Penile Implant For Young Patient Who Exhausted Usual Treatments. Advice.

[PeaceOfPainSeeker007 Junior Member Find all posts View Profile Close PeaceOfPainSeeker007]

If you don’t want to go thru my long history that I'll share below my questions, you can skip that part, and I hope you'll at least review the questions I have at the top here:


Hope all’s well. My name’s Shaad, 34, from NY. I feel that after years without success with typical treatments of erectile dysfunction, penile implant may be on the table now. Any useful advice is appreciated thru here or any form of contact. In respect of your time, I’ll try to describe years of ED as shortly as I can.


1) I’ve mostly seen data of high satisfaction rates reported by mostly elders, and not much data on how satisfied a young person still is with implants 15-40 yrs later. Are you aware of such data? Is there anyone out there who got a implant while young, and can report how satisfied they are 15-40yrs later?


2) Being young, I'll likely do more revisions as I get older than elders, so the impact from multiple revisions will effect me more. Does pain, penis shrinkage, & infection chance ACCUMULATE after EACH revision? If so, how much should I worry about it?


3) How do most patients describe their pain level and how long it took before they can satisfyingly use the implant with none-moderate pain?


4) I’ve heard a mix of good/bad stories on penile prosthesis. Most forums and medical studies I’ve came across show positive data, but then I've seen some places share bad stories. There's no financial benefit to sharing bad stories, but good stories can be marketing. The bad stories makes me question if the good stories might be marketing?


5) I’m considering Dr. Francois Eid or Dr. Andrew Kramer, but am open to researching more doctors. Recommendations? Anyone regret getting penile implants, especially from these 2 docs?


6) My history of treating ED naturally and thru typical treatments have been a failure. I'm at a decent weight (180lbs, 5'11), decent diet, and some muscle from exercising moderately. There is one thing I haven't tried, more weight loss. I'm wondering if I should spend the next 2-3 months eating less to reach 155lbs to see if that resolves ED. Do you think it's worth the time to try that 1st, before trying an implant that disables my natural function forever? Genetically, I have borderline high cholesterol since young, so I was thinking more weight loss while maintaining a decent diet might help.

7) Is there any other advice you can give for someone young considering an implant who exhausted usual treatments?

[PeaceOfPainSeeker007 Junior Member Find all posts View Profile Close PeaceOfPainSeeker007]

To best understand why I feel penile implant is my best option now, I would need to share my long history. This part can be ignored if you don't have the time:
I’ve had ED at least since around 19. None-minimal morning wood. I get an erection when desired about 65% of the time, and can hold it successfully for intercourse about 33%. Oddly, my libido and ability to hold an erection appears to get worse if I’m standing, which I read may be venous leakage.
I tried eating better and exercise even though I was a good weight. As it didn’t help much, I visited local doctors. In my mid 20s, I was prescribed tadalafil. As it was expensive back then compared to now, I bought tadacip (generic tadalafil) online from an indian pharmacy. I wasn’t sure if pills were real, but they likely were as reviews from many sites were good. It worked well, but then stopped working after 2 weeks. Not even 20mg of generic tadalafil a day helped at that point. Maybe I built up tolerance & needed a break. Although I’m unsure if it was the pills, the high dose probably bothered my back badly, but it’s ok now.
Later, doctor did a penile doppler scan that shows arteriogenic dysfunction. He believed the cause to be congenital or due to a penis injury, but I don’t recall any. He recommended bimix/trimix. Tried it and wasn’t happy for the usual reasons. Also, the response was unpredictable. Sometimes I’d stay hard longer than I wanted to, which was a problem if I needed to be in public.
My testosterone labs often came back on the high end of low - low end of normal, and my estradiol often came back low. I did some thorough research online and found a TRT specialist with positive reviews. While he wasn’t an ED specialist, the idea was that if my levels increase to a therapeutic level, EDmay go away. He honestly told me TRT may be a 6-12month process before it fixed ED, if it does at all. He tried testosterone and hcg shots, plus Anastrozole. The dosage was similar to standard therapy, usually around 28-32cc (56-64mg) testosterone cypionate twice a week, HCG 400-500iu twice a week, 0.3mg anastrozole twice a week, and 7mg tadalafil a day as needed. This combination improved my ED only somewhat. He routinely checked my blood work every 3-6 months. Generally kept my lab values of testosterone near the high end of normal - low end of high. After 1-2 yrs, I realized this protocol wasnt helping enough so I tapered off.


