Caverject injections

[Salmon]

I had a radical prostatectomy about 4 months ago. I'm 60 years. Only now I have full control over my bladder but is still impotent. From other internet sources it takes about 18 to 24 months to regain an erection. I have never used any pills or aids before the operation, was still able to get a good erection. After the operation the urologist prescribed firstly viagra, didn't work, then cialis, didn't work either and then caverject injections. He did the first injection with about 25 unit. Erections was about 50% compared to before the operation. The problem however is that it causes an intense burning sensation from about 2-3 minutes after the injection for another 4-5 hours. After about 3 hours it feels like somebody with a no 14 boot kicked you between the legs. Although I get an erection, the burning sensation is so bad that it kills the mood instantly. Does anybody else has this problem? Is there an alternative to caverject? Last week the pharmacist informed me that Pheizer anyway discontinues the production of caverject. I also now have, what they call, climacturia. Nothing is suppose to come out during ejaculation, but this means that urine is coming out, much more than the previous ejaculate. Does it go away with time? Sex becomes awkward.

[dunbar57]

My urologist just switched me to bimix injections because the PGE1 (Caverject ingredient) was giving me the same problem that you describe.

[Benjohn]

Hi Salmon,
If you're in the UK you can get prescribed Invicorp on the NHS.
I use it and it doesn't cause any aches or pains. It's very effective.

[alfa88]

The 1st few injections I'd get that intense burn but then with subsequent injections pain eased up quite a bit. Unfortunately for me I apparently had a venious leak so bad that if I had a reasonable erection with the injections they would dissipate once I was horizontal.

[bldoink]

I had a radical prostatectomy about 4 months ago. I'm 60 years..... The problem however is that it causes an intense burning sensation from about 2-3 minutes after the injection for another 4-5 hours. After about 3 hours it feels like somebody with a no 14 boot kicked you between the legs...... Is there an alternative to caverject? ......I also now have, what they call, climacturia....... Does it go away with time?.....

Welcome to the forum.

Can you please tell us the general area where you live? At least the County or State if applicable.

What size Caverject have you tried? How many times?

I can relate very well to your experiences. I've been down the same path. I have worked through the same issues somewhat successfully. Unfortunately in my case natural erections have never returned.

I have opined fairly extensively (droned on) on my experiences with climacturia and how I got past that. I'll see if I can find that or those posts and repost them for you.

I'll also post my thoughts on alprostadil pain when I can find them. However mens experience and tolerance with alprostadil seems to vary widely.

More later.

Meanwhile, Good Luck!

[bldoink]

Here are previous posts I've made on the topic or closely related topics. I've tried to edit out much of the repetition.

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

My comments from a few older related posts:

After the RP I did have serious leakage issues for a good while. I've plateaued at a point where I use no protection but do have occasional small leaks, not daily but one or more per week. Most often they are related to types of sudden exertion that cause mussel contractions that force a very small dribble. If I remember or anticipate I can consciously clamp down and prevent that issue. Also, if I'm out on my property doing hard manual work and get fatigued I'm more apt to have a small leak while exerting. Of course no one would notice anyhow as my clothes are sweat soaked by then. Overall it's not a big deal and causes no social issues but it (1. is a bit of a pisser) (2. does piss me off) at times (Your choice of bad puns).

All that just to put this next thought in context. As our play time is now always planned, I avoid fluid for an hour or so beforehand. I also always shower immediately beforehand for a couple of reasons. The relevant reason for this discussion is: At the end of my shower I will use some slippery shave gel (Avon Skin So Soft) to jack off my limp noodle for a couple of minutes. While it unfortunately remains limp, I do get the arousal feelings in my pelvic area with the associated mussel contractions (No, not orgasm contractions). Sometimes I actually feel like I'm getting erect until I look. Oh well! Anyhow, this prompts me to void my bladder (sometimes involuntarily) of whatever remains that I wasn't able to void normally. This leaves me ready for play time without the added undesired (for us) water sports. This method works well for me/us.

That's my sorry ass way of working around the effects of the RP but it does work. I can't think of any reason the relevant parts wouldn't work for any RP cancer survivor, implanted or not. I suppose there are those RP cancer survivors without such issues. Lucky guys!

Practice! You can learn to restrain the pee, even when you have the O, which is the toughest part. Initially when I'd cum I'd shoot pee like I did cum pre-surgery. You can learn better muscle control as your muscles strengthen. It will get better. It may take awhile though. I did a lot of chicken choking before I was ready to bring it back to the wife. It may always be a good idea to pee beforehand and even to restrict fluid intake beforehand. Hang in there it will get better. It's still early.

