Penile injections or implants. Women’s perspective.

[hamburg123]

I’m a 56-year-old man. I was diagnosed with prostate cancer in 2023 and had the prostate removed about a year ago. Operation was a success and thankfully they caught it before it spread.

One of the consequences of the procedure is erectile dysfunction. Most men recover within 3-24 months, either naturally or with assistance from Cialis or Viagra but in my case there’s been zero improvement.

So about six weeks ago a specialist showed me how to inject a medication called Alprostadil. You mix the medication in powder form with a liquid solution and inject it into the side of the penis (3pm or 9pm, as the doctor said) near the base. It’s not at all painful so that’s not really an issue.

It didn’t have much effect on the lowest dose so the idea was that I self-inject at home, increasing the dose until I find out what dose works for me.

Problem is when I tried it at home the first time I just couldn’t do it. My hands were shaking and despite knowing in my head that it wouldn’t hurt it just felt so unnatural I couldn’t go through with it.

I explained this to the doctor today and she suggested maybe coming in again to do it either supervised or with her helping out like the first time. Alternatively, if I can’t get over this mental barrier, she suggested another possibility - penile implant surgery.

I’ve known these two options were possibilities since before the operation but I didn’t really expect it to come to this. I’m certainly not ready to give up on my sex life but I’d appreciate women’s perspective on this choice.

The short-term pain of surgery seems a fairly small price to pay for an instant erection that lasts as long as I (or a partner) want it to. And I imagine women might find it a bit of a passion-killer having to wait while I go off to the bathroom, mix up a solution and inject myself and wait 5-10 minutes for a reaction.

I’m kind of resigned to never having a ‘natural’ erection again, but that’s life and it’s a damn sight better than having cancer. I also wonder how women would feel if they’re not the direct cause of an erection with a partner. Would it create doubt or anxiety if you didn’t have that kind of obvious evidence that you’re turning someone on?

If it’s relevant I’m not in a relationship and haven’t been since Covid so this is about potential relationships not any current one.

I’ve had a partner with ED as part of another, complex medical issue. What killed the relationship was not the ED but the broken communication and refusal to discuss it.
If a man I were in a relationship with chose either of the solutions you are being offered and talked to me about them, made me feel confident and sexy so the self-doubt didn’t creep in, and considered my needs as well as his own I’d be happy. I might even offer to help with the injections! Good luck!

Would implants give you a permanent erection?

I am sorry to hear about your diagnosis. You have a problem not of your making and it looks as if you have found a solution. I would feel relaxed about it and see the injections as a legal recreational drug. I hope all goes well. x

How does it work (sorry not really relevant)? Does it mean a permanent erection?

If the rest of the relationship is right it shouldn’t be an issue, any more than any other medical problem (sexual or otherwise). And like you say, it’s a lot better than having cancer.

If you're not currently in a relationship, don't panic too much. If you find someone you like, take your time and if it's mutual and you have chemistry, I'm sure there will be a solution - as the above responses indicate.

@hamburg123 I’m sorry you e gone through what you’ve gone through, unfortunately, as you know , prostate removal is one of the leading causes of ED and the likely hood of getting ED is around 80% I think?

you have three options - injections , such as grimace and quad max which are reliable, but need to be kept in the fridge and as you say kill the moment somewhat. Your body will also get used to them and the dosage will need to be increased until they no longer work. They can also cause scarring which can lead to Peyronie’s disease.

Vaccum pump - The least intrusive option, where by you use a vaccum to pump and then keep the blood in the penis with a constriction ring. Works for most men, isn’t particularly sexy and the blood can only be restricted for 30 minutes.

implant - there are two types- an inflatable ((IPP) or a rigid. A rigid has a lot lower chances of mechanical failure but you will have an erection constantly. An IPP gets pumped up and and when you need to use it and only goes down when you want it to, even after you’ve cummed. IPP’s are by far the most popular, but choose your surgeon wisely. You need a high volume surgeon who does a minimum of 100 per year.

As for your question - I got an IPP 3 years ago, at 37 years old. It’s the best decision I ever made and I can honestly say I have had zero negative feedback and actually quite the opposite. I’m very open about it, and will even tell random strangers about it after a few drinks. It looks no different, feels no different ( except the hardness is diamond hard ) and if I wasn’t open and honest about it I doubt anyone would know I had one.

at 58, I would suspect most women would be grateful you can get hard, how you get hard will be somewhat irrelevant. With ED it’s generally the corpus cavernosa that gets damaged, and not the glands so it should still be obvious that you are turned on. An implant does not affect your sexual desire.

One important thing to remember is it’s unlikely you’ll be getting night time erections so you will get atrophy if you haven’t done so already - expect to lose half an inch per year until you sort yourself out. Once you get an IPP the scarring in the corpus cavernosa will stop and you will not lose any more size.

I found frank talk a huge help, I have also PM’d you so feel free to ask if you have any questions.

@Dexysmidnightstroller no, there is a pump in the ball sack, it’s basically a third testicle and this gets pumped when an erection is needed and a tiny button the other side which when pressed deflates the penis.

@hamburg123 , first thing is, you are here. And tbf that's really the only important thing. Well done. You're ok. And getting an erection can be achieved one way or another, so it's all good.

If a woman met you and fell in love with you, then I'd hope she'd be the one to do the injection carefully for you. It could even be quite arousing to do that, to know you both want sex, and for her to help do that for you and you both wait for your reaction and erection, then make the most of it.

Someone who loves you will understand this. If I fell in love with someone I'd be just so happy he'd survived, and I'd help with the erection. Of course I'd understand if he can't now get naturally hard because of a technical issue, that doesn't mean he doesn't want me... just have to show it in other ways.

You just need a nice woman who loves you.