Implant advice requested

[cincinnatus1951]

Franktalkers:
I'd welcome advice on whether it is time for an implant. One was recommended by my prostate surgeon (who does not do them ) The ED specialist I went to wants to do and AMS LGX. I have a good friend who is a urologist, but not an ED guy per se. He recommended that I see a different ED specialist as his opinion was I should be able to regain good sexual function with just pills. I made an appointment with that doc and will see him in Mid Sept.
My question is based on the following story of ED treatments would those of you who have been sown this road say I have fought the good fight long enough and it is time to bite the bullet and go for the implant?
I am 75 and had a robotically assisted RPP in July 2013. Cancer is in remission.

PROSTATE:
Had two year follow up on July 14. PSA was 0.01. Dre was unremarkable.

ERECTILE DYSFUNCTION:
On March 23 visited ED uro. He recommended we try cialis 5mg daily and Viagra 100mg prior to sex as trimix is marginally effective and inconsistent.
After the March 23 visit I discontinued trimix until July 20.
Results with the pill regimen were night and morning erections, occasionaly spontaneous erections. The morning erections will point up from about horizontal to about 30 degrees from vertical. The penis however lacks longitudinal stability. The Cialis (5mg)seems to do more than the Viagra. (I have a similar reaction to Cialis 20mg before sex.) It does produce an erection of varying quality and usually short duration. The quality is usually marginal. The penis lacks longitudinal stability. We can penetrate in positions that have us lined up directly. Any non-straight alignment either slips out or we can’t achieve penetration. We have supplemented the Viagra with vacuum pumping with somewhat better, but still less than satisfactory results. Recently I have been vacuum pumping for about a half hour daily. I do not get an erection with pumping, I do “pack” a 2”diameter cylinder and my length is about ¾” shorter than before prostate surgery.
We used the trimix in conjunction with 5mg cialis daily and (not at the same time) 20mg of viagra before sex.
Any of these regimens yield marginal results

Bottom line is, we would like to get back to having sex without the “hassle” (pumping, “shooting up”) and frustration of us both being ready and then wilt
All in all, our sex life is not horrible, it just is not as satisfying as it was before surgery.
Afterall, we did fine post surgery with toys and tongues.
Had the following blood results:
Testosterone 366 ref 200 to 1000
Estradol 2 ref 0.5 to 5
SHBG 44 ref 10 to 55
Free Testosterone (calculated) 5.98

Thanks,
Cincinnatus

[dg_moore]

I always advise men who need an implant to get it immediately. ED doesn't improve with age. I waited and waited before I got mine, and then found it was too late. My wife had lost interest after menopause and the long struggle with ED, and I had a stroke that took away my libido. As a result, by the time I was healed from the surgery neither of us was interested any more and we never used the implant. If I'd gotten it when I first needed it we could have had additional years of intimacy, but by putting it off we lost it all.

[RelievedofED1]

The right time is different for everyone. My two cents is to try all the reversible treatments first. If they don't work or aren't tolerable then find a high volume implant surgeon and explore your options. The problem with an implant is that it is irreversible no matter the outcome. For me it was the right time in April and so far it has been better than I imagined. But I tried everything else first. Good luck and don't stop asking for and getting help.

[dg_moore]

...The problem with an implant is that it is irreversible no matter the outcome.

This is true, but if all other treatments have failed and you get an implant, what difference does it make if it's irreversible? You're no worse off than you were before regardless of the outcome. Putting it off for fear of irreversibility doesn't make sense to me - nothing good happens while you're waiting.

[RelievedofED1]

...The problem with an implant is that it is irreversible no matter the outcome.

but if all other treatments have failed and you get an implant, what difference does it make if it's irreversible? You're no worse off than you were before regardless of the outcome. Putting it off for fear of irreversibility doesn't make sense to me - nothing good happens while you're waiting.

I would agree with your statement DG if you have tried other treatments first and they dont work. When you stop them their side effects etc usually go away unless peyronies from injections (I had) or priapism (I was close a couple of times). In addition to irreversible there is the real risk of postop pain and infection that occasionally we hear about here. That said once you have decided you have tried all the options and they arent tolerable or effective I totally agree what do you have to lose and my experience is I have gained a lot! I just wouldnt jump over non surgical treatments without trying them first.

[DonBecker54]

cincinnatus1951, I have the same questions as you. You're not sure if going "all the way" with an implant is wise. At the same time, nothing else is working to your satisfaction.

You're 75. It's not like you have forever to endure failures of your equipment. Each time you have a failure, that's one less sexual encounter in your life.

I'm ten years younger, and have been going through the same thing. Sometimes the pills or injections work, sometimes they don't. As much as I hate to do it, I see no alternative but an implant.

[Leek65]

cincinnatus1951, I have the same questions as you. You're not sure if going "all the way" with an implant is wise. At the same time, nothing else is working to your satisfaction.

You're 75. It's not like you have forever to endure failures of your equipment. Each time you have a failure, that's one less sexual encounter in your life.

I'm ten years younger, and have been going through the same thing. Sometimes the pills or injections work, sometimes they don't. As much as I hate to do it, I see no alternative but an implant.