I don't know about the right or wrong of masturbation in general. I also don't know about any benefits of masturbation for ED in general.

I do believe it was essential to what recovery I've achieved in sexual function and activity, being a prostate cancer survivor (so far) and having had a RALP with some nerve damage. Don't get me wrong, I still have no erections without injections or at least pumping with a VED (with ring) assisted by viagra. Viagra by itself only makes me a little fuller with stimulation. So there's been no miracle cure.

However, initially injections didn't even work. Pumping with viagra got the blood going again and prevented atrophy. Right away I discovered pumping with a VED, even with viagra didn't work very well until I added erotic thoughts. The thoughts seemed to trigger something and allowed the VED to pull blood into my dick where as before it would only partially fill and would be lopsided.

So there I am doing cycles with a VED pumped up dick, which is also well lubed (required to use VED), in my hand thinking erotic thoughts. Well no brainer what to do with it. Of course the boner only lasted moments before more pumping was required but it did feel good.

However, there was another issue. While my continence had improved greatly to where a little leak was the exception, that was not the case when aroused and stroking a boner, even when adding the VED constriction ring. It was pretty messy and not something I'd bring to my wife.

What followed were many sessions that were, for all practical purposes, edging sessions although I didn't know to call them that. These allowed me to slowly gain control of my urine leakage. The other half of that problem was that even when able to control leakage during edging, an orgasm was a very messy thing. There's no other way to describe it other than spurting urine. Much continued "practice" enabled me to eventually gain control of this and learn to "O" without the waterworks.

It was a good while before I was able to bring my recovering dick to my wife. Meanwhile there were the other ways to please her. There's the standard oral but there's also a world of toys that can be had for that purpose. Now we can actually have a relatively normal sexual life. Of course we still have the toys.

I also often, maybe even usually, still use the VED between action days with the wife. I'd like to say I do
VED therapy every off day but I don't although I'm certain I should. And yes, while sometimes these sessions are restricted to non-erotic therapy, they still usually result in cranking one off. Well, what are you going to do with your lubed boner in your hand.

There may be wives or partners that would be right there from the beginning helping out in spite of dead dick, all of the water works and frustration but I doubt there's many. If you have one of those you had better make her feel appreciated and loved and pay it back somehow. Either that or lock her in a room so she can't get away.

I realize my experiences are not universal, but I don't think they're unique either. I know this has been TMI for some, sorry. The bottom line is, not taking moral considerations into account or ED caused by any other issues or even possible negative side effects, I think masturbation was essential in my recovery, such as it is.

I do have experience with the unpleasant experience of sexual urine leakage post prostatectomy.

I'm going to suggest a lot of solo practice and patience. I know many might feel uncomfortable with that suggestion but that's what I have to offer. ("I'm sorry honey but I'm going to have to whack off a whole bunch until I can get this under control.") It took me at least a couple of years to get the sex/leakage issue pretty much resolved. I learned to restrain the pee while the sex was ongoing including climax. It seemed counter intuitive mussel wise but a learnable art, at least for me. I still take care to restrict my fluid intake prior to sex and to void immediately beforehand. Yeah it doesn't help with spontaneity.

I did kegles in the beginning after surgery but pretty much quit after a good while. I found long walks works better. If like me you will pee yourself on the walks. I wouldn't wear a pad so I I'd have more incentive to hold it. I did have to hide in the bushes a number of times. I did 4 mile walks. The first 3 were pretty easy. The last mile was struggle. For me that worked way better than regular kegles.
---------------------------------------------------
I absolutely find cock rings (novelty/sex shop cock rings) to help with erections when used with injections. I've opined on this subject many times, probably as much as the urine issue (Is "urine issue" a pun?). As I've oft mentioned, finding the best cock ring for you is a trial and error type thing. Expect to buy and reject a fair number of them until you find the ones that work well for you. You can collect the rejects in your toy drawer or go ahead and file them in the round file.

As for the question about if rings will prevent pee leakage, well IMHO that's a different type of ring. medical grade VED rings will probably do it or at least help. They are generally much tighter and along with restricting blood flow will also restrict urine. Of course with those you are then time limited to 15 to 20 minutes due to being uncomfortable or even the risk of tissue damage. I'd think any medical grade VED ring would work such as an Osbon brand. There is a site supporter with a link on the left of this page that has the medical grade rings: https://www.erecaidpumps.com/

-------------------------------------------------------

It's with reservations that I make this recommendation. I'm going to suggest a lot of solo work. A lot of solo work while also concentrating on restraining pee. You can even learn to climax while restraining. Initially it does detract from the orgasm but that seems to eventually pass. Of course there's the obvious suggestions to reduce fluid intake before intimacy and to void beforehand. These suggestions are not medical advice and are just based on my personal experiences. I apologize if you've already tried these suggestions.

