How to Self-Inject: Penile Injections with Prostaglandin (PGE1, Caverject, and Edex), Bimix, Trimix, and Quad-Mix.

by Alex Shteynshlyuger MD


If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5211.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office

We offer affordable appointment prices with or without insurance.  Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.


Logistics of Penile Injection Therapy for Erectile Dysfunction

This discussion applies to the following medications Bimix, Trimix, Quad-Mix, and prostaglandin preparations including Caverject and Edex.

shutterstock_183978314-vasectomyUsually, a small needle used by diabetic patients for injecting insulin is used for the injection of these medications in the penis.  It is important to inject the medication on the side of the penis at a 90-degree angle to the penis (perpendicular). The preferred site of injection is about one third from where the penis originates.

I usually advise patients to stretch the penis, especially if you are uncircumcised, and then inject the medication while the penis is on a stretch.  

Usually, right-handed men hold the syringe in the right hand and pull the penis to the left to make injections easier.  It is better to inject towards the top than towards the bottom of the penis as urethra runs on the “bottom” of the penis which you want to avoid.

As a matter of policy, all men are taught how to perform self-injections at New York Urology Specialists before they are prescribed penile injections.

How the Dose of Injections is Determined:

There is no single dose that is used for everyone. Each man is individually evaluated and an appropriate dose of medication is chosen to provide adequate erection while minimizing the risk of priapism (an erection that lasts for > 4 hours). With combination medications such as Trimix, various Trimix preparations are available with various strength, in addition to the dose of medication (mL or microliters), the preparation strength is chosen.  Multiple visits may be required to choose the correct dose.

The goal when choosing an appropriate dose is to provide adequate erection hardness and adequate duration.  The duration of erection should be close to or just under 1 hour.

We have also noticed that some men with ED can benefit sufficiently from 1 injection to be able to skip additional injections for one to two weeks at a time. They are able to achieve adequate erections spontaneously for some period of time after an injection before they need another injection.

Storage of Medications

Prostaglandin injections come as refrigerated (less expensive) and those that do not require refrigeration (EDEX, Caverject).  We usually order prostaglandin (alprostadil) that requires refrigeration in small vials of 5 ml each.  We advise that you store them in the freezer; keep one in the refrigerator until you use it up; then thaw out a fresh vial at room temperature and store it in the refrigerator.

Trimix injections are also available as refrigerated (less expensive) and those that do not require refrigeration.  We usually order Trimix that requires refrigeration in small vials of 5 ml each.  We advise that you to keep one vial in the refrigerator until you use it up;  store other vials of Trimix in the freezer until you need them.  When you need a fresh vial of Trimix, remove it from the freezer and put it in the refrigerator; if you need it fast, you can thaw it in your palm for 10 minutes; store it in the refrigerator.

If properly stored, medications should work well for 3-6 months.  If you are not getting good erections there are two possibilities: the medication lost its potency; you can try a new vial from the same batch.  It is also possible that something happened in your body such as your diabetes worsened or your cholesterol is higher, or testosterone levels lower and as a result, the prior dose of medications does not work well.  Please schedule an appointment for a re-evaluation.

Where to Get Treatment for ED in NYC?

At New York Urology Specialists, we offer specialized treatment for ED for men. Same-day appointments are available.

Call/text today: 1-646-663-5211 or make an appointment online.  

We treat sexual and erection problems and offer comprehensive STD testing for infections.  We treat penile problems in men, including phimosis, balanitis, penile irritation, and penile redness. We perform a no-scalpel vasectomy, vasectomy reversal, cosmetic circumcision, circumcision revision, penile frenuloplasty. We offer confidential appointments.

Our prices are ED treatment prices are affordable with or without insuranceLow-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.  We offer free insurance verification.

Read Real Stories of Men who Underwent Treatment for ED at New York Urology Specialists.

We offer ED treatment to patients within driving distance to our offices as well as from other states and countries.  Our patients come from New York, New Jersey, Pennsylvania, and Connecticut, and over 30 countries worldwide.

What do Penile Problems Look Like?

You can find pictures of penile problems including before and after treatment images in our image gallery.

What You Need to Know:

Why Choose New York Urology Specialists for Treatment of Erectile Dysfunction?

  • All treatment is performed by a board-certified urologist experienced in treating men with symptoms of ED, premature ejaculation, and other sexual problems using medical therapy, minimally invasive therapies, lasers, and surgery.
  • We are one of the few practices in the region to offer a full range of options for the treatment of sexual, and erection problems in men.
  • We offer diagnostic testing in our office which avoids hospital costs.
  • Extensive Experience: Thousands of men have treated successfully using medical therapy, shockwave therapy for ED, penile injections with Trimix, and penile implant surgery.
  • Confidential and Understanding Care. We understand that most of our patients desire privacy.  We see patients with a variety of urological problems. Your reason for visiting us is entirely confidential.
  • We are one of the few practices in the region to offer a full range of options for the treatment of sexual and erection problems in men.
  • We are conveniently located within 30-60 minute commute to men who are seeking ED treatment in Manhattan, Brooklyn, Queens, Staten Island, Westchester, Long Island, Bronx, and New Jersey.

Scheduling Appointments for ED Treatment at New York Urology Specialists


If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5211.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office

We offer affordable prices with or without insurance.  Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.

We offer weekday, weekend, and evening office hours.

Dr. Alex Shteynshlyuger is a board-certified urologist, who specializes in all aspects of care for sexual problems in men including ED, premature ejaculation, and other sexual concerns.  He has successfully treated hundreds of men with sexual problems including ED and poor libido.


