doctors look at the mental health of the patient before performing the implant?

[España1980]

I say this because there are many people and I include myself
among them who are not psychologically prepared to receive an implant. So I think or wonder if doctors consider this fundamental issue. I just read a story of a young man who is going to get the implant at 27 years old and having weak erections. So I wonder if these conditions are studied by surgeons to refuse to operate on someone so young and who can still spend more chances to get erections in a natural way in addition to having to undergo a multitude of revisions and each one of them implies a higher percentage of infection up to 20 percent, and due to his age he will have to go through several more. and I am also going to include myself,; if I went to a doctor tomorrow to perform the implant,; when that doctor sees my state of nervousness, or sees that I might regret it the moment I wake up in the operating room after the operation. In short, this psychological issue is an important factor for doctors, or you simply tell him that you have exhausted all the possibilities and that you want an implant and nothing else, and then they put it on you.
I actually really want to do it, but I think coherently too much and I back off. and many times I see reasoning such as: well, you put it on and if it lasts 5 years, then you put another one on. And it is NOT logical, I used to say those phrases to my mother when I went to a party and came back 3 days later: mom, and if I die next year... well, I've already enjoyed this mom, and that they take away what enjoyed. but the latter was the reasoning of a teenager. I don't know if anyone will understand what I mean.

[wolfpacker]

No doctor wants to take on a "problem patient" where there will be no good outcome and only complaints no matter what. There is at least 1 forum member on here who has been "fired" by his doctor for personality reasons

[España1980]

and do you think they also warn the patient that the review has a 20 percent infection rate?
I mean 1 out of 5 people gets infected in the revision.
With this I want to say and also add that neither the industry nor I think it is convenient for surgeons to manufacture prostheses that will last a lifetime. Look when light was invented, the first light bulbs lasted a lifetime. the first refrigerators washing machines, telephones of the houses lasted a lifetime. until they realized that that didn't make money, money comes from making things that have an average duration of between 5 and 10 years.
I find it abusive and shameful that in the year 2022 the prostheses that exist are made with simple materials and that they last that average of at most 10 years with the consequent health risk for the patient who has to undergo the revision. Because? Well, they don't do it with a longer half-life because it doesn't suit one or the other, but it does suit the patient. in the year 2022 where there are many robotic things, we go to other planets, they launch satellites for life, very delicate eye operations and there are no better materials for a prosthesis with saline solution, two cylinders, and a pump?

[Fourtytwo00]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5715181/

Less than 5% of eligible candidate undergo IPP procedure, their averarage age is 61 and they have multiple issues. As you could understand it's not a big market. Restoring sexual activities for 15-20 years is preatty enough fot the majority of patients. I never met someone who got his implant in his 40ies twenty years ago here. Eventually every new improvement against ED (a better pill, injection or whatever) potentially lower demand for penile implants. Outside of the US there is also a degree of competition between malleable and IPPs. Inside the US the market is a dupoly. That's the reason why you're not going to see big bets from manifacturers soon imho. It'reasonable to expect improvements about safety and quality driven by pratictioneers (surgeons) and some in the malleable arena because of raising demand from middle income countries. Many incremental gains are likely. A paradigm shift would need a break through innovation in a process that for many aspects is the same of 40 years ago.

[España1980]

I don't understand what you mean by all this. So if the average age is 61 years old because in this forum there are much younger people like 32 years old,40 47. My case is that I have fibrosis in the penis and I think that any sexual activity causes an injury. an injection would already kill my penis. and the pills have an effect but my penense is deforming too much due to that corporal fibrosis. Right now I am in no man's territory, because I am 45 years old and I think I am very young because of the check-ups and at the same time I cannot use the pills or especially the injections because it would cause more trauma. what would you advise?

[Fourtytwo00]

I don't understand what you mean by all this. So if the average age is 61 years old because in this forum there are much younger people like 32 years old,40 47. My case is that I have fibrosis in the penis and I think that any sexual activity causes an injury. an injection would already kill my penis. and the pills have an effect but my penense is deforming too much due to that corporal fibrosis. Right now I am in no man's territory, because I am 45 years old and I think I am very young because of the check-ups and at the same time I cannot use the pills or especially the injections because it would cause more trauma. what would you advise?

It's not me the one who wrote that it's shameful and abusive IPP expected life. I just gave you a framework and a rational explanation of why this is the state of the art. Demand shapes the market and it's dominated by >50yo customers.

