Tests to do before deciding to commit to an implant?

[JH1982]

Hello guys i hope that you will be able to help me.

I'm a 40 years old male and i started experiencing erectile disfunction issues recently.

To the point that, i really struggle both with sex and masturbation.

It is important to say that, while morning erections don't seem to be the same anymore at night if i wake up i can still wake up with a boner. Maybe not 100% but let's say a 90 that i can bring to a 95% if i play with it.

It is important to say that i have been with hundreds of casual partner so my stress during sex is close to zero.

I'm not saying these things to brag but just to explain my situation fully and to explain the fact that, while i might try, i really doubt that psychotherapy will fix my issue.

The first thing that i did was to cheek my hormones and they are alright.

Then i looked into drugs. Unfortunately i had 2 retinal detachments and i have orthostatic hypotension. This means that i'm not a candidate for oral medications, creams, and most likely not even trimix.

This seem to lead me to one choice only: the implant.

Given that it is an enormous commitment i am thinking to do at least some tests to figure out what the problem is.

I have been to an andrologist. He carried the physical exam and i was fine.

I suggested blood tests to rule out cardiovascular disease. I am fine.

Given that i cannot take drugs he suggested shock waves. I read here that they are a scam.

He suggested that the injection test was not going to give us any valuable information.

My understanding is that the only tests that you can do to try and assess the situation better are_

a. nocturnal erection test
b. injection test
c. ultrasound

I have just been starting this journey so i would like to get the opinion of more experienced men on what i should do.

The implant seems a big commitment therefore it seems reasonable to do the tests first. Even considering that i don't trust the specialist that i saw. I think that he wasn't very interested in helping me but that his main goal was to squeeze money out of me with the shockwaves.

Can you tell me if you did those tests and if they helped you in any way? and can you tell me how much did they cost for you? My understanding is that most men on this forum are American. I live in Europe but i think that the prices for the tests will be similar or, at least, i will get a rough idea.

Thanks in advance to whoever will help me

[Floridaspeedo]

Though I am in the U.S. I did non of those tests. You need to visit a urologist and let them decide.

I visited with two surgeons who both did implants. Both ordered a venous leak test and one ordered a scope down my urethra.

My venous leak test showed blood going into my penis but moving out just as fast so there was no question about moving to an implant.

[wolfpacker]

If you aren't able to try oral meds or injections, and your hormones are in check and you live a generally healthy lifestyle etc, I don't personally think any of the tests are worth doing. What if the doc performs these erection tests and says everything came back totally normal? That doesn't change the fact that you can't get an erection to have sex with.

[Flounder]

I agree with Wolfpacker. I did several consultations before deciding on going forward with my implant. The majority of Dr’s basically said there is no point in doing all the tests because the treatment path is the same regardless of cause. However most insurances, that will cover an implant, require proof that the cause of ED is organic. So the tests may be necessary to get over that hurdle if it applies. And I suppose there is some comfort in knowing there is an organic reason for our ED and not just in our headspace.

I can’t speak for shockwave. In my case, pills and injections became ineffective and none of the doctors mentioned shockwave as a viable alternative to the implant.

[JH1982]

Thanks guys. Yes, what you are saying makes sense.

Whatever is the issue causing my ED knowing it won't change the fact that i have ED.

The only reason why i am kind of tempted to do the tests is the fact that, if the problem was psychological MAYBE would make sense trying therapy before committing to an implant that requires surgery every 10 years. Praying god that it doesn't get broken.

Have you ever tried the therapy's route? I am not a believer at all if i have to be honest in therapy but, my understanding is that, when that choice is done, you cannot go back from the implant.

So I am kind of entertaining the thought of doing therapy.

I guess that if the tests told me that the issue is physical i would avoid wasting time and money in therapy

[Flounder]

Thanks guys. Yes, what you are saying makes sense…….
…….. I guess that if the tests told me that the issue is physical i would avoid wasting time and money in therapy

Understanding your situation better, I’m going to say yes, there is tremendous value in doing the tests under your circumstances. You need to sort out the root cause of your ED first so you choose the correct pathway for treatment.

[Gt1956]

If you think that therapy might help. Go ahead & give it a try for a few months. I don't see how trying it would hurt you & an implant is still an option. At least it would remove a nagging doubt in the back of your mind. But if you're about 40? Early onset ED is not that uncommon as we see members report when theirs started.
Just my opinion.

[Lost Sheep]

If you still get nocturnal erections (morning wood, etc) it seems to me that when your conscious mind is the souce of your ED. When your mind wakes up, your erection goes to sleep.

