Implant as a last resort???

[s1985s]

Had initial consult for an implant. 40yrs old been dealing with ed for about 6 years. Pills starting to lose potency. I keep reading that an implant should be the "last resort". Why??? Tadalafil worked perfectly for 5 years. Then started to slip. Sildenafil has worked for the last year but is now starting to work only half of the time. Why should injections be next?

[newbie443]

Had initial consult for an implant. 40yrs old been dealing with ed for about 6 years. Pills starting to lose potency. I keep reading that an implant should be the "last resort". Why??? Tadalafil worked perfectly for 5 years. Then started to slip. Sildenafil has worked for the last year but is now starting to work only half of the time. Why should injections be next?

The implant only engorges 2 of the 3 erectile bodies. There are other small differences. Possible temporary loss of sensitivity. The implant is very good if you have nothing else that works. If you have something else that works with a natural erection men can nit-pick the implant and not be happy with it. Men have a WTF did I do to myself periods of time with an implant. Much worse if you had something else that worked. Implants are really a good choice if you have nothing else that works. As other things start to fail we all have to make that choice of when or if to have the surgery.

At least that is my take on what I have seen on this site. Good luck with this.

[LetoMan]

I think whether and when to get an implant is an individual decision, not one size fits all.

For example, I skipped injections. My urologist suggested that I might want to try them. But as I was newly single, I was clear that I wanted the confidence that came from a consistently reliable erection. And that was definitely the right choice for me. To be honest I wish I had done it a lot sooner.

Other guys who are married are fine going for as long as possible without an implant because they are in committed relationships and injections are not seen as challenging given a supportive partner.

On the other hand, another guy on this board today was commenting that he felt he should have continued without an implant for longer, even though he was single. Different guys have different views and circumstances.

The medical reason for urging delay is that surgery is a lot more invasive than injections, and is irreversible. Surgery carries a lot more risks, though most of them are resolvable. But once you go with an implant you can’t go back. On the other hand if you try injections and they prove problematic, you can always switch to implant at that point. That’s why pills are generally first line treatment, injections second line, and implants are viewed as the last resort… there is no going back from an implant.

Be well, Leto

[ElbowRoom]

I did the injections for over a decade. They work, I mean rock-hard erections. But they have downsides, you have to plan ahead for sex, you have to be prepared for an erection that lasts a long time and potentially puts you in the hospital if you overdo it.

I wouldn't say you're wrong for wanting to skip them. But the big difference with an implant is that it's the end of the road, there's no trying something else afterwards. If you have a rare bad outcome, or don't like some aspect of it, you're stuck with it for life. And what if two years from now some miracle ED treatment comes out that lets all men have rock-hard erections on demand with no surgery? Then you're still stuck in the dark ages with a mechanical device.

I'm not trying to talk you out of an implant, just saying it's a big decision and there are factors that should be considered. In the end you have to do what's right for you. There might also be insurance considerations -- most insurance won't cover an implant unless you've tried and failed all other treatments.

[LGXDownunder]

Had initial consult for an implant. 40yrs old been dealing with ed for about 6 years. Pills starting to lose potency. I keep reading that an implant should be the "last resort". Why??? Tadalafil worked perfectly for 5 years. Then started to slip. Sildenafil has worked for the last year but is now starting to work only half of the time. Why should injections be next?

Welcome, you will get a lot of feedback here. Only my 2 cents worth, it's a big decision. My understanding of the main reason an implant should be a last resort is because once you go down that path there is no going back. If the implant has to come out for some reason you can longer restore natural erections by any other method. Only further implants are then possible AFAIK. Given the lifespan of implants you are likely looking at multiple future revisions at your age. I had zero erectile function following prostate cancer surgery and I exhausted all of the more conservative options before deciding after 3 years that I was unlikely to get it back. Only then did I decide to go down the implant path. Now a few weeks post surgery and I'm happy I made that choice, even though I've yet to use it, but I'm a heck of a lot older than you. I did try injections for a period and they worked really well until they didn't. Had they remained a reliable option I think I would have persisted with them much longer. At 40 I think I would definitely give them a go at least and see what you think before jumping straight into an implant. The downsides are that injections are inconvenient, lack spontaneity for sex and there is some risk of priapism. Best of luck whatever you decide.

[wunhunglo]

Although I love the implant, as other posters have mentioned it isn't exactly the same as a natural erection. UNLESS, you still engorge post op and then it is AMAZING! So, if the pills still work, I would try VED daily to help bring fresh blood to your penis and keep your tissue healthy. You could also see an increase in girth. Either way, nothing to lose by trying. I would do more research to get a more balanced view of implants. Don't believe the hype of a bionic dick fucking for five hours. You can, but without engorgement in the glans, urethra and around the implant it will look and feel different...