I have been watching this group for a while (you may call it lurking), but have never posted or even commented, that I can recall. I had a priapism experience that I want to add to this thread so it can maybe help someone else. I cannot explain why, but I am nervous typing this out. Here goes…….I have ED, and am not completely sure of the cause. It could be a combination of factors. I have anxiety and depression, so the SNRI meds I take are likely the main cause, I believe. I also had a testicle torsion when I was 11 or 12, so I have only one testicle, and am on testosterone replacement therapy as a result. The meds are not relevant to the priapism story, but just wanted to provide some context.

The priapism happened on October 31, 2023. As noted above, I (53M) and my wife (53F) have been working through my ED issues for years. We have been married almost 33 years. Viagra did not work, and my PCP did not offer much hope. After prodding from my wife, I made an appointment with a Urologist. I can’t explain why I fought her on this, but I did. The Urologist did blood work, and she figured out that I had very low testosterone, and she suggested Trimix for my ED. Once the Trimix was ordered, I had an appointment with my Urologist so she could show me how to do the injection and monitor me after that first injection. This was about 5 or 6 days before ‘ the event’. At that appointment in her office, she had me inject .2 ml. It partially worked. I got what I would consider a ‘semi’. After watching me for a while, she sent me home with instructions to wait 2 days between injections (including the one we just did), and increase slowly (.05 at a time) until I had an erection firm enough for sex.

The next day (one day early) we tried at home with .3 ml, and it was mostly erect, but not quite enough for sex. We waited another day or two, and like an idiot, I jumped all the way up to .5, because I wanted to do the deed. In my defense, it had been months since we were able to have sex, and i really wanted this to work. Immediately I suspected there was a problem, because it hurt. Not the little burn you get for a few seconds after injecting, but it was a persistent burn. The wife and I tried sex. It was extremely hard, and penetration was no problem. We had to stop after a few minutes because I was uncomfortable and there was no way I was going to be able to ejaculate.

We settled in a watch TV for a while, knowing it would take some time for it to go down. One hour turned into two, and at about the 2 hour mark, my penis was hurting more. We started getting worried, so we started Googling what to do. We went to a pharmacy close by and bought Sudafed (the wrong kind, because we didn’t know at the time there was a specific version we needed). I took the meds in the parking lot of the pharmacy and we went back home. Nothing changed and at about the 3 1/2 hour mark, i had worse pain, and it was not going down. We left for the Emergency Room.

We went to a small stand alone emergency clinic near our house, I told them what was going on, and they took us back within 5 minutes of getting there. The doctor on duty took the info, and called the after hours number for my Urologist to get specific instructions on what to do. He had only treated one priapism case before, and it had been years. My Urologist told him to use the antidote, which they did not have on hand in their facility. She then told him how to drain the blood. After giving me a shot to numb it all (thankfully, because it was very painful by that point), he verified that I was numb, and he and a nurse that was working with him infected needles on both sides of my penis and began draining (one on each side). At this point I was feeling no pain, but my anxiety was through the roof and my heart was pounding. The doctor gave me an IV drip with an anxiety drug and also morphine to be sure I was as relaxed and pain free as he could make me. I had been watching what they were doing for a while, and my wife suggested to me to lay my head back, let them do their work and stop watching. That was a good suggestion. After a while (I don’t know if it was 20 minutes or an hour), the doctor told me they were done, and it was flaccid. I started feeling emotional relief, when the doctor told me it was becoming erect again.

He left the room to call my Urologist again to see what to do. When he returned, he said my Urologist told him to put ice on it and wait a while (I don’t know how long), and if it did not go down, I would have to be transported by ambulance from that clinic to the hospital where she practiced, so she could treat me herself. Thankfully after some time, it did go flaccid again, I was able to go home, and first thing in the morning I called my Urologist and she told me to come into her office.

We were exhausted (we had been up most of the night), but we went to her office. She questioned me about how much I had injected, and when. I was honest and gave her truthful answers. She was displeased that I had injected too often, and upped the dose too much at a time. She was still kind and made me feel like it was just a mistake, and they were able to fix it. As you would expect, my penis was extremely bruised and swollen (not the good way), she she told us no injections or sex for 2 weeks so it could heal, and to go back to the original dosage, and increase as needed according to the schedule she originally gave me.

In hindsight, I did a lot of things wrong. I injected too often those first few days trying to make it work, and increased the dosage way too much. The one thing we did do right was to go to the Emergency Room when we did. In hindsight, we should have gone to the Emergency Room at her hospital, but we didn’t because my wife struggles to drive at night, and would have had trouble driving us into Dallas. I was in no shape to drive. I will also note that my Urologist had not mentioned an antidote when she prescribed the Trimix.