with me but it was a learning process.

Good luck, it is a journey but you can do it.

[ftwabeck3533]

Here's a wrap-up of my journey since radical prostatectomy in Oct 2018 (I was 62 years old at that time) with no health problems at all:
1. Let's just say it -- getting that catheter out one-week after surgery was the beginning of the road to recovery.
2. I wore a pad for 3-4 weeks, and never was challenged with incontinence. The keys (1) Kegels prior to and after surgery (2) Treat the bladder as a muscle. Push it, work it, no pain-no gain. I drink a lot....water, coffee, alcohol. I hold it til I can't hold any longer. I can go hours without dribbles and drips.
3. I tested my ability to get hard about ten days after surgery, the old fashioned way, with my left hand. Result, orgasm while completely flaccid.
4. The next six months was a series of trial and disappointment with getting anything close to 50% firm. VED was a total failure, 100mg of sildenafil resulted in nothing down there. I continued to manually massage and encourage blood flow, it always felt good -- but nothing I could share with my wife.
5. In May of 2019 I asked my URO for an Rx of Trimix. Let me tell you, my manhood was back and we (wife and I) haven't looked back. Simply life-changing.
6. I could go on and on with the details of injecting, lessons learned and all, will save that for a later post.
7. I continue to take 20mg a day of sildenafil to assist with nocturnal erections, which are getting stronger.
8. I continue a daily (or multiple times a day) of manually stroking my penis and envisioning what I would do with a hard one. I can get about 90% firm, but not long lasting. I typically stop short of attaning that pleasurable end-point, but sometimes there's no stopping.
9. In conclusion, I believe that less than 5% of prostateless men under age 60 ever put ED in the rearview without the aid of injections, VED/cock rings, or implants (nerve spared or not).

[Jake000]

Hi Everyone,
I am new to this forum. I am here to share my experience but also have a couple of questions.
I am 43 year old and was diagnosed with prostate cancer in Oct 2020. I had my prostatectomy done in Dec 2020. Everything went well and I started taking Sildenafil after they removed the catheter (which in my case took 2 weeks). I am taking 20mg/day which doesn't trigger any erection and once a week I take the full dosage of 100mg which increases significantly the size of my penis but doesn't get me "hard". I started the trimix injection this week. My doctor prescribed me a light compound because of my age. So 1st of all the injection is not that bad... it freaks me a bit out to push/ force the needle into my penis but it really doesn't hurt much. Now coming to the result, my doctor advised me to try 5cc (in his office we tried 3cc which only gave a quick and light erection), but I was desperate to get a proper erection after 4 months so I tried 8cc. And boy did it work. I got a huge erection for 2 hours (and the best orgasm post RP until now). It was actually a bit too long to my taste and it got me worried after 1 1/2 hours and put an icepack on my penis which eventually worked out. Also I know that some men complain about losing size after the RP... definitely not my case.
Now the only thing that annoys me a bit is the pain I feel when I get the erection. It's not unbearable and wouldn't prevent me from having intercourse, but it is a bit uncomfortable. A bit like when you wake up with a morning wood that has been going on for too long. I don't think it is related to the trimix but more to my muscles and tissues that are stretched after so long time. Did anyone experienced the same thing? Did it go away after a while?

[bldoink]

The ache is probably due to the alprostadil component of the tri-mix which is usually considered the most potent ingredient of the mix. It's pretty common. Many guys get over the alprostadil ache with continued use. I did and I'm on alprostadil mono-mix.

As for the duration of the erection, What the heck is wrong with a 2+ hour erection? Surely you can figure out something to do with it.

[wolfpacker]

Hi Everyone,
I am new to this forum. I am here to share my experience but also have a couple of questions.
I am 43 year old and was diagnosed with prostate cancer in Oct 2020. I had my prostatectomy done in Dec 2020. Everything went well and I started taking Sildenafil after they removed the catheter (which in my case took 2 weeks). I am taking 20mg/day which doesn't trigger any erection and once a week I take the full dosage of 100mg which increases significantly the size of my penis but doesn't get me "hard". I started the trimix injection this week. My doctor prescribed me a light compound because of my age. So 1st of all the injection is not that bad... it freaks me a bit out to push/ force the needle into my penis but it really doesn't hurt much. Now coming to the result, my doctor advised me to try 5cc (in his office we tried 3cc which only gave a quick and light erection), but I was desperate to get a proper erection after 4 months so I tried 8cc. And boy did it work. I got a huge erection for 2 hours (and the best orgasm post RP until now). It was actually a bit too long to my taste and it got me worried after 1 1/2 hours and put an icepack on my penis which eventually worked out. Also I know that some men complain about losing size after the RP... definitely not my case.
Now the only thing that annoys me a bit is the pain I feel when I get the erection. It's not unbearable and wouldn't prevent me from having intercourse, but it is a bit uncomfortable. A bit like when you wake up with a morning wood that has been going on for too long. I don't think it is related to the trimix but more to my muscles and tissues that are stretched after so long time. Did anyone experienced the same thing? Did it go away after a while?

I've taken about 10 injections so far and the pain does seem to be getting slightly lessened.

Also, just an FYI on your wording, it is highly likely that you injected 3, 5 and 8 "units", not cc. One unit is typically 1/100 of a cc. 8cc would be an enormous amount of liquid to inject into your penis.

[bldoink]

.... it is highly likely that you injected 3, 5 and 8 "units", not cc. One unit is typically 1/100 of a cc. 8cc would be an enormous amount of liquid to inject into your penis.

I didn't catch that. I guess I just read it as units. I don't think I'd want to be injecting 8cc into my dick, although it might make it look a lot bigger