Trying to make the decision - implant or not

[jpd123`]

Hello everyone. First, thanks to all of you on this board for being so open and honest about you experiences. It is extremely helpful for those of us still in the decision phase. To the point, I've been reading the board, doing my research, and met with 3 different urologists. Now I'm trying to decide if I should go for an implant or not.
I'm 53 years old and have been diagnosed with a veinous leak. I believe I have struggled with this for years as I first realized I had ED many years ago. Along with the veinous leak, I struggle with extreme performance anxiety. I developed the anxiety as a younger man. So, I guess I have 2 factors contributing to my ED. Bottom line is I the ED seems to be getting worse.
Today, there are days that I awake with some varying degree of morning erection. Some days are better than others. Also, ED meds sometimes can help me achieve a semi-erection. But any erection requires constant stimulation to maintain. I am able to achieve a very good erection using injectables. The problem is however that the injectables cause me to lose sensation in my penis. Basically I can get a good erection, but it is very difficult to have an orgasm. Most times it takes manual stimulation (hand job) to have an orgasm if it is at all possible. My urologist said the reason for loss of sensation is due to the pressure (high blood volume) inside my penis caused by injectable medications. I don't have any loss of sensation when my penis is flaccid.
So far, I've tried a variety of injectable formulations with varying degree of pain and sensation loss. Caverject was the worst a I believe it is due to this product being a high concentration of alprostadil (which I have read causes pain/burning). Try-mix worked better because it has a far less concentration of alprostadil. Bi-mix works best because it contains no alprostadil but it takes a higher does. But I have no pain with Bi-mix and it gives me the best chance of orgasm.
To fix my veinous leak, I've tried all the herbal supplements. Too many to list. I've also tried electro-stimulation which I've researched has shown to improve veinous leak in various studies. I bought an Erec-Fit unit from the UK. It is quite a process to use, fairly uncomfortable, and also deadens nerves, which is what I don't want. But I have seen some improvement in penis size and erection quality since using it. But it has by no means proven to be a cure.
This leads me to today. My urologist believes my only option to achieve erection without using the injections is to go with an implant. She says that it will enable me to get an erection without the massive pressure and desensitization being caused by the injectables.
So, now I am making my decision and would really like some good insight and advise. Obviously I'm concerned about the complications, possible loss of length, and even a reduction in sensation. I know there is still blood flowing down there, but the quality is getting worse. The injections work, but there are problems with that option. At the same time, I know this is a no turning back decision.
I am working with a different urologist here in Charlotte who has done a number of implants, and is recommended on the websites of both implant manufacturers. I guess since he's listed by both companies, he's probably fairly good. Really can't take time or afford to fly to NY or Miami for a specialist. Hoping my insurance (United Healthcare) will cover the procedure since it's due to a veinous leak.
So, what do I do?

[strongagain]

Really can't take time or afford to fly to NY or Miami for a specialist. So, what do I do?

If you don't have time to go to one of the very best doctors then rather forget about it, leave it as it is. Between the lines I can read that the problem isn't worrying you too much. Maybe wait a couple of years, then make a decision.

I waited until last year August, then I was operated in Freiburg, Germany. According to Coloplast that doctor is the most experienced one in Germany. Before I made the final decision I spoke to a couple of his previous patients. All were extremely satisfied. Now I hardly ever think of the implant, it's there and ready whenever I need it. Like Merrix, when I notice a nice woman I know I could give her the pleasure of her life.

My implant was paid by medical aid. Also foreign patients get operated in Freiburg 'cause it's often cheaper than in other countries. I never had the slightest problem with my implant, the dick looks and feels fantastic.

[JTVallee]

It is a big decision. If the shots are working, maybe you could scale back just a little on the dose and still get hard but have better sensation. Another thing to consider is take oral medication with a lesser dose of injection, this worked great for me for a while. As far as mental state, the implant will make a world of difference about how you feel. You could wait and see if something else comes out that could help you, but on the other hand you don't want to lose out on having positive relations and mental well being. I myself never got wrapped up in this high volume Dr. Do your research on Dr.'s and referals and pick one you feel comfortable with. There are many great Dr.'s doing this procedure that don't only do this or primarly this procedure. The Dr. I had chosen was from the University in the cities here. Very good Dr. and did an excellent job. Ask questions and if they are good at what they do you probably won't need to ask only a few at the most.
Good luck in whatever you decide.

[RelievedofED1]

Though I couldn't be happier with my implant as others said here already two things you should consider 1) if you have choices still don't get an implant yet. If the treatments with lower doses of injections etc still don't work well enough for you then an implant has definitely worked for a lot of us. Not all as I'm sure others may point out but for a lot of us our reality has been great since the implant hallelujahs and all. That brings me to point #2) if you decide your only choice is an implant please at least speak with a high volume surgeon like Dr Kramer or Eid before deciding on your surgeon. Clearly other docs have done great work I just think like anything else practice makes better. Not perfect just better. Your penis is worth the time and effort to travel certainly enough to save up some money and vacation time if that is an option.

