Why some men reject a cure for ED

Even though I've been a Medical Social Worker I had no clue I'd been suffering from PTSD, short for Post Traumatic Stress Disorder.

How and why would I experience PTSD when I made a choice which would put an end to my suffering with erectile dysfunction? To say I was confused would be the understatement of the year.

Post-traumatic stress disorder (PTSD) can affect those who personally experience the catastrophe, those who witness it, and those who pick up the pieces afterwards. Receiving a dx of prostate cancer, coping with the loss of urinary control, & erectile dysfunction are catastrophic changes in the life of a man and in the life of a couple.

Symptoms of PTSD include
Re-experiencing the traumatic event.
Intrusive, upsetting memories of the event
Flashbacks (acting or feeling like the event is happening again)
Nightmares (either of the event or of other frightening things)
Feelings of intense distress when reminded of the trauma
Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating)
Symptoms of PTSD: Avoidance and numbing

Avoiding activities, places, thoughts, or feelings that remind you of the trauma
Inability to remember important aspects of the trauma
Loss of interest in activities and life in general
Feeling detached from others and emotionally numb
Sense of a limited future (you don’t expect to live a normal life span, get married, have a career)
Symptoms of PTSD: Increased anxiety and emotional arousal

Difficulty falling or staying asleep
Irritability or outbursts of anger
Difficulty concentrating
Hypervigilance (on constant “red alert”)
Feeling jumpy and easily startled

After I scheduled myself for implant surgery I began to experience many of these symptoms. Especially trouble sleeping and a high level of anxiety. In addition, my wife and I saw a dramatic rise in irritability and fighting. We didn't understand what was happening in our marriage. We saw a counselor who confirmed both of us were suffering from PTSD.

That took me by surprise. I was expecting to be restored by surgery, It was a choice I made and I was expecting a positive outcome. I didn't understand why these circumstances would bring about symptoms of PTSD.

For the last four years, there's only one thing that brought my wife and I into San Francisco, Every trip involved something to do with the diagnosis and treatment of prostate cancer. Pre surgery & post surgery visits as well as my unsuccessful penile rehab all took place in the city San Francisco. Receiving the news I'd be impotent for the rest of my life also took place in San Francisco.

Even though I was cured from cancer in San Francisco, my life was unalterably changed for the worst in that city as well. Now I was returning to UCSF in San Francisco once again, hoping for a positive life changing experience.

Our minds were locked into all the negative life changing events that happened as a result of our visits to San Francisco. Although we wanted to feel positive about the reasons why we were returning to San Francisco once again, we got stuck re-living the trauma of all that happened there during the last four years.

For many men it's not the return to a city that triggers PTSD, it's a return to ANY surgeon that triggers PTSD. That's the reason why I hear the following comments when I discuss the amazing restoration brought about by the implant procedure. Here's a sample of those comments:

"I"ll never go within a mile of another surgeon."
"There's no way I'll have another surgery."
"I won't let a surgeon touch me ever again."

The comments above are all expressions of a powerful desire to avoid any further surgery that's now associated with the devastating effects of erectile dysfunction. This avoidance that comes from PTSD is powerful and resistant to any form surgical treatment no matter how successful.

It's often worse for the men who've had double nerve sparing surgery, yet failed to re-gain their erectile dysfunction, In this situation issues of trust are involved. Many men with double nerve sparing surgery believe they've been lied to or betrayed, As a result, they've made a life long decision they'll never trust a surgeon again. That decision effectively sentences a man to a life time of misery coping with erectile dysfunction.

My point here is this, while penile implant surgery isn't for everyone, it's important to make this life altering decision based on the merits and risks involved in surgery rather than have the power of fear, the loss of trust,or avoidance that comes from PSTD make your decision for you. All too frequently, the resistance to penile implant surgery comes from PTSD, fear, or the lack of trust, rather than an objective analysis of whether this surgery could benefit you.

Penile Implant surgery has the highest success rate in treating ED. There's no other treatment of ED that has a higher user and partner satisfaction rate. I can say from personal experience that my implant restored what prostate cancer and surgery took away from me.

So don't let PTSD, fear, or the lack of knowledge determine your choice whether or not have implant surgery. Base your decision on the facts about penile implants.

This whole sex thing and quality of life (Qol) are things which many seldom speak about. There is a lot one could do; one needs to be adventurous and explore "new" avenues. I'll leave you with that thought!
.