Revisions are riskier basically because it seems to me it requires more time and there is more exposition to air, agents, etc. Recovery could be easier but infection risk is higher. Btw yes infection risk is correlated with some factors. Ex.: patients with diabetes risk more.

Why can't you try pills?

[Fourtytwo00]

yes, thats whats worries me. the revisions are not that safe. Im not sure why they have higher rates of infections and post op complications, since the only thing they do is remove the old device and put a new one.

With that worry in mind, thats why i think about malleable. I dont want to go for too many revisions. Talk to your doctor.

As long as revision risk is your main concern, yes malleable are reliable. Just extrusion risk is higher and it's why they can't give you too girth.

[MK1965]

Espana1980,
I don’t know where you find “worst case scenario” research which is not even correct. You are definitely not for implant because you are so skeptical about it. That is why you search doctor you can trust and build the relationship with your doc on that trust.
You are just bringing so much negativity to your own tread.
Many urologists mentioned on this forum have good intent to make any impatiens happy and restore your functioning to the best possible. Even not good outcomes are not premeditated or planned.
Trust yourself ( what you want and need) trust your chosen urologist and start from that point.
For many of us here, implants were our only option ( not best option but only option ) to restore lost function and get involved in sex again to fool feeling our physical emotional and social needs.
Take it or live it; tertium non datur ( no third option).
Good luck man.
MK

[España1980]

I don't understand what you mean by all this. So if the average age is 61 years old because in this forum there are much younger people like 32 years old,40 47. My case is that I have fibrosis in the penis and I think that any sexual activity causes an injury. an injection would already kill my penis. and the pills have an effect but my penense is deforming too much due to that corporal fibrosis. Right now I am in no man's territory, because I am 45 years old and I think I am very young because of the check-ups and at the same time I cannot use the pills or especially the injections because it would cause more trauma. what would you advise?

It's not me the one who wrote that it's shameful and abusive IPP expected life. I just gave you a framework and a rational explanation of why this is the state of the art. Demand shapes the market and it's dominated by >50yo customers.

Revisions are riskier basically because it seems to me it requires more time and there is more exposition to air, agents, etc. Recovery could be easier but infection risk is higher. Btw yes infection risk is correlated with some factors. Ex.: patients with diabetes risk more.

Why can't you try pills?

right now nothing suits me, I hurt myself in a sexual relationship, I got a nodule of fibrosis in the corpus cavernosum in January, from then on my penis began to bend upwards, I took 5 mg of cialis every night, and more treatments, it seemed that things were getting better but I got a new injury from an erection at night or from a simple masturbation, this time near the glans but it is related to the other because I notice a tight thread between the two . In short, I'm sunk and I only think of solutions, and I just analyze and analyze and read and read, I've been to a lot of urologists but there are very few specialists in this, and the ones that do exist are typical Peyronie's lesions in the tunic and my lesion is not in the coat and they don't know if it's peyronie's or not, or how to treat it or anything. what if I am sure that right now any sexual activity injures my corpus cavernosum. It is difficult to explain, I don't know if you understand me. Right now I can't even masturbate and I don't know if I ever will. It is already physically and psychologically the problem. to the answer of the pills why not? Well, because an erection that is too hard now would produce more injury, in addition to having a distal hourglass that influences me a lot psychologically when I see it. Anyway, physically I can't force myself and psychologically I'm very bad

[España1980]

Espana1980,
I don’t know where you find “worst case scenario” research which is not even correct. You are definitely not for implant because you are so skeptical about it. That is why you search doctor you can trust and build the relationship with your doc on that trust.
You are just bringing so much negativity to your own tread.
Many urologists mentioned on this forum have good intent to make any impatiens happy and restore your functioning to the best possible. Even not good outcomes are not premeditated or planned.
Trust yourself ( what you want and need) trust your chosen urologist and start from that point.
For many of us here, implants were our only option ( not best option but only option ) to restore lost function and get involved in sex again to fool feeling our physical emotional and social needs.
Take it or live it; tertium non datur ( no third option).
Good luck man.
MK

If I am in favor of the implant, of course I am, I only analyzed many questions of pros and cons, and things caught my attention that in the year 2022 I see them behind schedule. Regarding the rest of the relationship with the urologist, you are right. a question friend: I am seeing that in 2018 you had an implant and in 2020 a revision, why did this happen? how did it go well? I would like to know more about you. thank you and delighte