At a Pivotal Crossroads - Some Merrix-Style No-BS Advice Desperately Sought

[Gt1956]

It's not an easy choice. Could you be able to fuck also w/o Cialis before being cheated with your last partner?

I could but only conservatively and because I felt ultra safe and loved.
Now my mind is the worst it’s ever been. I’m very depressed and very anxious. And the root cause is ED. It’s draining. Just feels like there’s no right answer.

I think that you've just answered your own dilemma.
If your sex life can't get any worse, then what is the downside to an implant??
If your state of mind is so poor, then what is the chance an implant would make it worse??
If you can't give good answers to those two questions. Then I'm really afraid that FT can't help you very much.
Much like the sayings that an addict must hit bottom before recovery can start. There is more light above you than below you.
I'm wishing you the best of luck.

[TANGERINE]

from your posts it does look like there may be some psychological issues . My opinion is that if you can get a good erection from injection, then you should stay with injection until that mode quits working. For me, in the earlier days, I routinely got four hour erection from injection. Those were really good erections with big glans, and I was also able to keep thrusting even after orgasm, so, with injections, I was "able to fuck like a king". But then the erections quit working and I moved to implant. I like sex better with the implant because it is more spontaneous (I can have sex anywhere and at anytime) and that improves confidence and has removed any fear that I have about sex and being faced with a situation where I failed to perform.

in my implant wiki (posted in a adifferent thread here on franktalk), I have a chapter (chapter 3) which discusses reasons why NOT EVERYONE is a good candidate to have this surgery.

Part of that chapter discusses a paper written by Dr Gopal Narang at UNC, and Dr Gopal states:

"..."...To maximise satisfaction from penile prosthesis insertion, full and accurate pre- operative counselling of the patient and partner is mandatory. This will prevent unrealistic expectations, which are the major reasons for complaints. As insertion of a prosthesis involves replacement of the patients' cavernosal tissue with loss of any residual erectile function, surgery should only be considered when all non-invasive methods of achieving a natural erection have been exhausted....."

My response to the above quote is that you should always remember that you should not get an implant unless injections or pills have failed for you. Otherwise, you might regret 'going nuclear' too soon.

"...Both patient and partner should be aware that the erection achieved with a prosthesis is a compromise. The glans penis will not be ....."

And finally, I just ran across a nice lecture posted by Dr Tobias Kohler who cautions surgeons from operating on patients with the following slide and his stted remarks:

Dr Kohler says:

Complications are a harsh teacher: Patient Selection
....Dr. Trost, a good friend of mine, now a current partner at the Mayo Clinic, he wrote this paper .....basically it’s a mnemonic stated the type of characteristics of patients that you want to avoid putting an implant in. I would argue to avoid doing any kind of cosmetic surgery in. ....it talks about counseling the patient’s properly beforehand, giving everybody in your office staff veto power to say, “This is not a good candidate, et cetera.” I’ve learned the hard way that, sometimes, if you implant the wrong patient, you end up with a lot of misery.

Dr Trost's pneumonic "cursed" can be summarized as follows:

This pneumonic is essential for implant surgeons;..... Men who are not good candidates may have characteristics or conditions as listed below:

compulsive
Unrealistic
Revisions previously
Surgeon Shopping
Entitled
Denial
Psychiatric conditions

from J Sex Med 2013 Apr 10 (4):893-906

You asked for "no bullshit" response. I know the above is harsh with no sugar-coating. Sorry.
So, in your defense, you need to convince yourself that you are realistic, NOT entitled, NOT compulsive and NOT a psychatric case.

And one other thing, although I personally believe that a man should not go "nuclear" until all options (ie injections) have failed, I do acknowledge that some surgeons state that it is perfectly proper to implant men who have tried, but reject, injections.

As a final piece of advice, it looks like there is a member here on frank talk LeRoastBeef who is younger and who has esteem issues and who has not yet used his implant as he acknowledges in the below post:

LeRoastBeef » Fri Dec 10, 2021 9:13 am

I have an lgx 700.........I have not used the implant for sex yet, mainly because my self esteem is still very low, and I'm embarrassed about how to go about the logistics of things in the moment. Need to man up.
34 (Venous leak), UK
Implanted with AMS 700 lgx on July 2021.
Love Franktalk.

It sems like the two of you may have a lot in common. maybe a discussion is needed to share with since he has seen the other side, yet, is not over the moon "fucking everything that moves". I hoe that discussion can take place in the public sphere here at franktalk so that all can learn.