You talk as though having an implant was a cure for ED when in is not! A cure would be in a sense restoring the ability to have a natural erection which a penile implant does not. Forget about having the sense of relief when a man ejauclates. What about those impulses that we used to feel when someone crossed our path to get us aroused? Will a penile I planr solve that? What about having a ncturnal erection? Will that return? So when you discuss implantas a cure, what do you really mean?

Q,

"point" taken!

Enjoy!
.

A number of people seemed offended because they got the impression I said PTSD was the ONLY reason SOME men live in misery with ED and won't consider an implant. My point was base your decision on the facts not your fears. Obviously there are dozens of reasons not to have the implant and they are all valid reasons.
Almost a 10 and Bigal I'll answer your questions:
You talk as though having an implant was a cure for ED when in is not!
We disagree here. Before surgery I was impotent, know I can have erections and resume making love with my wife. For me that restoration fits the definition of a cure. A cure does mean everything is restored to a pre surgery level.

Forget about having the sense of relief when a man ejaculates.
Like you there was a time when I hated the fact I no longer ejaculated and felt my experience with orgasms were ruined. I got over that grief. Now I enjoy my orgasms without ejaculation. In fact I told me wife the other day that I doubted I could tell the difference anymore about whether or not I've ejaculated because my orgasms feel as good as they did before surgery minus the mess. So I no longer mind the absence of ejaculation.

What about those impulses that we used to feel when someone crossed our path to get us aroused?
As a married man who is in his 60's I lost that before surgery. There was a time when simply seeing my wife resulted in an erection. If I want that experience again, I can look at her and pump myself up. It's different, but it works and I enjoy that.

What about having a nocturnal erection? Will that return?
Once gain you are focused on what you've lost and can't get back. If I'm not mistaken there's a touch or boat load, I don't know which of anger about these losses you've experienced. They are losses that need to be grieved before you'd enjoy any form of restoration. As for nocturnal erections, I'm delighted they are gone, all they did for me at night was to keep me awake. I sleep much better without them. In fact in my 30's I went to my Urologist and asked if he could give me anything to prevent nocturnal erections. Little did I know PC surgery would take care of that problem.

So when you discuss implants a cure, what do you really mean?
I mean this-two weeks ago my wife and I couldn't enjoy making love. Now we have mind blowing sex that involves sexual intercourse. After years of impotence and missing that experience I can safely say I feel cured of ED and mean just what I said.

Do you feel the implant was worth it?
Getting an implant was one of the best decisions I've made in my life. Why would I want to deprive myself and my wife of making love for the next two decades when we live in an era where most insurance companies covers the procedure and that implants have come a long way in terms of safety and reliability.

Do you honestly feel it has restored your sex life?
YES I do! Yet Is it different. I make feel more natural. For instance I have my wife rub my penis while I use the pump, so I have the experience of getting hard while she's touching me. After an orgasm, I like to deflate the pump so I have the experience of getting soft again after I've been satisfied. So we do things so the sequence of events is familiar.

Does it feel somewhat natural?
Once I'm enjoying sex there's no difference in my mind from pre surgery with one delightful exception. I know I can stay hard as long as my wife needs me to. No more early orgasms and incomplete experiences.
The sense of confidence brought about by implant is a life altering confidence.

Does your partner feel happy with the result and finds it seems natural?
My wife couldn't be more delighted.

Is it fun again?
Oh yea! It's amazingly fun AND no more worries about whether I'll stay hard or enough or orgasm too early. It's way past fun. It's amazing. In many ways it's BETTER than pre surgery sex. So if you've grieved your losses and ready to embrace a new post surgery sex life, and implant is a cure for ED.

Post Edited (RickRed40) : 3/22/2015 10:33:02 AM (GMT-6)

Nope, I didn't misunderstand what you said and don't feel offended, slightly patronised maybe.
I have looked in to all possibilities to help my ED and don't dismiss things on a whim or because I'm traumatised.
Glad it's working out for you.
Mike

Rudy
Thank you for your service to our country. Studies show that as many as 33% of those dx with cancer will suffer from PTST. If you google "PTSD and cancer" you will find hundreds of articles and studies that confirms this.
As far as ED goes, some men adjust well. Others do very poorly and relationships end. Implant surgery isn't for everyone. It does have the highest cure rate and patient satisfaction rate than every other form of treatment for ED. I've used ED meds, the vacuum pump and penile injections. The implant is by far and away better than all other treatments I've had. I couldn't be more pleased.

Post Edited (RickRed40) : 3/23/2015 12:09:04 AM (GMT-6)

You're not listening are you Rick?

Rick, I appreciate your thread here. I have strongly considered an implant, and in fact my URO encouraged me to start thinking about it because I was so young. He must be thinking I seem younger than I am, at 66 I don't feel all that young, especially post RRP. But I have found sexual sensation in general(on those oh so rare occasions of sexual activity) to be significantly less pleasant than before RRP, and there are a couple of other issues that make me wonder if it would be worth the trouble and risk of another surgery. Frankly, I just wish to heaven above that I would be relieved of any and all sexual thoughts or desires, the way the guys with androgen blockade have been, except without the other health related implications of no testosterone. I wish that desire would just go away on it's own, I think I would be better off. I'm in need of malebrainopause.

PeterDisAbelard. said...
I'm not sure which of us are obsessed with sex and erections, those of us who cut our losses and decide to settle for the unnatural possible, or those who pine for their lost "natural" capabilities, angry at their surgeons and envious of the serenity that they imagine comes with castration.

Well, that would be me I guess, definitely obsessed with sex and erections! Always have been! And surely do miss them, and the pleasure that went with them, miss what is lost from natural aging and/or the rapid speed up that came with surgery. And I may well go for the unnatural possible someday, but there are definitely one or two things to be considered to decide if the results of that would be worth the effort.

Not sure about the serenity part. But if and until I am actually ever able to achieve something pleasurable, and just can't see what good the desires ever do me, as opposed to providing longing for what is not available anymore. I do not desire any of the probable negative health effects that would come with castration, but I do not see what would be worse if I had zero desire for sexual intercourse with a woman.

EDIT: I could not finish- called to supper with the family- one of life's pleasures that remains full strength: good food!

But as for angry with my surgeon? MMMMM, not sure about that one. Possibly on some subconscious, irrational level. But it would be hard to justify. After all, he did a fine job of doing what surgeons do, and after 36 years in the OR I know all about surgeons. He did tell me it was a "no brainer" for some one with my stats and DRE results to have surgery. So I'm not so sure about that one now, but really I was never at all sure it actually was a no brainer, so that's on me. Plus, he apparently did a fantastic job for me to make it over a year < .01 considering my G9 and SV+.

And angry at him for my impotence? He told me up front that he could not spare nerves and I should expect total ED. Turns out he is very smart about that. So I can not really blame that on him. He told me no big deal I could just inject. That has turned out not to be very accurate, but seems to work pretty well for lots of other folks so maybe it's just me.

So, angry at my surgeon? Not consciously. Angry at myself? Maybe. Because I think in my heart I knew better. I knew I was going for maximum, immediate SEs, when it was quite possible that another treatment with probably fewer SEs and almost certainly fewer up front rather than down the road, and may well offer at least equal survival or cure possibilities. But still I chose surgery. So, if I am angry, I am angry with myself.

When you know it's permanent might be when the serenity settles in, I'm a bit serene.

Cheers, Doug

Oh, PDA, I forgot: it's good to know the surgery is not that bad(and again I have NOT 100% ruled it out), but what I am wondering lately is if having a fully adequate erection would restore pleasurable sensation? Because there is very little now. ( I did not realize before hand that this could even be an issue) I'm not sure I would be all that much happier being able to perform grandly if it still did not feel any better than those rare occasions have so far. And there is at least one other consideration. So I still have to think about it. For at least another day or two.

halbert said...
.................. My wife of 35 years is one of those women who went through menopause and (a) lost a good bit of her libido and (b) has found intercourse to be painful. She also has family history of breast cancer, so she has chosen to not even consider any of the hormone based creams or supplements. I guess I was taking the position that things were already very different..and we'd found ways to enjoy each other in spite of the changes of age.

If I was in the affected group, would I consider the implant? I honestly don't know. I do agree with one of the basic statements above: there is little value in obsessing over what is lost. What have I kept and what have I gained?

That actually is one of the other considerations for me- along with my own lack of pleasure(so far anyway). Though my wife is very considerate of my needs, at this point I'm pretty sure she could care less as far as she is concerned, or she might even prefer it as it is if I was happy with these conditions. Apparently she has those lack of desires I have been wishing for!

Since an implant is a surgery to recover from and like all surgeries has potential problems, a person has to- as always- look at the reward to risk(or pain/SEs etc) ratio. I think if I was convinced that the physical sensation of sex was(or would be) anywhere near as pleasurable as pre-RP and the only problem was the struggle to get the erection, and/or I had someone else who needed servicing so to speak, and/or I was a relatively young man with a young wife/girl friend, I most likely would be looking forward without reservation to my implant in a few more months. But as it is, I am not as excited about the possibilities as I was a few months ago.

Post Edited (BillyBob@388) : 3/24/2015 7:18:23 AM (GMT-6)