Would you recommend an implant in my case?

[packer]

Hi Everyone,

I am a 42 year old man. Up until the age of 39, I had a perfectly functional sexuality, and was able to have sex without the need for drugs (and several times in a row if I took 10 mg cialis.)

I then made the biggest mistake of my life and began using trimix in conjunction with recreational drugs. I got the trimix from a friend and had no idea how to use it. I had no idea that it could cause fibrosis to penile tissues. Upon discovery of the damage, I ceased use of trimix and was prescribed pentoxifylline in an attempt to heal the scarring. 2 years later, some functionality has returned but nothing like how I was before.

My local urologist has prescribed bimix injections and advised against an implant. I spoke to Dr. Eid in NYC via phone, and he suggests an implant as he doesnt believe in injections as a long term fix. I am hesitant becuase I still do have some residual functionality.

Specifically, I am able to achieve a partial erection when masturbating. With Cialis, I am able to achieve a full erection while masturbating, but my penis requires constant stimulation for this to last. I can have brief sex with cialis, but only in lying down positions. This sex is unfulfilling due to feeling rushed.

I am very hesitant to return to injections given past experiences with it and damage caused. Needless to say, I have been undergoing therapy due to depression issues related to this rapid change in my body. The affect on my sex life with my wife has been devastating.

Do you think an implant might be suitable for me?

Many thanks for sharing your opinions!

[antelope]

My opinion--and my opinion only:

Do whatever you can as soon as you can to restore optimum sexual function.
Use common sense--start with less invasive and more toward more invasive: pumps, pills, shots, implant.
I think you've answered your own question: if pumps, pills, and shot are not producing satisfactory results, it's time for the implant.

Again, just my opinion. I'm still in the "shots" phase and will continue using trimix as long as it's working to my satisfaction. But I will be knocking on the door of an implant surgeon as soon as it's NOT working any more.

Greg

[Bionic_by_AMS]

My local urologist has prescribed bimix injections and advised against an implant.

Why would your URO allow Injections when you already have an existing condition? Did he say why he was against an Implant?

Now ask yourself ... are you going to take pentoxifylline longterm? ... and to what end? It is not a cure, but rather relieves the condition.

I can have brief sex with cialis, but only in lying down positions. This sex is unfulfilling due to feeling rushed

Have you tried VED? (vacuum pump) ... you should be doing this to maintain (erect) penis health in any case. VED should also help in the sex department ... try pumping prior to sex. Try using a constriction ring to help maintain your erection. Read thru the many posts in The Pumps section for more info.

The affect on my sex life with my wife has been devastating.

The majority of us here certainly can relate to that ... an understanding partner makes all the difference in the world. If she doesn't understand explain it to her in detail on what has happened to your body ... involve her in your decisions as ED affects her too.

Do you think an implant might be suitable for me?

Pills and pumps are a short-term fix at best ... I agree with you that Injections are out, as you certainly don't want to make your condition any worse.

After my Robotic Prostatectomy I was 100% ED ... and an Implant completely cured my ED and we couldn't be happier ...

[packer]

Thanks for the notes. It is wonderful to have a place to be able to talk about this.

In answer to Bionic_by_AMS's questions

>Why would your URO allow Injections when you already have an existing condition?
>Did he say why he was against an Implant?
>Now ask yourself ... are you going to take pentoxifylline longterm? ... and to what end? It is not a cure, but rather relieves the condition.

My URO suggests injections but wants me to hold my finger over the injection site for 5 minutes prior to sexual activity. He additionally wants me to continue taking pentoxifylline indefinitely, as this will prevent future injections from causing further damage. He did not say why he was against an implant but I will press him on this. Up until now he has just said "I don't recommend an implant for your condition".

Pentoxifylline is relatively hard on the stomach and so I don't see this as a long term solution.

>Have you tried VED? (vacuum pump). you should be doing this to maintain (erect) penis health in any case.

No, and thanks for the recommendation. I will give this a shot. I am able to get a full erection via cialis and a lot of manual stimulation, especially if this happens in the morning, and I try to do this most days, so hopefully this is taking care of my (erect) penis health?

Many thanks again

[Bionic_by_AMS]

He additionally wants me to continue taking pentoxifylline indefinitely, as this will prevent future injections from causing further damage.

If you decide to continue Injections, be sure to keep a careful eye on any future bends, curves, etc. in your penis ...

Pentoxifylline is relatively hard on the stomach and so I don't see this as a long term solution.

I would suggest adding "L-arginine" (suppliment) to your list of meds ... see link below.
http://www.google.com/#q=pentoxifylline+Peyronies+Larginine&hl=en&prmd=imvns&ei=q5SJUNP7M8qu0AHphoGwBw&start=

As for VED ... if you have good Insurance, ask your URO and he should be able to provide the necessary method to obtain one. If not you can find quite a few pumps at Amazon.com (search: penis pumps) ... get into a daily routine of pumping.

[oifsps]

You have my sympathies for your situation. It sounds a lot the way I feel, I m certain I could get some use out of my penis with use of meds, injections, but it s only going in one direction, less and less function, then nothing else but an implant, and I cant see any reason to go through the less and less, rather than just getting the implant. I m going to myself when I can afford it.

[packer]

Thank you very much for the kind advice. I will follow up with your suggestions.

I asked my Uro to elaborate on why he has not recommended an implant and this was his response:

"There is no question that if you don’t want injection, prosthesis is a good alternative and many are very happy with it.
On the other hand, I have a patient who has been doing injection for 22 years and still like it.
Today, I have a patient who has already had 6 operations to replace and revise penile prosthesis and he is only 62 years.
This is a personal choice only you can make."

Six follow up operations sounds like the ultimate nightmare. How common is it for an implant to need this many adjustments/revisions?

Thanks again

[buckshot]

packer...I'm 78 years old and tried everything from every pill on the market to vacuum devices to MUSE in order to get a satifactory erection without having any success. This was after I had prostate cancer surgery in June of 2011 and then had total ED. After CAREFUL and LENGTHY consideration and discussions with my uro/surgeon, I decided to have the Titan OTR 3-pc.inflatable penile prosthesis implanted on August 6 of this year. Now, 3 months later, I am once again 100% sexually active , able and enthusiastically having sex with my wife....the implant is truly a life-saver!!! I also did not lose ANY of the wild and super feeling in my penis that comes with an orgasm...I just don't ejaculate anymore and that is normal if you no longer have a prostate.The implant surgery is relatively easy, no great amount of pain,just mainly requires a good bit of patience to allow your body a few weeks to heal and repair itself. Packer, I would do it again in a heartbeat if needed.Good luck and I wish you many, many more years of enjoying life!

[Bionic_by_AMS]

How common is it for an implant to need this many adjustments/revisions?

It is very rare and usually indicates Doctor error of some kind ... with his attitude I think I would find another URO if you are considering an Implant.

[packer]

That's very interesting.

Clearly the choice of surgeon is critical. Could anyone recommend a way to identify the leading surgeons and research them?

I found Dr. Eid in NYC via a google search, and spoke to him twice via his Phone Consultation service. He seemed very experienced and knowledgable about the process, but i would like to speak to others before making a decision.

Thanks again