32 old and severe ED. Considering an implant. Is there any world class surgeon in Europe?

[SwissTalk]

Hi guys, I am 32 year old and resigning himself to the idea that only an implant will solve my severe ED issues.

My story. Until 30 I knew no erection problems! I could when and as often as I wanted. In the last two years, the disaster took its course (in rapid steps). Performance problems that I did not know before, missing morning erection etc. In the beginning Viagra and Cialis worked wonders, last summer the smallest dose was easily enough and now 8 months later it doesn't even work properly with 100mg Viagra. I am really desperate and am being passed from doctor to doctor. I had used Finasterid from 26 to 31, I stopped once I noted ED issues. Of course usage of finasteride a big mistake, because I cannot excluded that my ED comes from the medication. At the same time I know that my father already had erection problems in his early 20s, so a family problem cannot be ruled out. Until a week ago, the suspicion was a venous leak, but the cardiovascular CT, then again did not show any venous leak! The doctor looked super puzzled. The CT is now being repeated.

But I don't really believe anymore that they will find the cause and a solution. Honestly, as much as I miss my old Willi, I don't think I can get around an implant and want to take the step. I just can't imagine running around with a cook ring and syringes for the rest of my life.

Are there world class surgeons for implants in Europe or do I have to go to the US for this? Any Name and Review would help me.
If there is any young European who went the final step. I would really appreciate if you would share your story. I would like to know what I can expect.

[2435tjklAS]

An implant seems to be a necessity for you. It's the best option.

Regarding world class surgeons, that's a thing people seem to talk about here often, and I'm not a doctor or an expert, though I am quite positive it's a completely and utterly unrealistic belief. It doesn't take world class surgeons to cut your dick open and stick something in it. Trained urologists with the proper surgical experience (which is like every single surgeon in any first-world country) will be entirely capable of this procedure and there will never be a discernable difference between a "good" surgeon's penile implant or a "less good" one. I mean, it's not brain surgery - google says it's a 45 minute to 1 hour appointment. Surgeon needs 35 years of experience and critical acclaims to do this well?

If you're worried about size, a "good" surgeon won't have an effect. People here say, "well with a good surgeon you wouldn't lose two inches." That's flawed and outdated and tbh doesn't even make any sense because modern implants are supported by current medical and peer-reviewed studies that regaining/gaining more length is likely.

What will have an effect is the amount and the intensity of your post-op exercises, not if the surgeon is a genius doctor like those portrayed in television.

Lastly, I get why you want the best, because it's your freaking dick - I mean, what man would ever go through this carelessly? Thing is, though, once you book an appointment and discuss this with your urologist, you all of a sudden are doing nothing carelessly.

[galactic]

With the greatest of respect to the above poster, I disagree.

I’m sure you asked the question because you’ve done your research and realised that this is a surgery that (sadly) is best done only by a high-volume surgeon.

There seem to be a few in Europe. Dr Antonini in Italy and Professor Ralph in London, UK are two names I see often.

[Blankloads69]

Consult with a few options and just make sure they're specifically implant specialists, not just general urologists that do a few implants a year. You want someone who is high volume and puts in the implant on a regular basis, like multiple times a week throughout the year.

[Fran4524]

Dr. Rosselló Barbará and Rosselló Gayá, father and son. In Madrid, spain.

[Whywhywhy]

Come to the us and get it done right the first time. Penoscrotal, no floppy glans, low risk of infection. That being said, I would encourage you to try to see if you find the root of your issues and try doing some lifestyle changes at first before getting an implant. Dietary habits, overconsumption of porn and masturbation, high bp, being dehydrated, prostate issues, tight pelvic floor muscles, medications, and Peyronie’s disease can all play a role in causing Ed in a young man. At our young age we shouldn’t have ed so there must be something causing it and if it’s reversible we should explore it before jumping into a implant.
A implant is a irreversible treatment option that irreversibly changes your penis for the rest of your life. Sensation will not be completely the same you will never know how you feel about having it until you can’t go back. There is nothing like a natural penis, an implant is a great solution if you really are at the end of the road and that natural penis is entirely gone. I know it sucks to have Ed as a young guy and the implant with its everlasting erection sounds like the holy grail, but I encourage you to really think about the making decision and not rush into it until you give it time and try other avenues.