I am 66 and hope to have an active sex life for more than a couple years. (I have had none for the past three!) I don't view the vacuum pump, Muse or injections as something I would want to do for the long term. So why not go ahead with the implant? My surgeon did not discourage me once he knew I did not want the other options.

[pockie]

I'm 29, got my implant and couldn't be happier. It's been only a few months, but so far it feels as the best decision I've ever made.

Pre-implant, I was in a similar spot like yourself - partially functional with meds, non-functional without them.

You're 65, and the quality of the erection only gets worse with age. If I was in your situation I'd go for it.

I'll explain my situation so maybe you could relate with me and make your own decision:
In my situation, I want to have sex multiple times per day, viagra lasts up to 4 hours, but in my case it was less. So I could have sex with partial functionality probably only once, maybe twice during those 2-3 hours.
If I wanted to do it in the morning, mid-day and night, it was simply not possible because you shouldn't take viagra more than once per 24 hours, and that's the upper limit.
I could get an erection good enough for penetration. Even when I did get it, after I switched to a certain position it would start to go limp, the erection was really unstable.
Viagra also made my heart beat pretty fast, gave an unpleasant kinda euphoric feeling, and also made me pretty flushed. I didn't like it.

I guess for you it depends on how important sex is. If you're content with having sex 1-2 a week max and you're happy with the satisfaction you get, and the partial erection quality - then you might not need an implant - it's personal preference.

If you want to have sex often, at any time of the day without worrying about losing your erection, implant would be a right choice.

There's also the psychological part. I would get so upset and worried that the parts down there are not working, had such a hard time with that. Now with the implant, I'm much much happier overall, including during time periods I'm not actively having sex. The fact that you're 100% functional at all time, really boosts your moral and brings back your manliness.

Franktalkers:
I'd welcome advice on whether it is time for an implant. One was recommended by my prostate surgeon (who does not do them ) The ED specialist I went to wants to do and AMS LGX. I have a good friend who is a urologist, but not an ED guy per se. He recommended that I see a different ED specialist as his opinion was I should be able to regain good sexual function with just pills. I made an appointment with that doc and will see him in Mid Sept.
My question is based on the following story of ED treatments would those of you who have been sown this road say I have fought the good fight long enough and it is time to bite the bullet and go for the implant?
I am 75 and had a robotically assisted RPP in July 2013. Cancer is in remission.

PROSTATE:
Had two year follow up on July 14. PSA was 0.01. Dre was unremarkable.

ERECTILE DYSFUNCTION:
On March 23 visited ED uro. He recommended we try cialis 5mg daily and Viagra 100mg prior to sex as trimix is marginally effective and inconsistent.
After the March 23 visit I discontinued trimix until July 20.
Results with the pill regimen were night and morning erections, occasionaly spontaneous erections. The morning erections will point up from about horizontal to about 30 degrees from vertical. The penis however lacks longitudinal stability. The Cialis (5mg)seems to do more than the Viagra. (I have a similar reaction to Cialis 20mg before sex.) It does produce an erection of varying quality and usually short duration. The quality is usually marginal. The penis lacks longitudinal stability. We can penetrate in positions that have us lined up directly. Any non-straight alignment either slips out or we can’t achieve penetration. We have supplemented the Viagra with vacuum pumping with somewhat better, but still less than satisfactory results. Recently I have been vacuum pumping for about a half hour daily. I do not get an erection with pumping, I do “pack” a 2”diameter cylinder and my length is about ¾” shorter than before prostate surgery.
We used the trimix in conjunction with 5mg cialis daily and (not at the same time) 20mg of viagra before sex.
Any of these regimens yield marginal results

Bottom line is, we would like to get back to having sex without the “hassle” (pumping, “shooting up”) and frustration of us both being ready and then wilt
All in all, our sex life is not horrible, it just is not as satisfying as it was before surgery.
Afterall, we did fine post surgery with toys and tongues.
Had the following blood results:
Testosterone 366 ref 200 to 1000
Estradol 2 ref 0.5 to 5
SHBG 44 ref 10 to 55
Free Testosterone (calculated) 5.98

Thanks,
Cincinnatus

[dirtman1993]

Going January 27th for implant and part of the delay is the hope it will get better. I have had three early morning erections in the last year and nothing else, Have tried pills and all they have done is increase the blood flow a little. A pump works fine but no fun and waiting for sex kills the moment. Going to Dr. Kramer after reading about all doctors here. Thought about Dr. Eid but New York is pricey, Philly doctor beside is not the best but who cares if great surgeon. Based on everything I read, Dr. Kramer was my choice.

Dr. Kramer has an excellent reputation, very very low rate of infections/problems, will email and also speak with you at anytime. Between reading all the stories here about him, speaking with him convinced me to do it.

I am looking forward to sex as we wish and not be dependent upon something that may not work. I will have an AMS placed and looking forward to wild sex with my partner again. I remember how it was when 21 and wish to return to those days.

[dg_moore]

...I remember how it was when 21 and wish to return to those days.

We all do, but the ability to get an erection won't necessarily get you there! Good luck.