[defiant]

from your posts it does look like there may be some psychological issues . My opinion is that if you can get a good erection from injection, then you should stay with injection until that mode quits working. For me, in the earlier days, I routinely got four hour erection from injection. Those were really good erections with big glans, and I was also able to keep thrusting even after orgasm, so, with injections, I was "able to fuck like a king". But then the erections quit working and I moved to implant. I like sex better with the implant because it is more spontaneous (I can have sex anywhere and at anytime) and that improves confidence and has removed any fear that I have about sex and being faced with a situation where I failed to perform.

in my implant wiki (posted in a adifferent thread here on franktalk), I have a chapter (chapter 3) which discusses reasons why NOT EVERYONE is a good candidate to have this surgery.

Part of that chapter discusses a paper written by Dr Gopal Narang at UNC, and Dr Gopal states:

"..."...To maximise satisfaction from penile prosthesis insertion, full and accurate pre- operative counselling of the patient and partner is mandatory. This will prevent unrealistic expectations, which are the major reasons for complaints. As insertion of a prosthesis involves replacement of the patients' cavernosal tissue with loss of any residual erectile function, surgery should only be considered when all non-invasive methods of achieving a natural erection have been exhausted....."

My response to the above quote is that you should always remember that you should not get an implant unless injections or pills have failed for you. Otherwise, you might regret 'going nuclear' too soon.

"...Both patient and partner should be aware that the erection achieved with a prosthesis is a compromise. The glans penis will not be ....."

And finally, I just ran across a nice lecture posted by Dr Tobias Kohler who cautions surgeons from operating on patients with the following slide and his stted remarks:

Dr Kohler says:

Complications are a harsh teacher: Patient Selection
....Dr. Trost, a good friend of mine, now a current partner at the Mayo Clinic, he wrote this paper .....basically it’s a mnemonic stated the type of characteristics of patients that you want to avoid putting an implant in. I would argue to avoid doing any kind of cosmetic surgery in. ....it talks about counseling the patient’s properly beforehand, giving everybody in your office staff veto power to say, “This is not a good candidate, et cetera.” I’ve learned the hard way that, sometimes, if you implant the wrong patient, you end up with a lot of misery.

Dr Trost's pneumonic "cursed" can be summarized as follows:

This pneumonic is essential for implant surgeons;..... Men who are not good candidates may have characteristics or conditions as listed below:

compulsive
Unrealistic
Revisions previously
Surgeon Shopping
Entitled
Denial
Psychiatric conditions

from J Sex Med 2013 Apr 10 (4):893-906

You asked for "no bullshit" response. I know the above is harsh with no sugar-coating. Sorry.
So, in your defense, you need to convince yourself that you are realistic, NOT entitled, NOT compulsive and NOT a psychatric case.

And one other thing, although I personally believe that a man should not go "nuclear" until all options (ie injections) have failed, I do acknowledge that some surgeons state that it is perfectly proper to implant men who have tried, but reject, injections.

As a final piece of advice, it looks like there is a member here on frank talk LeRoastBeef who is younger and who has esteem issues and who has not yet used his implant as he acknowledges in the below post:

LeRoastBeef » Fri Dec 10, 2021 9:13 am

I have an lgx 700.........I have not used the implant for sex yet, mainly because my self esteem is still very low, and I'm embarrassed about how to go about the logistics of things in the moment. Need to man up.
34 (Venous leak), UK
Implanted with AMS 700 lgx on July 2021.
Love Franktalk.

It sems like the two of you may have a lot in common. maybe a discussion is needed to share with since he has seen the other side, yet, is not over the moon "fucking everything that moves". I hoe that discussion can take place in the public sphere here at franktalk so that all can learn.

That was an excellent and fair response, Tangerine.

And I agree with all of it. Wholeheartedly.

There are psychological issues on my end but they stem from ED; the fact that my penis does not stay hard for as long as I’d like it to with worsening severity over an approximate 15 year period. That will take a psychological toll on any man, especially one in his youth and formative years trying to find a wife.

Every time I go through a break up and find myself single, my baseline ability lessens. And baseline performance anxiety increases. Exponentially.

As of now, I get anxious at the mere thought of attempting sex because I know that my arousal process is well, fucked up.

I will try again naturally, but I do believe that as ED is at the root of my immense stress, that it has governed the way I live and dictated my life to a large extent, that an implant can solve that root problem.

I say I will but as I mention, I’m finding myself really at odds with anything sexual right now and that comes from a fear of failure and having to ‘start all over again’. The pill life becomes unreliable as we all know and that unreliability feeds into more stress and thus depression.

