Confused and sad

@daddystressed
Oh my , that is really frustrating and on top of it painful : (((, I am so sorry that you have to endure all that . : ((( Yes, sometimes those implants leak but mostly do not and when they leak it is really very minimal and very thin pad or two a day would be more than sufficient. We had here couple of members that were very satisfied with those implants and it changed their lives completely.

Also, did you hear about so called "sling" that can be placed under the bladder (via surgery) and there is the newest device named " ProAct" ? Please Google those and maybe you will find them as possible solution.

Sending you the best wishes for finding help very, very soon 🍀.

@surftohealth88 Alan Wein continues his discussion with Craig Comiter about male stress urinary incontinence treatments, focusing on artificial sphincters and emerging technologies. Dr. Comiter explains that artificial sphincters provide more reliable outcomes than slings but with higher risk, achieving over 90% patient satisfaction with 20% never leaking and 77% using one pad or less daily. Long-term efficacy may decrease due to cuff or urethral atrophy, but replacement restores effectiveness. He highlights several innovations: the ATOMS sling, ProACT adjustable periurethral balloons, and electronic artificial sphincters including the Artus and UroActive systems. These electronic devices could offer remote control, automatic cycling, and catheter-sensing capabilities. Now to try to find out which one is right for me. Thanks for the replies. My stress level is at a all time low. When you find out, there is still hope you can take a break and put your mind at ease.

@daddystressed
If you have radiation or started off with surgery and may need to have salvage radiation in the future, thnn the ProACT Device won’t work. It squeezes the urethra in order to get the flow to stop, and when the urethra hardens due to radiation, it doesn’t work.

The sling also doesn’t work very well if you have radiation.

I will definitely look into the Artus and UroActive systems devices.

Hello "@kayefo" - I am sorry to read of your situation, but...I COMPLETELY understand where your man-friend is, because I am in the exact same place. Urologists are VERY good at "over-promising and under-delivering" with post-prostatectomy men, telling them "when" they will be able to achieve erections again, because that "when", slowly, insidiously slides to an "if."
All urologists will document in their surgical report of the prostatectomy procedure, that they "preserved the (integrity of) the two neurovascular bundles that are necessary in both regaining full urinary continence, and the ability to get an erection. My thought has been: "did my urologist REALLY preserve the neurovascular bundles? How could I prove that he didn't? The "slow, insidious slide" begins with the urologist telling the man that "most men should be able to achieve a full erection between 3-6 months post-op" (and many do). At six months and no success, the urologist then "slides" that to "it might take 6-9 months" (and many do), and at nine months they say "it can take some men up to a full year to achieve an erection. (and many do). At one year the urologist says, "it can take up to two full years, and some men never regain their ability to achieve an erection."
I am at exactly one year post-op, and have not even had a "twitch" down there. Men such as your friend and me start to have strong feelings of inadequacy and futility in the pursuit of a relationship. As a 70-year old male, I was as virile and capable as a 35-year old up to the day before my surgery, but now I am dead in the water. Sex is a HUGE part of any man's relationship with his wife or special girlfriend, and our inability to perform, means - in our minds - that we are inadequate...and that kills our self confidence. To me, if there is no sex in my relationship with a wife/girlfriend, then we are just "platonic friends." This is a slightly different, comparative analogy, but it would be like a woman who has had a double mastectomy. I have known a few female friends and relatives in my life who had the mastectomy, and they sadly became different people...a complete emotional transformation. Even with behavioral therapy/counseling, they became different people...changed forever. They all conveyed or actually shared that they felt incomplete, inadequate, and undeserving of a sexual relationship. They felt unattractive, self-conscious, and incapable of being able to satisfy their husband. "THAT" is what has happened to me. I can only speak "for myself", but I'd bet big money that the majority of post-prostatectomy men who are incapable of achieving an erection feel the same way: inadequate, incapable, and lacking in self confidence knowing they can't satisfy their wife/girlfriend "completely."
Right now, I am exploring the possibility of trying/using Trimix to achieve erections, but I can't fathom sticking a needle in my penis. Talk about a foreplay/mood killer: Can you hold on a couple minutes while I inject myself and wait for it to start working?" Nope...I don't want to "go there." And...
I wouldn't do it until I meet a new lady friend with whom I want to have sex. My divorce was final last March 2025 and I had the prostatectomy exactly one month later ("lucky me"..."not"). I was looking forward to eventually finding someone special and enjoying an active sex life with her, but now that I can't achieve an erection naturally, I have just stopped my pursuit and "active looking" for a woman: "Wow...we've been together a month (or so), and I really want to take it to the next level with you, but I am incapable of achieving an erection to satisfy you, so...I guess we can only be friends until/if I can achieve an erection." I would never say that to a woman, but that is what would be going through my mind the moment I met someone new: "why bother getting to know her, if I can't perform, when our relationship takes us there in the near future?" It would be too humiliating as a man, and I would not want to disappoint her, nor feel like I was deceitful in not telling her "Day #1". And of course, that is something you would never mention on "Day #1", so...you just make sure that you don't have a "Day #1" until/if you can hopefully achieve an erection.
The other huge piece of this prostate cancer puzzle, is that MANY of us will see the cancer return within 5 years (it varies with the severity/aggressiveness and type of prostate cancer that we had). I have strong feelings of needing to tell a woman from Day #1 that "oh, BTW, I had prostate cancer, and had my prostate removed, but my type of cancer has a 25% - 50% probability of recurring within the first five years...and it could kill me shortly thereafter if I am not so lucky." What woman wants to start a relationship with a man whose cancer may return within 5 years, and kill him in five to ten years? Being with a man who every three months is full of anxiety waiting for his most recent PSA test to see if it is starting to increase, showing that the cancer has started to return. It would make me feel like I am being "settled for"...why would "any" woman want to be with a guy who can't satisfy her sexually, and could be dead in 5-10 years instead of having 15-20 or more years together? So...
I understand where you are coming from, but maybe what I have shared here will help you understand "where" your man friend is. It might help you develop some caring, gentle questions to draw him out. He, like me, may not have anyone else in his life with whom to share his fear, anxiety and depression. You likely know where he lives, so maybe you could drop by on a Saturday afternoon and get him to take a drive or a walk, or just sit in his backyard so he can open up and share to experience your friendship, support, and his ability to trust you with his feelings. It's a start...it sounds like he is worth trying to fight for, so give it a try. Good luck.