Should I get an implant?

[Jimakos]

I am also interesting to read news about psychological reasons of ed.. recently i had a conversation with an ourologist which told me if ed continue exists although there are only psychological problems science of ourology suggest after pills etc implants

[UpNorth]

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macoza; From what you have been reading on this forum and gaining advice for you to make the decision to or not to get a bionic dick.
What do you think?
It won’t turn every woman Asian.
Natural boners will be done, sure we have good feeling dicks, some feelings are natural and some are not.
And they are ready whenever we want them to be.
If you start the proceedings now to get one that gives you plenty of time to make a yes/no decision. So start.
Not much else I can say as I’m only four months post-op other than I wish I would have done this over 20 years ago.

[fucked0ne]

I’m pretty sure some guys here have gotten implants for psychogenic ED.

I think we are learning that persistent ED where the patient can *sometimes* get an erection is largely correlated with a physical deficiency, venous leakage. Guys with venous leakage can often get and keep erections when under little to no stress, lying on their backs, no partner, looking at porn, etc. but the venous leakage makes it easy to lose that erection, and the effect of that compounds psychologically into what we have historically called “performance anxiety.” I’m not sure there is actually purely psychogenic persistent ED, I suspect it is always hand in hand with some sort of physical cause.

Regardless, whether it is always the case or often the case that “psychogenic” ED has a contributing physical cause, the bottom line is that it is not useful to use the evidence of whether one can get an erection *under certain circumstances* as an inference for whether the cause of the ED is “all in your head.” Instead, the relevant question should simply be whether the intervention is working to give the patient the desired result (a satisfactory sex life).

I’m not a doctor or a sex therapist. But I think if the OP is not getting satisfactory erections from pills and injections, that suggests that therapy is not going to work. When pills first came out, the docs used to say that you WILL get an erection as long as you are excited. If he is still not getting satisfactory erections with those interventions, I doubt it’s a psychological issue.

On the other hand, it could be that he really is not turned on by his girlfriend, so even with medication he is not getting an erection. Maybe therapy could help with that, but probably not.

Either way, seeing a therapist can’t hurt, and it sounds like Macoza has a number of things he might want to discuss with a therapist, so I can get behind that advice!

I just wanted to point out that being able to sometimes get an erection is no longer seen as evidence that the cause is psychological. Our modern understanding of ED is that for persistent ED the psychological effects accompany the physical causes. There may be purely psychogenic ED, but most of the guys we once described as having that actually have venous leakage.

This is a great post, but what about the fact he still gets morning wood? Diagnostically, wouldn’t that alone cancel out a venous leak?

[LetoMan]

This is a great post, but what about the fact he still gets morning wood? Diagnostically, wouldn’t that alone cancel out a venous leak?

I’m not a doctor, and can’t tell you what the qualification level is for “diagnosis”, but as I understand it based on my reading about it and conversations with doctors, no, morning wood is not evidence of the absence of a problem with venous leak. Venous leak is when blood is flowing into the corpus cavernosa, but for some reason leaks out. Men with venous leak can often get erections but have trouble maintaining them. Moreover, the ability to maintain the erection is largely tied to being in a relaxed state. So being asleep is a particularly good time to get an erection from that perspective!

My doc put it like this: we really don’t know what causes most venous leakage, and the treatment is the same regardless of cause: the same old escalation of pills, pumps, shots and implants. So a “diagnosis” of venous leakage is particularly useless, because it doesn’t change the treatment.

But the characteristic of venous leakage compared to a lot of other problems is that venous leakage sufferers *can* get erections. Other problems mean you are not getting any blood in the first place.

Note that the psychological “treatment” of ED is just relaxation techniques. When you have ocasional ED, a relaxation technique might help you. But it’s not going to help you for very long.

Pills didn’t come out until I was in my twenties. So I learned before that to try to make sex as relaxing as possible for me, and that would ocassionally work. But it wasn’t a solution AT ALL. And I got morning wood and spontaneous erections too, definitely from porn. But as years/decades went by, there was deterioration in my ability to get an erection across the board.