Patients Reviews

Overall Rating:

5

Total Ratings

5

Total Reviews

19

Ratings

Ease of Appointment: Bedside Manner:
Promptness: Spends Time with Me:
Courteous Staff: Follows Up After Visit:
Accurate Diagnosis:

Patient review
by on Jan 24, 2020

Peronis Disease
by on Aug 04, 2019

Dr Alex was both knowledgeable and concise with his diagnosis and advice which was well received. Dr was her knowledgeable in the subject and provided good advice.

3P Removal
by on Jul 24, 2019

Went to get my penile papule remove. Got done same day, it was fast, great staff, and most importantly, pleased with the result.

Recommendation
by on Jul 18, 2019

Therefore I would like to recommend you to anyone who need your services.

Urology Visit
by on Jul 18, 2019

Staff were all very welcoming. Dr. Alex Shteynshlyuger was very knowledgeable and attentive during my time spent with him.

Outstanding
by on Jul 09, 2019

Went in for a procedure with Dr. Alex and he was very calm and thorough about the the operation and the recovery. From the front desk to his assistants, everyone was very courteous, professional and polite. I highly recommend NY Urologist Specialist. They are outstanding!!!

Friendly , courteous, effiecient and professional
by on Sep 15, 2018

Wyts Wyts recommends New York Urology Specialists via Facebook. September 15, 2018 · Friendly , courteous, effiecient and professional staff members. This office i highly recommend for any and all Urology matters. Dr Alex Shteynshlyuger is very professional and knowledgable easy to communicate with. Thanks Dr Alex

Satisfied Patient
by on Sep 15, 2018

I am very please and satisfied with everything that has been offorded to me by New York Urology Specialist Office.....Dr Alex

Surgical Procedure
by on Sep 01, 2018

Dr Alex and his staff are through professionals in every sense of the word. From initial diagnosis to a period of evaluating and ruling out options, we decided upon a surgical solution, which appears for the most part to have corrected the issue. Thanks to Ana, and the staff, especially Dr. Alex for treating me so well. Best regards, Lee

Review
by on Aug 16, 2018

Outstanding service

A very good doctor
by on Aug 15, 2018

Dr. Alex Shteynshlyugerand is careful, patient, experienced. Uses innovative approaches, that actually yield results. He is indeed a good doctor, in every sense

urology services
by on Apr 11, 2018

I am very satisfied with the treatment I received at new york urology specialist and would recommend them to other patients.they are the very best.

My wife was elated
by on Jan 15, 2018

Well I put it to use last night and man, good job. My wife was elated. u made it much better somehow, so thank u for fixing my penis

Thankful
by on Dec 05, 2017

"Cannot express how thankful I am I found Dr. Shtetnshlyuger. After undergoing surgery to correct a penile torsion I couldn't be happier with the results. A great doctor who is clearly good at what he does. With something as important as your private area, It's nice to be able to rest easy and know you are in good hands.." via HealthGrades.com 12/5/2017

Review
by on Nov 19, 2017

I am writing to thank dr. Alex. He is thorough, professional, knowledgeable, helpful and friendly. I have seen him for ED and prostate issues, and he has explained all my options clearly, and found solutions that have been a great help. thank you! I highly recommend both Dr. Alex and his staff, which I find to be helpful, friendly, knowledgeable and very professional. They are a pleasure to deal with and all have been a great help.

Dr visit
by on Sep 14, 2017

I am very much thankful for meeting Dr Alex .I had a very serious medical problem I visited many doctors but none could not help me it was very difficult for me until I visited Dr Alex after a couple visits my medical problem is no more I feel very great also I felt almost 20 years younger Dr Alex is second to none fantastic doctor. Thanks again Dr Alex from my family.

Excellent doctor
by on Jul 03, 2014

I am feeling better now after visiting clinic New York urology specialists. Excellent staff and appointment on time.

Thank you for excellent care
by on Jan 07, 2013

Dear Dr. Alex: We want to thank you for the excellent care you provided for George during his emergency operation and the follow up treatment. Your quiet, confident manner was reassuring to us during a very scary time for us. We will never forget you. George Sally R. Date: 2013

We love you!
by on Feb 16, 2012

Dr. Alex Shteynshlyuger and Staff – Thank you so much for taking care of my husband Bob. Dr. Alex: I thank God everyday for you. You were an answer to prayer.

ED is Treatable in Nearly Every Man

Excellence-Urology_Care-banner2At New York Urology Specialists, our urologists are specially trained in the evaluation and treatment of erectile dysfunction.  We understand the challenges that ED creates for our patients, their relationships, and their self-esteem.  We help you find a treatment for erectile dysfunction that fits your needs, lifestyle, and your preferences.

Urologists are doctors specializing in the treatment of men with erectile dysfunction. By the virtue of our experience and skill, we are able to offer an effective treatment option for nearly every man who desires an effective treatment for ED.  We offer medical and surgical treatment for erectile dysfunction.

We Treat Some of the Most Complex ED Problems Including:

Schedule an Appointment with Dr. Shteynshlyuger:

Call/text today: 1-646-663-5211 or make an appointment online

Dr. Alex Shteynshlyuger is a fellowship-trained board-certified urologist with expertise in the evaluation and treatment of sexual and erection problems in men using modern effective and proven treatment methods.  We offer inflatable penile implant, shockwave therapy for ED, and treatment for Peyronie’s disease.

He is highly recommended by top primary care physicians in the New York area. If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to contact us with any questions.


If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5211.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office

We offer affordable appointment prices with or without insurance.  Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.

We offer weekday, weekend, and evening office hours.

 

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