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Medical Forum / Diseases and Disorders / Prostate Cancer / March 2008Penile Implants
Hi, I would be interested in hearing from those in this NG who could provide me with information about their experiences with penile implants. Having had RP in December 2006 followed by Radiation (IMRT) in April/May of 2007 at 60 years of age I am now unable to achieve an erection. Meds do not work for me and neither do the so-called 'Gold Standard' Trimix Intracavernosal Injections which produce at best only a very weak erection barely adequate for 'stuffable vaginal penetration', very frustrating. I've tried various combinations and strengths of Trimix solutions from 3 different E.D. specialists so I've ruled out the possibility that I just haven't found the right doctor or the right Trimix combination. I've also tried VED's and although they do initially produce an adequate erection I find it doesn't last very long before going limp again even when I use the smallest ring size (I have a relatively small penis which doesn't help), so again the result is way less than satisfactory. I have been informed by one of the specialists I consulted with that my Testosterone level is very low and this is the likely cause of my problem. This is hard for me to believe because my sex drive is not suffering at all, just as strong as it ever was. I have also been informed by one of the other doctors that it is very highly unlikely at this stage that my natural erections will ever return which based on what I'm currently experiencing is quite believable. The other 2 doctors haven't totally ruled out the possibility of a return to normal sexual function at some point in the future but don't offer any guarantees that it will either. I just can't see me waiting another year or two to find out if my natural erections will return or not and as I near age 61 I would now like to move on with my life and resume a more normal sexual relationship with my loving wife. We've been together 38 years and I just feel I'm letting her down in the bedroom and although being the wonderful and supportive person she is she denies that I am and tells me we're doing alright. I guess being a typical man, I can't believe she's actually telling the whole truth to save me from being hurt. Oral sex and other erotic sexual foreplay activities are nice but in my opinion nothing quite replaces the sexual fulfillment of being able to enjoy vaginal sex with a fully erect penis. Since I am finding my current predicament totally distressing, I am now very seriously considering having a penile implant inserted but I'm concerned about how well these things work and what some of the side effects or other problems might be. I would greatly appreciate hearing about the experiences of others who have been through this and would gladly like to receive any advice, comments, and suggestions anyone can provide me with. I want to make an informed decision based on what others who have gone through this procedure have to say about it rather than what the doctors are telling me about it. I'm sure that most doctors intentionally or unintentionally leave out a lot of the details involved and therefore fail to tell the whole story just like they did prior to my RP and RT. If possible I would also very much like to hear from any of the female partners of the recipients of penile implants to hear what women think about this and what their experiences have been like. This information will be useful when I discuss this with my wife if and when I tell her about my plans to go ahead with this. I'm not sure how she will react at the moment so it would be good if I had a woman's perspective on this to prepare me to deal with what she may have to say about this. My suspicions are that she my be horrified that I'm even thinking of going to this extreme, not sure why I feel this way, just a hunch. Any information anyone can provide me with on this would be greatly appreciated. Best Regards, Norman > Routine check-up: June 2006 - No symtoms - revealed PSA of 27 @ age 59 > Biopsy: Aug 2006 G7 (4+3), T1c > RP: Dec 07 2006 G7 (4+3), T3, nerves spared but Pos margins > PSA: 0.2 @ 6 wks; 0.4 @ 12 wks; 0.57 @ 15 wks > IMRT: Apr 10 -May 22 2007 @ age 60 > PSA: 0.07 Aug 2007, 0.05 Dec 2007 > Hi, > [quoted text clipped - 16 lines] > size (I have a relatively small penis which doesn't help), so again the > result is way less than satisfactory. Good to hear from you again, Norman. Sorry to hear of your tribulations since you last posted. I'll not try to talk you out of the implant. However, it might be of some interest that it took me 1½ years to have a usuable erection. We have had at least three people in this NG in the last 6+ years who have had penile impants. The only one with a usuable address is: emeraldkr@aol.com Of the three, I think two were happy and one was botched.  SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 PSAD .056 years Lupron 07/03 (1 mo) 8/03 and every 4 months there after PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years Casodex added daily 07/06 PSA <0.04, <0.05, <0.04, <0.04, <0.1 2/12/08 Non Illegitimi Carborundum Thanks Steve for your quick reply and I appreciate your comments. I would be inclined to wait longer to find out if my natural erections will return except that in my case I'm lead to believe that because I've had both RP and RT, the 'double whammy', it is very unlikely this will happen. I've also had no improvement at all in over a year since RP in spite of the E.D. meds, injections, VED's and strong support from an attractive and attentive wife.So with all that, I've come to the conclusion it's just not gonna happen. I think that if I were going to become sexually functional again I would have at least seen some modest improvement by now. Unless I'm mistaken I don't believe it likely that I would progress from the completely impotent state I'm in now and suddenly wake up one day a few months from now with a useful erection. I'm sure this happens very gradually over time. If I had seen even a small amount of improvement during this time I would most certainly be waiting longer before considering an implant. Thanks again for your helpful response, Norman > Routine check-up: June 2006 - No symtoms - revealed PSA of 27 @ age 59 > Biopsy: Aug 2006 G7 (4+3), T1c > RP: Dec 07 2006 G7 (4+3), T3, nerves spared but Pos margins > PSA: 0.2 @ 6 wks; 0.4 @ 12 wks; 0.57 @ 15 wks > IMRT: Apr 10 -May 22 2007 @ age 60 > PSA: 0.07 Aug 2007, 0.05 Dec 2007 >> Hi, >> [quoted text clipped - 28 lines] > > Of the three, I think two were happy and one was botched. > Thanks Steve for your quick reply and I appreciate your comments. I would > be [quoted text clipped - 7 lines] > wife.So with all that, I've come to the conclusion it's just not gonna > happen. I too had the double whammy, but if you're convinced, you're probably right. The other side of the coin is that implants would be considered the gold standard if they did not involve cutting. If I ever regain interest in sex, I will very seriously consider an implant. Like you, I have another person to consider. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 PSAD .056 years Lupron 07/03 (1 mo) 8/03 and every 4 months there after PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years Casodex added daily 07/06 PSA <0.04, <0.05, <0.04, <0.04, <0.1 2/12/08 Non Illegitimi Carborundum Norman, I have no personal experience with these implants but spouse worked in a VA hospital for a number of years and saw the potential sad consequences of the old style, the one that is a semi-solid rod that leaves you with a permanent semi-rigid erection. These can cause erosion of the tissues at one end or the other resulting in considerable damage even to the point of working their way out. I'm sure you've seen pictures of a two-headed snake. I don't know if they even make these things anymore but if you're going down the implant route, opt for the newer pump-in-scrotum style. Dave Perry > Hi, > [quoted text clipped - 69 lines] > > - Show quoted text - Just posted this on my blog. Will try to do a complete interview with the subject. Every guy i know who's had this done, likes it. You can find out a lot of info about penile implants at the prostatepointers.org list, pcai (pc and intimacy). Quote of the Week: Life With My "Bionic Penis" "John", 59, wrote about his sex life with his new penile implant: After RP, three years of pills, VEDs, injections, frustrations . . . Now I have the AMS LGX -- and now she has what she needed. I'm afraid of too much wear and tear on this thing. The positive side of this disease is that with our new "bionic" penises we can do what teenagers can't do. Even after fighting this disease I now feel very fortunate and completely content with my sexual condition. If life plays more tricks on me and my condition goes the other way, I will still be appreciative because I have now gotten more than my fair share of sexual happiness Norman, It's great that salvage radiation appears to be working for you. That's the main thing. There are many men who envy you. Now to the secondary problem: I have no personal experience with penile implants. However my impression of them is negative for a number of reasons. First, there is very little long term data about them. You could be letting yourself in for significant health problems down the road. I would take Dave Perry's comments very seriously. The last thing you want is a few years of an erect penis followed by lasting damage and more surgeries that leave you worse off than you are now. Secondly, I'm not sure that the experience of an erection with a penile implant is really what you remember from your pre-treatment days. The surgery is a radical modification of the penis. You can imagine what inserting a big object like that must mean for the tissue that's there now. Sure, the penis is erect. But is the experience the same? I have no experience and can't say, but I am very suspicious that it's not the same. I take positive testimonials about these things with many grains of salt. A man goes through some major emotional trauma in deciding to go this route and when he comes out of it, he wants very much to convince himself that he did the right thing. I also think a lot of the testimonials we see from patients of surgeons who specialize in selling these procedures are taken just a few months after the implant. That's not enough time to see what is really going to happen or what the patient's long term feelings about it are. Finally, I want to make the case that your wife's comments about your doing alright are sincere and accurate. I don't mean to be crude, but to put it baldly, a case can be made that a penile implant is essentially a dildo. I'm not sure that it's any more lifelike, or real, or satisfying, than a dildo, or a strap-on, or a vibrator you can buy from a sex shop, and maybe it's less real than a finger. My own potency is reduced from what it was before treatment. I have tried to compensate by becoming a more sensitive and competent lover. Based on my wife's reactions, I think I've succeeded. You can too. In my view, sex and intimacy are not about preserving our youth. They're about an always evolving relationship between two people. We can't recapture our youth, but even as we grow old, we can continue to grow in other ways. Life is different. It doesn't have to be worse. We just have to learn to adjust and find new ways to live to the best of our ability. None of this is intended as criticism of your distress or your investigation of penile implants. I understand it completely. But I'm suggesting that they're not all that the purveyors of these things make them out to be, and they're not as necessary or even as useful as we might think. Good luck. Alan >Norman, > [quoted text clipped - 18 lines] >penis. You can imagine what inserting a big object like that >must mean for the tissue that's there now. My very limited understanding is that two of the three existing internal penile erectile structures are removed and replaced with the fluid chambers of the device, at least for the pump up version. As to all the stuff below, you said it VERY well. >Sure, the penis is erect. But is the experience the same? I >have no experience and can't say, but I am very suspicious that [quoted text clipped - 41 lines] > > Alan > Hi, > [quoted text clipped - 69 lines] > > - Show quoted text - ======> Dear Norman, I saw this news article that referenced penile implants and so I thought of you. Here's an excerpt and good luck Leah ------------------------------------------------------------------------------------------------------------------------------------------. Conventional Medical Treatment for Impotence Subodh Jain February 20, 2008 In some cases, especially in young men with vascular injuries, physicians may recommend surgery. Surgery may be used to implant a prosthesis to cause the penis to be erect, reconstruct arteries to increase blood flow to the penis, or repair veins that may allow a too- rapid exit of blood from the penis. Two types of implants are used: one consists of two semi-rigid but malleable rods; the other is an inflatable implant that can be expanded with a pressurized saline fluid. Men and their partners using prosthesis report a 93 percent satisfaction rate.
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