This suggests to me that hypnotherapy may be a quicker way to determine if 1) there is or is not a physical cause and 2) if couselling might help.

Under a hypnotherapist, your conscious mind is bypassed even while you are awake and able to interact with your surroundings.

Hypnotherapy is thought by some to be invalid, but by others as useful, so you must make your own decision about trying it. From your description that you wake up with a good erection which goes away as you try to maintain it suggests to me some mental involvement.

When you do wake with an erection, can you recall if you were dreaming about something? Do you ever get spontaneous erections when you let your mind wander? Is there a higher level of chronic stress in your life than a couple years ago?

[JH1982]

Hi guys and thank for your answers, i really appreciate them

To be honest i struggle to think that the issue is psychological, whatever psychological means.

The reason being is that while
YES i am under stress as recently I had two retinal detachments and, while i'm very far from that scenario, this condition is potentially blinding for a few people
NO i still don't think (trying to be honest with myself -as much as i can) that my issue is stress related as, during my life i learned to deal with insane amount of stress

The reason why i'm considering the psychilogical route is the fact that the implants seems such a massive commitment.

If i could i would use drugs, unfortunately i can't,

That's why i'm looking into:
- physical tests
- psychoterapy

with my mindset if i was completely healthy i would be already taking Viagra.

Can the problem be my conscious mind?

Hard to say.

Yes i do have boners at night (at times i notice them when i wake up but i cannot recollect what i was dreaming about) but for sure the boners in the morning are much rarer and i would say even less strong.

Long story short...
- while still somewhat and sometimes alive
- most of the times (and especially when i want) my dick is close to be a corpse

And if the issue is not psychological i really struggle to see it improving while getting holder.

Speaking about hipnoterapy:
- if it works how many sessions would be needed?
- how much money do you think i should invest?
- where do i find a specialist that has experience with this kind of cases? It seems beyond the average hipnoterapist's skillset

And if hipnoterapy led to psychoterapy:
- do you have any idea of how long it could take to fix this?

My retinal conditions taught me that life is short so one of my fears is to:
- wasting a lot of money
- and especially a lot of time (maybe years)

to discover that i still need the implant and that i could have used those money for the surgeon.

So it is really a difficult position to be in. More information would help to make the right decision

[Lost Sheep]

(edited for brevity and focus)

Hi guys and thank for your answers, i really appreciate them

Speaking about hipnoterapy:
- if it works how many sessions would be needed?
- how much money do you think i should invest?
- where do i find a specialist that has experience with this kind of cases? It seems beyond the average hipnoterapist's skillset

And if hipnoterapy led to psychoterapy:
- do you have any idea of how long it could take to fix this?

My retinal conditions taught me that life is short so one of my fears is to:
- wasting a lot of money
- and especially a lot of time (maybe years)

to discover that i still need the implant and that i could have used those money for the surgeon.

So it is really a difficult position to be in. More information would help to make the right decision

Hypnotherapy could be as inexenpensive as a self-help book and the time and effort to put the concepts and techniques of self-hypnosis into practice. The simplest and powerfully telling example of this type of hypnosis is hypnotic anesthesia. A person thinks so hard on one subject thaht they do not even feel a dentist drilling on a tooth. Simpler example is when a child is playing a game or with friends so intently that he/she does not even notice hunger or thirst. The mind is capable of blocking physical feelings like that.

More complex forms of hypnosis (also able to be done as self-hypnosis) is the ost-hypnotic suggestion. This is where (usually a therapist) suggests to you while you are in a relaxed state (also known as hypnotic spell in an earlier era) that, upon awakenting your desire to smoke cigarettes or be unable to get an erection is gone. This is known as post-hypnotic suggestion.

How long it takes to achieve temporary relief or permanent relief with post-hypnotic suggestion varies widely.

Finding a hypnotherapist or psychological therapist who has hypnothereapy as ONE of his/her treatment techniques might be difficult. Perhaps more difficult than finding a urological surgeon to do an implant properly. But if it works for you, I imagine you will be happier for it.

I recommend you do some research on hypnotherapy, particularly the techiques involved in "self directed hypnotherapy" to start with. Be skeptical of people trying to sell you unreasonably optomistic promises. Here is a link to an innteresting article

https://www.mindsethealth.com/matter/self-hypnosis

Once you understand the possibilities (and the lmitations) of hypnosis, you will be in a fair position to evaluate it it might be applicable to you.

Good luck.