Impossible decision

[ElbowRoom]

it will get worse

at your age you should have 0 issues

go with implant, even if the op fails you have nothing to lose

The depressing truth. I will give injections a try, and then go for implant if it fails

I hope you get some resolution. I did injections for a long time, and am now scheduled for an implant. Some things to be aware of with injections:

1) It only affects the shaft, not the head. You'll have to rely on your natural arousal to get the head to engorge.

2) It's inconvenient. You have to have a partner who's okay with you stopping your foreplay to shoot up and then wait ~20min for the results. If you're on a trip it's really hard to take injections with you because they need refrigeration. It's hard to get the dose dialed in, so you can have some times where you get inadequate erections, or have one too long.

3) It can cause problems, like fibrosis, scarring, and Peyronie's (curvature). This can make things more complicated later if you need an implant. *very* few men stay on injections for decades, and at your age I'd worry about the length of time you might need to use them going forward in your life.

4) They are expensive. Depending on the dose you need, it can cost you $100+ per month or more. In the long run an implant is less expensive.

If it were me, I'd make an appointment with a high volume implant doctor and let them evaluate you. They can do a doppler scan to check blood flow in/out of your penis, and tell you the actual situation without guessing. If you are a good candidate for an implant, I'd consider either skipping injections or just using them as a stopgap until you can get the surgery.

You don't have to suffer, but you should weigh all your options and choose the best one for you.

[Nico_from_belgium]

Implant or not is a personal decision.
I have made mine relatively quickly after problems began.
Every decision has it's own risks and downsides. There is no good or bad decision, there better and less better decisions (at a given moment a decision can be the righter and at another moment or condition the other can be better). So don't overthink, act as your feeling guides you. You seem to know the advantages and disadvantages of both choices (medication or implant).

If you know that you won't inject yourself for the rest of your life, you can take the decision for an implant but you don't need to make it tomorrow. You can prepare for it and the day that you are ready, you do it. Don't rush but don't let fear stop you if it's only matter of that...

I'm personally a great optimist and told myself that I had a problem and a permanent solution NOW and maybe that for my first revision there will be a great progress in process and technology. I skipped injections, not for me.

[tooyoung]

Hi Gadsi. True, 27 is young, on the other hand you described a situation that happens to many men, and over time it only gets worse, in any case you described a situation that requires change. I think that in the first stage if you want and are built for it (less spontaneous) you should try injections that in most cases work well, and if you don't like the injections. I think you should get an implant and not continue to suffer. That's my opinion. Good luck.

What about psychotherapy and pde5i before an implant ??

[tooyoung]

Making a decision to irreversibly destroy your healthy penis is horrible, but at the same time these are my prime sex years. I wish implant technology didn’t exist, or I was just fully impotent, so i didn’t have to make this impossible decision.

Gadslee,
your penis is not healthy and it will get worse.
However, first try pills and injections and if that doesn't work sufficiently or you don't like it, you have the option for an implant, which is a great choice!
All the best
Dan

On what basis it's not healthy?

[tooyoung]

Brother if you get proper nocturnal erections, this is probably a sign of a healthy penis.. maybe not but before implant, have you tried counselling??

Thank you...also I recommend sensate focus therapy along with sexual psychotherapy (try different counselors too)...if it even fails pills can buy him atleast 10+ years depending on how sympathetic drive is offsetted...but implanting a healthy penis before those attempts is a horrible idea.

[tooyoung]

I’m 27. I get proper nocturnal erections, random erections, but only erections for sex when i’m *extremely* aroused. Always been like this.

Sex always goes like this: tell her i’m shy (to prepare her for the ED), ask her to suck me off (very embarrassing with a limp dick), and then, about 50% of the time, i manage to come close to orgasm at which point i’m fully erect. I then stop her, and i can have good sex, but usually only in 1 position because when I switch i lose focus and my erection immediately dies.

I think my penis is physiologically not perfect, but okay. I have yet to try injections (trying to get PGE, which isn’t approved in my country), but feel an implant is what I truly need if i ever want to enjoy the experience of sex, including the anticipation, instead of only feeling good after the fact (“i did it!”).

Making a decision to irreversibly destroy your healthy penis is horrible, but at the same time these are my prime sex years. I wish implant technology didn’t exist, or I was just fully impotent, so i didn’t have to make this impossible decision.

Random erections are a solid sign for a psychogenic rather than an organic ed especially if your nocturnal erections are strong and don't fade easily upon moving...

Yes a psychogenic ed might be more severe than an organic one because sympathetic overdrive could be more erection killing than a venous leak or cloged arteries...but take care (and I know you do) there's a perfect precious warm spongy tissue underneath with complications-free decades ahead of you (considering life expectancy for a man is 70s)..

so what I recommend (any andrologist would too) is you get a penile doppler first...to rule out any organic cause and you see yourself how good your hemodynamics are...get a proper counseling by a sexual psychotherapist..I imagine he or she would clue you in sensate focus therapy which sometimes is very effective by the way..spared tons of young men from pills not just surgery...and if it fails you still have pde5i doses from minimum to maximum to try alongside....However if something comes up during your penile doppler (which isn't always accurate that's why i recommend having two at two different centers) or physical examination/symptomatology that's a different story with some overlap .

[Kodixx]

Gadsiee, I agree with the thought of getting diagnosed in the comment below. In addition, the world of "Men's Health" and sexual therapy in general, there many avenues to diagnosing and treating what's going on. I think implants are a great solution, but only when due diligence indicates that's the best option.

- Chuck

If it were me, I'd make an appointment with a high volume implant doctor and let them evaluate you. They can do a doppler scan to check blood flow in/out of your penis, and tell you the actual situation without guessing.

[Bambino09]

I’m 27. I get proper nocturnal erections, random erections, but only erections for sex when i’m *extremely* aroused. Always been like this.

Sex always goes like this: tell her i’m shy (to prepare her for the ED), ask her to suck me off (very embarrassing with a limp dick), and then, about 50% of the time, i manage to come close to orgasm at which point i’m fully erect. I then stop her, and i can have good sex, but usually only in 1 position because when I switch i lose focus and my erection immediately dies.

I think my penis is physiologically not perfect, but okay. I have yet to try injections (trying to get PGE, which isn’t approved in my country), but feel an implant is what I truly need if i ever want to enjoy the experience of sex, including the anticipation, instead of only feeling good after the fact (“i did it!”).

Making a decision to irreversibly destroy your healthy penis is horrible, but at the same time these are my prime sex years. I wish implant technology didn’t exist, or I was just fully impotent, so i didn’t have to make this impossible decision.

I have a mild venous fibula and I can have sex.
I don't have many nocturnal erections. If you have them, it means you're better off than me.
It wouldn't be a good idea for you to start with injections or implants; you're too young.

[Juerhareb]

I’m 27. I get proper nocturnal erections, random erections, but only erections for sex when i’m *extremely* aroused. Always been like this.

Sex always goes like this: tell her i’m shy (to prepare her for the ED), ask her to suck me off (very embarrassing with a limp dick), and then, about 50% of the time, i manage to come close to orgasm at which point i’m fully erect. I then stop her, and i can have good sex, but usually only in 1 position because when I switch i lose focus and my erection immediately dies.

I think my penis is physiologically not perfect, but okay. I have yet to try injections (trying to get PGE, which isn’t approved in my country), but feel an implant is what I truly need if i ever want to enjoy the experience of sex, including the anticipation, instead of only feeling good after the fact (“i did it!”).

Making a decision to irreversibly destroy your healthy penis is horrible, but at the same time these are my prime sex years. I wish implant technology didn’t exist, or I was just fully impotent, so i didn’t have to make this impossible decision.

I got implanted at 27 and It was the BEST decision of my Life. Although I was completely unable to have sex. At least I didnt try.

If pills dont work I would go for It, but first have a doppler test to make sure that its no psychological.

[Gadsiee]

Just had two rounds of amazing sex fueled by 100mg of viagra and pt141. I did have ED in the beginning again before finally getting hard, causing a great deal of stress again. Once i was hard I had absolutely no issues.

It’s so difficult. My dick is capable of being porn worthy with some drugs. But i will never be able to have spontaneous stress free sex without an implant