For men with severe erectile dysfunction (ED), the radical option of a penile implant may very well be worth the high sticker price, according to a study published Monday in the Journal of Sexual Medicine.

Polling 47 men who received a penile prosthesis sometime in the past decade, the Portuguese researchers found that 79 percent reported feeling satisfied afterwards. The reasons for that satisfaction included, among others: a renewed ability or desire to have sex; an improvement in their intimate relationships; and simply being able to pee standing up again. In addition, nearly all the men said they would recommend an implant to those in a similar situation.

“[T]he level of satisfaction with the implementation of penile prostheses is very high, therefore constituting a treatment for ED with a positive impact on the experience of men at a sexual, psychological, and relational level,” the researchers concluded.

A Boost Up

According to the research team, hailing primarily from the ISPA, University Institute in Lisbon, penile prostheses have come a long way in their design and function throughout the decades. Despite these advances, they can still come saddled with rare complications, from infection to coming loose and having their parts extrude through the penis itself.

And though earlier research has found an overall customer satisfaction with implants, the researchers this time around wanted to get a more specific picture of why men were and weren’t pleased with their procedure. Interviewing their subjects over the phone, they hit upon several broad themes.

The most common reasons for their satisfaction revolved around the psychological, with the men often citing improvements to their self-esteem and confidence after implantation. Similarly, the boost to or restoration of their sexual function was also frequently referenced. A smaller percentage cited their relationships as a measure of the implant’s success. “I did not get satisfied and nor did the other person, even if I wanted to get involved with someone,” commented one anonymous subject to the researchers. “Now it's different. I can give and receive pleasure.”

For those who weren’t so happy with their new device, it often came down to unfulfilled and likely unrealistic expectations about how much it would improve their lives — sex or otherwise. Others were displeased with the size of their penis after its insertion, while at least two reported that their wives still weren’t satisfied themselves.

The 47 men underwent 53 surgeries from 2003 to 2012, with their average age at the time being 58. Of these, 13 involved an implant being fixed or replaced. Fourteen of the implants were semi-rigid and malleable prostheses and the rest were inflatable. More than 90 percent of men currently had either a long-standing relationship or occasional partners, while the lack of a partner contributed to greater dissatisfaction with the implant. Strange as it might seem, 19 percent of these partners had no idea about the implant at all.

Given that penile prosthesis implantation (PPI) is oftentimes a treatment of last resort for people who have already failed to respond to less intrusive options, the researchers are encouraged by their findings. “Only one man would not repeat surgery and six reported not being sure. All would recommend the implant except for two who were not sure,” they wrote. “Thus, the results support other studies that found high levels of satisfaction with PPI.”

Source: Carvalheira A, Santana R, Pereira N. Why Are Men Satisfied or Dissatisfied with Penile Implants? A Mixed Method Study on Satisfaction with Penile Prosthesis Implantation. Journal of Sexual Medicine. 2015.