So, starting with your diabetes. Is that controlled? That's the first thing to do in order for health. Are there barriers to this? It can be hard to get under control for some. I assume this is type 2? How is your overall cardiovascular health? Work on these things first. Have you tried a vacuum pump? That would be something to try before surgery. Since you've tried these things, it sounds like you've worked with a urologist. What is the why of your ED? Have they determined? There is also a psychological component as well. Other medications you are taking. All of that factors in. I'm hoping your doctor has talked to you about what may be at the cause of your ed that you can share to help you further