Hello, from Ontario Canada! Tough next step choice in my ED journey, TRT or Implant??

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KaBoom
Posts: 6
Joined: Thu Aug 14, 2025 12:27 pm

Hello, from Ontario Canada! Tough next step choice in my ED journey, TRT or Implant??

Postby KaBoom » Thu Aug 14, 2025 5:19 pm

Just stumbled upon this board recently. God I wish I knew this resource much sooner.

Greetings to all you fellow men who share our common struggle.

Here's my Journey:
All my plumbing was working splendid until late 30's. This might be co-incidence, but it occurred soon after I started taking propecia. It still worked fine when needed, but I started to notice that in a flaccid state, it just felt more "floppy' , and the times when me and wife wanted to go more than once, I couldn't the second time. Needed two hours to recoup which didnt use to be the case. But in general everything worked properly and didnt seem to be any serious issues

I then also got a vasectomy a year later. I dont think that affected things but thought I'd mention, you never know.

Unfortunately another year thereafter I divorced, and this is where things started sideways. I was suddenly out in the dating scene again, I was getting many 'opportunities' with matching and meetup apps that didnt exist in my pre-marital days. It was really awesome, not gonna lie. However, my batting average was not 1.000 anymore. Perhaps a mix of nerves and aging, or maybe the continued use of propecia, but I'd say a third of the time my member wouldn't co-operate, despite me being totally turned on. Of course, this is embarrassing both for me, and also the new ladies I would be with who would think she didnt turn me on. Many of you know the feeling. But since most of time it was working I thought everything fine. But it was enough for me to start taking Cialis.

It worked wonders. Most of the time I didnt use it, but I saved it for times when I would strikeout, then pop a pill, and take another shot an hour later and all things went well. couple years on, battling average down to 50%.

Then I turned 51 and things got worse suddenly. I was diagnosed with High Blood Pressure, and it definitely affected my performance. I also have a fiancé at this stage and I spoke very open to her about my ED. I dont know if it was the high blood pressure that put a clamp on my unit, or the medication for it. Either way, I slid to point where I was now dependant on Pills for regular sex. My girl was fantastic and supportive through it all, and many times we tried to get it on spontaneously, and we would both get excited and aroused, only to have to leave it unfulfilled. She was cool, but lets face it its a total downer not just for me.

I then tried the shockwave thing. The clinic promised it helps 85% of the guys fix the ED, but of course there was no warranty or money back guarantee if you were one of those 15%. After 10 sessions....it did F all. Goodbye $3000. Maybe it works for others but I doubt it will fix 85% that have ED. Total ripoff imho taking advantage of desperate middle aged men on a faulty promise.

Anyways 3 years later, and even the pills have weakened. Still work, but much less virile....for instance we cant switch positions else it deflates during transition. Even when we are in middle of it sometimes it just decides to end the party despite Cialis or Viagara.

So I am now 56 and want to make most of my remaining years. I dont want to have to schedule sex with wife with a pill, that puts pressure on her to perform and its less organic, and we cant act in the moment.. But to be honest, I can still get it hard enough for penetration au natural from time to time (1 in 5). unfortunately it takes a much longer time for her to 'get there' than me, so these sessions end up with a smile only on my face..which lessons the experience of course (but she is so good and supportive regardless).

I have to take the next step, and to me its TRT or Implant. Im worried about TRT because of the potential side effects, and im not sure of its ED enhancement effectiveness. I dont trust YouTube videos or google on that I want to hear directly from men who tried. Although would be nice to get some more energy and muscle help at this stage.

The implants seems the way to go but much more invasive and pricey. (but then again, all the $$ I spend on pills adds up too). I guess with the implant it's kind of scary that once you do it, natural erection will never happen again and those muscles are compromised. Its irreversible.

Also I dont know the OHIP health coverage requirements or procedure here so if anyone knows Ontario that would be great!!!

Thanks for any feedback guys!!

wilsonmill
Posts: 443
Joined: Mon Mar 11, 2019 9:50 am
Location: Raleigh NC

Re: Hello, from Ontario Canada! Tough next step choice in my ED journey, TRT or Implant??

Postby wilsonmill » Thu Aug 14, 2025 5:32 pm

Good luck, 58 when I got the first one, a Titan, revision 5 yrs later and if this one fails I will get another..
Age 64, type 1 diabetic, Married 20+ years, Titan implant 23 cm 27Feb2019, Duke Medical Hospital, Dr Lentz, failed March of 2024, revision 25Jun24 AMS700 LGX 18cm 5rte's Dr Andrew Chang associated urology Raleigh NC, Rex Hospital

KaBoom
Posts: 6
Joined: Thu Aug 14, 2025 12:27 pm

Re: Hello, from Ontario Canada! Tough next step choice in my ED journey, TRT or Implant??

Postby KaBoom » Thu Aug 14, 2025 7:35 pm

wilsonmill wrote: revision 5 yrs later and if this one fails I will get another..


Sounds like you are a happy customer despite the revision. After 5 years was it covered under some kind of warranty?

