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Hello my brothers,

I have just come from the beautiful offices of Dr David Ralph in London, following one night's worth of NPT study.

NPT is Nocturnal Penile Tumescence for those that don't know and is a device that ties around the base and tip of your member and monitors activity overnight to give an indication as to penile health and potential leaks.

(A healthy male has several erections overnight while in deep sleep).

First, my history once more:

- Bad experience of erection loss at 21
- Became a 'spectator' of my own erections henceforth
- Declining ability until 26
- Got cancer, beat cancer
- Urologists ran Doppler scan at 27 - 'mild venous leak' diagnosed - general, not isolated.
- Prescribed Cialis, amazing effect - became dependent
- Sought second opinion with Andrologist John Dean - Doppler again - this time, NO leak identified
- Sought third Andrologist Mr Kuehas - Doppler again, NO leak
- Psychosexual counselling advised, dependence on Cialis now complete
- Tried counselling, no avail
- Masturbation now hard to complete - far too stressed & never use Cialis for just masturbation
- Each failure reinforces the belief
- Fed up, sought out the IMPLANT expertise of Dr Ralph
- Dopplers not deemed necessary by him, NPT testing requested
- NPT done
- Psychiatry commenced w/ Wellbutrin (a mood elevating drug with reported sexual benefits as opposed to the usual adverse effects)
- Now I'm here.

NPT Results:

- Slept 8 hours
- 5 confirmed episodes of penile activity
- Each lasting 20-30 minutes
- All reaching 80% hardness (100% being "cast-iron solid")
- Diagnosis: Venous Leakage impossible. Normal erectile function.

So here I am.

This was the best result I could have hoped for in that my years-old query over leak vs. no leak is now settled. I take heart from this. But my mind is very, very ill. And my belief systems have created a 'SYMPATHETIC overactivity' and profound complex around erections.

I can never just 'lose' myself, brothers. I am critically dependent upon Cialis.

Mr Ralph is aware of how long I've been battling this and he is willing to implant me and even more kindly, on the NHS (our free health service). His and indeed my justification is, how long can a man put up with this? Indeed, it truly is a mind-body process.

So, gentleman, do you have any advice for me in this matter?

I cannot stress enough just HOW IMPORTANT the relationship between the mind and the penis is. It may as well be profound venous leakage at times.

My plan is to continue with this psychiatry that I've just commenced and try one last time with a partner who I hope will be the love of my life, very understanding and someone with whom I can work with in conjunction with the mood elevation, meditation, psychiatry and every tool in the box.

If that fails, I will take the pragmatic approach and seek the implant.

So sorry for the lengthy post but all information is pertinent when asking for advice.

Thank you, brothers.
Defiant

I could say a lot, but seriously don't have time now.
I also did an NPT, and the results were not at all as bad as my actual condition.
Also did several Doppler tests with various results.
If you want to discuss, PM me.

merrix wrote:I could say a lot, but seriously don't have time now.
I also did an NPT, and the results were not at all as bad as my actual condition.
Also did several Doppler tests with various results.
If you want to discuss, PM me.

I’m very interested to read what you have to say mate, I’d appreciate your thoughts...

My knee jerk reaction with no thought process filters in place is this. If I were experiencing what you described I'd hook up with the hottest woman I could find for a weekend of erotic exploration. When I was in my early 20s I developed a fascination with having the most intense sexual encounters imaginable. Well you say, who didn't, right? I think there's a profound difference between sex and intensely erotic sex. I sought out the latter. I coached women through edging me with blowjobs and also how to stop me right before I made them cum with oral as well. I used to like seeing if I could kiss every square inch of a woman's body. The women usually loved this. In fact, I just had a memory of over 40 years ago one of them sitting up in bed and saying "that was sooooooooooo GOOOOOOOD!". Delay the orgasm as long as possible while trying every imaginable position. The excitement of erotic sex I think would have evaporated any psychological blocks I had concerning my ability to have sex. Hell, I'd even discuss at length with a woman beforehand what I'm trying to accomplish and find the most willing one to help you. There are a lot of women who would enjoy the challenge of helping a guy overcome obstacles to having sex. I may have greatly over simplified your problems and concerns. I didn't mean to. Like I said, this was my knee jerk reaction. By the way, DO NOT try to replace a real live woman with porn for the erotica exploration. Nobody's imagination is good enough to replace the real thing! LOL.

