When to consider an implant (Long post)

The final frontier. Deciding when, if and how.
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When to consider an implant (Long post)

Postby cincinnatus1951 » Sat Apr 01, 2017 3:54 pm

April 1, 2017

Guys: I’ve been doing a lot of thinking about the “right” time to decide on an implant. A lot of discussion about pumps and injections as well as pills indicates that a lot of men get some initial positive results, but, after time, the effectiveness declines. With injections, many report scarring and penile distortion. What’s not nearly as clear is what percentage of injection and pill users continue to have erection difficulties. Human nature teaches that the satisfied folks rarely complain. There are plenty of examples of marginal effectiveness of pills and injections, what I can’t tell is how large the percentage is.
In my own case, I went for about six months with pumps and pills with marginal results. My prostate surgeon recommended injections, which I used for about a year with inconsistent results. ( I had a Robotic assisted nerve sparing prostatectomy in July, 2013.) Sometimes, very little, sometimes too long, and never knowing how long the erection would last. I did have good firmness and longitudinal stability when it worked. At my two year surgical follow up visit, the surgeon suggested we consider an implant. My initial reaction was “They are not doing that to me!!!” We continued to bumble along. If the injection did not work (rarely) or did not last long enough, we would resort to toys and tongue. We were both able to climax; but, it was certainly not as satisfying as traditional penetrative sex. We were also getting tired of the hassle with injections. We visited one urologist (sexual medicine) specialist and he recommended “combination therapy” of pills and injections. He also recommended we consider an implant, showed us the prosthesis, gave us web sites where we could watch the surgery. We also learned of FrankTalk through a prostate cancer support group.
As we learned more about the surgery, risks, aftercare, healing, etc. the thought of surgery became less scary. My wife initially discouraged it saying we can do OK with toys and tongue, is it worth the risk? We agonized and went to see another sexual medicine specialist. He did not try to sell us on an implant, however, said none of the other therapies were working for us. At that stage 21/2 years out of prostate surgery, the likelihood of spontaneous erections returning were essentially nil. After one particularly frustrating love making session, I said to the wife, “Heck with it “I’m signing up for the implant. She agreed. I had the implant in January 2016. We had a text book recovery and we both wish we had not wrung our hands for so long. The implant removes all the hassle and uncertainty of the lesser methods.
That brings me to the point of this note. I have advised a goodly number of people both in public and private posts not to consider an implant unless nothing else works. While I still believe that to be the case. For the above reasons, I would recommend seriously thinking about an implant as soon as frustration begins to build. Essentially, once pills become less effective and you have tweaked your formulation and injection dosage without satisfactory results, I have come to believe that further avoidance of an implant is not helpful. In talking with my docs, they too, believe couples get frustrated and just give up on sex. My cardiologist even offered he would like to see way more men go for implants. He says many patients report that they have just given up.
Bottom line is I do not know how to accelerate the process to an implant. We believe we waited six to nine months too long. I also recall my almost complete rejection of the first implant recommendation. For guys who are say over age 55, are frustrated and have systemic ED regardless of the cause, I would say “Go for it”.
Sorry for the long post. Just food for thought.
Age 79, Wife 77 Married 52yrs RPP Dr Brian Miles, Houston Methodist, July 2013. Used VED, pills, MUSE, and trimix with no or mixed results. 18cm Titan, one RTE by Dr Mohit Khera, Baylor, Houston, Jan 2016

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Re: When to consider an implant (Long post)

Postby shooter1000 » Sat Apr 01, 2017 4:27 pm

Well spoken !
Age 75 Implanted by Dr. Andrew Kramer 03/22/2017. AMS 700 LGX 18 CM with 2 Cm RTE for a total of 20 CM. Previously used injections over 1000 no scarring

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Re: When to consider an implant (Long post)

Postby ThePlumber1964 » Sat Apr 01, 2017 6:31 pm

Very well expressed! It is worth reading every word of it, and hopefully will serve as a discussion starting point among couples going through this difficult, yet important decision. Thanks!
54 years old, happily married for 30 years to a beautiful & outstanding lady. Onset ED at 49. Finally fixed on 11/08/2017 by the master Dr. Eid with a Titan XL 26, no RTEs! Previously had 3 AMS implants (LGX & CX), all botched.

