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Case Title:  Penile injection resulted in Priapism twice for no more sexual orgasm
Reader: 7/16/2005>
Hello Dr. Lin.

I am 50 years old male, that had little problem with maintaining erections during sexual activity for too long. So I naturally went to a urologist who said that the best solution for me would be and injection of a cocktail of papaverin prostaglandin and anther which I am not sure of itís name. 

I used this on and off for few years and at one time in the past I developed a long erection, for more the 10 hours and I went to the ER where it was taken down with Aspiration. I havenít used it after that for a while but my erections where total normal after that. 

About 10 weeks ago, I developed another long erection, but this time I went to the hospital ER after 6 hours, the Urologist arrived about an hour later and then he started with the aspiration. It went well, and 3 hours later I left the hospital feeling ok.
The next day I developed a full erection and tried to avoid it. Yet even in the next morning I developed a normal erection and was able to perform a full sexual act. 

However a week later I felt pain in my pines and some what of rigidity in the side where the aspiration and the injection took place. A week later, I try to masturbate and I felt like I couldnít get hard at all. I even took Viaggra, to try to help the situation but it didnít help much either. It was hopeless. The urologist that preformed the aspiration in the ER told me to give it time, and suggested that I will take twice a week, Ciaalis to insure that blood flows into the penis. 

I started to take all kind of supplements including, L-aginine Saberian Ginseng, Vitamine e and Q-10 by suggestion of various alternative medicine healers.. 
In the first four weeks I couldnít get an erection whatsoever but after about 5 weeks the pain subsided a little and I could get some what of an erection, after 6 weeks I felt more of an erection and could for the first time masturbate and ejaculate. But it was still not what it used to be. Since then, it has been some what of a battle. I can get partial erection at most time, but at times they are more firm then others. But none of those erections are what they used to be before. 

My questions Are

A. Do you think that a damage was done, and if so, is it reversible since it was constantly improving during the first 8 weeks.. And is there a medical test or way to determine the damage and itís extent.

B. Is there anything that you suggest for me to take or do that can help and expedite the healing and to retain back a full rigid erection that will be suitable for intercourse. 

C. If firborisis developed in small area, is using laser, as one urologist suggested can help with the formation of the scare tissue. 

please answer me ASAP, as you probably know, it is effecting me in so many levels. It really depresses me, to no end. I am so desperate, and I donít get a real answer. 

I thank you very much.
Dr. Lin: 7/16/2005>Your 2 Priapisms have destroyed the penile blood vessels and nerves with oxygen and nutritional starvation! Based upon my few experiences in dealing with the Priapism patients, the destruction may be irreversible.
Penile injection for pains and Priapism - no more erection or sexual orgasm
A. You can not have a destructive or intrusive test. The only medical test is to use the Ultrasonic Doppoler Flow meter to measure the penile blood flow. There is no way to check the nervous damage in micro scale. The modern high-tech medical non-invasive instruments can not resolve the micrometer damage.
B. Rebuilding the damaged nerves and blood vessels requires your penile erectile tissues to produce sufficient prostaglandin E-1/E3 and nitrix oxide(NO). The question is: can your erectile nervous function bring in some blood flow for the penile tissue to produce prostaglandin E-1/E3 and NO? If yes, you can try ViaPal-hGH-P(3-010) and 5-HTP (2-001), plus L-Arginine 500 mg 3 times a day, Fish and Borage Oil(1000 mg each meal) and calcium (400 mg)/magnesium (200 mg)/Viatmin-D(200 IU) to boost the prostaglandin E-1/E-3 and NO synthesis.
It will take a long time (6-12 months) to rejuvenate the nervous function.
C. No. the penile scar tissue/Fibrosis will spread inside the erectile spongy tissues, not a surface area where a Laser can reach.
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