I trust it works to get you up when you are aroused.
But what if you are not? Does it still work same if you pump it up? Like the rare times when she is in the mood but you aren't, or you already climaxed but need to carry on to get here there too?

wilsonmill
Posts: 443
Joined: Mon Mar 11, 2019 9:50 am
Location: Raleigh NC

Re: Hello, from Ontario Canada! Tough next step choice in my ED journey, TRT or Implant??

Postby wilsonmill » Thu Aug 14, 2025 8:55 pm

KaBoom wrote:
wilsonmill wrote: revision 5 yrs later and if this one fails I will get another..


Sounds like you are a happy customer despite the revision. After 5 years was it covered under some kind of warranty?

I trust it works to get you up when you are aroused.
But what if you are not? Does it still work same if you pump it up? Like the rare times when she is in the mood but you aren't, or you already climaxed but need to carry on to get here there too?



No, there was no warranty, tube got a hole going to the left cylinder. It was a Titan. Now have the AMS LGX, I like it. As far as getting an erection, you have to pump, as far as feeling arousal you still should have that. Arousal is in the upper head, which thankfully still works. I had issues with my glans getting aroused, I started taking nitric oxide supplements and that has helped a great deal, keep the blood flowing.. you will have the ability to screw all night if you have the stamina, that ain't me.. you climax and it still stays hard... Till you deflate.
Age 64, type 1 diabetic, Married 20+ years, Titan implant 23 cm 27Feb2019, Duke Medical Hospital, Dr Lentz, failed March of 2024, revision 25Jun24 AMS700 LGX 18cm 5rte's Dr Andrew Chang associated urology Raleigh NC, Rex Hospital

stgalli
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Joined: Mon Sep 27, 2021 11:47 am

Re: Hello, from Ontario Canada! Tough next step choice in my ED journey, TRT or Implant??

Postby stgalli » Thu Aug 14, 2025 10:48 pm

The standard advice is to try everything else before going to a penile implant. As you said, the implant is irreversible. Most people are very satisfied with the implant, but a small percent wind up unhappy with the result, and not able to get good results with revision surgery. I think you have to ask yourself, are things bad enough now that if you can't have penetrative sex after the implant would you be no worse off? Before reaching that decision you need to find out if something you haven't tried will work for you. By TRT I assume you mean testosterone replacement. If your testosterone levels are low this can definitely help. Also, have you tried intracavernous injections? Some people get great results with these for years. Intraurethral alprostadil gel is an alternative to the penile injections that works just as well for some, but not for others. If it works, it's a good option since you avoid the needles and potential scarring of the cavernosa from needle trauma. Some men get good results by combining a daily low dose of cialis with injections or urethral gel. There's some concern that the risk of priapism is increased, but I think most urologists are comfortable with combining the low dose cialis regimen with injections and the risk is small. You could add a cock ring to any of the above to improve the erection. It should be the stretchy kind, as it only needs to constrict the superficial penile veins, which doesn't require a lot of pressure. If you've tried all the above and you still aren't getting anywhere, it's time to get an implant.

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ElbowRoom
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Re: Hello, from Ontario Canada! Tough next step choice in my ED journey, TRT or Implant??

Postby ElbowRoom » Fri Aug 15, 2025 12:04 pm

Have you confirmed low testosterone, and if so what are your levels?

I have been on TRT injections for over 20 years now. No real side effects other than my hair is gone, but my Dad’s did the same so might not be related. It’s a great therapy, I’d definitely correct that first before going to an implant.

If TRT doesn’t restore things in 3-6 months, then you can move to the implant quickly. But at least give TRT a try, for some men the difference is night and day, and it will improve your muscle mass/body composition, endurance, mood, and other aspects of life as well.
58yo Coloplast Titan implant scheduled for 10/23/2025 with Dr. Hakky. Pre-op erect measurements:
8.5"L and 6.5"C

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bldoink
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Location: Fl.

Re: Hello, from Ontario Canada! Tough next step choice in my ED journey, TRT or Implant??

