Last Resort or sooner?

[cincinnatus1951]

Crobin: Attached is a few thoughts I wrote about a year after my implant. As has been said, no one can decide but you. Wisdom suggests trying lesser therapies first, if they don;t work, there is no sense in delaying.
April 1, 2017

Guys: I’ve been doing a lot of thinking about the “right” time to decide on an implant. A lot of discussion about pumps and injections as well as pills indicates that a lot of men get some initial positive results, but, after time, the effectiveness declines. With injections, many report scarring and penile distortion. What’s not nearly as clear is what percentage of injection and pill users continue to have erection difficulties. Human nature teaches that the satisfied folks rarely complain. There are plenty of examples of marginal effectiveness of pills and injections, what I can’t tell is how large the percentage is.
In my own case, I went for about six months with pumps and pills with marginal results. My prostate surgeon recommended injections, which I used for about a year with inconsistent results. ( I had a Robotic assisted nerve sparing prostatectomy in July, 2013.) Sometimes, very little, sometimes too long, and never knowing how long the erection would last. I did have good firmness and longitudinal stability when it worked. At my two year surgical follow up visit, the surgeon suggested we consider an implant. My initial reaction was “They are not doing that to me!!!” We continued to bumble along. If the injection did not work (rarely) or did not last long enough, we would resort to toys and tongue. We were both able to climax; but, it was certainly not as satisfying as traditional penetrative sex. We were also getting tired of the hassle with injections. We visited one urologist (sexual medicine) specialist and he recommended “combination therapy” of pills and injections. He also recommended we consider an implant, showed us the prosthesis, gave us web sites where we could watch the surgery. We also learned of FrankTalk through a prostate cancer support group.
As we learned more about the surgery, risks, aftercare, healing, etc. the thought of surgery became less scary. My wife initially discouraged it saying we can do OK with toys and tongue, is it worth the risk? We agonized and went to see another sexual medicine specialist. He did not try to sell us on an implant, however, said none of the other therapies were working for us. At that stage 21/2 years out of prostate surgery, the likelihood of spontaneous erections returning were essentially nil. After one particularly frustrating love making session, I said to the wife, “Heck with it “I’m signing up for the implant. She agreed. I had the implant in January 2016. We had a text book recovery and we both wish we had not wrung our hands for so long. The implant removes all the hassle and uncertainty of the lesser methods.
That brings me to the point of this note. I have advised a goodly number of people both in public and private posts not to consider an implant unless nothing else works. While I still believe that to be the case. For the above reasons, I would recommend seriously thinking about an implant as soon as frustration begins to build. Essentially, once pills become less effective and you have tweaked your formulation and injection dosage without satisfactory results, I have come to believe that further avoidance of an implant is not helpful. In talking with my docs, they too, believe couples get frustrated and just give up on sex. My cardiologist even offered he would like to see way more men go for implants. He says many patients report that they have just given up.
Bottom line is I do not know how to accelerate the process to an implant. We believe we waited six to nine months too long. I also recall my almost complete rejection of the first implant recommendation. For guys who are say over age 55, are frustrated and have systemic ED regardless of the cause, I would say “Go for it”.
Sorry for the long post. Just food for thought. Cincinnatus

[LMCatman]

Sooner.....

[JohnThomas]

Now that I have mine, I wish I had it done 10 years ago - so go with your intuition, but sooner rather than later