Specific questions for first visit

[4jacres]

I am in my early 60's and I had a DaVinci radical prostatectomy 8 years ago that left me with 70% ED
I have tried all the meds but none have worked so I am now willing to try injections.
I am visiting a new urologist that has a practice at the hospital that did my surgery. He is in the Mens Health Center in the hospital.
My insurance DOES NOT cover visits or meds for ED
My questions are...
1. How many visits are average for new patients?
2. Do they train or inject on the first visit?
3. What is the average total cost before you're on your own?
4. I am hesitant to try Caveject because of the cost, so should I request the Trimix everyone seems to use?
5. Any "red flags" I should watch for?
Thank you all for this forum. This has been very helpful.

[bldoink]

A belated welcome to the ED club. If you haven't been using a VED for at least therapeutic purposes I'd suggest you get with it immediately. My insurance doesn't cover injection meds either.

1) If the doctor has your prior records he should be able to get you started right away. POSSIBLY, give you script on the first visit and have you come back for a first injection after you get it filled. However, I don't know if there is an average for this. If it's a clinic that specializes in men's sexual issues he/she might have meds on hand to demonstrate with. Make sure all of your records from your surgery and any subsequent Uro visits especially those dealing with your ED are sent to your new Uro prior to your visit. This might take awhile so start on that early.

2) Kinda covered in #1 as in probably not but maybe.

3) Average? Who knows. I understand some of these clinics that specialize in men's sexual health pretty much rape you on cost. On the other hand some Uros will hit you for the cost of one or two office visits and then you're good to go. My insurance covers the office visit to the Uro but with a $60 co-pay. I don't generally encourage dishonesty but you could also have another complaint such as incontinence issues thereby giving the doctor another covered code to file with the insurance. If purchases from one of the more competitive compounding pharmacies the actual meds should be pretty cheap.

4) Caveject will not be cheap. Mono-mix, what I use, is essentially the same thing from a compounding pharmacy. It's basically just sterile saline with alprostadil AKA PGE1 AKA Prostaglandin. Also pretty much the same as the also expensive Edex. So at least ask for a generic script for alprostadil written for a compounding pharmacy. Or you can ask for a Tri-mix formula also written for a compounding pharmacy. Many here will recommend the Tri-mix over the Mono-mix. The Mono-mix works for me. The disadvantage of the compounded mixes over the Caveject or Edex is that the compounded mixes have to be refrigerated or frozen whereas the Caveject and Edex don't as they come in dual chambered syringes with the actual drug as a dry powder that mixes with the saline in the syringe at time of use. Nice but not anywhere near worth the cost difference. I keep my mix frozen.

5) If the doctor won't write a generic script for a compounding pharmacy - Red Flag. If they will only send the script to their "special" pharmacy - Red Flag. If they want to do a whole bunch of special expensive testing before at least trying you on the injections I'd say also a Red Flag. Other than that I don't know. Try posing questions to this forum if you have other concerns.

Good luck

PS: Remember, I'm just another limp dick struggling through life and nothing I say should be considered medical advice as I'm no doctor.

PS2: I'll probably have to edit this for typos etc.

[Cigar56]

Here are some random notes:

If you don't already have a urologist, search for one whose specialty is men's sexual disorders, such as ED. The learning curve and process will go much faster if you're dealing with a uro who has broad experience treating ED. An experienced urologist is more likely to hit on the right formula faster and will inject you in the office. At most you may need only two visits.

Leave it up to the uro on how to write up the visit so your insurance company will pay for it. Absolutely stay away from the so-called "men's clinics."

If you go with Trimix be sure to shop around. Prices can vary by a lot. Mail order might be cheaper than your local pharmacies. Search this forum for the names of pharmacies to try.

Keep us posted!

[4jacres]

Thank you sir for your reply.
Yes, I have been using a VED since surgery and I do believe my records are on file. I was still in the system when I made my appointment. Those are points I left out, thanks for bringing them up. I do know that the clinic has subscribed Tri-Mix in the past because I found a compounding pharmacy close to the hospital that gave me the name of one of the doctors at the clinic that prescribes it and uses that pharmacy to fill the prescriptions. I think I'm on the right track, just a little apprehensive about the cost. I was told by the clerk that scheduled my appointment that the consultation/first visit would be $122-$365 but I'm not sure what that entails. They do know that I will be self paying. Hopefully it won't be much more than that. Thank you again.

