Penile Rehab after RP Prostatectomy - Pills, Pumps, Injections

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Below is a text file that I saved to be able to recount my experience with Penile Rehabilitation.

I am recounting my experience - I am NOT a medical professional.
Penile Rehab / Penile Therapy - Just my experience.

Updated March 24, 2023 - Prostatectomy Sept 2020 age 55; Male Urethral Sling Surgery Sept 2021

My penile rehabilitation.

1) Week 2 ==> tadalafil (generic cialis) 10 mg daily (started day catheter was removed)

2) Week 9 ==> Bathmate HydroXtreme penis pump

3) Month 6 ==> Trimix penial injections - started at 6 months (doctor wanted to start sooner, but I needed more time to mental adjust to inserting a needing into my penis).

At 9 1/2 months, I have some natural erections using daily 10 mg tadalafil (generic cialis purchased using GoodRx (prescription required)). I use the Bathmate HydroXtreme penis pump 3 to 5 times a week (extreme has a hand pump) (link below). I started Trimix penis injections at 6 months. Using Trimix once or twice a week, I was able to have an erection without Trimix starting around 8 months after prostatectomy. I still use the Trimix once a week (March 2021 to Sept 2021).

At 9 1/2 months, I was incontinent leaking about 20 ounces a day (4 pads a day). In Sept 2021 (12 months after Prostatectomy), I had the male urethra sling surgery and am continent.

The longer version of above :

1) Just after treatment (prostatectomy) Daily cialis is about getting blood flowing to the penis and pelvic area to help the nerves to heal. It took 3 months to notice any firmness about 50%. I use GoodRx to find a good price - a grocery chain store pharmacy had the best price for me.

2) My urologist recommended the Bathmate penis pump. Unless you have a firm pelvic area, you will want the Bathmate with the hand pump - HydroXtreme. I went from 5 1/4 inches before prostatectomy down to 4 inches, then back up to 4 3/4 inches after using the Bathmate pump for 3 months.

The Bathmate HydroXtreme pump is more about penile rehabilitation than producing an erection to constrict (ring to hold erection) and try to use for sex.

I sit on the corner of my tub with cups of warm water to fill the cylinder (about 100 degree). The instruction are to pump for 3 minutes, massage for 2 minutes (I use shampoo plus conditioner to reduce friction), and repeat twice for a total of 3 times 15 minutes.

The Bathmate uses water in the cylinder and seems to work on girth more. I am not looking to get bigger than I was, just to restore my pre prostatectomy size.

Bathmate website - sign up with your email to get 20% to 30% off.
Get the Xtreme because of the hand pump. I purchased the comfort cushions to reduce the chance of pulling a testicle into the pump (very painful). The size of the cushion ring goes with the size of the pump.



YouTube search for instruction - note - most are not using the pump for rehabilitation. Sign into YouTube with a gmail account to see adult versions.

I also purchased the Vacurect. I used it a few time with the rings, but the ring to hold an erection was to constricting. I also used it a few times for blood flow (pump 2 minutes, release 2 minutes). I prefer the Bathmate.

Other options

Encore Penis Pump



3) Trimix injections - I had a difficult time starting and using these. I was shaking inserting the syringe at first. Do NOT use an auto injector - it was not the thing for me to do. I had to stop for a while because I was putting too much mental pressure on myself to use the Trimix when I was not ready.

I also had concerns about using Trimix for every erection or orgasm. I would use Trimix, then not feel like trying for an orgasm for 5 days. That was okay. After 6 weeks on Trimix, I noticed on the days trying for an orgasm without Trimix that my erections were getting firmer and at 8 weeks of using ( month 8 ) I was getting to 90% hard.

Trimix is ordered from a compounding pharmacy. It comes in a 5 ml bottle. My initial does of 0.15 cc or 0.15 ml produced a 6 hour erection. Some member in the Facebook group (link below) also reported that they had to return to the doctors office. Make sure you get your initial dose in the morning so that if there is a problem, you can return to the doctor. After 4 hours, I contacted my doctor - I took 4 30 mg Sudafed (the 4 hour pill not the 12 hour pill).

I found that 0.05 cc gave me a 4 hour erection in the beginning. You can prefill a few syringes. I found that adding an extra 0.05 cc for storage. Before use, you shake the syringe and squirt out the extra trimix. (Trimix is compounded and needs to be shaken before each use for better results.)

Trimix tips
0) Trimix is stored in the refrigerator or freezer
1) comes in a 5 ml vial
2) make sure the order comes with 20 to 40 syringes
3) Ask the doctor to include the "Undo" injectable or pills so that you do not have to go to the emergency room.
4) Have 30 mg generic Sudafed tablets on hand (After my 5th time injecting, I started taking FOUR 30 mg Sudafed tablets after one hour and each hour until my erection started to soften.)
5) I found eating and drinking 32 ounces of water worked better than the Sudafed at deflating the erection. Part of it is that I am taking my attention away from the erection. I will watch an hour of Television.
 
What great information you provided. I haven't had surgery. And hope I can stay free of this, but do know if something happens, will come back to this page for reference, thank you so much
 
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