Why is an implant not recommended for incurable pelvic floor /hf issues?

The final frontier. Deciding when, if and how.
Never_Enough
Posts: 255
Joined: Fri Nov 24, 2023 7:54 am

Why is an implant not recommended for incurable pelvic floor /hf issues?

Postby Never_Enough » Wed Jul 22, 2026 3:45 pm

I'm asking this because an admin for FT wrote this in the HF/CPPS forum.

Frank Talk Admin wrote:Guys,
I don't very often step in, but implants are not at all a treatment for hard flaccid. HF is caused by tight, inflamed, and spasmed pelvic floor muscles. The treatment is a good physical therapist, plus learning coping skills for stress and holding your tension in your abs/pelvis. Get to a therapist to learn to manage stress. If needed, valium suppositories are helpful. Botox injections sometimes help. It is all about releasing the tight pelvic floor. Once that is cleared up, normal sexual function will return.
There is no easy fix. But the answer is definitely NOT surgery of any kind.
Please read the sticky post at the top of this forum on educational materials.
Paul



I replied on there but because that forum is so niche it barely gets any attention.

Im not necessarily criticizing the post, but I must ask does the poster have any of those conditions or have they just read about them?

Its quite frequent that absolutely none of the options mentioned work in the slightest. Valium suppositories might help a little but also Valium causes ED. Botox again can help but the action of the pelvic floor muscles makes erections harder. ' Just releasing the tight pelvic floor' is one of those things that is a bit throwaway, as If I were to say 'Its just about repairing the nerves after Prosectomy' 'Its just about getting over Diabetes' etc.

I have suffered from Pudendal Neuralgia CPPS and on and off HF for 3 years now- it is ( or can be) a hellish nightmare condition that ruins your life even without the fall out issues such as ED.

I have pain from the moment I wake up until the moment I sleep that is a mixture of throbbing tight stabbing and burning, and has made spontaneous erections impossible- the bulbospongiosis muscle is completely wrecked with hypertonicity and pain.

I can get ok erections about 70% of the time with high doses of pde5s, but injections are generally out of the question- partially due to being in THE UK ( No Trimix) and partially due to having such a difficult penis to inject as it goes rubbery and difficult.

The thought of an implant is often one of the things that keeps me going and I was a little dismayed to hear it refuted in cases such as mine. I understand there is at least one person who was cured with an implant- and someone else told me their pelvic pain lessened a lot due to there being less strain on the muscles.

I know its a personal thing anyway- but I tend to take a lot from the advice of the experts here as I age towards to point where I will inevitably need one, and would like to hear more from people. either with the condition or experts in the field.

Thanks.
39 m UK

Psych ED since forever less problems being erect alone.
3 kids. Long term partner.
CPPS pudendal neuralgia and muscle tightness in late 2023 making ED worse.
Cialis no longer works. Sildenafil 100mg with diazepam works some of the time.

MovingForward
Posts: 10
Joined: Mon Jan 16, 2023 9:13 am

Re: Why is an implant not recommended for incurable pelvic floor /hf issues?

Postby MovingForward » Wed Jul 22, 2026 4:17 pm

I've struggled with hard flaccid and chronic pelvic pain for years. I can only reach about 70% most of the time.
I am strongly considering implant because I am so tired of not being able to function properly.
I have tried just about everything people recommend for chronic pelvic pain and I am starting to feel ready to make a bigger move towards surgery.

Never_Enough
Posts: 255
Joined: Fri Nov 24, 2023 7:54 am

Re: Why is an implant not recommended for incurable pelvic floor /hf issues?

Postby Never_Enough » Wed Jul 22, 2026 5:25 pm

MovingForward wrote:I've struggled with hard flaccid and chronic pelvic pain for years. I can only reach about 70% most of the time.
I am strongly considering implant because I am so tired of not being able to function properly.
I have tried just about everything people recommend for chronic pelvic pain and I am starting to feel ready to make a bigger move towards surgery.


Pelvic floor conditions are far too broad to be caught under one brushstroke- and this leads to a lot of people feeling helpless due to the lack of understanding.

-Pudendal Neuralgia
-Puendal entrapment
-General Pelvic pain
-Hard flaccid
-Chronic UTI

What works for one doesnt for another and its not uncommon for absolutely nothing to work.

If surgery is recommended in cases of total or partial ED due to VL or prosectomy where nothing will work well then why not this?

I think saying 'surgery is not recommended' is a very dangerous line- surgery absolutely is recommended in some cases, and I am 95% sure that it will in my case as well so im with you on that.
39 m UK

Psych ED since forever less problems being erect alone.
3 kids. Long term partner.
CPPS pudendal neuralgia and muscle tightness in late 2023 making ED worse.
Cialis no longer works. Sildenafil 100mg with diazepam works some of the time.

Frank Talk Admin
Site Admin
Posts: 675
Joined: Mon May 18, 2009 11:06 am
Location: NYC

Re: Why is an implant not recommended for incurable pelvic floor /hf issues?

Postby Frank Talk Admin » Thu Jul 23, 2026 1:08 pm

I work in Men's health and men's sexual medicine. I diagnose men every day with pelvic floor issues. It is a complicated field of issues. Nope, it is NOT one-size-fits-all. This is also the most mis-diagnosed area of men's health today. it is treatable - very treatable. It requires patience, trial and error, etc. it is mental health issue as well as physical issue. the key is finding a doctor who specializes in this. Most doctors have never heard of it and don't know how to treat it. it is frustrating. it is hell. It is treatable.
I still stand by my statement that a penile prothesis should never be a treatment for pelvic floor issues.
Paul

LiverpoolLad
Posts: 69
Joined: Sun Oct 20, 2024 5:51 pm

Re: Why is an implant not recommended for incurable pelvic floor /hf issues?

Postby LiverpoolLad » Thu Jul 23, 2026 1:55 pm

Frank Talk Admin wrote:I work in Men's health and men's sexual medicine. I diagnose men every day with pelvic floor issues. It is a complicated field of issues. Nope, it is NOT one-size-fits-all. This is also the most mis-diagnosed area of men's health today. it is treatable - very treatable. It requires patience, trial and error, etc. it is mental health issue as well as physical issue. the key is finding a doctor who specializes in this. Most doctors have never heard of it and don't know how to treat it. it is frustrating. it is hell. It is treatable.
I still stand by my statement that a penile prothesis should never be a treatment for pelvic floor issues.
Paul


Hi Paul,

I just wondered if you’ve come across those with cerebral palsy struggling with ED? I have spastic diplegia which affects my legs.

I’m currently seeing a pelvic floor physio and have a tight and overactive pelvic floor. I think it might be unlikely due to my condition for this to improve to a meaningful level and was considering an implant.
28 years old.

Currently trying injections - may be a neurogenic cause of ED.


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