Erections and Invicorp

Please find below my experiences and journey to becomming an Invicorp fan:-

My background is; 18 months post-op, where only one nerve was spared, No natural erections since my op.

I was was told to use the pump regularly to maintain a good blood flow to the penis and did this almost daily from 6 weeks post op to 6 months and this seems to have maintained good circulation.  My routine was to use the pump and fit a ring before showering each morning, let the ring maintain an erection for 10-15 minutes during my shower and remove at the end of the shower. I found that this routine took very little time out of the day and helped maintain my circulation.  It definately brought back the natural colouring to my penis which had been very pale post op.

One tip if you are reading this 'pre-op' is to get a ruler and measure your normal penis length when fully erect (I suspect most men have a very good idea of this number but if not just make a note of it).  When you get your pump post op mark this length onto the side of the vacuum tube (don't be tempted to add an inch for good measure).  I tried using a magic marker but my daily shower quickly washed it away.  My final solution was to wrap a piece of clear cellotape around the tube at the appropriate distance from the bottom (Bottom of the tape should equal the original length).  Then every time you use the pump you have a clear target to achieve before popping the ring on.  I was told to expect some shortening of the length due to the stretching of the urethra to connect to the bladder so on the first few weeks using the pump I took it easy and gradually increased the vacuum limit but only to what was comfortable. Over maybe a month I eventually reached the target line and was made up with the results.  Like all recovering patients I found it good to set myself little goals to achieve and worked towards them, just take it one day at a time and you will get there in the end.

As the main purpose of the pump exercises are to improve blood flow I also found it usefull to pump up the vacuum to a achieve a comfortable length and then release the vacuum pressure for a few seconds so blood is allowed to drain from the penis.  Repeat this pump and release action a dozen times before popping on the ring.

I experimented with different rings/sizes until I got a reasonably useable erection. Best ring I found was the 'Osbon ErecAid High Tension Ring'. Expensive but effective. Pump and standard rings all provided by my GP on prescription after my surgeon wrote to the surgery with recommendations.

My surgeon then asked me to try out Viagra but absolutely no responce, just a headache.

Next step was to try Caverject (for some reason my health board insist on trying this before Invicorp). The pre-charged injectors were really easy to use and although I think I missed the target with my first attempt all looked promising.

Next attempt I was amazed to get my first 'pump-free' erection since my op and in this respect Caverject worked a treat.  The excitement quickly subsided though due to the associated pain (It felt as though my penis was bruised or had been battered with a hammer) so it was a real passion killer!!  I did try Caverject half a dozen more times to see if the pain became more tolerable but unfortunately not for me.

My local health board approved the move onto Invicorp. It works virtually every time, any times it hasn't have probably been down to my aim with the needle rather than the drug itself.  No pain, great results lasting 1-2 hours.

One thing to remember is that after injecting yourself and massaging the area you do still need stimulation/arousal for it to work at its best.  Apart from that I have found it ticks all the boxes.

Couple of user tips:-

If your partner wants to join in and do the injection for you all the better (my wife is a little squeemish with needles so she doesn't won't to do it for me and prefers not to see it).   I find it easier to inject myself in private and sitting up so I can concentrate on getting the aim and penetration depth for the needle spot on . I find that the standard needles are a little too long so I stop maybe 5mm short of its full penetration, a bit of trial and error and you will get it right. I also find it better to inject closer to the base of the shaft (10-20mm away from the body). This area is probably a bit less sensitive to the needle going in. 

The needles are very fine and is not painfull!! 90% of the time you cannot feel it go in (A short stabbing motion to pierce the skin works best for me) squeezing the syringe can be a bit difficult and needs some dexterity to hold it steady. Once the injection is in it takes maybe 10-15 minutes for the erection to start taking effect. 

At this point you need to concentrate on your mind rather than your body.  The greater the stimulation you have (Mental & physical) the better the results ! This can be foreplay, masterbation, porn whatever suits you best to get yourself ready for the main event. Try to follow a routine that works for you and it will quickly become 2nd nature.

I have sometimes used the pump and a lightweight ring in addition to the Invicorp when I felt the erection was not absolutely 100% or you want to achieve 'extra length/rigidity'. I have had no problems with any aftereffects, just go easy with the pump as you literally only need a few pumps to get the maximum effect, Invicorp does 90% of the job for you.

Storage of Invicorp in the fridge is the only down side vs Caverject but is only really an issue when travelling.  I have bought a small cooler bag designed for transporting insulin and that has 2 gel filled bags that can be frozen before travelling.  This keeps the interior of the drug temperature below 8c for around 24hrs and I pack it in my hold luggage.  If you can get a hotel room that has a fridge then you can keep it in there for the duration of the holiday.  If you have any ampoules left over for the return journey as the hotel to re-freeze the gel bags before you leave. 

I have searched the internet to get a definitive answer on What happens if the ampoules get warm ? The only answer I could find was a statement that "the active ingredient in the drug may stop working if overheated" so worst case seems to be you will not get the erection you expected. 

