My ED and implant journey started about 4 1/2 years ago when I was diagnosed with low range/low risk prostate cancer.
Erectile function was still pretty good, although 25 mg Sildanefil definitely helped with keeping it up.
Initially I was just on active surveillance to monitor the PC. My urologist had a lot of similar patients whose cancer never progressed.
But after about 12 months of that I had an MRI that indicated an increase in the size of the tumour. A further biopsy confirmed it had grown about 1.3 mm, but was still completely contained within the prostate gland. PC was regraded to Gleason 7/Medium Risk and my doctor strongly advised immediate surgery. He guaranteed that he could rid me of the cancer as it hadn't gone anywhere else. So I took the plunge and went ahead with a Radical Robotic Prostatectomy with Bilateral Nerve Sparing in March 2022. Thankfully I've been cancer free since then, all PSA tests have been zero/undetectable for PC.
Unfortunately the side effects from the surgery have been diabolical. Initially I had awful urinary incontinence, heavy leakage that went on for many months despite conscientiously applying all the conservative treatments. It has very slowly improved over the last couple of years, and a further procedure in 2024 to inject Botox into my bladder wall has gotten me to where it's mostly a trivial problem. No pads etc unless doing something really strenuous, although I can occasionally get a small amount of arousal leakage or climacturia during sex.
The ED is another story altogether - I've had zero erectile function since the RRP despite the nerve sparing procedure. Initially I tried Tadalafil and so on, with minimal effect. Then I moved to Trimix injections, which worked well for a while until scar tissue built up and I could no longer get any results at all, despite trying every cavernosal location I could find. I briefly underwent a course of shockwave therapy, which did absolutely nothing. Also tried another oral concoction of Phentolamine and something else that my urologist suggested, but it didn't help either. Ultimately I switched to using a Vacurect VED both for sex and penile rehab, but found that it's not a great solution for PIV sex due to the "hinge" effect. However that's the only semi-workable option I've had and it's been my regime for almost 2 years until implant surgery last last week.
I delayed getting an implant in the hope that the erectile nerves may recover. I asked my urologist in January if he has had anyone come back after more than 3 years. He told me that he has only ever had one guy who recovered good erectile function naturally, after 4 years, but he was much younger than me. I didn't like the odds, so I started planning and preparing for an implant. I considered both malleable and IPP but was eventually sold on the IPP.
I had researched implants a lot, including on FT. So I started on a fairly aggressive program of daily VED use, probably overdoing it at times if I'm honest about it. However I wanted to try and recover lost size from the RRP if possible, so trying to maximise the size of the cylinders that could be implanted. I chose to use my existing urological surgeon. We have very few high volume implanters in Australia, in fact probably only one or two who would qualify using USA parameters and they are both interstate, which would not work for me. We just don't have the same population size. Much less volume, but my own urologist implants regularly, usually two or three a month. I have grilled him at length about how he would ensure that my surgery is successful. He was very keen to ensure the outcome I wanted and so far so good. I'm not overly well endowed, probably average, but he was able to implant the AMS LGX 21 cm with no RTEs (MS pump) and was really happy with the results when we discussed it the day after my operation. I also considered the Rigicon Infla10 Pulse AX, which is available here. He has also implanted those but said that the last couple he did the patients were not happy with the results, so we ruled it out.
So here I am a few days post surgery, suffering diarrhea from the post op antibiotics, soreness, bruising, scrotum the size of a grapefruit etc, and getting around with an uncomfortable partial erection for the next 6 weeks until he activates me. Curiously he only inflates to 20% initially, where I've read on here that 60% is more common. I'm already finding it a real challenge to cope at 20%, I can't imagine how 60% would be.
Anyway, let the bionic journey begin
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