Based on my research, I think my plan will be:
-Retry tadalafil one more time, but this time from a source I’m sure is legit as I know generic is now available legally in the states.
-I'm already at a decent weight of 180lbs at 5'11, but I can spend the next 2 months slowly dropping my weight to 155lbs and see how my ED is.
-If no success, consider a penile implant.
If you know of any other better alternatives, or new better treatments that are coming out fairly soon, let me know.




Medical conditions that may be causes/contributors to ED:
----- I know I had high cholesterol since youth, and maybe that led to ED. I recall my primary checked cholesterol around my late teens. He told me it was high for someone young. It may be genetic as my skinny mom has high cholesterol too. I eat better than the average american and exercise, but total cholesterol and LDL results still often come back on the low end of high these days.
----- Moderate pain and occasional involuntary spasms, mostly on the left side of my body only, mainly near core/pelvic regions and head. Possibly from playing alot of basketball in my youth and heavy lift exercises in my 20s. Had 1 MRI that stated mild spinal stenosis (dad has severe spinal stenosis) with disc herniation at L5-S1, and another that only mentioned disc herniation at L5-S1 and no spinal stenosis. Tried PT without much success. Managed thru exercise.
----- As explained earlier, I’ve had testosterone tested multiple times that often came back on the high side of low. Not sure why it’s low as I'm muscular. Most likely genetic as my brother's is low too, but his sex life appears normal.


Medical conditions less likely related:
----- Irregular bowel movements for yrs. Powdery/loose stool 1-2x a week on avg for probably a decade. About 5 yrs ago, doctor did a colonoscopy and found nothing. He believed it to be diet related. Recently, I think I noticed that once I stop eating probiotic foods and oatmeal for awhile, the irregular bowel movements returned, so that’s how I manage.
----- Eczema flareups every few yrs. Sometimes moderate or severe. When severe, I used to resort to steroid creams or prednisone more when I was younger, but now I try my best to manage naturally.

[closed278 Senior Member Find all posts View Profile Close closed278]

Hormones tested? what were they exactly?

Citrulline and nitrate rich vegies? have you tried?

Good erections require a few things. GOOD hormone levels, arginine in the blood to boost NO, best way is citrulline supplenement, and also a nitrate rich diet such as cellery/beats/ etc.

1. Get hormones up high
2. Add LOTS of nitrates into diet
3. Try citrulline supplemt or watermellon if you want the full natural way

Until you do all these things, I wouldn't even consider an inplant.

4. Red light therap
5. Shockwave therapy

Good luck.

[Jay1983 Senior MemberMember of the Month Apr 2014, Sept 2016 Find all posts View Profile Close Jay1983]

Visit a pelvic floor specialist if you haven't already.

Welcome to the jungle.

[Pegasus AdministratorPE Gym EditorPEGym Hero ☺ Admin of the Month Mar 2015 Find all posts View Profile Close Pegasus]

Your back issues seem to have caused pelvic floor issues which are implicated in your issues . A physio who also does male pelvic floor work is well worth a consult .

[not2big Senior Super ModeratorPEGym Hero Find all posts View Profile Close not2big]

What was the dose of Trimix you tried and do you recall the mix of the ingredients? Both can be adjusted to change your reaction To Trimix.

Have you tried a “Medical Type” Vacuum erection device (VED.) You need to exhaust these two treatment options before you take the final step to an implant.

[closed289 Senior Member Find all posts View Profile Close closed289]

"I get an erection when desired about 65% of the time, and can hold it successfully for intercourse about 33%"

Is this with or without erector drugs?

[PeaceOfPainSeeker007 Junior Member Find all posts View Profile Close PeaceOfPainSeeker007]

Hormones tested? what were they exactly?

Citrulline and nitrate rich vegies? have you tried? Good erections require a few things. GOOD hormone levels, arginine in the blood to boost NO, best way is citrulline supplenement, and also a nitrate rich diet such as cellery/beats/ etc.

1. Get hormones up high
2. Add LOTS of nitrates into diet
3. Try citrulline supplemt or watermellon if you want the full natural way

Until you do all these things, I wouldn't even consider an inplant.

