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My story. Please reach back and offer support! I am a Young male (27 years old) with ED for 10 years now. Here is my story and also questions about Penile implant and insurance.


To make a long story short, I was a hockey player and had several concussions, which two were considered severe. After my last one at 17 years old, I lost control of my bladder a bit. Had very bad urgency. Over the years, I retrained my bladder and now it is under control where I live normally again. They never pin pointed what was wrong other than my brain and bladder were not receiving the right signals with my nerves, most likely from my head trauma. Another issue that came along with this was with my girlfriend at the time, I noticed we would go to have sex and I was getting soft. The doctors said it was performance anxiety or possibly a result from head trauma. Keep in mind, prior to this I never had a problem and I was very very confident with sex and had a very high sex drive.

Over the last 10 years, I’ve had 3 serious relationships. All have ended and I think a big part of the reason why is my performance and not sustaining an erection firm enough for satisfactory sex. This has been so hard on me, and has affected my life terribly as a young man. I’ve seen many counselors and therapists to work on the performance anxiety they said I have.. Have been taking sildenafil for many years with little help. not much.. I finally decided to quit fighting the “it’s in my head and I will get over it” because this has gone on for 10 years now and it never went away even in a 4 year relationship that I was open and comfortable in. I finally decided to see Dr. Kohler at Rochester Mayo. My first appointment is August 26th..

I know I will get answers soon but it would be nice if someone can answer a few things I’ve been thinking about a lot lately…

1. Does it sound like I am a good candidate for the penile implant given my situation?
2. I have very good insurance. Blue cross blue shield PPO blue plan.. the details on coverage for penile implant is described below.. I’m concerned my issues are all related to brain trauma and insurance won’t cover because possibly the doctor can’t find anything to show insurance other than suspecting this could be related to the head trauma, just like my bladder was.. is it all about how the doctor writes it up to the insurance? thank you ahead of time for answering any questions

* side note, vacuum decides and injections are not something I want to try and sounds like there’s no need to if pills weren’t successful, you can go right to implant..

Again, below is my insurance and the penile implants. Let me know your thoughts!

I.    A surgically implanted penile prosthesis may be considered MEDICALLY NECESSARY for treatment of erectile dysfunction when all of the following criteria are met:
• Erectile dysfunction is due to one or more of the following:
◦ Neurologic condition (e.g., diabetic neuropathy, multiple sclerosis, spina bifida)
◦ Vascular condition (e.g., hypertension, intrapenile arterial disease)
◦ Peyronie’s disease
◦ Pelvic trauma with urinary system injury
◦ Previous radiation therapy to the pelvis
◦ Renal failure
◦ Spinal cord injury/disease
◦ Complication of surgery (e.g., cystectomy, prostatectomy) AND
• One or more of the following medical therapies have been tried and failed or patient has contraindications to ALL of the following:
◦ Oral medications (i.e., phosphodiesterase-5 [PDE5] inhibitors);
◦ Vacuum constriction device;
◦ Intracavernosal injection;
◦ Intraurethral medications. AND
• Patient is free of contraindications including but not limited to:
◦ Systemic  infection
◦ Active urogenital infection or
◦ Active skin infection in the region of surgery.
II.   Removal of an implanted penile prosthesis may be considered MEDICALLY NECESSARY for any of the following:
• infection; or
• mechanical failure; or
• urinary obstruction; or
• intractable pain.
III.  Replacement of an implanted penile prosthesis may be considered MEDICALLY NECESSARY when medical necessity criteria in section I continue to be met.
IV.   Implantation, removal and/or replacement of a penile prosthesis is considered NOT MEDICALLY NECESSARY when criteria above are not met

I have the very same insurance and I am seven weeks out of surgery. I can go into more detail if you want to private message me but I believe I only paid about 4000 out-of-pocket. And that was an outpatient procedure. I think my total bill was $95,000 so not a terrible deal there huh?

I can't answer any of your questions, but I'd recommend that you start using a VED to prevent losing size, or possibly regaining any size lost.

I do feel if you can get an implant, it could be life changing.

Seems like a no-brainer. I can relate to brain/bladder problems, diagnosed neurogenic bladder. I peed 15-20 times a day for like four years, which was f’ing terrible. Finally primary care doctor realized his failures and referred me to a urologist. Though actually I’m not positive that has anything to do with erection problems, my signals weren’t firing but it was always urinary stuff. My erection problems were more social with morbidly-obese women leading to me abusing viagra. but I do plan to blame implants on brain injury issues that if any girl judges me lol.

1. Does it sound like I am a good candidate for the penile implant given my situation?

Obviously. What’s a single reason not to have one?

2. I have very good insurance. Blue cross blue shield PPO blue plan.. the details on coverage for penile implant is described below.. I’m concerned my issues are all related to brain trauma and insurance won’t cover because possibly the doctor can’t find anything to show insurance other than suspecting this could be related to the head trauma, just like my bladder was.. is it all about how the doctor writes it up to the insurance? thank you ahead of time for answering any questions

My health insurance is much better than most I say, it’s an Aetna Medicare Advantage plan, if anyone knows what that means. I wish I could give exact numbers and I just messaged the office last week to ask but they haven’t replied yet. I think I got billed like $3000 or $4000 or something and insurance took the rest, but I’ll update that if I hear back.

