One year post implant and not doing well

[Redsf4040]

Earlier this month I had my one year anniversary for my implant surgery. I heard so many wonderful stories about the success of implants but that is not the case for me. I wanted to wait a full year to give my body time to heal.

A brief background. I am now 60 years old, I am in great shape physically as I regularly do both cardiovascular and weight training and when people find out my age they often remark that I look much younger. My problems with ED started about 11-12 years ago. Viagra worked for a long while but I had to gradually increase my dosage and eventually it stopped working. I tried the other ED drugs with no success. I tried the VED and it did next to nothing. I did the trimix and super trimix and the only thing I got from that was peyronie's disease due to injection site swelling.

I ended up having the implant earlier this month. My insurance is with Kaiser and I went with the high volume Urologist Dr. Kai Li. The surgery went great. No significant pain and no other complications.

I do not know to measure my length before surgery but I noticed pretty quick that erection size was smaller. With daily cycling for a year it did get bigger but not sure if it returned to pre surgery size. I always thought my erections were on the small size.

The implant is Boston Scientific, Accessry Ams 700 Penile Prosthesis; Rear Tip Extender; Ams 700 Lgx Ms Pump.

My sense is that after surgery the sensitivity/feeling of my penis was less than before surgery, I hoped with time that this would get better but it has not. I would not say it is numb but definitely has less feeling.

I have not been able to obtain ejaculation except for 2 times (one back in November and a 2nd in December). I hoped that it would get better but it has not. I can masturbate with a hard effort. But to be honest with you, I did not spend a lot of money, time and stress to achieve some half hearted results through masterbation (which also carriers a stigma for me for religious reasons). So I am viewing the surgery as a failure. I did have a post implant appointment with my surgeon at about 6 months and he recommended I take Amantadine 2 hours before attempting intercourse. I did that but it is not helping.

The surgeon is not available for any additional follow up appointment (video or in person. apparently a promotion has changed his schedule) so being with Kaiser the only way to communicate with him is through email.


See below email from the Surgeon that I received last week when I reported my results:

Thanks for the update. The implant solves the erection issue, but not the orgasm issue. The implant is just a mechanical device. The threshold to orgasm happens in the brain and has many inputs such as degree of stimulation (visual, touch, smell, etc) and other factors. The only trick I have in my book is the amantadine which I'm sorry is not working well.
I would recommend seeking a sex therapist in the community. This is not something we have at Kaiser.
Kai Li, MD
Department of Urology

I was hoping to get some peoples comments about my situation. Is the doctor correct that the Amantadine is the only option post-surgery option? Should I pursue therapy with someone with sex therapy experience? This is going to get really expensive as insurance will not cover this. I know results with counseling therapy are not assured. Should I accept that the implant was a failure for me? Any other advice?

[Old Guy]

Your doctor is right; the implant only controls the erection. Did you have sensitivity issues prior to getting the implant? At one year post the nerves should have healed by now.

[Redsf4040]

No sensitivity issues neither before the ED problems nor when using viagra. Maybe there are some psychological issues but something just does not feel right with the post implant erection. No big lifestyle changes or stresses in my life over past few years.

[LetoMan]

A lot of guys have orgasm issues post-implant. I think the reasons start with the feeling in your penis after surgery - it needs some time to heal. But your penis has changed… you probably had a fairly well-defined way of bringing yourself to orgasm prior to implant, and now that has changed, probably quite a bit.

I think what you need is practice. You are incredibly precise in how many times you orgasmed and when it was. And you said you don’t masturbate much. I think you might find that you can “re-wire” your brain for how to make yourself orgasm if you experiment and practice a bit.

I think that’s why your doc suggested a sex therapist. They can give you some ideas on how to explore and get over any blocks you might have. Give it a try, even if it’s just for a few sessions.