Young patient considering IPP – confusion about ejaculation and sensation after surgery

[Husseinmohamud]

Hello everyone,

I’m in my early 20s and currently considering a penile implant (IPP). My situation is mainly related to psychological issues rather than physical disease, and I do not have conditions like diabetes or prior prostate surgery.

I’ve been reading many posts here, and I feel confused because I see different experiences:

- Some men say their ejaculation and sensation are normal after surgery
- Others say ejaculation becomes delayed or difficult, and sensation changes

From surgeons like , I often hear:

«“If you could ejaculate before, you will ejaculate after — nothing changes.”»

But forum experiences seem mixed, so I would really appreciate honest clarification.

My questions:

1. Is the change in ejaculation or sensation only temporary (first months after surgery)?
Does it improve over time and return to normal?

2. Are negative experiences (delayed ejaculation, reduced sensation) mostly related to other conditions?
For example:

- Prostate surgery (prostatectomy)
- Diabetes
- Older age

3. Since most implant patients are older,
is it different for younger, healthy men with no underlying disease?

4. For those who had normal ejaculation before surgery:

- Did your orgasm feel the same, better, or worse?
- Did your ejaculation timing change long-term?
- Did your sensation is change?

5. Do psychological factors (anxiety, overthinking) after surgery affect ejaculation control?

---

I am trying to make a serious and informed decision, so I really value real experiences from patients.

Thank you very much for your help.

[LGXDownunder]

Hi Husseinmohamud,
If you are otherwise physically healthy, at your very young age I would expect that you should be fine and able to ejaculate normally, but some guys do report a reduced flow of semen. The comments you read on Franktalk are not necessarily representative of the entire implant population. A lot of guys come here looking for answers to existing problems. Most probably never come here at all.
You have asked a wide range of questions and no single individual can possibly answer all of them from direct experience.
I'll try and answer as best I can.

1. Is the change in ejaculation or sensation only temporary (first months after surgery)?
Does it improve over time and return to normal?

I've been unable to ejaculate since prostatectomy in 2022. It is standard to remove the seminal vesicles with the prostate gland.
Sensation is fine. Although I can no longer cum I do orgasm 100% of the time post implant. It took months to get to that point though.
Soreness and discomfort initially made climaxing difficult when I started having sex again at 8 weeks post op.
I also had some numbness on the underside of the penis near the penoscrotal incision. That has gradually faded and no longer an issue.

2. Are negative experiences (delayed ejaculation, reduced sensation) mostly related to other conditions?
For example:

- Prostate surgery (prostatectomy)
- Diabetes
- Older age

I would say not necessarily. I don't have diabetes and could still orgasm post prostatectomy, just couldn't get hard. Age hasn't significantly affected my sexual performance. I'm still very active and in reasonable shape but aerobically a little less fit these days. Sometimes I need a short breather or just to slow down briefly during very long PIV sessions with a lot of sustained thrusting. Post implant anyone can get DE or reduced sensation, including younger guys, but they are usually temporary and disappear or improve over time.

3. Since most implant patients are older,
is it different for younger, healthy men with no underlying disease?

I'll let the younger guys answer, but my observation on here is that younger healthy men often recover more quickly.

4. For those who had normal ejaculation before surgery:

- Did your orgasm feel the same, better, or worse?
- Did your ejaculation timing change long-term?
- Did your sensation is change?

No cum but I'll substitute climax as it's the mechanism that triggers ejaculation anyway. My orgasms are very intense and I believe as good or better better than pre ED. I'm more relaxed now knowing that I have complete control over how hard and how long I want to stay erect. So now I deliberately delay orgasm during sex for the best experience. Never had that level of control before.

5. Do psychological factors (anxiety, overthinking) after surgery affect ejaculation control?

I think all of those things can apply whether or not you have ED or an implant.
When younger and without ED I leaned towards premature ejaculation but could usually recharge quickly and go again.
My previous statement applies as I now have total control and my sexual confidence is next level post implant/recovery.

[LetoMan]

Excellent answer from LGX!

I will add just two things.

First, based on what I read here (there is no scientific evidence I am aware of), there are definitely a number of guys that have problems with ejaculation following surgery, particularly from PIV sex alone. For many, that resolves itself over some months, or in some cases a year or more. But for some it doesn’t, although that seems to be associated with older age. There is definitely an adjustment period that many or all guys go through as their dick gets used to their new equipment. Your doctors are mostly right, though: if you can orgasm before you can orgasm after. But I think that neglects that there will be some adjustments made by most/all guys, and that some have complications that are somewhat serious.

The second thing is this. If your decision to get an implant is based on a fine understanding of how good your post surgery PIV orgasms will be, you may be missing something. The reason you should get an implant is because you do not currently have PIV orgasms because of your ED, or because your sex life is completely unsatisfactory as a result of side effects and complications from pills or needles.

In other words, getting an implant is a major surgery and a risk. It takes many months to recover from it, and the outcome is uncertain. The great majority of men are satisfied with the outcome, and some are even ecstatic about it. That goes for young guys as well. But that is largely because for most/all of them what they left behind was terrible. Meaning, they really were getting no satisfaction from their sex life at all, and so they are ok with the trade offs and risks that come with getting implanted.

When I see guys get highly concerned about replicating an ideal scenario for themselves, my concern is that they are “optimizing” by getting an implant rather than solving an otherwise unsolvable problem.

So I would flip some of your questions around for you. Are you currently having successful and satisfactory PIV orgasms? If so, then you may not want to get an implant.

If not, then an implant could be a solution for that. But it doesn’t come without trade offs or risks.

Be well,
Leto