4. Red light therap
5. Shockwave therapy

Thanks. This is a 15yr ordeal so I exhausted many of the popular natural and conventional treatments already.
-I have more discipline than the average person, so I already researched and tried all the ED diet stuff.
-I haven't heard of red light therapy. What is that?
-I saw a doctor who does shockwave, but he didnt recommend it in my case given it's new, experimental, and costly, so I've never tried that. He prescribed me trimix/bimix instead, which isn't ideal for me.

Visit a pelvic floor specialist if you haven't already.

Interesting. You've peaked my curiousity. I'll google some pelvic floor specialists. I think I tried pelvic floor exercises on my own from watching videos long ago, so if that's what the treatment is, maybe it won't help. I never tried with an expert though. Perhaps I should look for one.

Your back issues seem to have caused pelvic floor issues which are implicated in your issues . A physio who also does male pelvic floor work is well worth a consult .

Physio as in physiotherapists?

"I get an erection when desired about 65% of the time, and can hold it successfully for intercourse about 33%"
Is this with or without erector drugs?

Hi Darren, as mentioned prior, with drugs, I get a great response for 2 weeks of taking about 20mg or so every other day. But then side effects of more back pain starts creeping in, and the pills stop being effective. Perhaps a tolerance buildup, or the buildup of side effects taking away the mood. I tested this twice and same result.

What my plan will likely be after reviewing these responses:
-Research what pelvic floor specialist or physios can do for ED. If it's something I havent tried already, then I'll try their treatment.
-I'm at the higher end of a healthy BMI (5'11, 180lbs) with slightly above average muscle. Over the next 2-3 months, I'm going to drop my weight to the middle of a healthy BMI, 160lbs. Doing that might help with ED and lowering genetically high cholesterol.
- The 2-3 months gives me time to research implants more as well and how to prepare for it if it comes to that. If the pelvic specialist and weight loss works, great. If not, then at least I'm at a healthier weight to handle to stress of surgery.

I wish I could find someone who had the implant while they were young, and how happy they are 20+ yrs later. Although unsure, it seems like young people are only doing this treatment more so recently (due to the increasing rates of young males with ED). Thanks.

[Pegasus AdministratorPE Gym EditorPEGym Hero ☺ Admin of the Month Mar 2015 Find all posts View Profile Close Pegasus]

Most commonly recommended pf exercises on the net are kegels which would be counterproductive.

Like several of us have said a physio who does male pelvic floor.

[closed278 Senior Member Find all posts View Profile Close closed278]

You still didn't mention if you have your hormones tested.

Many people say they've tried natural/alternative means but they haven't done it in proper order.

1. Get your hormones straight.
2. Get your stress levels straight (inluding any pelvic floor work)

3 Get your nutrition straight.
This includes a good source of nitrates and healthy oil like olive oil.

4. Add in things like Red light, PEMF, other things to stimulate sex drive, arousal, etc.

Just saying "I've tried it all" doesn't mean you tried it right.

I was worse then you and now I have too many erections that wake me up at night and morning wood every morning.
I had servere ED for 15 years, worse then you, until I did what I wrote above and fixed things.

[Pegasus AdministratorPE Gym EditorPEGym Hero ☺ Admin of the Month Mar 2015 Find all posts View Profile Close Pegasus]

You still didn't mention if you have your hormones tested.

Many people say they've tried natural/alternative means but they haven't done it in proper order.

1. Get your hormones straight.
2. Get your stress levels straight (inluding any pelvic floor work)

3 Get your nutrition straight.
This includes a good source of nitrates and healthy oil like olive oil.

4. Add in things like Red light, PEMF, other things to stimulate sex drive, arousal, etc.

Just saying "I've tried it all" doesn't mean you tried it right.

I was worse then you and now I have too many erections that wake me up at night and morning wood every morning.
I had servere ED for 15 years, worse then you, until I did what I wrote above and fixed things.

My experience in the pre e field is I get guys every week saying they "tried it all " never yet been true .
The Op who tried it all is cluesless about the whole pf field .
In the pre e field I now say yeah look just read the stickies throughly then we can talk.

[PeaceOfPainSeeker007 Junior Member Find all posts View Profile Close PeaceOfPainSeeker007]

You still didn't mention if you have your hormones tested.

Many people say they've tried natural/alternative means but they haven't done it in proper order.

1. Get your hormones straight.
2. Get your stress levels straight (inluding any pelvic floor work)

3 Get your nutrition straight.
This includes a good source of nitrates and healthy oil like olive oil.

4. Add in things like Red light, PEMF, other things to stimulate sex drive, arousal, etc.

Just saying "I've tried it all" doesn't mean you tried it right.

