31 years old and very conflicted after talking with Dr. Clavell

[Gt1956]

New_Member, there is no doubt that an implant is a huge decision. Let me point to some things that you posted.
You predict that you'll be having sex into your 80's. That shows confidence but perhaps not reality. You might not have a partner, she might not wish to have sex, her body might not let her have sex, your mind/body/health might not allow sex & finally you might not even be alive. Example, out of just the classmates of my age in school. Something like 50 to 60 have died. I didn't come from a huge school.
Yes, revisions happen. I just had this talk with my surgeons nurse to verify that if I had trouble that he would be willing to fix it. Yes, he does revisions. Pressing the issue a little farther I asked whose work does he usually fix. She went on to say that most of his revisions were fixing low volume drs mistakes. ANY licensed urologist can install an implant. She said many only do a few a year. Those are the implants that make up the bulk of his revisions. Recently I found out that a fellow FT member is going to him for a revision.
A few words about age. She told me that he implanted a 101 year old man that was in excellent health. His lab work was better than the nurses. Seems that the mans wife had died. He was marrying a 90 something year old woman. On the younger end. Most of his young patients have had accidents or spinal injuries. Makes sense to me because I live in a mountainous state.
Ok, you say that you're currently having a 50% success rate with Cialis. You don't say if you have a steady partner or if you're dating. Big difference in my mind. The general advice is to exhaust all reasonable treatments for erections before getting an implant.
My suggestions are to try the different pills formulations on the market. Some work alot better than others. I think Viagra is generally considered the strongest. I should caution you to only buy your meds from licensed pharmacies so you can avoid weak or fake meds. When those totally fail, which they most likely will. Then you can consider injections. I never used injections but I do self inject insulin for my type 2 diabetes. Injecting is easy to get used to.
You say that you're 31. With some luck trying some of these things might get you 5 or more years. Once all the doors to an erection are closed. The decision does get easier. Also, you should consider that sex in your youth shouldn't be passed by. If you need an implant i.e. everything else has failed. Get one from the most skilled dr reasonably near you.
Good luck, GT1956.

[nerdynerd]

I'm sure that there are members who have had success, at least temporarily, with injections but I developed Peyronie's shortly after starting them. I believe this is not an uncommon occurrence. Now I have to rely on an implant to overcome both my venous leak and my Peyronie's curves. Have you considered using a VED + rings prior to sexual activity? I know it eliminates the spontaneity but if you are in a committed relationship it may be accepted by your partner and buy you some time.

Best of luck to you.

[Old Guy]

Yes you have a very tough decision to make. Are there other options to try first? It seems like pills, shockwave and injections all have their limitations and either work or don't work.
An implant is the final step, and at your age definitely a few revisions will be needed. The bottom line is what is it worth to be able to have confident sex every time? Best of luck making that decision.

[New_Member]

Thank you everyone for your responses and support. I wrote the original post a bit emotionally (and to be honest slightly inebriated too, I think I wanted to vent to a community of people who understand). The journey of dealing with ED is a real head trip, and I wouldn't wish it on anyone.

A few things:

- I am in a committed relationship with my girlfriend of 2 years. We don't have sex frequently since we're long-distance, but the times we do see each other it's about once a day. She doesn't know about my ED struggles since I'm embarrassed to talk about it, but I would have to eventually tell her once we start to live together. To be honest, she is satisfied with our sex life since she can get herself off easily during sex (even when my dick isn't working). This surgery would be more for me and my confidence and reducing anxiety around sex so I can be more in the moment.

- I've tried probably every pill on the market. I hate the side effects I get from both sildenafil/tadalafil, stuffy nose, headaches, unable to sleep, heart racing, etc. I hate the anxiety of not knowing if it'll work or not, or trying to time it around sex (which might not end up happening)

- When I drink, my dick is out for the count even with pills. I enjoy drinking socially and wouldn't want to give it up. She also enjoys drinking and unfortunately gets extra frisky when she's had a cocktail or two with me

- Injections are definitely not something I want to be doing or dealing with. I understand it'll be low side effects but to me that's worse than taking pills. I want to be able to have spontaneous sex on a trip without having to worry about bringing something with me

- I've researched about the malleable but that's not something I'm really interested in either. It doesn't seem like it gets as good results and patient satisfaction as implants do

My erections have their good days which is also why it is hard for me to make this decision. I can last in bed (with cialis) and do about anything I want for 5-10 mins. I can ejaculate fine and enjoy sex. I can even go for a round two once the refractory period has passed. I can masturbate alone without cialis and still get hard enough to enjoy myself.

But the times it doesn't work, it sucks. For me mentally it sucks, my partner doesn't really mind. I already am confident I would love the implant and love the results. Dr. Clavell believes that me in my 30s would feel like a sex god with it. But, it's the me 30-40 years from now he's concerned about. Implants can stretch tissue over time, and there's a chance it might get loose after I've done enough revisions and used it enough times by then. Implant failures can happen randomly and I don't know how many surgeries I might need as I age.

