For many years, we have used medication to improve blood vessel circulation in the penis. These medications include papaverine, phentolamine, and prostaglandin E1 — Trimix is a mixture of all three of these drugs. Scientists have found that these drugs can induce a penile erection when injected directly into the penis.
Since 1983, these erectile dysfunction injections have gained acceptance across the globe. The FDA approved Prostaglandin E1 for treatment in 1995.
Medications like Viagra, Cialis, or Levitra do not work for every man dealing with erectile dysfunction. However, penile injection therapy is another viable option. The thought of injecting a needle into your penis may sound intimidating, but about 70 percent of men are highly satisfied with this therapy.
We do the first injection here in our office so we can show you how to do it yourself at home. It also helps us determine the correct dose for your needs.
We typically start you off at 15 units. You may increase your dose by five units each time until you get the effect you want. If you are using 50 units and not getting the erection that you need, call us and we will prescribe you a stronger dose.
We allow a maximum of three injections per week, but you must wait 24 hours before taking another dose. And make sure you alternate between sides of the penis for each injection.
However, injection therapy is not always a good long-term option for some men and that is when they may want to consider the penile implant.
Trimix Injection Site
Below are step-by-step instructions detailing how to properly use your penile injection at home without a doctor.
1. Tear open an alcohol swab and wipe the rubber top of the bottle to sterilize it.
2. Peel open the syringe carefully and remove the protective cover from the needle. It is important that you do NOT contaminate the needle with anything but the rubber bottle cap.
3. Push the needle through the rubber stopper, then flip the ampule (the glass container of medication) upside down. Pull on the plunger until you withdraw 1.0 cc of the medicine.
4. As you continue to hold the ampule upside down, inject whatever air remains in the syringe into the ampule.
5. Withdraw the fluid until there are no more air bubbles in the syringe and the correct amount of medication is in the syringe.
6. Pull the needle out of the ampule and lay the syringe on the edge of a flat surface. Make sure the needle hangs over the edge to keep it from touching anything.
7. Grasp the head of the penis between the index finger and thumb and gently pull the penis away from your body until the skin is taut.
8. When choosing an injection site, avoid any area where a vein is clearly visible. We recommend changing injection sites from left to right as well as up and down the shaft and back again to ensure that you do not develop scar tissue at one specific site.
9. Wipe the skin with an alcohol swab.
10. Pick up the syringe with the other hand and position your hand like you're about to throw a dart.
11. Touch the spoint of the needle to the place you want to inject. (Only inject your penis while you're sitting or standing.)
12. Hold the syringe at a 90-degree angle and push lightly to penetrate the skin near the base of your penis.
13. Once you've poked through the skin, you will feel some resistance. Push firmly forward until a distinct "give" is felt. The needle should now be in the right place (within erectile bodies). The whole length of the needle should be also be in up to the hub.
14. Hold the syringe between your index and middle fingers and place a thumb on the plunger to inject the entire contents of the syringe. Then take the needle out of your penis.
15. Immediately apply pressure to your penis with your thumb and index finger for two to three minutes using the alcohol swab. Wait until there is no bleeding.
16. Place the needle in the disposal box.
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How Long Does It Take For Trimix to Work?
Your penis should swell within five to 15 minutes after injection. It may be erect. However, many men will not achieve an erection until sexual foreplay is started.
Some men have even noticed decreased sensation in their penis or have trouble ejaculating. This is usually part of the impotence condition which we are treating with the penile injections, although inadequate foreplay and excitement may play a role in this as well.
Important Things to Remember
Always keep your medicine in the refrigerator. You may pre-load syringes and keep them in the freezer once you know what dose works for you.
Never increase the dose by more than 0.05 cc or else you run the risk of a painful erection that may not go away. This could require a trip to the emergency room.
Never inject your penis more than once a day.
If you have failed to penetrate the erectile tissues after injection, you will feel a burning sensation. This should go away within an hour and no erection will result.
The needle must never touch any object other than the alcohol-wiped ampule stopper or penile skin. If the needle is contaminated, throw out the syringe and start over.
Do NOT insert a contaminated needle into the ampule.
Do NOT inject any substance other than the medication provided.
Do NOT share needles or medications with other people.
Go to the emergency room for erections that last more than three hours.
Return to our clinic in three months.
Trimix Side Effects
Some men experience pain or bruising, while others experience none at all. Other side effects include:
Temporary swelling of the penis skin — This can occur when you don’t place the needle properly.
Transitory pain — About 10 percent of men develop pain or discomfort in the head of their penis shortly after injection. This subsides spontaneously after a few minutes and is more common in men with impotence secondary to nerve problems.
Bleeding at the injection site — This usually results in a black and blue patch on the skin that disappears in a few days. This occurs when you don’t put enough pressure on the injection site after removing the needle or from puncturing a skin vein.
Prolonged erection (priapism) — This is an easily managed but potentially serious complication. If you ignore it, you could have severe pain and may need a small operation. It could even make you completely impotent (meaning you cannot respond to injections). Therefore, only make SMALL adjustments to your dose, if needed.
*If you develop a full erection that lasts more than three hours, call us immediately at 801-213-2700.
To treat a prolonged erection, we put a small needle in your penis, drain the blood, and inject a small amount of adrenaline. If the procedure is done early, there’s usually minimal or no damage to the penis.
If you get no response from the treatment, it could a be a result of:
- wrong technique,
- expired medication,
- inadequate dose,
- scarring or deformity (curvature) of the penis, or
- penis infection.
If you would like to schedule an appointment with one of our specialists, call us at 801-213-2700. You do not need a referral from a physician to see us.