Good luck!!!!

[jpd123`]

Thanks to everyone for the thoughtful replies. This is big decision as I don't need to tell anyone here. My dilemma is that I can still get an erection using injections, but the loss of sensation caused by the injections is totally destroying my sex life with my wife. Although there is no problem satisfying her, it has become somewhat of a chore for me. She is totally supportive and will stand behind any decision I make. If I could somehow know that by going with an implant my sensation could be restored, it would be a no brainer. But there is no guarantee of that. One urologist is positive that the loss of sensation is due to the injection medication. She is very confident that the erection achieved by an implant will not cause me to lose sensation like the injections do. This urologist, although female, is supposedly an expert in the area of ED and penile implants. The second urologist who is also highly recommended by both implant manufacturers told me that there is no guarantee that an implant will restore normal sexual sensation and would put the odds at 50/50. I am seeing a third urologist today just to get one more opinion.
I also know the implant route is a no turn back decision. If it doesn't restore my normal sexual sensation, I'll be here in the same place I am today but totally reliant on the implant for the rest of my life.
I can certainly see other benefits to going the implant route. Not the least of which will be restoring normal "spontaneous" sexual activity. As it is now, any sexual relations my wife and I have need to be "planned" to accommodate the shot. I also intentionally avoid having sex when going to bed at night because I never know how long the chemical induced erection will last. Nothing is worse than going to sleep only to wake up an hour or so later with a raging, painful erection. The implant would certainly eliminate this problem.
I am going to keep reading, researching, and praying about this. I always welcome more advice and opinions.

[DonBecker54]

There's something else to take into consideration. I did injections for a bit over a year, and developed Peyronie's disease. I got a 30 degree curvature, and lost about an inch of length.

Two well-respected surgeons told me that injections can cause Peyronies and scar tissue (almost the same thing). It's not guaranteed, but it's possible.

I wish I'd never done injections. Almost none of the encounters I had with women were satisfactory with the injections, and they did a lot of damage. I wish the first urologist who suggested injections had warned me about the potential for scar tissue. I wouldn't have gone ahead with them.

[strongagain]

Injections are extremely dangerous. I did it only for a short period of time but still developed fibrosis plus an hour glass dent. The penis started to bend to the left. A doctor who recommends injections is a careless fool. I went to my urologist, showed her the problems. "Of course injections are not good, I didn't inform you about the danger because I thought you are aware of it." That's what she said...

[williamb]

JPD123, It seems like you have nothing to lose and possibly some to gain by getting the implant. If the injections are causing the loss of sensation then it won't get any better while doing the injections and maybe cause additional damage. The implant , even if the sensation is not fully restored you will at least have a working penis that will work on demand.
I am having issues with loss of sensation after implant surgery but it seems to be getting better after 4 months, so I am hoping that it will resolve itself with time.
Williamb

[archway]

I had never visited this forum until well after my surgery over a year ago. My research was initiated less than two years ago by web searches which revealed Dr. Eid's youtube videos and then on to his website. Patient testimonials were always positive, for obvious reasons, however I felt there were enough benefits to motivate me to proceeded. Like you, after years of pills, a year or so of muse, and finally injections not working (and even if they had worked) spontaneity was long gone for many years, and in recent years, the added anxiety any time sex was well planned, was very discouraging. Maybe ignorance is bliss, however after one consultation with Dr. Eid, and a few telephone conversations with his patient advocates, I felt very confident in my decision. One year post implant and well past the healing curve, the implant allows for a very natural relationship with my wife and spontaneity ( it only tales 20 seconds for an erection) without worry. Everyone must make his own decision, so call it luck that I stumbled on Dr. Eid, or luck that I had no post op issues, or loss of length, I'll never know what the future brings, so for now, I feel this was a good decision.

[jpd123`]

Thats for the feedback everyone. I have decided to go forward with the implant for several reasons. Foremost is the fact that I can stop injections and restore some degree of normal sexual relations with my wife. I hope we can move past all the anxiety and uncomfortableness associated with having to "plan" our sex life around the injections. Not to mention we have a 12 year old son at home, and its becoming less possible to plan for sex. We're getting to the point where we need to seize any opportunity that arises, and having to inject certainly gets in the way. Second, I am hoping that I can restore some degree of normal sensitivity during sex by not having to inject. I totally believe that the injections and associated pressure on my penis are causing desensitization.
I have decided on a urologist in our area. He has been doing implants for 20+ years. He is listed on the websites for both implant manufacturers so I assume he is good. His office has been very responsive and helpful and friendly. So he's the man.
Now, I would really like to know what to expect. What is involved in the surgery? How difficult is the recovery? How soon will I be back to work, driving, walking, and back in the gym. I try to work out regularly and will want to be back ASAP. How long is the realistic recovery? I am planning the surgery for last week of March. I have vacation planned for 2nd week of June. Will that be enough time for a full recovery?
I would really appreciate any and all feedback I can get. Also, any suggestions for pre-op and what I should find out from my doc beforehand would also be great.
Thanks to all!