[smphead]

Most likely you have Post Finasteride Syndrome. PM you

[defiant]

Come to the us and get it done right the first time. Penoscrotal, no floppy glans, low risk of infection. That being said, I would encourage you to try to see if you find the root of your issues and try doing some lifestyle changes at first before getting an implant. Dietary habits, overconsumption of porn and masturbation, high bp, being dehydrated, prostate issues, tight pelvic floor muscles, medications, and Peyronie’s disease can all play a role in causing Ed in a young man. At our young age we shouldn’t have ed so there must be something causing it and if it’s reversible we should explore it before jumping into a implant.
A implant is a irreversible treatment option that irreversibly changes your penis for the rest of your life. Sensation will not be completely the same you will never know how you feel about having it until you can’t go back. There is nothing like a natural penis, an implant is a great solution if you really are at the end of the road and that natural penis is entirely gone. I know it sucks to have Ed as a young guy and the implant with its everlasting erection sounds like the holy grail, but I encourage you to really think about the making decision and not rush into it until you give it time and try other avenues.

‘Come to the US and get it done right the first time’

Yeah because the US is the only country in the entire world with skilled surgeons.

Give me a break! Get over yourself.

Dr Ralph in London is essentially the don of Urology and an implant specialist. He does approx 200 a year.

[2435tjklAS]

With the greatest of respect to the above poster, I disagree.

I’m sure you asked the question because you’ve done your research and realised that this is a surgery that (sadly) is best done only by a high-volume surgeon.

There seem to be a few in Europe. Dr Antonini in Italy and Professor Ralph in London, UK are two names I see often.

Can you link me any of this research that claims surgeons must be "high-volume" to do implant surgeries well? Is it research research or a doctor's advertising website saying he's an expert?

I can stand corrected, admittedly, but I'm buying this.

Hmmm well I did find this study. Conclusion:

Patients treated by higher volume implanters are less likely to
require reoperation after inflatable penile prosthesis insertion than those treated
by lower volume surgeons. This trend appears to be driven by associations
between surgeon volume and the risk of prosthesis infection.

https://garber-online.com/pdf/Higher%20 ... ctions.pdf

Patients less likely to get reoperation? Not sure what that means.

Found this source too but it refers to implant surgery as "benign":

It is well established that surgical outcomes tend to improve as surgeon volume increases (13,14). In a simplistic sense, this may relate to an increasing expertise and efficiency on the part of the surgeon, but it is equally likely that improvements in systems (e.g., operating room staff that are knowledgeable about the procedure, established treatment pathways for surgical patients, etc.) also contribute to these superior outcomes (15). Penile implants are no exception to this general rule of surgical outcomes; ergo, it may be preferable that penile prosthesis surgery not be performed by “dabblers” but rather by individuals who have had intensive training and/or extensive experience with implant surgery. A greater depth of experience and knowledge enables the implant surgeon to recognize and manage problems and potential solutions. This “center of excellence” concept is well recognized in the realm of urologic oncology, but there is no reason it cannot be applied to benign urologic surgeries such as penile implant placement.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7108986/

I'm reading that to say that if a surgeon does a high-volume of any surgery, he's gonna have better outcomes. Implants aren't different than any others where that remains true.

So yeah, I mean I'm surprised this seems more of a legit concept than I expected, but meh, I'd have a hard time believing there's realistically a noticeable difference. Not that I actually know anything though, tbh.

[Whywhywhy]

Come to the us and get it done right the first time. Penoscrotal, no floppy glans, low risk of infection. That being said, I would encourage you to try to see if you find the root of your issues and try doing some lifestyle changes at first before getting an implant. Dietary habits, overconsumption of porn and masturbation, high bp, being dehydrated, prostate issues, tight pelvic floor muscles, medications, and Peyronie’s disease can all play a role in causing Ed in a young man. At our young age we shouldn’t have ed so there must be something causing it and if it’s reversible we should explore it before jumping into a implant.
A implant is a irreversible treatment option that irreversibly changes your penis for the rest of your life. Sensation will not be completely the same you will never know how you feel about having it until you can’t go back. There is nothing like a natural penis, an implant is a great solution if you really are at the end of the road and that natural penis is entirely gone. I know it sucks to have Ed as a young guy and the implant with its everlasting erection sounds like the holy grail, but I encourage you to really think about the making decision and not rush into it until you give it time and try other avenues.

‘Come to the US and get it done right the first time’

Yeah because the US is the only country in the entire world with skilled surgeons.

Give me a break! Get over yourself.

Dr Ralph in London is essentially the don of Urology and an implant specialist. He does approx 200 a year.

I am over myself. I’ve read many threads of people getting implants done elsewhere and they are short changed and left with floppy glans. The majority of the threads I’ve read that have been success stories have been from the well known us doctor’s.

I’m sorry if I offended you or your country, but perhaps it is you that has to get over themselves.