The solo work practice is what I've described as a type of edging or ruined orgasms'. It's a matter of getting to the point of no return and then doing a very hard kegel clamp which ruins the orgasm and stops any urine spurts. One member told me the method was more like a MMO technique (Multiple Male Orgasm). I guess so but I don't really know anything about MMOs. The trick is that by doing this practice I learned to control the kegel to the point that I could clamp down enough to restrain any pee while still actually having an orgasm. I guess I learned to individually and separately control the relevant muscles. This didn't happen overnight and took a lot of practice. It now takes very little effort for me and the kegel clamping is almost automatic. This technique will work if you can master it.

================================================

Injection pain

I'm referring primarily to Alprostadil pain. Alprostadil being the active ingredient of Edex and Caverject as well as the mono-mix prepared by some compounding pharmacies. Some guys just can't tolerate alprostadil. It's just too painful for them. Some guys never have any issues with it. The largest group, of which I'm a member of, initially get pain from the alprostadil but find with continued use the pain diminishes or completely goes away.

I initially started with Edex 10s which contained 10mcg of alprostadil in the cartridge to be mixed in the cartridge with the 1ml of sterile water. Initially the Edex 10 didn't do it for me and I went to the 20 right away. On the Edex 20 initially got a fair bit of pain but I also got a better erection. Because of the better erection I continued with the Edex. I eventually went to Edex 40s but found if I used who whole 40 I had lasting ache. As I continued I got better at injecting but still had pain but at a more manageable level. Then my insurance quit covering ED injection drugs completely. It was now too expensive.

I found a compounding pharmacy that could make a generic Edex substitute. However it would come pre-mixed in vials. I would have to use separate insulin syringes. I got my doctor to write me a script for a generic based on the Edex cartridge ingredients. Armed with my generic Edex substitute I was able to perfect my injection technique. I discovered I could use less of the new mix and I learned better shot placement and I learned to inject the juice slowly. I discovered done perfectly I no longer had pain. I discovered that if I started depressing the plunger and found it was painful I could adjust the needle depth until there was no pain while pushing in the juice. About this time I also discovered I could use a novelty/sex shop cock ring and use even less juice, further reducing the chance of pain.

Using less of the juice, referred to by the pharmacy as mono-mix, made it fairly inexpensive compared to the Edex which I couldn't afford without insurance coverage. Having become better at injecting I asked my doctor to double the strength of the mix. This now made the juice down right cheap at 80mcg per ml at about 15 units per shot.

Now with a much more perfected injection technique and by pushing the juice in with the plunger very slowly I get almost no pain while injecting and no ache.

Hopefully all of that makes some sense. I also hope this doesn't need too much editing because I'll have to do it later.

I'm sorry this post got so long. Maybe I can edit it smaller later too.

[Salmon]

Thanks for the reply. I'm from South Africa (Pretoria).

I'm using caverject now for about two months continuously. After the first injection with the intense burning, the urologist told me to wait a month before the next shot. The waiting time had no influence. I'm glad to hear that the burning sensation may/will subside with time. I discovered by taking two paracetamol tablets about 15 minutes after the injection, reduces the burning sensation quit a lot. I'm not sure if it has an effect on the quality of my erection jet.

I will definitely try the "edging" to reduce or stop the urine leakage during orgasm. According to Dr Google, climaturia will not get better. The urologist however said it will disappear, be patient.....easy for him to say, he didn't had the operation.

I'm using the vacurect pump on a daily basis to prevent scaring. I do not use it for sex, it seems to reduce the sensitivity and I struggles to get an orgasm, the erection does not last that long anyway. The website that sold me the vacurect refers me to an Australian website https://www.atouchysubject.com with very useful information. Maybe worthwhile for somebody else as well.

[Salmon]

Here are previous posts I've made on the topic or closely related topics. I've tried to edit out much of the repetition.

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

My comments from a few older related posts:

After the RP I did have serious leakage issues for a good while. I've plateaued at a point where I use no protection but do have occasional small leaks, not daily but one or more per week. Most often they are related to types of sudden exertion that cause mussel contractions that force a very small dribble. If I remember or anticipate I can consciously clamp down and prevent that issue. Also, if I'm out on my property doing hard manual work and get fatigued I'm more apt to have a small leak while exerting. Of course no one would notice anyhow as my clothes are sweat soaked by then. Overall it's not a big deal and causes no social issues but it (1. is a bit of a pisser) (2. does piss me off) at times (Your choice of bad puns).