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Re: When to consider an implant (Long post)

Postby dg_moore » Sat Apr 01, 2017 6:33 pm

I waited at least 5 years too long while fumbling around with pills, injections, etc. that did not work. I got the implant at long last, but it was too late. I had a stroke that ended my sex life. If I'd gotten the implant when I needed it I could at least have had a few more years of intimacy before it all came crashing down. If you need an implant, get it. Nothing good happens while you're waiting.
Dave, 77, Maryland - Implant (Titan) 2008 by Dr. Andrew Kramer (failed Sept 2020) - never used due to a stroke that, among other things, ended my sex life.
Life is not the way it's supposed to be, it's the way it is.

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Re: When to consider an implant (Long post)

Postby rahod1 » Sat Apr 01, 2017 9:31 pm

From someone who recently switched to injections from pills, I whole heartedly agree...100%. I used pills successfully for about 15 years..then the effects started to wane. I fiddled around with them for an additional 2-3 years and finally tried injections last year with great success. I now wish I had switched over much earlier. I plan on continuing doing the injections until such time they become problematic, then it's a no brainer for an implant. I don't plan on putting it off either. Time is of the essence..especially when you're 70 years old like me.

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Re: When to consider an implant (Long post)

Postby Xomanow » Sun Apr 02, 2017 12:43 am

"When To Consider An Implant"

When your dick stops working!.......and that's when I considered it (it took very little considering) and made my decision.......the pills were losing their effectiveness and so I went for the injections......after 3 times (the injections worked well but it was a production and spontaneity was lost) I thought to myself "fuck this"......get the implant and move on......implants were proven and I knew that I would be better off....so I picked one of the best (Dr. Eid) and never looked back......one of the best decisions I ever made in my life.....
Implanted Jan 4 2017 by Dr. Eid - 70 yo and single...ED gradually over 15 yrs...tired of pills, injections, cock rings....happy with my choice and results. Titan OTR - one 20cm cylinder - one 20cm+1 RTE...."got a rocket in my pocket"....

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Re: When to consider an implant (Long post)

Postby TANGERINE » Thu Apr 06, 2017 12:40 am

In a nutshell, "get the implant when other methods stop working for you". For me, I was on injections for 8 years, they were fine, but I am much happier now with the implant because of the spontaneity and 100% certainty of successful sex. Some guys skip the injections and go straight to implant (and that seems like a fine course as well....just not what I wanted to do)

I also had a "perfect really fast recovery" and was having sex two weeks after the implant was placed. With the ability to have sex "anytime, anyplace, for a long time" has given me confidence such that I regained my swagger and zest for life. Before implant, I was depressed once the injections stopped working. It was really bothersome to see any sexy scenes in a movie or to endure a viagra or cialis commercial during the ball game -- not being part of the group that can enjoy sex meant that I had lost a really important part of my identity.

You will see some comments on this board about the "side benefits of an implant that extend beyond the bedroom." Those benefits are quite true for me.

So, I am super happy that I got the implant; and super happy how Dr Eid provided me with a "fairy tale perfect" great result and recovery.

Do not wait, Nothing good happens while you wait.
"Strive hard to find the best implant surgeon -- surgical experience really matters"
(55 yo with Titan 22cm implant Feb 2017 by Dr Eid) Great experience -- I'm super pleased with my length and girth and implant performance.

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Re: When to consider an implant (Long post)

Postby David_R » Thu Apr 06, 2017 8:30 am

TANGERINE wrote:not being part of the group that can enjoy sex meant that I had lost a really important part of my identity.

There's a reason why one of the euphemisms for penis is "manhood."

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Re: When to consider an implant (Long post)

Postby JDavid » Thu Apr 06, 2017 9:04 am

I will just add that quite a number of guys here have posted that, due to ED, their spouse gave up on sex and is no longer interested, even after an implant. ED is frequently destructive to one's sense of self, to the spouse's sense of self, to intimacy and communication, and the routines that sustain partnerships. I believe that, in general, implants should be done sooner.
I am sixty-six years of age and dealing with gradually worsening ED for twenty years. At sixty-three I wanted something that worked reliably. I got an AMS 700 LGX implant in 6/25/13. I am entirely pleased with the outcome. My surgeon was Dr. Karpman.

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Re: When to consider an implant (Long post)

Postby AVL_UK » Tue Apr 18, 2017 5:39 am

What if you're able to get your corpora hard but not your glans?

With a lot of pde5s and a relaxed environment I can get hard shaft, but still soft glans. Glans is unaffected, possibly even worsened by an implant. Corpora would be irreversibly damaged by the surgery, but at least they would be 100% reliably hard without pde5s and any stress.
31 / VL

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