Trimix Antidote-Treatment for Priaprism: PHENYLEPHRINE HCL INJECTION

[looyvillelarry]

63 yo here. Previous usage of Cialis resulted in moderate anaphylactic reaction. Four days ago, urologist had me try Tri-Mix 20 units (0.2 ml) with instructions to call if still tumescent after 3 hours. 120 mg. (real) Sudafed did nothing. Went to ER at a different medical facility. Ten consecutive injections of Pheneylepherine (5 min apart-all on right side) did nothing. Urologist resident then inserted 18 gauge needle with big blue plastic tab on right side. Four times he aspirated/irrigated/aspirated. Between each of these he injected another 3 doses of Pheneylepherine. After each aspiration, I fully tumesced again. He finally decided to go get the senior urologist to insert a shunt. I was left waiting on the gurney for 75 min., as the senior urologist was with other patients. Being alone and able to relax apparently allowed my stress level and heart rate to drop and after an hour I detumesced. When the senior urologist finally arrived, he stated that was a good thing as the shunt he was going to install would have caused permanent and irreversible ED. I am caucasian, but entire penis and scrotum (sans glans) are solid black from hematoma. Surprisingly, there is no pain or tenderness.

I do plan to try again, but will insist urologist begin with far smaller dose and have treatments for priapism on hand. I will post updates.

So sorry to hear your experience, it sounds much like mine. 20 units ( I suppose it depends on the strength ) is an awful lot to start with. I know what you went through, and it is even less fun that it sounds.

Just take charge is what I've learned. If he balks, ask him if there is a medical reason for not starting lower ( 5 units ) ? If not, lets do that. If he disagrees, maybe time for a second opinion.

 

[TH]

Just take charge is what I've learned. If he balks, ask him if there is a medical reason for not starting lower ( 5 units ) ? If not, lets do that. If he disagrees, maybe time for a second opinion.

She is very young, apparently finished residency very recently. She already agrees we will attempt with far lower dosage.

 

[looyvillelarry]

I just wanted to provide some updated information on the amounts here. the 1ml amount, if you read the entire document, is for flushing AFTER corporal aspiration. That is where they take a 27g butterfly, and basically drain your penis of all of the blood. THEN they flush with the 1ml of 1% PE solution to prevent a rebound..

The last urologist that I saw, used .2ml of 1% PE direct injection, every 5, for an hour before the aspiration. I don't know what size needle, but I can tell you it wasn't a 30g.

I think I'll post this over in the Ask A Uro for a better reply. Having been there, I really don't know how you could even GET 1ml into a priaprisim, and certainly not every 5min.

BTW, I would ** NOT ** recommend home aspiration


Cross Link to Ask the Uro Post

 

[Neil]

Hi Larry, I've got a couple of questions. It certainly sounds like a vial of Phenylpherine from Empower is in order for users of trimix. Empower lists this vial's strength at 0.1% (1 mg/mL) 2 mL vial. Not sure how that compares (strength) to what is used in the ER. But I'm wondering if at home for a troubling erection if the injection of the Phenylpherine alone will be sufficient to resolve the erection, as it seems like the ER also does the draining of the penis.
Any thoughts on this? I also found this video, a glimspe of what you went through. OMG. https://youtu.be/48jOPHs-L9w

Edit: And I was also wondering if the vial of Phenylpherine from Empower "only" contains 2ml, how is that enough for a treatment? Thanks

 

[looyvillelarry]

Hi Larry, I've got a couple of questions. It certainly sounds like a vial of Phenylpherine from Empower is in order for users of trimix. Empower lists this vial's strength at 0.1% (1 mg/mL) 2 mL vial. Not sure how that compares (strength) to what is used in the ER. But I'm wondering if at home for a troubling erection if the injection of the Phenylpherine alone will be sufficient to resolve the erection, as it seems like the ER also does the draining of the penis. Any thoughts on this? I also found this video, a glimspe of what you went through. OMG. https://youtu.be/48jOPHs-L9w

Yep, that's it. I can personally guarantee that either they gave that guy about 4 dilaudid, or edited the actual penial block. Getting kicked in the balls is gentle in comparison, but, it really is a kind gesture on the doc. I gently discussed this with my GF after, that if the CIA knew about this, we'd never have heard about waterboarding.

500mcg/ml - he may have had some issue there (maybe a cardiac issue, or being cautious)

The last, the dr was actually "teaching" the NP on how to create the dilution.
1) Remove 1ml of saline from a 10ml vial.
2) Add 1ml of Phenylpherine 1% into that vial, mix.
This is what they did to create a .1% mixture in the ER.

I was given I think 7 shots from 2 vials, with no result. Then went to the aspiration (about 7+ hrs at this point).

EDIT: The following is **NOT MEDICAL ADVISE**. I went back and looked at the treatment sheet. I was injected with 200mcg of 100mcg/ML every 5 minutes. I think that is .2mL of the .1% solution, which seems more appropriate amounts. I *know* what 1mL of saline feels like going into a priapism, it's not something you would want every 5 min.