All that just to put this next thought in context. As our play time is now always planned, I avoid fluid for an hour or so beforehand. I also always shower immediately beforehand for a couple of reasons. The relevant reason for this discussion is: At the end of my shower I will use some slippery shave gel (Avon Skin So Soft) to jack off my limp noodle for a couple of minutes. While it unfortunately remains limp, I do get the arousal feelings in my pelvic area with the associated mussel contractions (No, not orgasm contractions). Sometimes I actually feel like I'm getting erect until I look. Oh well! Anyhow, this prompts me to void my bladder (sometimes involuntarily) of whatever remains that I wasn't able to void normally. This leaves me ready for play time without the added undesired (for us) water sports. This method works well for me/us.

That's my sorry ass way of working around the effects of the RP but it does work. I can't think of any reason the relevant parts wouldn't work for any RP cancer survivor, implanted or not. I suppose there are those RP cancer survivors without such issues. Lucky guys!

Practice! You can learn to restrain the pee, even when you have the O, which is the toughest part. Initially when I'd cum I'd shoot pee like I did cum pre-surgery. You can learn better muscle control as your muscles strengthen. It will get better. It may take awhile though. I did a lot of chicken choking before I was ready to bring it back to the wife. It may always be a good idea to pee beforehand and even to restrict fluid intake beforehand. Hang in there it will get better. It's still early.

I don't know about the right or wrong of masturbation in general. I also don't know about any benefits of masturbation for ED in general.

I do believe it was essential to what recovery I've achieved in sexual function and activity, being a prostate cancer survivor (so far) and having had a RALP with some nerve damage. Don't get me wrong, I still have no erections without injections or at least pumping with a VED (with ring) assisted by viagra. Viagra by itself only makes me a little fuller with stimulation. So there's been no miracle cure.

However, initially injections didn't even work. Pumping with viagra got the blood going again and prevented atrophy. Right away I discovered pumping with a VED, even with viagra didn't work very well until I added erotic thoughts. The thoughts seemed to trigger something and allowed the VED to pull blood into my dick where as before it would only partially fill and would be lopsided.

So there I am doing cycles with a VED pumped up dick, which is also well lubed (required to use VED), in my hand thinking erotic thoughts. Well no brainer what to do with it. Of course the boner only lasted moments before more pumping was required but it did feel good.

However, there was another issue. While my continence had improved greatly to where a little leak was the exception, that was not the case when aroused and stroking a boner, even when adding the VED constriction ring. It was pretty messy and not something I'd bring to my wife.

What followed were many sessions that were, for all practical purposes, edging sessions although I didn't know to call them that. These allowed me to slowly gain control of my urine leakage. The other half of that problem was that even when able to control leakage during edging, an orgasm was a very messy thing. There's no other way to describe it other than spurting urine. Much continued "practice" enabled me to eventually gain control of this and learn to "O" without the waterworks.

It was a good while before I was able to bring my recovering dick to my wife. Meanwhile there were the other ways to please her. There's the standard oral but there's also a world of toys that can be had for that purpose. Now we can actually have a relatively normal sexual life. Of course we still have the toys.

I also often, maybe even usually, still use the VED between action days with the wife. I'd like to say I do
VED therapy every off day but I don't although I'm certain I should. And yes, while sometimes these sessions are restricted to non-erotic therapy, they still usually result in cranking one off. Well, what are you going to do with your lubed boner in your hand.

There may be wives or partners that would be right there from the beginning helping out in spite of dead dick, all of the water works and frustration but I doubt there's many. If you have one of those you had better make her feel appreciated and loved and pay it back somehow. Either that or lock her in a room so she can't get away.

I realize my experiences are not universal, but I don't think they're unique either. I know this has been TMI for some, sorry. The bottom line is, not taking moral considerations into account or ED caused by any other issues or even possible negative side effects, I think masturbation was essential in my recovery, such as it is.

I do have experience with the unpleasant experience of sexual urine leakage post prostatectomy.

I'm going to suggest a lot of solo practice and patience. I know many might feel uncomfortable with that suggestion but that's what I have to offer. ("I'm sorry honey but I'm going to have to whack off a whole bunch until I can get this under control.") It took me at least a couple of years to get the sex/leakage issue pretty much resolved. I learned to restrain the pee while the sex was ongoing including climax. It seemed counter intuitive mussel wise but a learnable art, at least for me. I still take care to restrict my fluid intake prior to sex and to void immediately beforehand. Yeah it doesn't help with spontaneity.

