Topic
Bi-mix is a terrific treatment for me
In December of 1999, I underwent a radical prostatectomy, the so-called nerve-sparing kind, from a highly respected and experienced urologist in my small city. He had studied under Dr. Patrick Walsh, who had invented, or discovered, the nerve-sparing procedure for prostatectomy’s. My operation was a success and the result was that I was cleared of cancer, but have ED and typical incontinence.
Prior to the operation, I was a 49-year-old, single, very fit, healthy, and active man, who worked out regularly and ran 10 races, and even a few half-marathons. Had no sexual issues whatsoever, a wonderful girlfriend who is now my wife, and a very good sexual life.
My doctor warned me that he thought fewer than half his patients experienced ED after the operation, but he could not verify that, and he also thought some of them, being men, were not admitting to him they experienced ED, so he stated clearly that nobody knew why some men experienced ED after nerve-sparing radical prostatectomy’s and some didn’t. From what I read, they still don’t know. I imagine the real number who experience permanent ED, however, is close to 90%, or maybe even 100%. Just my opinion. Since my operation, newer techniques for the radical prostatectomy have been developed, such as arthroscopic surgery, but I don’t know whether they have any less impact on the damage or destruction of the nerves that manage erections.
At any rate, for months, I expected the ED to diminish and I would gradually get full erections back, but it didn’t happen. I’ve tried all the usual pills and treatments, Viagra, Cialis, and Levitra. Tried a pump that my doctor loaned me. Have tried intensive acupuncture, treatments to specifically–supposedly–stimulate the nerves that enable erections, but the nerves are gone evidently and my ED is more or less permanent.
The best treatment, by far, that has worked for us is Dr. Goldstein’s Bi-mix formulas. Tri-mix works also, but for me, the erection produces sort of a minor, aching pain. The two Bi-mix formulas work well, and produce a decent erection, but still not like ten years ago. I’d say it’s about 90%, compared to the erections I used to have. I also find that I have to use more of the mix than before. About 20 – 25 mcg, I believe. But the Bi-mix is a terrific treatment, for me, and I’m very, very happy that it is available.
My main issue with the erections produced by the treatment is that, for me, they last about four hours. No big deal, but it would be more convenient if they only lasted an hour or less.
| Quality of life after prostatectomy surgery |
I underwent a radical retropubic prostatectomy in April 1998. The postoperative Gleason score was 7 and the preoperative PSA ~6. A recent PSA was <0.1ng/mL, so the primary objective of the surgery appears to have been achieved. The surgery was performed at a major medical center that was renowned for its success rate in the management of prostate cancer. Unfortunately, the operation left me incontinent and impotent, despite preoperative assurances that these were unlikely outcomes. Perhaps because of this optimistic view of the post-operative outcome, there was no follow-up from this hospital. At discharge one of the nurses gave me a few feminine panty liners. As I was concerned about the impotence, I followed up with the surgeon. He wrote a prescription for a vacuum device that was painful to use and not particularly effective. The general urologist from the small community hospital, who had diagnosed my problem and performed the original biopsy was the most helpful. He had developed a stepped program, Viagra, an intra-urethral compound, Alprostadil intra-cavernosally and finally Tri-Mix. A strength of Tri-Mix was finally identified that proved adequate.
The incontinence slowly became worse. I needed 4-5 Walmart Assurance pads for men per day. The location of the nearest bathroom became an obsession in a new setting and my entire living space had to be stocked with clean pads. From a Web search an urologist was identified, who could place a urethral sling. This was done in May of last year. The operation was a remarkably successful and my pad use fell to one a day. However, unlike the prostatectomy there was no formal consent process. I had consented in one of the many forms provided by his office that I had signed. The outcome was then really a surprise. My scrotum swelled to the size of a grapefruit and remained so for a few days. This was followed by weeks of intense testicular pain, as the sling seemed to contract into place. Any sexual activity was foreclosed during this phase post operatively. However, when the pain had subsided the Tri-Mix was much less effective and it was harder and in some circumstances impossible to achieve orgasm.
Again a Web search proved to be helpful. San Diego Sexual Medicine (SDSM) was identified as a likely place to find help for the impotence. In February, Dr. Irwin Goldstein the Director of SDSM provided a very detailed and skilled work-up. His proposal was to provide a higher concentration of the Tri-Mix along with a kit to reverse its effect, should priapism result. Initially there was still a problem with orgasm, but this resolved spontaneously. SDSM is definitely the place to go for any type of sexual problem. They offer a far greater range of diagnostic procedures and treatment options than one will find in even the urology departments of a major hospital.