Postby bldoink » Fri Aug 15, 2025 12:37 pm

KaBoom wrote:...This might be co-incidence, but it occurred soon after I started taking propecia.
Yep, Propecia is a known risk factor!
KaBoom wrote:... and the times when me and wife wanted to go more than once, I couldn't the second time.
...However, my batting average was not 1.000 anymore. Perhaps a mix of nerves and aging, or maybe the continued use of propecia, ...
Yep, yep and yep! Nerves, aging and Propecia are all risk factors. I think I'd lose the Propecia.
KaBoom wrote:But it was enough for me to start taking Cialis.
Daily or as needed?
KaBoom wrote:...I was diagnosed with High Blood Pressure, and it definitely affected my performance.... I dont know if it was the high blood pressure ...or the medication for it... I slid to point where I was now dependant on Pills for regular sex.
More risk factors. HBP is never good and can indicate general vascular issues that would include your dick. Check your BP meds for side effects. Some are not erection friendly.
KaBoom wrote:...many times we tried to get it on spontaneously, ... only to have to leave it unfulfilled. ... ...the pills have weakened. Still work, but much less virile....for instance we cant switch positions else it deflates during transition. ... sometimes it just decides to end the party despite Cialis or Viagara......I dont want to have to schedule sex with wife with a pill,... I can still get it hard enough for penetration au natural from time to time (1 in 5).
You have a lot going on. Are you using daily Cialis? or as needed? Try daily if you haven't. Again, lose the Propecia. Check the potential ED side effects for whatever blood pressure meds you're on. Is your BP issue properly controlled?
Have you done some serious experimentation with different novelty/sex shop cock rings. If not, get with it. You sound like a great candidate for them.
KaBoom wrote:...unfortunately it takes a much longer time for her to 'get there' than me, ...
I hesitate to make suggestions here. I will suggest you get hers first. That could be done with a longer warm up, toys, oral, whatever works.
KaBoom wrote:I have to take the next step, and to me its TRT or Implant....
Unless there's some medical contraindication why not go for the TRT? There's guys on here that can give good advice on the best ways to administer it for preventing side effects, like vanishing balls. It may or may not help with the ED but it could sure make you feel better if it's not as high as it could be. TRT is a no-go for me due to cancer issues.
KaBoom wrote:The implants seems the way to go but much more invasive and pricey. (but then again, all the $$ I spend on pills adds up too). I guess with the implant it's kind of scary that once you do it, natural erection will never happen again and those muscles are compromised. Its irreversible....
The implant may be your best answer but it seems a bit early to come to that decision. They are invasive and pricey, for sure. If you're spending a lot on pills I'd guess you're buying them from the wrong place. Yes, the implant is irreversible.

Have you considered injections as a backup plan?
Last edited by bldoink on Fri Aug 15, 2025 2:23 pm, edited 2 times in total.

mrksman
Posts: 30
Joined: Wed Jan 19, 2022 11:14 pm

Re: Hello, from Ontario Canada! Tough next step choice in my ED journey, TRT or Implant??

Postby mrksman » Fri Aug 15, 2025 1:23 pm

Some good advice here. For me I decided to try TRT first. If that doesn’t help (along with the pills) then I will go to penile injections.
Age 59, happily married over 39 years. T levels on the low end. Cialis (Tadalafil) was working great but not anymore. Now taking Vardenafil. Also use a Vacurect VED with a PosTVac Mach Ring as a backup.

Old Guy
Posts: 2901
Joined: Tue Mar 31, 2020 4:31 pm
Location: Ohio

Re: Hello, from Ontario Canada! Tough next step choice in my ED journey, TRT or Implant??

Postby Old Guy » Fri Aug 15, 2025 2:32 pm

Hello Ontario-
Sounds like you've spent enough cash already to pay for an implant. Your story sounds very similar to mine, except I stayed married. Pills failed after a while. No PIV sex for a couple years. Then I found out about Trimix. Stick a needle in my where? There was no way, then they showed me an autoinjector. Trimix worked for a while then began to be a guessing game if it was going to work this time. Back to no PIV sex for a while. On vacation I saw an ad for a doc who does implants. Never knew there was such a thing. Back home one year later and I was on the surgical table at 68 years old getting a bionic dick. I haven't regretted it one bit as much as my recovery was tough.
If you want reliable erections and spontaneous sex go for the implant.
Nov. 8, 2019
5+ years, Coloplast Titan OTR
Married 37 years to my beautiful young bride
Always here to answer questions if you PM me

KaBoom
Posts: 6
Joined: Thu Aug 14, 2025 12:27 pm

Re: Hello, from Ontario Canada! Tough next step choice in my ED journey, TRT or Implant??

Postby KaBoom » Sat Aug 16, 2025 10:15 am

Some great feedback here, thanks to all you guys.

A few quick answers back to the various questions:

- Yes I have considered stopping propecia over the years. I have cut back on it where I only take a pill every 2nd day. Its not certain that its the ED cause. But it definitely works for its intended purpose. My father had major receeding hairline though his 30's, and both grandfathers were bald by time they hit 40's. Nothing wrong with that, but I knew that was going to be my path and could do something about it. Mid 50's now, I still have a full head of hair, not even a little spot in the back of head. And bonus most of it is still original black colour, with some grey strands here and there. Far more pepper than salt.

- Testosterone numbers are lower for me, but not too unusual for my age. My doctor gave me a prescription to try it out so I am on gel patches now every 2 days for a month and will see how it goes. I just started yesterday. I figure the full effect won't show in just a month, but a trend might start to appear, and also any negative side effects.

- I failed to mention that I also tried Trimix injections last year. Yeah it worked, like 5 of 6 times. was better than the pills. But the maintenance, keeping the fridge, the 4 week expiry span, the challenges to transport it if we go away.....is kind of a hassle. Plus if you use you are supposed to wait at least another 24 hrs......we often like to get it on in the night and have another go in the morning in case she didnt "arrive" the night before. So logistically, I didnt like it.

Unless the TRT wows me after I give it a couple months, I am leaning towards the Implant.

If I was planning on having more kids, or if there was some impending miracle cure for ED within the next 3 years, I would wait. But the idea that I can get it up, anytime, instantly, for however long I (or she) needs it, is a big life boon for guys in our spot. YOLO, and I want to make the most of what ever life I have left


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