One would hope that the confidence of having an on command erection, performed by a top top surgeon would go far, not all the way by any means because there would definitely be work to be done elsewhere, to allieviating much of my distress.

[merrix]

Great post Tangerine.
In a way, you said what I said above, just in much more sophisticated way. Backed up with some science as well.

But it makes me comfortable in repeating my gut feeling statement - made without any research behind it - that an implant won't "cure" everybody.
If you are in very dark place, and you have made yourself miserable because of your dick - then I wouldn't bet on an implant to fix that.
It could very well happen. But it could not happen as well.
I think your (Tangerine's) example of the member here that still hadn't dared to use his implant because of fear or anxiety on HOW to use it very much proves my point.
If you want to (well, perhaps not want to, but let's just say do) feel like shit because of your crap dick - you can do that with an implant as well.
If your brain is going to use an natural porn star dick as the benchmark, an implant won't live up to that benchmark either.
In terms of performance, yes, but not in terms of anything else.
To be happy with an implant, I think a man needs to (exactly as Tangerine pointed out with references above) have realistic expectations.
You will not be "normal" as in getting hard when getting horny. You will have a piece of plastic in your dick, and another one in your scrotum.
You will have plastic tubing in your groin and someone will eventually notice your dick is anything but normal.
If that is a huge problem for someone, then think long and hard about this before. Don't get an implant and expect to feel normal.
Expect to be able to have an erect penis and to be able to have great sex.
But all of that takes some acceptance and some mental strength as well.

I keep saying that an implant will be great if you accept it.
"Yes, I've got a bionic dick. I can fuck like a machine and outperform anyone. I'll give you a ride you'll never forget".
Versus having anxiety over how/when/where to pump, what to say if she detects it, will she think I'm a freak.
Miles of difference.

[defiant]

Great post Tangerine.
In a way, you said what I said above, just in much more sophisticated way. Backed up with some science as well.

But it makes me comfortable in repeating my gut feeling statement - made without any research behind it - that an implant won't "cure" everybody.
If you are in very dark place, and you have made yourself miserable because of your dick - then I wouldn't bet on an implant to fix that.
It could very well happen. But it could not happen as well.
I think your (Tangerine's) example of the member here that still hadn't dared to use his implant because of fear or anxiety on HOW to use it very much proves my point.
If you want to (well, perhaps not want to, but let's just say do) feel like shit because of your crap dick - you can do that with an implant as well.
If your brain is going to use an natural porn star dick as the benchmark, an implant won't live up to that benchmark either.
In terms of performance, yes, but not in terms of anything else.
To be happy with an implant, I think a man needs to (exactly as Tangerine pointed out with references above) have realistic expectations.
You will not be "normal" as in getting hard when getting horny. You will have a piece of plastic in your dick, and another one in your scrotum.
You will have plastic tubing in your groin and someone will eventually notice your dick is anything but normal.
If that is a huge problem for someone, then think long and hard about this before. Don't get an implant and expect to feel normal.
Expect to be able to have an erect penis and to be able to have great sex.
But all of that takes some acceptance and some mental strength as well.

I keep saying that an implant will be great if you accept it.
"Yes, I've got a bionic dick. I can fuck like a machine and outperform anyone. I'll give you a ride you'll never forget".
Versus having anxiety over how/when/where to pump, what to say if she detects it, will she think I'm a freak.
Miles of difference.

What you’re saying is all true. And I’m certainly under no illusions as to an implant giving you a sense of normality. But I have read enough testimonies and spoken to enough men who’ve had it done to know that getting the implant can not only allieviate all the angst that comes with ED but unleash and foster confidence, freeing up the mental space to just get on with life, free of that burden.

ED is going to take a psychological toll on all men that suffer it, to varying degrees. That’s a fact. And I would assume that ‘having’ to get an implant is going to play negatively, again to an extent, on the mind of anyone getting one.

As you say, it’s a process of realising that receiving one is right for you as an individual, that it’s absolutely necessary to your continued sex life and overall quality of life. Because the alternative is a sexless life which no man should have to go through.

[Fourtytwo00]

Honestly, if you could fuck even without taking pills when you felt loved and protected you have something to lose before going nuke. A surgeon can fix your erections but not the need of feeling accepted and loved. As long as you don't have organic problems and nocturnal erections are fine you have all the time you need to think about it. Better said, unless you have a severe ED that started to treated your size / length / girth / tissues, you may wait.