This bpost compares all non-psychological treatments. (… so “devices” must not disappear from the title.)

— Q: why over 17 ~18 May 2023, I experienced such a relief and excitement, that drove me to run 4km in stadium, swim 800m + 100 chin-up?

• A#1: I confirmed with a SGH pharmacist that 25mg sildenafil (probably) helped me within 15 minutes. My amazing erection was unlikely to be unaided, but that would be a good thing in hind sight. The conclusion raised my hope of “try unaided -> fast pill”
• … A: Now Spedra is another insurance-approved medication, and very fast.
• A#2: I had long wanted to try the VED but was put off by a very high risk of dashed hopes. With the insurance approval, I now feel the door is open in front of me. The risk of disappointment is still high, but am emboldened.
• A#3: I see some (small) hope of multiple effective solutions, fully insured.

— reliability可靠性/consistency .. After speaking to Dr Teo, I am convinced that the implant (and the pump) are truly mechanical, in both the positive/negative sense of the word, therefore guaranteed to work like anything mechanical, treating the penis like an opamp. They are unaffected by psychological factors.

Echoes https://augustams.com/how-does-somatherapy-ed-work/ — “penis pumps mechanically create an erection, bypassing nerve dysfunction, blood flow problems, psychological issues, and other causes of impotence.”

However the pump still needs incoming blood. The implant requires no blood.

ED-ring is also mechanical, but requires a lot of stimulations to get the initial engorgement. In contrast, pills require initial arousal, but subsequently “autopilot”.

How about frequency of intimacy that tends to reduce the strength of erection? I think pump is unaffected, and pill is slightly affected (arousal).

Q: what if the erection is mechanically created but there’s nothing emotional?
%%A: Not a big problem IMO. I guess it would be similar to a long-lasting erection, which can occur due to a ring or a pill.

— the full list of physical (non-psychological) treatments .. https://my-doc.com/sexual-health/erectile-dysfunction-singapore-treatment/ lists:

• ESWT i.e. shockwave therapy.
• self-injections
• surgery
• pills

These treatments are clinically proven, with documented success rates above 50% (or whatever rate documented). In contrast, all other treatments are clinically unproven, including natural supplements. When I asked Dr Teo, he said not worth trying. In contrast, he gave green light to sex toys.

EddieByGiddy .. is not medically proven, but medical grade.

— devices like pumps, rings,,,
— pills
— ESWT
— self-injection .. most patients get used to using it and find it more effective (fast, more consistent) than oral medications, according to this Sgp clicnic.

Many lay men are horrified by the idea of self-injection, but some drug addicts are turned on by these needles. They feel a temptation, even though the needle brings (mild) pain.

More broadly, yoga, stair climb, mountaineering, endurance cycling, my 5.6k run,,, are painful self-tortures. In my early teenage years, I didn’t understand why people would choose them. Now I engage in these self-tortures myself.

==== implant .. Rather few people around me know the implant, but it is fairly safe and durable (10Y warrantee). Main drawback: irreversible — once the implant is worn out, you won’t get another erection without a replacement implant, since your spongy tissue is no longer present. As such, implant is suitable for me only at an older age, perhaps 60s.

Long development history, dating to 1950s (or earlier)

Each year nearly 25,000 inflatable penile prostheses are implanted in the USA alone.

Highest satisfaction and reliability:

~~ https://edition.cnn.com/2015/06/23/health/penile-implants-erectile-dysfunction/index.html quotes an expert “Penile prosthesis is the only thing that works for almost every man with ED – unlike injections and pills.”

“There’s a real need for penile prosthesis, but this isn’t generally recognized by the public and even some medical professionals…Not being able to have intercourse has been shown in numerous studies to cause low self-esteem depression.”

~~ https://www.mayoclinic.org/tests-procedures/penile-implants/about/pac-20384916 claims that “In fact, penile implants have the highest rate of satisfaction of all erectile dysfunction treatments.”