Early 30s considering implant - MANY questions

[ElbowRoom]

Hey awf_1993… it sounds like you’re going through the same progression many of us have traveled before.

It’s certainly fine to try pumps and injections, but IMO there are significant downsides to both, particularly if you’re a young single man. Both are “spontaneity killers” in that they take some prep work before each use. I ended up planning sex when I was on injections for a long time, which kind of ruins some of the fun. In my case injections still worked pretty well, but I wanted the spontaneity back.

Also injections can cause scarring and fibrosis in the corporal bodies, which can make them less effective over time and cause curvature of the penis (Peyronie’s Disease). I found pumps to take multiple uses, so you’d pump up, fuck a bit, get soft, stop to pump again, rinse and repeat. Not a great way to build excitement.

The implant has been a great solution for me, it’s on demand and produces extremely hard erections if desired. It only takes a few seconds to inflate, and women would never know it’s there unless you tell them.

But keep in mind there are downsides to implants too. You can have complications, infection, etc, that can make it frustrating. At your young age you’d probably have several revisions to replace the device over your life, they typically last 8-10 years, but yours might last 20 or it might last two, there is no way to know. Either way you are looking at several surgeries over your lifetime, with a slight increase in infection risk each time.

The implant is fantastic if you want to have amazing sex as much as you want, but in the rare case the surgery or recovery goes sideways, it can be quite traumatic.

[Tokyo_123]

My urologist had an interesting approach to this question. He said there really isn’t a point to testing for venous leak, because it doesn’t change the treatment plan. The test involves inducing an erection with an injection and b serving with Doppler the rate at which blood then escapes your corpora. My doc essentially said I had a very high probability of venous leak, based on my description of a lifetime ability to get an erection under certain circumstances, but extreme difficulty in maintaining it.

Venous leak is essentially a failure in preventing blood from leaving your cavernosa once it gets in. It hinders getting an erection in the first place, but also in keeping it. For those that have it, it can often manifest as something that looks psychological, because you are capable of getting erections, especially when relaxed, such as when masturbating by yourself. And as a result it is deeply intertwined with our history of blaming ED on psychological issues.

Let’s say a Doppler test confirms you have venous leak. So what? It doesn’t change the treatment plan, which is pills first line, injections second, and implant if neither work or produce a satisfactory sex life.

Let’s say it doesn’t confirm you have venous leak. Now what? It could be your insurance doesn’t cover the implant, claiming it’s psychological. Or the patient gets confused and blames their psychology. Or it could even be a false negative. Or whatever.

The point is: the treatment plan is for erectile dysfunction, not for venous leak. It doesn’t really matter *why* you have ED, what matters is how you solve it.

Venous leak can come about because of an injury. So a Doppler test may make sense if you are trying to rule out a sudden onset of ED for psychological reasons. But if your ED is chronic and not responding to pills, it’s not psychological.

My advice: if your urologist recommends a Doppler test, great. But I would focus more on the solution for your ED rather than the reason for it, because the reason doesn’t matter for your treatment.

Strongly disagree. The reason why so many men have erection difficulties is due to a weakened heart. This could be the canary in the coalmine, so to speak, and could be indicator of future heart attack. I want to know what is wrong with myself, in case there are other issues that are related.

Personally, I wanted to know why I had ED issues. It also gave me closure. Also, as I recall the test was only $200, took 30 minutes or so. After tested, my doctor told me I had the near worst case of Veanous Leakage he has ever seen. My issues were not physical, not emotional, and I am thrilled to know it's cause.