Lastly, if anyone is curious, below are the doppler scan results of when I did it at the age of 27:

IMPRESSION:
1. Equivocal arteriogenic ED study.
A. Peak systolic velocity is below 25 cm/s in the right mid
cavernosal artery before injection and 5 minutes after injection.
B. Peak systolic velocity is below 25 cm/s in the left mid
cavernosal artery 0 minutes after injection.
C. Right cavernosal artery dilated more than 75% immediately
after injection.
D. Left cavernosal artery never dilated more than 75% after
injection.

2. Veno-occlusive insufficiency not demonstrated.

FINDINGS:
RIGHT: (velocity / RI / diameter)
Base: 26/0 cm/s / RI = 1 / 0.3 mm
Mid: 21/0 cm/s / RI = 1 / 0.5 mm

Post injection: (velocity / RI / diameter)
0 minutes: 31/9 cm/s / RI = 0.71 / 0.9 mm
5 minutes: 25/0 cm/s / RI = 1 / 0.7 mm
10 minutes: 43/0 cm/s / RI = 1 / 0.5 mm
15 minutes: 40/0 cm/s / RI = 1 / 0.4 mm
20 minutes: 26/0 cm/s / RI = 1 / 0.6 mm

LEFT: (velocity / RI / diameter)
Base: 26/0 cm/s / RI = 1 / 0.8 mm
Mid: 27/0 cm/s / RI = 1 / 0.7 mm

Post injection: (velocity / RI / diameter)
0 minutes: 19/7 cm/s / RI = 0.63 / 0.8 mm
5 minutes: 34/0 cm/s / RI = 1 / 0.6 mm
10 minutes: 35/0 cm/s / RI = 1 / 0.5 mm
15 minutes: 32/0 cm/s / RI = 1 / 0.7 mm
20 minutes: 33/0 cm/s / RI = 1 / 0.7 mm

Onset time of erection post injection: less than 5 minutes.

[indeed]

Interesting. Clavell basically told me not to worry about future revisions.
What do you mean by tissue getting loose? If your tissue gets stretched more, wouldn't that just mean you get upsized with revisions?

[Witheringhog]

Im new to the implant game, 6 weeks post op, had sex twice so far with my wife. I havent even got to the good part yet, that 3-6 month mark where you can pump to max and have fun. I say that to say, why would you not get an implant, why go through all the other treatments first.

I dont have those same views. The implant is a god send, even if you could only have amazing sex for 30-40 years, wouldnt you want that now when your body is healthy. Why save it for when your 80 when you could be a sexual all star now?
Implant has a super high satisfaction rate, doesn’t need hours to start working, fixes those mental blocks, makes you a more patient lover and never lets you down… till it does… your young and would most likely have an easier recovery than most of us here, your body just heals better the younger you are.

[Gt1956]

Just a non medical peson opinion. I don't see anyway to get a "loosened" penis. Its almost without question the penises will atrophy without use i.e. erections or night time partial erections. So I'm not seeing how a penis can become loose if it is always trying to atrophy around the implant.

[Journeyman]

This thread has all the heavy hitters responding . Lots of knowledge and good advice being given. I find myself agreeing with the post I just read and then get to next one and agree with that. My advice is kinda a combo of what has already been said . ....No one is promised tomorrow so live for today. Don't worry about 50 years down the road . If you're alive and still actively having sex , the implant technology and techniques will evolve. How you feel today is what's important. I was miserable. Tried everything- pills , shots , electroshock therapy. Eventually everything failed by the time I was 40 and I thought that was it . I was fucked ! I was depressed. I didn't even feel like a real man . I didn't know anything about implants . I lost a whole decade with no sex ( regrets ) . Fast forward to today ... I got my implant with Dr. Clavell in April . Cycling for 2 weeks . Had sex 2 times ( it was great ) and am going for #3 tonight. Getting an implant was the best decision I ever made ! I'm a totally different man than I was after the disaster on New Years Eve night when the injection failed me . I love my implant! It's like a cheat code ( figure the young man is a gamer .. got to speak his language,lol ). I can get on demand rock hard erections in seconds , and last for hours ( if she could ). You can keep an erection after an orgasms. It's incredible. I'm bigger , thicker, and longer than pre-implant . I high volume surgeon is the only way to go . Dr. Clavell is world class . Good luck to you on your decision. Joining the Bionic Brotherhood isn't so bad .

[Dent4ever]

Agreed on the above.. even Hakky said to me "just be mentally ready for when the revisions are due -in say, 10yrs or whatever" but nothing about running out of them .. perhaps he sensed that you were still conflicted when you spoke, not mentally prepared and for some.. they really like injections. Personally I hate them but Im STILL giving dimix a shot since I haven't tried that one although my surgery is scheduled for next month. I agree with Hog too. Life's short, why give up on tons of sex

[Marktheman05]

Thats exactly what i think!
Have you discussed the malleable implant option with Dr Clavell? I think for young people with ED this is the best choice. You can easily use the malleable implant for more than 10 years! Even malleable can be with you life time.

Is it really possible for a malleable to last the implantees lifetime? I am 29 and need the implant but I live in a place that it is impossible to have enough money for an ipp and I will never be able to afford especially considering revisions.