I did kegles in the beginning after surgery but pretty much quit after a good while. I found long walks works better. If like me you will pee yourself on the walks. I wouldn't wear a pad so I I'd have more incentive to hold it. I did have to hide in the bushes a number of times. I did 4 mile walks. The first 3 were pretty easy. The last mile was struggle. For me that worked way better than regular kegles.
---------------------------------------------------
I absolutely find cock rings (novelty/sex shop cock rings) to help with erections when used with injections. I've opined on this subject many times, probably as much as the urine issue (Is "urine issue" a pun?). As I've oft mentioned, finding the best cock ring for you is a trial and error type thing. Expect to buy and reject a fair number of them until you find the ones that work well for you. You can collect the rejects in your toy drawer or go ahead and file them in the round file.

As for the question about if rings will prevent pee leakage, well IMHO that's a different type of ring. medical grade VED rings will probably do it or at least help. They are generally much tighter and along with restricting blood flow will also restrict urine. Of course with those you are then time limited to 15 to 20 minutes due to being uncomfortable or even the risk of tissue damage. I'd think any medical grade VED ring would work such as an Osbon brand. There is a site supporter with a link on the left of this page that has the medical grade rings: https://www.erecaidpumps.com/

-------------------------------------------------------

It's with reservations that I make this recommendation. I'm going to suggest a lot of solo work. A lot of solo work while also concentrating on restraining pee. You can even learn to climax while restraining. Initially it does detract from the orgasm but that seems to eventually pass. Of course there's the obvious suggestions to reduce fluid intake before intimacy and to void beforehand. These suggestions are not medical advice and are just based on my personal experiences. I apologize if you've already tried these suggestions.

The solo work practice is what I've described as a type of edging or ruined orgasms'. It's a matter of getting to the point of no return and then doing a very hard kegel clamp which ruins the orgasm and stops any urine spurts. One member told me the method was more like a MMO technique (Multiple Male Orgasm). I guess so but I don't really know anything about MMOs. The trick is that by doing this practice I learned to control the kegel to the point that I could clamp down enough to restrain any pee while still actually having an orgasm. I guess I learned to individually and separately control the relevant muscles. This didn't happen overnight and took a lot of practice. It now takes very little effort for me and the kegel clamping is almost automatic. This technique will work if you can master it.

================================================

Injection pain

I'm referring primarily to Alprostadil pain. Alprostadil being the active ingredient of Edex and Caverject as well as the mono-mix prepared by some compounding pharmacies. Some guys just can't tolerate alprostadil. It's just too painful for them. Some guys never have any issues with it. The largest group, of which I'm a member of, initially get pain from the alprostadil but find with continued use the pain diminishes or completely goes away.

I initially started with Edex 10s which contained 10mcg of alprostadil in the cartridge to be mixed in the cartridge with the 1ml of sterile water. Initially the Edex 10 didn't do it for me and I went to the 20 right away. On the Edex 20 initially got a fair bit of pain but I also got a better erection. Because of the better erection I continued with the Edex. I eventually went to Edex 40s but found if I used who whole 40 I had lasting ache. As I continued I got better at injecting but still had pain but at a more manageable level. Then my insurance quit covering ED injection drugs completely. It was now too expensive.

I found a compounding pharmacy that could make a generic Edex substitute. However it would come pre-mixed in vials. I would have to use separate insulin syringes. I got my doctor to write me a script for a generic based on the Edex cartridge ingredients. Armed with my generic Edex substitute I was able to perfect my injection technique. I discovered I could use less of the new mix and I learned better shot placement and I learned to inject the juice slowly. I discovered done perfectly I no longer had pain. I discovered that if I started depressing the plunger and found it was painful I could adjust the needle depth until there was no pain while pushing in the juice. About this time I also discovered I could use a novelty/sex shop cock ring and use even less juice, further reducing the chance of pain.

Using less of the juice, referred to by the pharmacy as mono-mix, made it fairly inexpensive compared to the Edex which I couldn't afford without insurance coverage. Having become better at injecting I asked my doctor to double the strength of the mix. This now made the juice down right cheap at 80mcg per ml at about 15 units per shot.

Now with a much more perfected injection technique and by pushing the juice in with the plunger very slowly I get almost no pain while injecting and no ache.

Hopefully all of that makes some sense. I also hope this doesn't need too much editing because I'll have to do it later.

I'm sorry this post got so long. Maybe I can edit it smaller later too.

Thanks for the reply. Very useful indeed. I realized I'm not alone or unique. I'm from sunny South Africa