2435tjklAS wrote:Seems like a no-brainer. I can relate to brain/bladder problems, diagnosed neurogenic bladder. I peed 15-20 times a day for like four years, which was f’ing terrible. Finally primary care doctor realized his failures and referred me to a urologist. Though actually I’m not positive that has anything to do with erection problems, my signals weren’t firing but it was always urinary stuff. My erection problems were more social with morbidly-obese women leading to me abusing viagra. but I do plan to blame implants on brain injury issues that if any girl judges me lol.

1. Does it sound like I am a good candidate for the penile implant given my situation?

Obviously. What’s a single reason not to have one?

2. I have very good insurance. Blue cross blue shield PPO blue plan.. the details on coverage for penile implant is described below.. I’m concerned my issues are all related to brain trauma and insurance won’t cover because possibly the doctor can’t find anything to show insurance other than suspecting this could be related to the head trauma, just like my bladder was.. is it all about how the doctor writes it up to the insurance? thank you ahead of time for answering any questions

My health insurance is much better than most I say, it’s an Aetna Medicare Advantage plan, if anyone knows what that means. I wish I could give exact numbers and I just messaged the office last week to ask but they haven’t replied yet. I think I got billed like $3000 or $4000 or something and insurance took the rest, but I’ll update that if I hear back.

How did your insurance cover? What was your surgeons diagnosis to the insurance company to get them to cover it? Head trauma?

tomas1 wrote:I can't answer any of your questions, but I'd recommend that you start using a VED to prevent losing size, or possibly regaining any size lost.

I do feel if you can get an implant, it could be life changing.

Thank you for the advice

Willis911 wrote:I have the very same insurance and I am seven weeks out of surgery. I can go into more detail if you want to private message me but I believe I only paid about 4000 out-of-pocket. And that was an outpatient procedure. I think my total bill was $95,000 so not a terrible deal there huh?

Okay I personal messaged you

PSSDorAmINormal wrote:

Minnesota#2 wrote:1. Does it sound like I am a good candidate for the penile implant given my situation?
2. I have very good insurance. Blue cross blue shield PPO blue plan.. the details on coverage for penile implant is described below.. I’m concerned my issues are all related to brain trauma and insurance won’t cover because possibly the doctor can’t find anything to show insurance other than suspecting this could be related to the head trauma, just like my bladder was.. is it all about how the doctor writes it up to the insurance? thank you ahead of time for answering any questions

* side note, vacuum decides and injections are not something I want to try and sounds like there’s no need to if pills weren’t successful, you can go right to implant..

1. No it does not sound like to me you are a good candidate for penile implant at this time. Not trying to be sound disappointing or mean, but you are pretty young to want that at this point. Don't let your experience of going soft with one girl determine whether or not you have major surgery to your most sensitive penis! With your more recent sexual experiences, you say your erection isn't firm enough for "satisfactory sex". That is completely subjective to you, and maybe your expectations are just a little too high. If it went into the vagina; that's all you need. Give yourself some slack and consider yourself lucky that those head injuries you had didn't do more harm. You're still young and who knows maybe your brain is still healing. Hopefully you avoid further injuries. You retrained your bladder, who's to say you can't retrain your erection response? I think the less you are cut on(surgery), the better. I don't consider your situation the same as a man in his 60s or 80s that has undergone prostate removal and feels the need for an implant. It's your brain that was injured; not your reproductive organs just keep that in mind.
2. I can't speak for insurance company policies, but I would think they would want you to have exhausted all other treatments before they payout for expensive surgery. I think most guys move from the PDE5 pills to the injections directly into the penis. That kind of medicine is supposed to make you erect whether you want it or not! I don't see how or why you would skip over potentially good medicine and jump to the surgery. Insurance and doctors might wonder the same thing. There are many guys on FT that use pills or injections. I know it seems like 10 years is long, but we're all dealing with the same thing one way or another. Just don't rush and don't think your penis has to be like steel to be a man. If you can enter a female partner that's all you have to be able to do.

I mean I know I’m a candidate simply based off of everything I’ve tried. It’s been 10 years and this hasn’t been just random bad experiences. I can’t sustain an erection to have sex and at best I barely can for a short period. 10 years is a long time to most and honestly I don’t really feel like jabbing my penis with anything or using a vacuum. I want my life back with spontaneous sex that I’ve missed out on for 10 years. I’m all about the numbers. You look at the studies, satisfaction rates, and the best success out of any treatment for ED… it’s a no brainer that
I want this surgery. Thanks for your input though

I tried everything. I would urge to at lest try injections. I had the best sex of my life on ICI and would rather still be doing that but it stopped working over time. But some guys use it for decades

Hi, near identical boat here as well. I’m 30 and contemplating an implant for severe psychogenic Ed as well. If you’d like to talk shoot me a dm as well. I’ve used injections with one girl but find it a bit frustating(missed quite a few times) and am ultimately deciding on doing an implant with eid