Erectile dysfunction is a common problem affecting a large number of men worldwide. Among the various treatment options available, intracavernosal injections occupy an important place, especially when oral treatments such as Viagra or Cialis are ineffective or contraindicated. However, despite their recognized efficacy, these injections are not suitable for everyone, and some patients end up abandoning this treatment after a certain period. In this article, we explore in detail what treatment with intracavernosal injections involves, why some patients aren’t satisfied, and what surgical alternatives exist, including penile implants, through the testimony of one patient, Yassine, accompanied by Dr. Sébastien Beley, urologist and andrologist in Paris.

Intracavernosal injections: an effective but sometimes limited solution

Intracavernosal injections involve injecting a vasoactive drug directly into the corpus cavernosum of the penis. This treatment is generally proposed when oral medication does not work or cannot be used, particularly in certain patients with medical contraindications. Dr. Sébastien Beley points out that this treatment is effective in more than 8 out of 10 patients, even in men whose erectile dysfunction is more severe than that treated with conventional pills.

This high level of efficacy makes intracavernosal injections a serious and often recommended treatment option. However, it is important to point out that this solution is not suitable for all patients. Indeed, despite the positive results observed in terms of erection quality, many men end up abandoning this treatment after a year or so. This begs the question: why abandon the treatment when it is so effective?

Reasons for abandoning intracavernosal injections

Several factors explain why some patients stop intracavernosal injections:

• Psychological difficulties: Having to inject a drug into the penis can cause apprehension, embarrassment and even fear. Some patients feel dependent on an external product they have to administer themselves, which can affect their spontaneity and self-confidence.
• The complexity of dose management: Finding the right dose isn’t always straightforward. Too low a dose may not achieve a sufficient erection, while too high a dose may result in an erection that is too rigid, painful and prolonged, which is uncomfortable and can even be dangerous.
• Side effects: Some patients may experience a loss of sensitivity or pain following the injection, which can impair the quality of the sexual act.
• Invasiveness and constraint: The need for preparation before each sexual encounter, such as retiring to a private area to perform the injection, can be perceived as a hindrance to pleasure and spontaneity.

These combined factors explain why, despite their undeniable clinical efficacy, intracavernosal injections do not always win lasting patient acceptance.

Yassine’s story: a journey from injections to penile implants

To better understand the challenges faced by patients undergoing intracavernosal injections, Dr. Sébastien Beley shares the testimonial of Yassine, a patient who experimented with this treatment before opting for a surgical solution.

Yassine’s difficulties with injections

Yassine explains that his experience with intracavernosal injections, in particular the drug EDEX, has not been satisfactory. Several reasons contributed to this dissatisfaction:

• An important psychological dimension: Yassine admits to having found it difficult to inject himself, not wishing to depend on an external product to achieve an erection. This perceived dependence generated a psychological block, reinforced by the need to hide in a private place, such as the toilet, to carry out the injection.
• The difficulty of finding the right dose: After several trials at the doctor’s office, Yassine experimented with doses that were too strong, resulting in a very rigid, almost “wooden” erection and a loss of sensation for several hours. This situation forced him to do exercises to reduce blood flow to the corpus cavernosum.
• Doses too low: Conversely, some injections were not strong enough to maintain a sufficient erection for sexual intercourse, which was frustrating and discouraging.

These technical and psychological difficulties led Yassine to consider other options, including surgery, to regain a satisfying sex life without constraints.

Choosing a penile implant: regaining your freedom

After weighing up his options with Dr Beley, Yassine decided to have a penile implant. This surgical solution involves inserting a prosthesis into the penis, enabling a mechanical erection to be achieved on demand, without relying on injections or oral medication.

A few months after the operation, Yassine reports great satisfaction:

• He no longer feels the pressure or stress of having to inject.
• He has regained complete autonomy for his sexual relations.
• He no longer needs to resort to drug treatments.
• Erectile quality is stable and controllable.

For Yassine, the surgery was a real liberation, allowing him to live his sexuality to the full without constraints or anxiety.

Understanding the different options for treating erectile dysfunction

Intracavernosal injections are just one of the many options available for treating erectile dysfunction. Depending on the severity of the problem, patient preferences and medical conditions, different treatments may be considered:

1. Oral treatments

Phosphodiesterase type 5 (IPDE5) inhibitors, such as Viagra (sildenafil) or Cialis (tadalafil), are often the first line of treatment. They promote vasodilation and improve blood flow to the penis. However, they are not suitable for everyone, especially those with cardiovascular disease or taking certain medications.

2. Topical gels

Gels such as Vitaros or Eroxon can be applied locally to the penis. They are an alternative for patients who cannot tolerate tablets or prefer local application. Their effectiveness, however, depends on individual sensitivity.

3. Intracavernosal injections

As explained above, these injections are used when oral treatments are ineffective or contraindicated. They offer a rapid and effective response, but can be difficult to manage for some patients.

4. Penile implant surgery

When other treatments fail or are unsuitable, a penile implant is a lasting solution. This involves inserting a prosthesis into the corpora cavernosa, enabling a mechanical erection to be achieved. The procedure is generally well tolerated, and offers a high level of satisfaction.

How do you choose the right treatment?

The choice of treatment must be personalized, taking several factors into account:

• The degree of erectile dysfunction: some mild forms can be effectively treated with oral medication, while severe forms require more invasive solutions.
• Patient preferences: Tolerance to treatments, fear of injections, or the desire to avoid surgery influence the choice.
• Medical conditions: Certain pathologies or drug treatments may prohibit certain treatments.
• The desired quality of sexual life: Spontaneity, frequency of intercourse and couple satisfaction are all factors to be taken into account.

A specialized consultation with an andrologist can assess these criteria and guide the patient towards the most appropriate option.

The role of medical and psychological follow-up

There’s more to treating erectile dysfunction than simply prescribing a treatment. Regular medical follow-up is essential for :

• Adjust doses of medication or injections.
• Monitor any side effects.
• Assess patient satisfaction and adapt care.

The psychological aspect also plays a major role. Erectile dysfunction can be a source of stress, anxiety and even depression. Psychological or sexological support can help to remove blockages and improve the quality of sexual life.

Conclusion: between intracavernosal injections and penile implants, find the solution that’s right for you

Intracavernosal injections are an effective treatment option for erectile dysfunction, particularly when oral treatments are unsuitable. However, they are not suitable for everyone, due to their invasiveness, psychological difficulties or dose management.

Yassine’s story illustrates these challenges, but also the alternative solutions available. A penile implant can offer new-found freedom, consistent erection quality and a fulfilling sex life free of constraints.

It’s vital not to be left alone in the face of these disorders, and to consult a specialist for a precise diagnosis and personalized support. Each patient is unique, and treatment must be tailored to his or her needs and expectations.

Finally, it’s important to remember that sexual health is an integral part of general well-being. Taking care of it also means preserving quality of life and emotional relationships.

If you have any questions or would like to make an appointment, please do not hesitate to consult a specialist urologist andrologist.