Picture an 86-year old bedridden man. He has recently married a 16-year old girl, his third wife. He feels the need for a little "boost" to his manhood to fully enjoy the marital life and satisfy his new bride. Viagra no longer works for him. What can he do?
The man is fortunate to be a Saudi. He can easily get help with a penile prosthesis, inserted free of charge at the government hospital. If one hospital rejects his request, he will just keep looking until he finds a physician willing to operate on him. Lucky for him it does not matter that he is nearing 90, cannot walk and that his new wife could be considered a child by some. Saudi medical ethics are exceptional in his case. The man is entitled to have some fun after all. At least one limb should be working!
At the hospital the surgeons will pat the mans back and congratulate him on the new wife. Of course the old man needs to be able to perform! Surgery will be planned and an implant inserted to enable a constant "state of readiness" for him. After the operation the room fills with curious male relatives congratulating the man on his new upgrade popping up from under the blanket. He will leave the hospital with a new cane but this one is not meant to assist in walking.
The sensitive issue of erectile dysfunctions are relatively common in Saudi-Arabia. Contributing factors are often social like multiple wives, arranged marriages, consanguinity and lack of sexual education before marriage.
Many of the cases are young newly married men presenting with "honeymoon impotence". Sometimes those men were not able to consummate their marriages simply because the social pressure was too heavy on them. The problem can be so severe it leads to divorce. Unconsummated marriage is not seen as a valid marriage and impotence is a just cause for the woman to file for divorce.
Elderly patients with this problem are not a Saudi specific occurrence of course. What makes it different in the Kingdom is the fact that many of the old patients will end up having surgery despite the risks.
Elsewhere and in the western world performing such invasive surgery would be seen as unethical and down right dangerous due to old age and higher complication risks. Penile prosthesis surgery is usually performed on young men with certain medical conditions and older men will be treated with medicine such as sildenafil (Viagra). But in Saudi the lack of medical ethics as we know them and the "gentleman's club" attitude enable these old babas to have their way.
The culture in Saudi-Arabia does not frown upon very old men wanting to enjoy marital life. It's seen as their right. Same does not apply for older women though, after the women reaches menopause she is not seen as a sexual being anymore.
The elderly man of the above story was an extreme case but nevertheless such cases do sometimes occur. And they are viewed as perfectly normal. A new young wife is seen as an acceptable indication for surgery!
Elderly men, regardless of their underlying medical conditions or even their mobility in the most extreme cases, will be granted the implant if they so wish. These old Saudi men will happily continue their marital relations and keep their social status with their eternal erections. Only in Saudi-Arabia!
Some interesting research from the Middle-East region on the matter:
A urologist I used to work with concluded in his study conducted in Saudi-Arabia that patients with penile prosthesis had a 92% satisfaction rate.
The link between low sexual desire and consanguinity: http://www.ncbi.nlm.nih.gov/pubmed/15672966
Study from Iran about the pressures of the wedding night: http://www.ncbi.nlm.nih.gov/pubmed/19090943
Researchers found that in "240 cases, unconsummated marriage was due to being under social pressure to have a quick intercourse while relatives waited behind the door to confirm and celebrate coitus by checking a handkerchief that was placed beneath the bride to become bloody by hymen perforation."
Research from Turkey concluded that 67% of honeymoon impotence cases were of psychogenic origin.
Alarmingly high rate of honeymoon impotence among Saudis due to severe performance anxiety: http://www.partal.com/mares/sexologies/angles/arxius/47/sommaire2.html
American Bedu discusses the popularity of use of Viagra among Saudi men: