Understanding ED
Managing ED When You Have Diabetes
Diabetes is one of the most common causes of erectile dysfunction, but it doesn't have to mean the end of your sex life. This guide explains the connection between diabetes and ED and explores the definitive, long-term solutions that can help you regain control and intimacy.
On this page
Why Diabetes Causes ED
The Two-Fold Impact of Diabetes on Erectile Function
High blood sugar levels over a long period can damage the two key systems required for a firm erection: the blood vessels and the nerves. This is often referred to as a "double hit."
Vascular (Blood Vessel) Damage
Diabetes can cause the blood vessels throughout the body, including those in the penis, to become narrow and hardened (atherosclerosis). This restricts the robust blood flow needed to enter the penis and create a firm erection.
Neurological (Nerve) Damage
High glucose levels can also damage the peripheral nerves (diabetic neuropathy). This impairs the ability of the brain to send clear signals to the penis to initiate and maintain an erection, regardless of sexual desire.
The Challenge with Oral ED Medications
While oral medications (PDE5 inhibitors such as sildenafil or tadalafil) are a common first step for ED, they have a significantly lower success rate in men with diabetes.
Why they may fail:
These pills work by enhancing the effects of nerve signals to increase blood flow. If the nerves are too damaged from diabetes to send the initial signal, or if the blood vessels are too narrow to allow sufficient blood flow, the medication may not work effectively. Studies show that while PDE5 inhibitors are effective in 70-89% of the general population, only about 50-64% of diabetic men respond favorably to these medications.[5]
Your Path to Recovery
For men living with diabetes and ED, the treatment journey typically progresses through several stages, beginning with conservative approaches. Due to the vascular and nerve damage caused by diabetes, initial therapies often have reduced effectiveness.
Lifestyle Changes
Adopting healthier habits such as balanced nutrition, regular physical activity, smoking cessation, and moderating alcohol consumption can contribute to improved erectile function in diabetic men.
Oral Medications (PDE5s)
PDE5 inhibitors (such as sildenafil or tadalafil) are commonly prescribed initially. However, their effectiveness depends on functional nerve pathways, which are often compromised in diabetic patients.
Devices & Injections
When oral medications prove insufficient, penile injections (ICI) or vacuum erection devices (VEDs) may be recommended. Although these can produce erections, many patients find them cumbersome and less spontaneous.
Penile Implants
For those who have not achieved satisfactory results with other options, a penile implant represents the most reliable long-term solution. It works independently of damaged nerves and blood vessels, delivering consistent, on-demand erections.
Learn MorePenile Implants: A Reliable Solution That Bypasses the Damage
When other treatments fail, a penile implant offers a definitive and highly effective solution for men with diabetes. Unlike pills or injections, an implant does not rely on damaged nerves or blood vessels to work.
How It Works
A penile implant is a medical device that is surgically placed entirely inside the body. It mechanically provides the rigidity needed for intercourse, bypassing the biological problems caused by diabetes. This allows you to have an erection whenever you choose, for as long as you desire.
Managing Infection Risk
While men with diabetes can have a higher risk of infection with any surgery, this risk is managed effectively by experienced urologists. Rigicon implants, such as those with a hydrophilic coating, are designed to minimize this risk. Your surgeon will also ensure your blood sugar is well-controlled before the procedure.
Rigicon Penile Implant Options
Rigicon offers several advanced penile implant options designed for reliability, natural appearance, and patient satisfaction:
Dynamic Inflatable Penile Prosthesis (DIPP)
The first hydraulic penile prosthesis with a fully-integrated dynamic-flow system that delivers pulsation during intimate moments. Designed to enhance sensation for both partners, while maintaining proven reliability and natural appearance.
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Two-piece Inflatable Penile Prosthesis
A simplified two-piece inflatable penile prosthesis with an integrated reservoir designed to reduce surgical complexity. Pre-filled and pre-connected for efficient implantation, offering reliable rigidity, natural appearance, and easy patient control.
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Malleable Penile Prosthesis (Bendable)
A semi-rigid implant offering straightforward functionality without mechanical components. Manually positioned as needed, providing reliable rigidity with a simple design that requires no pump activation.