After a recent trip where I could not get access to a fridge and the travel bag warmed up, I was left with 2 ampoules that had sat at room temperature of around for 12 days (still in the insulated bag to avoid large temperature variations). The temperature guage on the travel bag read around 20c every time I looked at it.  I returned them to the fridge when arriving home and about a week later I used one of these ampoules for my injection and found that it worked exactly as normal.  Obviously this is not a full medical trial and you should always try to follow the instructions as closely as possible but it is a practical demonstration that there is probably a little tolerance in the storage requirements.

Hope these comments provide some help & feedback to other recovering patients.  Good luck with your treatment and I hope you all make a full recovery !!

Hello everyone,

My OH Ian and I have been getting a little action with the Invicorp injections!! The erections are not always great, but I understand the lingering effects of the HT will influence this? Ian has been off the HT since end of February. Last time we also used the Durex ring, but he found it quite uncomfortable, and as soon as he took it off, he leaked. Ian's urology nurse has taken him off his daily Cialis, and told him he only needs to use to pump 3 times a week now. Even though Ian had non-sparing RP, there is some reaction when he's not using the pump or the injections. Any tips and suggestions are welcome, regarding the rings, etc.

Ian is making good progress, but still has periods of fatigue, often 2-3 weeks, but the tiredness is less pronounced, I believe the effects can take 12 months or longer to leave your body. He was on HT for 18 months. He still gets a PSA test every 2 months, when will that change to every 6 months? His readings are always cancer-free. He had one testosterone test done in March which was about 2,9ml, and he's been told to get another one in January/February. His incontinence is also improving, some days he doesn't need a light pad. It will be 3 years soon, from his diagnosis, so he's come a long way. We are just very grateful and need to enjoy life, as one doesn't know what's around the corner!

Injections will generate a better response if you have no nerves, but the suggestion is he may have some nerves, so it's worth seeing how well they work, and if they're getting better over time.

I have heard it said don't use a pump with injections, but never done injections myself. Don't use injections with PDE5 inhibitors unless your clinician explicitly says it's OK. You can use a pump with PDE5 inhibitors if it helps to get things going.

Edited by member 27 Oct 2022 at 17:29  | Reason: Not specified

Thank you for sharing your story. I found it both informative and encouraging. That said, I am less far travelled in my own journey.

I had radical salvage surgery 6 months ago. That was 11 years after brachytherapy, following which I had no erection issues, could climax but not ejaculate.

After surgery I had a catheter for a month before commencing rehabilitation. I reacted adversely to Sildenafil and settled on 5mg of Tadalafil (Cialis) alongside using a SOMAerect Response II. My initial reaction, both physically and emotionally was great. My penis had retracted almost entirely so, seeing it enlarge over the next few weeks was fantastic. (It also allowed me to pee, standing!) At first I didn’t use rings. I created a vacuum for, say, 20-30 seconds and then released it, repeatedly over 3 to 5 minutes, daily.

I then started using rings. Initially, I chose bigger rings but they didn’t maintain much and eventually  settled on the ‘FREE SAMPLE Ultimate Ring (SureFit)’. That was much more bearable but, generally, I could only tolerate it for 3 or 4 minutes and my penis wasn’t terribly firm. It did allow me to masturbate to gain relief from growing frustration. I attempted intercourse a couple of times but, having to stop foreplay, use the pump and fit the ring, didn’t help the moment and penetration was poor or failed. I have little sensation from the skin surface around my groin/scrotum and no amount of stimulation, erotic thoughts, even porn, would achieve an erection.

I continued the therapy and would, from time to time, masturbate to alleviate my frustration.

Meanwhile, my urine control is now, just about back to normal and I only wear a pad if going out, to boost confidence.

At my 5 month consultation I shared the above and conceded that we had discussed the possible nerve damage but my priority had been to avoid the risk of the cancer spreading to my colon as it did with my dad, 20 years before. We agreed to drop the Tadalafil and see what happened. I asked about MUSE/Caverject (?) and was told that my Health Board didn’t support that. I am not good with needles and said so. (I struggled injecting myself with the anti-clot stuff for the 28 days post-op and that was into the convenient roll of fat around my midriff!). I was also reminded that it was only 5 months since surgery and that it might take as much as 12-18 months (which your experience supports).

I now regret not taking the Tadalafil any more as my penis has, again, retracted and, prompted by your story, I see that the skin colour is pale, The pump can give me an erection but not as full/firm/long as while on the Tadalafil. Additionally the ring works less well and I lose whatever firmness I achieve, sooner. I have used an artificial vagina/sleeve to test my ability to penetrate and it’s barely possible but, I did achieve a climax recently, which helped uplift my spirits.

I have written to my Consultant asking if I might go back on the Tadalafil but, inspired by your experience, I will try to persevere with the pump and I quite like the idea of showering as part of that regime.

I also feel that I just might be willing to explore injecting myself, if other methods remain less successful.

Thank you.