DaveKell wrote:My knee jerk reaction with no thought process filters in place is this. If I were experiencing what you described I'd hook up with the hottest woman I could find for a weekend of erotic exploration. When I was in my early 20s I developed a fascination with having the most intense sexual encounters imaginable. Well you say, who didn't, right? I think there's a profound difference between sex and intensely erotic sex. I sought out the latter. I coached women through edging me with blowjobs and also how to stop me right before I made them cum with oral as well. I used to like seeing if I could kiss every square inch of a woman's body. The women usually loved this. In fact, I just had a memory of over 40 years ago one of them sitting up in bed and saying "that was sooooooooooo GOOOOOOOD!". Delay the orgasm as long as possible while trying every imaginable position. The excitement of erotic sex I think would have evaporated any psychological blocks I had concerning my ability to have sex. Hell, I'd even discuss at length with a woman beforehand what I'm trying to accomplish and find the most willing one to help you. There are a lot of women who would enjoy the challenge of helping a guy overcome obstacles to having sex. I may have greatly over simplified your problems and concerns. I didn't mean to. Like I said, this was my knee jerk reaction. By the way, DO NOT try to replace a real live woman with porn for the erotica exploration. Nobody's imagination is good enough to replace the real thing! LOL.

That’s actually very interesting advice! Thanks.

How are you finding your implant, may I ask...?

I am starting to believe that both tests NPT and Doppler US are of not use.
Each doctor seems to have his/her own protocol of applying it and evaluating it. So many factors are involved in the outcome. What they ask you to do after the injection, how long after injection they start the test, the position of the device and after this, their own evaluation of the results. I have had 3 penile dopplers where the result was venous leak written as such by the person performing the test. After when showing the results to the uro, he/she will automatically dismiss it as meaning nothing.

As for the NPT the same thing. Depends on the exact position of the rings, on how you slept that night, and on how the doctor reading the results evaluates them. During my NPT, I could see the rings bending my penis in the middle of the night and then the results of the exam stating perfect rigidity at that exact time. NPT does not measure rigidity along the shaft (axial¿?).

So my point here is that you can get any result in these tests, urologists will read whatever they want out of them because they either don't care about what the clinical guides say or because they think you are too young to have such an ED problem.

Hope this helps!

jmontesco wrote:I am starting to believe that both tests NPT and Doppler US are of not use.
Each doctor seems to have his/her own protocol of applying it and evaluating it. So many factors are involved in the outcome. What they ask you to do after the injection, how long after injection they start the test, the position of the device and after this, their own evaluation of the results. I have had 3 penile dopplers where the result was venous leak written as such by the person performing the test. After when showing the results to the uro, he/she will automatically dismiss it as meaning nothing.

As for the NPT the same thing. Depends on the exact position of the rings, on how you slept that night, and on how the doctor reading the results evaluates them. During my NPT, I could see the rings bending my penis in the middle of the night and then the results of the exam stating perfect rigidity at that exact time. NPT does not measure rigidity along the shaft (axial¿?).

So my point here is that you can get any result in these tests, urologists will read whatever they want out of them because they either don't care about what the clinical guides say or because they think you are too young to have such an ED problem.

Hope this helps!

Hmmmmm,

I agree on the Dopplers but for me the NPT is simple phsyics and if done correctly should give an accurate result. One at the base, one just under the glans. I didn’t play with it, assess it myself, I just let myself enter as deep a sleep as possible. They seemed to stay in place and at times I will say they were a bit ‘too’ tight but for all intents and purposes, the test seems to make good sense to me in that it will detect the pressure and extension of the rings electronically.

I think there’s far less room for misinterpretation in an NPT than a Doppler; what with all the things you’ve already mentioned.

I remember getting hard during that night, feeling it expand around me at certain points and I can’t be negative about this. I want to believe in the results and the evidence is there for me to see and I can correlate it to what I felt. So I just have to believe if my dick can do that at night, there’s no physical aetiology.

I'm curious, what do you mean dependant on Cialis? Is someone who doesn't hear well and uses a hearing aid becoming dependant on the aid? Whether our need is physical or mental or a combo, if it's not illegal or is not harming us, then why not allow it to assist us in a more fulfilling life.
I wish I had my implant long ago, even though I'm going to have to address the issue of hideous tubing showing with my doctor. My thoughts are IF Cialis is working for you & your partner, I'd hold off on the implant for now, especially at your age. Implant is normally the last option after all else fails. However, if nothing is working for you, and your quality of life is suffering, that's a possible reason for an implant. Please don't take this decision lightly, especially if you are depressed! We are hear to share our experiences dealing with ED with you and hopefully will give you a lot to think about. Just know their is hope! VegasED

I have discussed this at length and my guidance for what it’s worth is a kid the implant. You know you “work down there”. Somehow you have to break any chain reaction when “awake” and can then have the etections you obviously have at night. I totally agree and have suggested to you to find a woman prepared to help and share your problem with. I think may women would be thrilled to assist even if only to bolster their own sexual egos. You are able, young and have time. The implant is the place of last resort. Testimonial after testimonial confirms this rightbhere on this site regardless of the positive outcomes you will read there isn’t a man in here that would not prefer a natural erewcruon from normal arousal and sexual activity. If the Cialis works then that’s fine. Try and wean off of it. Surely that’s the plan. Best of luck

I’d agree, if Cialis is working...you’re in great shape! And unlike levitra or Viagra, if you take the daily dose, there’s no waiting for it to kick in so you can be spontaneous. It also makes one less prone to developing Peyronie’s disease.