Hi, I am a 28-year-old based in the UK under urology for some intermittent psychological ED and firmness/narrowing at penile base. Generally however, my erectile function has been good and I could generate full erections alone or with a partner on demand allowing multiple episodes of sexual activity within 24 hours. My question is, has anyone experienced priapism (prolonged, unwanted erection) whilst taking pentoxifylline 400mg three times a day and cialis 5mg once a day?
I was on this regimen from my urologist, and started to wake up at night/in the morning with very rigid, full-size erections that would tend to persist if I remained lying in bed. Once I got up and either went to the toilet or stood up for a few minutes, the erection would subside over the course of maximum 5 minutes back to flaccid state. I never experienced any obvious pain and never required medical intervention to return the erections to flaccid. This happened about 10 times over the course of about a month and a half. Unfortunately, I have no idea as to the duration of these episodes as I was asleep prior to waking (therefore I worry the erections could have been persisting for a while in my sleep and causing potential damage from ischaemic/low-flow priapism).
Since these episodes, I have subsequently lost essentially all erectile function. With a lot of work, I can generate something resembling an erection when I am alone, but it is by no means a 100% erection. Furthermore, I need to be sat down and if I stop stimulation it will fade away quickly. My flaccid penis feels less 'elastic' and just not as I remember it. Furthermore, I have no nocturnal or morning erections anymore and this has been the case for about a month and a half.
Has anyone else on the pentoxifylline + PDE5i (viagra or cialis once daily) combination had a similar problem and, if so, has there been any improvement?
Furthermore, does the description of the overnight episodes seem to fit with low-flow/ischaemic priapism, or would there typically be pain and more difficulty in relieving the erection once waking?
I am awaiting results of a penile MRI and USS (both done without injection in flaccid state due to worry over priapism from Consultant) but the initial informal feedback suggests they have seen nothing overtly abnormal.
Thanks and I hope someone will be able to shed some light on my situation!
If you can get full hard erections without Cialis and it seems you might be on the verge of priapism, I would either cut your dose in half or eliminate it and tale L-Arginine.