Learn moreIs a Penile Implant Right for You?
A penile implant may be the right choice if you identify with the following:
Other Treatments Haven't Worked
You've tried first-line treatments like PDE5 inhibitors (pills), injections, or vacuum devices, but they haven't provided satisfactory results or caused unwanted side effects.
You Want a Permanent, Spontaneous Solution
You're looking for a long-term solution that allows for spontaneity without the need for pre-planning or medications. Implants restore the ability to have an erection whenever you desire.
You Are Ready for a Surgical Option
You understand that this is a surgical procedure and are prepared to discuss it thoroughly with a urologist to make a shared, informed decision about your health.
The Implant Journey for Men with Diabetes
Understanding the specific considerations for diabetic patients helps you feel prepared and confident about your treatment.
Pre-Surgical Preparation
This is a critical step. Your surgeon will work with you and your primary care doctor or endocrinologist to ensure your blood sugar levels (specifically your HbA1c) are well-managed before surgery. This significantly reduces the risk of infection and ensures optimal healing.
The Day of Surgery
The procedure is the same as for non-diabetic men, typically taking about an hour under anesthesia. Special precautions, such as specific antibiotic protocols, are often used to further minimize infection risk.
The Healing and Recovery Period
Healing may be slightly slower for individuals with diabetes. It is vital to follow your surgeon's post-operative instructions carefully, including wound care and monitoring your blood sugar levels closely to support your body's healing process.
Device Activation and Beyond
After the standard 4-6 week healing period, your device will be activated. Once you learn how to use it, you can return to a spontaneous and fulfilling sex life, free from the frustrations of diabetes-induced ED.
FAQs: ED After Prostate Cancer
Why don't ED pills work for me anymore?
ED pills require healthy nerve function to work. After prostate surgery or radiation, the nerves that control erections are often damaged, so the pills cannot produce the desired effect.
Will a penile implant feel natural to my partner?
Yes. When the implant is inflated, the penis becomes firm and rigid, much like a natural erection. Most partners report that they cannot tell the difference during intercourse.
Will the implant affect my ability to have an orgasm or ejaculate?
A penile implant does not interfere with sensation, orgasm, or ejaculation. These functions are separate from the erectile mechanism and are typically preserved.
How long does a penile implant last?
Modern penile implants are highly durable, with mechanical survival rates of approximately 87-93% at 5 years.[6] The Rigicon Infla10® has demonstrated a 95.6% freedom from revision or removal at 21 months in clinical studies.[7] While implants are designed to last for many years, a revision surgery may be needed at some point in the future.
Is the surgery safe?
Penile implant surgery is a well-established procedure with a high success rate and low risk of complications when performed by an experienced surgeon. Your doctor will discuss all potential risks with you.
Ready to take the next step?
Speak privately with a Patient Counselor
Get personalized information about inflatable penile prostheses in a confidential consultation. Our patient counselors understand the sensitive nature of ED and provide judgment-free support.
What you'll discuss:
- Your specific ED history and concerns
- How inflatable prostheses work
- Recovery expectations and timeline
- Finding the right surgeon for you
Private referral to a Rigicon Global Reference Center
Connect with experienced urologists in your area who specialize in penile prosthesis surgery. Our surgeon directory includes qualified professionals familiar with Infla10® Pulse™ products.
Search by:
- Geographic location
- Penile prosthesis experience
- Insurance acceptance
- Patient reviews and outcomes
Your privacy is our priority: Your enquiry is confidential. We never sell personal data.
Rigicon® Talks Videos
Rigicon Talks brings together doctors from around the world to share knowledge, helping patients better understand their treatment options.
