First of all, I haven't read your whole story in detail, so sorry if I don't get all the facts right. Also haven't read all replies here in detail, just skimmed through.
But I wanted to raise a different view here.
Here is what I understand from your situation:
Cialis works great, 98% success rate.
2/3 tests revealed NO venous leak, 1/3 revealed mild VL.
Then, I'd really say don't get implanted. Use the pills. You know they work. Just work on your anxiety. And why the anxiety when the pills work 98%?
I lived for 20 years prior to implant with a success rate of 70% on the pills. If I would have been 98% on Cialis, there is no FUCKING WAY I would have got implanted. 98% is equal to any normal guy. And a pill, especially Cialis which has a longer active time frame than Viagra, is no big deal. Actually it is no deal at all. You can take it anytime from a few hours before up till 15 minutes before. And if you don't know when sex will happen, take half of it when you expect it will happen within 2 hours, then the other half when you know it's on. Taking a Cialis is nothing.
If I was depending on a vacuum pump or an injection, I would have gone for the implant as a preferred solution. But compared to a 98% success rate with a pill, an implant is a poor choice.
Anxiety and psychological issues is one thing, but look at the facts.
An implant won't improve the reality, the hard facts of your sexual performance in the bigger picture. An implant fixes your erection (but you already do get hard 98% of the time!) but comes with other downsides. Risk at surgery. Need for revisions. Risk for half-assed outcome due to half-assed performance by the doc, awkwardness of pumping, loss of 100% spontaneousness. A pill has one tiny little downside - you've got to pop it 20-120 minutes before sex. That's it.
I would say there is no guarantee you will fix your emotional issues with an implant. If you are having such huge issues now, even though you know your Cialis will work 98% of the time, I am not sure at all an implant will fix that. If you do have some issues, they might still be there after the implant. Just related to other issues. If you're in a dark place now, it is not because you cannot have sex. Because you can. In 98% of the time. Which is great. You're a stallion from a physical point of view. Just by swallowing a tiny little pill which nobody will ever notice.
Just as you hate masturbating today with a semi-erection, you might hate the feeling of needing to pump up your prosthesis at such young age just to masturbate.
And if you are scared shitless now to have sex because maybe you are in for those 2% occasions when the pill does't work, with an implant you might avoid sex because of fear for the girl detecting it, or just for your own fear of feeling like a freak for being implanted.
I don't say this is how men normally feel about their implant - I don't feel that way - but I am saying that if you are in a dark place mentally, the implant is no guaranteed fix to that problem. There is plenty of things with an implant and being implanted to worry about as well if that's the mental place one is in.
Don't take this as advice. Don't take anything written here as advice. We don't know your situation in detail, we are neither doctors nor shrinks. But take all you read here as input, use it or disregard it in your process of coming to a decision which is right for you. But my point in this debate is mainly, to summarise:
* Hey, for fuck's sake, you have a 98% success rate with Cialis! I would swap with you any time!!!
* Don't take this decision now, in your current state of mind. If you are depressed (or whatever label we should put on it), then you could easily find yourself feeling bad about having an implant at 34 as well. The guarantee is there for getting a hard dick (which you already have a 98% guarantee of today...), but nothing else. There is plenty of potential reasons to feel bad about an implant as well if one is not in a peaceful state of mind.
* Take the helicopter view. You want to get implanted to be able to have sex. But you can already!!! 98% on Cialis. What will the implant really add? You will swap taking a tiny little pill a few times per week for having a prosthesis in your dick for the rest of your life. Don't do it for any other reason than not being able to have sex. Even if you need to pop a pill to masturbate, well do it then. If pills work 98%, an implant is not the obvious solution for a 34 year old.
Finally: An implant (with a good surgical outcome) is a great solution for a lot of people. E.g. for someone who, like me, had a horrible VL which made me a 30% impotent failure, 70% a poor lover who had to fuck like a maniac with constant friction for 5 minutes and hope that semi wouldn't go down. But I don't think it's a great solution for someone who gets reliable results from Cialis.
If you are not happy with things now, there is no guarantee you'll be happy with an implant. Only (huge) difference is that you have taken a decision irrevocably decision which you may or may not regret.
Hang in there. Get a few good experiences under your belt, even at the cost of a few shitty ones. When things don't work on the pills anymore, then go for the implant with the best surgeon you can afford.
I also know this goes against previous replies in this thread. I don't say I'm right, I don't say others are wrong. But maybe that's the case. No matter what, only you know what is right for you. At least I hope I give you some food for thought.
Good luck and wish you all the best.
Thank you so very much for the reply and for that point of view which I’m sure most people would agree with. Hell, I agree with you.
I would just say that this has been going on now for over a decade. The psychological impact grows by the day. I’m an entirely dependent on cialis and now that I’m single and even unable to masturbate (which I do without cialis) the negative impacts on my psyche are utterly devastating.
I’m at such a low point that I’m not even confident enough to approach someone new. I know that my psychological component is overwhelmingly the main cause for my problems, if not the only cause. This doubt alone as to its etymology is enough to cause problems.
I don’t feel able to chase the people I want to chase anymore because I’m filled with fear and now my fear is that the pills won’t work next time. These fears usually become self fulfilling prophecies.
I’m at such a crossroads.
I’m seeking the help of a psychiatrist who can perhaps prescribe me some meds (that DO NOT interact with libido and I’m also seeking a referral to the UKs leading implanter so he can run his own tests on me.
I’m also going through the trauma of a horrible breakup at the moment so I’m sure that doesn’t help matters either.
I just feel like an implant could make me super confident. I know it will affect so much; the way I view my penis, sex, it may introduce self consciouness with the appearance of my dick but the overwhelming majority seem to be in love with their implants. I know theyd all swap for a natural erection but if something exists which can restore my function, then that’s a very attractive option to me.