Can you take ED medication after an implant?
Tablets for erectile dysfunction are not needed for rigidity once an implant is in place, because the implant makes the shaft firm. After surgery, PDE5 inhibitor tablets and alprostadil have been used to improve warmth, sensation and swelling of the glans, but the evidence is too limited to guide practice. PDE5 inhibitors must never be combined with nitrates.
What does an implant replace?
PDE5 inhibitor tablets, such as sildenafil and tadalafil, are the first-line treatment for erectile dysfunction. When tablets seem not to work, incorrect use or too little information about how to take them is the main reason, so their use is reviewed before moving on. An implant is recommended when treatments like these fail or when the patient prefers a definitive option. Once the implant is in place, it makes the shaft firm on its own, and the erection lasts as long as the man wants.
The implant does not usually make the glans, or head of the penis, rigid. That is the part of the erection where medication has been tried after surgery.
Why would ED medication be used after implant surgery?
"Post-operatively, IU alprostadil and PDE5i medications have been used to improve glans temperature, sensation, and enlargement." Source 2, p. 31
IU alprostadil is a medicine placed into the urethra, and men with erectile dysfunction are told about it as one of their treatment options. It is effective in improving erections, although data are still limited, and an in-office test is performed before a man starts using it. Its use after surgery is aimed at the glans, which the implant cylinders do not fill. The American guideline panel considers the data on approaches like these insufficient to provide clinical guidance, so whether medication is used after surgery is decided with the surgical team.
Is it safe to take PDE5 inhibitors with other medicines?
Nitrates are the main danger. Using any form of organic nitrate or nitric oxide donor, including recreational amyl nitrite or nitrate known as poppers, is an absolute contraindication to PDE5 inhibitors, because the combination can cause a precipitous drop in blood pressure.
Men who take nitrates regularly should not use PDE5 inhibitors. Men who carry nitroglycerin tablets for angina are advised not to take them within 24 hours of a PDE5 inhibitor, and possibly longer after a long-acting tablet such as tadalafil. Many other medicines can also interact with PDE5 inhibitors, so the full medication list is reviewed before any prescription.
Does an implant change sex drive or orgasm?
An implant has no direct effect on sex drive, and a man who is struggling with low desire has that problem assessed separately. The implant does not enhance orgasm or ejaculation, and medication after surgery is aimed only at the glans.
Counselling aimed at sexual and relationship concerns may help both the man and his partner after implant surgery. Counselling before surgery also covers these limits so that expectations match what the device does. Men with realistic expectations before surgery report higher satisfaction afterwards.