I was worse then you and now I have too many erections that wake me up at night and morning wood every morning.
I had servere ED for 15 years, worse then you, until I did what I wrote above and fixed things.

DontTakeCiPro, I appreciate any advise. I really do. However, in case missed, I touched on hormones in my 2nd post (I didnt share the results, which I can if useful, but I've had others evaluate it as well as the doctor). My testosterone and estradiol is naturally low. My brothers testosterone is low too, but he doesn't appear to have sexual side effects, although I'm unsure. Still, I researched the topic for hours, and tried naturally to solve it for 1-2 yrs. Not just blindly but based off what I researched. As that failed, I saw a very well-reviewed and popular doctor for TRT/HRT for the next 13-15 months, Dr. Saya. As treating hormones unnaturally didn't help enough, I tapered off TRT/HRT about a yr ago.

As you suggested, I already tried high nitric oxide foods already like beets/arugula. I was hopeful it would help ED at the time of learning about it, but it just never helped enough.

However, I'm unaware of red light therapy and PEMF. I'll look into it and if the research shows a high satisfaction rate for treating ED while at least being somewhat cost-effective, I'll definitely try it.

[PeaceOfPainSeeker007 Junior Member Find all posts View Profile Close PeaceOfPainSeeker007]

Most commonly recommended pf exercises on the net are kegels which would be counterproductive. Like several of us have said a physio who does male pelvic floor.

Thank you. I tried kegels. I then mixed in reverse kegels as the data out there was confusing on which way helps for ED. Although hard to remember, I vaguely recall researching "pelvic floor erectile dysfunction" long ago and ran into some guy recommending multiple exercises and releasing tension thru trigger points. Gave it up after about 2 weeks and went back to my usual exercise routine. I'll research specialists now. If you recommend any near NY, feel free.

My experience in the pre e field is I get guys every week saying they "tried it all " never yet been true .
The Op who tried it all is cluesless about the whole pf field .
In the pre e field I now say yeah look just read the stickies throughly then we can talk.

I'm sure I haven't tried it all, but I did try many natural treatments as researched on the web thru pubmed and articles, as well as many conventional treatments by doctors. While I'm open to experimental treatments, I try to limit it unless the data is very positive, while at least somewhat cost-effective.

[Pegasus AdministratorPE Gym EditorPEGym Hero ☺ Admin of the Month Mar 2015 Find all posts View Profile Close Pegasus]

Thank you. I tried kegels. I then mixed in reverse kegels as the data out there was confusing on which way helps for ED. Although hard to remember, I vaguely recall researching "pelvic floor erectile dysfunction" long ago and ran into some guy recommending multiple exercises and releasing tension thru trigger points. Gave it up after about 2 weeks and went back to my usual exercise routine. I'll research specialists now. If you recommend any near NY, feel free.


I'm sure I haven't tried it all, but I did try many natural treatments as researched on the web thru pubmed and articles, as well as many conventional treatments by doctors. While I'm open to experimental treatments, I try to limit it unless the data is very positive, while at least somewhat cost-effective.

Ok so it often takes more than 2 weeks for a guy to even learn how to do a rk correctly .
Read this then we can talk if you want.

https://www.pegym.com/forums/erectil...tml?highlight=

[PeaceOfPainSeeker007 Junior Member Find all posts View Profile Close PeaceOfPainSeeker007]

Hormones tested? what were they exactly?

Citrulline and nitrate rich vegies? have you tried?

Good erections require a few things. GOOD hormone levels, arginine in the blood to boost NO, best way is citrulline supplenement, and also a nitrate rich diet such as cellery/beats/ etc.

1. Get hormones up high
2. Add LOTS of nitrates into diet
3. Try citrulline supplemt or watermellon if you want the full natural way

Until you do all these things, I wouldn't even consider an inplant.

4. Red light therap
5. Shockwave therapy

Good luck.

Hi closed278/all,
Where can I go to try red light therapy for ED? I found articles about it but not how I can buy it to try.

Already tried 1, 2, and 3 awhile ago for months-yrs. It wasn't good for me socially to be as strict as I was with diet (and possibly mentally too), but I went thru it. A urologist I saw specifically that offered 5 (shockwave) discouraged me from trying that.