Top 10 Questions Answered About Penile Prosthesis
| Time | Question | Play |
|---|---|---|
| 01:24 | Are you a candidate for a penile implant? | |
| 03:03 | Will the penile implant affect ejaculation or orgasm? | |
| 04:11 | Will the penile implant affect the length and girth of the penis? | |
| 05:09 | Will my partner notice the implant? | |
| 07:07 | How long is the recovery period after penile implant surgery? | |
| 08:24 | How to prepare for penile implant surgery? | |
| 09:33 | Can I choose the type of the penile implant I receive? | |
| 11:50 | How does the penile implant affect the appearance and feel of the penis? | |
| 14:30 | Will the penile implant interfere with urination? | |
| 15:46 | What is the lifetime of a penile implant and what is the likelihood of needing a revision? |
The Patient and Nurse Perspective in Prosthetic Urology
| Time | Question | Play |
|---|---|---|
| 00:40 | What is the nurse's role in prosthetic urology surgeries, and how do nurses help patients prepare for the procedure? | |
| 02:23 | How can nurses help patients manage their expectations and concerns before surgery? | |
| 03:26 | What does the typical recovery process look like after surgery? | |
| 05:19 | How does teamwork between nurses and surgeons impact patient care and outcomes in prosthetic urology surgeries? | |
| 06:06 | What advice would you give to patients considering an implant? |
Discover More
Patient Education Resources
Prosthetic Urology FAQs
Evidence-based FAQs on artificial urinary sphincters, penile and testicular prostheses—grounded in peer-reviewed research and international guidelines
Prosthetic Urology Glossary
Evidence-based glossary covering penile implants, AUS, ED treatments, and surgical terms in prosthetic urology
Specialized Treatment Information
Penile Implant Revision Options
Comprehensive solutions for revision surgeries and complex cases requiring specialized approaches
Solutions After Prostate Cancer Treatment
Specialized ED treatment options for patients following prostatectomy and other prostate cancer treatments
Solutions for Prostate Surgery & Diabetes ED
Specialized treatments for erectile dysfunction related to prostate surgery and diabetes complications
When Oral ED Medications No Longer Work
Advanced treatment options for patients who no longer respond to oral ED medications
Urinary Sphincter Solutions After Prostate Cancer
Artificial urinary sphincter options for managing incontinence after prostate cancer treatment
Rigicon Talks
Listen to expert discussions, patient stories, and educational content about prosthetic urology on your favorite platform.
Disclaimer
Important Notice:
This website provides educational information only and does not constitute medical advice. Product availability varies by country. Always consult with qualified healthcare professionals for medical decisions.
Regulatory Information:
Rigicon products are medical devices that require prescription and surgical implantation by qualified urologists. Individual results may vary.
Lifetime Warranty Availability & Terms:
A Product Replacement Lifetime Warranty is available for the Rigicon Infla10® Pulse™ family of inflatable penile prostheses and Rigi10™ family of malleable penile prostheses in countries/regions where the products are sold, subject to the Rigicon Limited Warranty and applicable local laws. Availability and terms vary by country/region; void where prohibited by law. Coverage is limited to device replacement for defects in materials or workmanship as determined by Rigicon; applies to the original patient only, is non-transferable, and requires replacement with a Rigicon device. The warranty does not cover surgical, hospital, or physician fees; removal/re-implantation costs; or damage from misuse, trauma, or off-label use. This warranty does not guarantee clinical outcomes. For complete terms and claim instructions, please refer to the Rigicon Limited Warranty.
References:
[1] Infla10® Pulse™ Series, ContiReflex®, ContiClassic® and Testi10™ products are not available for sale within the United States.[2] Rigicon® Infla10® Inflatable Penile Prosthesis Data on file.
[3] Salonia, A., et al. (2024). EAU Guidelines on Sexual and Reproductive Health. European Association of Urology.
[4] Hatzimouratidis, K., et al. (2010). Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. European Urology, 57(5), 804-814.
[5] Vardi, M., & Nini, A. (2007). Phosphodiesterase inhibitors for erectile dysfunction in patients with diabetes mellitus. Cochrane Database of Systematic Reviews. / El-Sakka, A.I. (2010). Microvascular Complications in Diabetic Erectile Dysfunction. Diabetes Care, 33(Suppl 2), S420-S422.
[6] Miller, L.E., et al. (2022). Long-Term Survival Rates of Inflatable Penile Prostheses: Systematic Review and Meta-Analysis. Urology, 166, 31-39.
[7] Wilson, S.K., et al. (2023). Initial safety outcomes for the Rigicon Infla10® inflatable penile prosthesis. BJU International, 131(6), 729-733.