[4jacres]

Thank you Cigar56...
I will be using a certified urologist that works in the "mens clinic" at the hospital where I had my surgery. This particular hospital was very good in my treatment, surgery, support, and followups. The two urologist working in the health center specializes in mens sexuality treatment. I'm hoping it all goes well. Thank you again.

[Larry10625]

I am in my early 60's and I had a DaVinci radical prostatectomy 8 years ago that left me with 70% ED
I have tried all the meds but none have worked so I am now willing to try injections.
I am visiting a new urologist that has a practice at the hospital that did my surgery. He is in the Mens Health Center in the hospital.
My insurance DOES NOT cover visits or meds for ED
My questions are...
1. How many visits are average for new patients?
2. Do they train or inject on the first visit?
3. What is the average total cost before you're on your own?
4. I am hesitant to try Caveject because of the cost, so should I request the Trimix everyone seems to use?
5. Any "red flags" I should watch for?
Thank you all for this forum. This has been very helpful.

May I suggest that you create a signature. It makes things much easier to answer your questions without asking a lot of questions. Here's how you do it
Click on your name in the top right corner and select "user control panel"

Then under the big letters "User Control Panel" there is a row of words... select "Profile"

Then down the left had side of the "User Control Panel" select "Edit Signature" (You might have Create Signature or something. I don't know exactly what you'll get because I already have a signature to edit)

Most guys put something like what I have, but you can put whatever you want. Here is mine -
"AMS 700 (18 + 2 rte's). Implanted March 30, 2017 by Dr. Brock of London, Ont, CANADA. Great surgeon. Went in to septic shock and had to have implant removed April 29, 2017. I'm from Belleville, Ontario, CANADA. Appt. for consult for second attempt is on November 6, 2017... I can't wait."

Don't get too carried away with the doctor like his name, address, phone number, etc (anything that looks like advertising for him).. you can certainly say Dr. Jones (great Dr.)

If you need further help, please ask, that's what i'm here for.

Larry
Moderator

[tomas1]

I think the best case scenario would be for the office to have some tri-mix on hand and give you the first shot.
After noting that it works, they should give you the prescription for around 10ml and also allow refills. Maybe a lesser amount since it may not be strong enough?

Don't be surprised if the prescription is pretty weak and you need to come back to get it strengthened.
If the test shot doesn't seem strong enough, ask for a stronger formula.

I hope the office visit doesn't break you since everyone wants to get rich quickly nowadays.

If all goes well, buy the syringes at Walmart and get the alcohol swabs there also. Syringes should cost around $12.50 for 100.

[Larry10625]

I think the best case scenario would be for the office to have some tri-mix on hand and give you the first shot.
After noting that it works, they should give you the prescription for around 10ml and also allow refills. Maybe a lesser amount since it may not be strong enough?

Don't be surprised if the prescription is pretty weak and you need to come back to get it strengthened.
If the test shot doesn't seem strong enough, ask for a stronger formula.

I hope the office visit doesn't break you since everyone wants to get rich quickly nowadays.

If all goes well, buy the syringes at Walmart and get the alcohol swabs there also. Syringes should cost around $12.50 for 100.

When I started injecting, my doctor said to titrate up 25 units until I find success. If you have no luck with injections, get you doctor to help with the paperwork for implant... I have read on here that some people were originally denied by insurance but approved after the doctor got involved.

Good luck

Larry

[Pabowhunter]

I self pay no insurance .. Urologist appointment consultation physical urine blood work 300.00...Penile Doppler ultrasound with injection... 430.00 total cost ... $730.00 I highly recommend the Doppler ultrasound my Urologist wouldn't prescribe without .. His office called in 8 refill prescription to a compound pharmacy they use out of Nj .. Not the cheapest I've seen but not horrible either 85.00 5ml .. hope this helps if self paying.