'We're also treating a relationship': Sask. doctor applauds government's move to cover penile implants

Saskatchewan urologist Dr. Francisco Garcia said it can be difficult for men to admit they're experiencing erectile dysfunction, but he's hopeful public conversations can ease the stigma. 

He also thinks it might be easier to talk about now that the province is helping foot the bill for a procedure that can help men perform again.

"Not only is it OK to ask for help, but we have some solutions," Garcia said. 

Under an order of council that came into effect earlier this month, Saskatchewan's government will now cover the penile implant procedure. That coverage was ended by the province in 1993. 

"The psychological benefits, I think, are immense" for men who get the implants, said Garcia. "The idea of being able to be potent can be very important for a lot of guys, and almost defining."

Garcia said confidence is a key factor, especially for men who experience erectile dysfunction because of a cancer, trauma or deformity. 

Once the procedure was insured, Garcia was able to bring men into his office to discuss options they previously couldn't access because of cost — some of whom were clearly happy about the news.

"I'm fairly sure at least one of those guys skipped in," he said, noting his administrative staff described the incident.

But Garcia notes the effects of the implants go beyond a man's psychological and physical well-being.

"We're also treating a relationship," he said, adding it allows partners to "re-engage in that nice, very intimate and personal way, in that physical way that they may not have been able to do for years."

Criteria for coverage 

Before the procedure was funded, Garcia said it would cost a patient about $15,000 to $16,000, including about $7,500 to $9,000 for the device on top of hospital fees.

The change came about after a physician submitted a request through the Saskatchewan Medical Association to have the penile prosthesis procedure insured by the Ministry of Health, according to a ministry spokesperson, and the two organizations began negotiations.

They agreed to insure penile prosthesis under specific conditions. The ministry estimates that given the criteria an estimated 12 to 15 patients per year will qualify for coverage.

For example, the procedure must be medically required and all other treatment options must be exhausted.

Furthermore, the cost of the prosthesis will be covered if the erectile dysfunction stems from surgical injury or trauma. This could include prostate, rectal, colon or bladder cancer survivors who experienced damage from surgery or radiation, Garcia said.

"It opens up the door for those who've had car accidents or other trauma where they've had permanent severing of the nerves."

It can also be covered if the need comes from severe penile deformity and Peyronie's disease — which "can cause twisting [into] all sorts of different shapes when the penis is erect," said Garcia.

"Basically it's a scar that will cause curvature."

He said men with this condition can have reconstruction surgery, but the surgery that straightens the penis often leaves the man unable to have normal erections.

Now, Garcia said he'll be able to put in an implant at the same time they do reconstruction surgery.

There are some limitations. People who have lost function because of vascular disease or blood vessel problems are not covered, Garcia said, adding that could be put to the ministry in the future.

He noted the coverage change was a long time coming and credited another physician in Saskatoon and the SMA for pushing for the change.

"We were able to have our voices heard and get some patient stories there to understand the impact," he said.

"I think everybody kind of agreed that there definitely is a role for restoring this sexual function in men."