Implant after RP

The final frontier. Deciding when, if and how.
buddypayne
Posts: 83
Joined: Sat Jan 29, 2022 3:26 pm

Implant after RP

Postby buddypayne » Mon Oct 02, 2023 7:34 am

I'm looking for information from men who have Radical Prostatectomy with no returning erections.

What has your experience been like after being implanted?

Some of my questions/concerns are.

1) With no glans enlargement how is sex?
2) Will the penis feel cold after the implant?
3) Does sex feel natural?
4) Do you have any regrets?
5) Any recommendations?

I'm considering an implant.

Lost Sheep
Posts: 6151
Joined: Mon Jul 04, 2016 11:16 pm

Re: Implant after RP

Postby Lost Sheep » Mon Oct 02, 2023 3:45 pm

Buddypayne, I had an implant before prostatectomy (RP will happen soon, actually). But I think I can answer most of your questions
buddypayne wrote:I'm looking for information from men who have Radical Prostatectomy with no returning erections.

What has your experience been like after being implanted?

Some of my questions/concerns are.

1) With no glans enlargement how is sex?

The implant should not affect glans engorgement/enlargement, so sex should be about the same to your glans. The only difference is that that after you orgasm, your glans may deflate while your erection (supported by the implant) remains. So you may have a soft knob atop a rigid penis.

Of course, the spongiosum tissues (responsible for glans engorgement) may not deflate at all since the erectile tissues usually responsible for erections (now replaced by the implant) get their blood flow from a separate and independent system the blood flow the engorges the spongiosum tissues of the glans.

So, absent surgical damage during the operation (rare), you should get glans engorgement as you did before. And it MIGHT continue or return after orgasm if you keep going with stimulation.

buddypayne wrote:2) Will the penis feel cold after the implant?

It might. But look at it this way. Normally, a penis fills with body-temperature blood and that blood is trapped (in the erection) by stopping the outflow. That blood-filled penis is exposed to outside air which begins extracting heat from the penis. So, an erect penis starts out hot and cools because it has a lot of surface area losing heat.

An implanted penis fills wit body-temperature saline solution trapped in the erection. The penis begins losing heat to the outside air just as the blood-filled penis did, so begins to cool.

The idea that an implanted penis is colder than a blood-filled erect penis flies in the face of simple thermodynamics. There is the matter that the blood-filled penis DOES HAVE some exchange of fresh, body-heat blood does suggest that the natural erection will be warmer than the saline-filled erect penis.

So, I will suggest that the implanted penis may be a bit cooler than a naturally erect penis, but not by much.

Also, there is the idea that if you keep up a lot of energetic thrusting in a vagina, the friction may generate more heat and make the penis warmer. :D
buddypayne wrote:3) Does sex feel natural?

Not 100%. But there are two salient points. It feels a WHOLE LOT more natural than sex with a limp penis or an erect penis that I have to worry about every second.

buddypayne wrote:4) Do you have any regrets?

No regrets, not even (as most men report) a few moments or days immediately after the operation asking themselves, "What the fuck did I DO to myself?" I researched ED and its treatments thoroughly before taking the step. I do not even regret the time I took to find a good surgeon (more than a year). I only regret not mentioning my ED to my primary care physician earlier so I could have started the journey earlier. Out of embarrassment and uncertainty I kept my ED problems limited to myself and partners and did not mention it to any medical experts for decades. If I had started oral medications when I first would have qualified for them, my path would have surely been different.
buddypayne wrote:5) Any recommendations?

Explore all less-invasive treatment (ignoring the snake-oil and magical crap) before taking the step of an implant. And select a really good surgeon in whom you have confidence. I found one who LISTENED to me and I was convinced would hold my best interests as the most important. Dr Eid wrote to me this, "Find a surgeon in love with his craft." He went on to say that such a surgeon will do all he/she can to provide the patient with the best possible outcome.
Lost Sheep
AMS LGX 18+3 Nov 6, 2017
Prostate Cancer 2023
READ OLD THREADS-ask better questions -better understand answers
Be part of your medical team
Document pre-op size-photos and written records
Pre-op VED therapy helps. Post-op is another matter

portageriver
Posts: 116
Joined: Thu Feb 03, 2022 1:50 pm

Re: Implant after RP

Postby portageriver » Mon Oct 02, 2023 8:39 pm

buddypayne wrote:I'm looking for information from men who have Radical Prostatectomy with no returning erections.

What has your experience been like after being implanted?

Some of my questions/concerns are.

1) With no glans enlargement how is sex?
2) Will the penis feel cold after the implant?
3) Does sex feel natural?
4) Do you have any regrets?
5) Any recommendations?

I'm considering an implant.



Good day buddy. I see lost sheep has weighed in so you have some solid advice already I am sure...

But you specifically mention the RAP procedure so I thought I would weigh in as that's me.

1. I still have glans engorgement. Maybe right after the implant procedure, it wasn't much, but it gradually came back to me after a few months. Now, after orgasm - I still lose glans engorgement. Obviously, with the implant I can keep on going but any 'natural' thickness goes away after orgasm. I don't have an overly eager partner so I have never tested out how quickly the engorgement might come back but it 'feels' like it would, if that makes sense.

2. My penis has never felt cold to the touch (or otherwise). I am two years in and haven't ever noticed that. Yes, as I was researching the implant like you I also read about people complaining it was cold. I got the implant anyway, accepting the fact that my penis would be cold. But it simply never happened for me. Or I should say, if it has happened, I have never noticed.

3. Yes, sex feels natural as hell. No difference here other than I can continue after orgasm now. The difference I miss has nothing to do with the implant - I miss shooting a load, lol. The act itself is the same on the pleasurable, natural feeling scale.

4. Zero regrets. In fact, I will do it all again, god willing I live long enough.

5. Just get yourself a high-volume surgeon is the only recommendation I would have. And if you have been 'dormant' down below for any length of time, I might research a VED device to get that blood circulating in your unit for a few months prior to being implanted. I am NOT an expert or even well-informed on VED so that's all I will say. Because I had ALOT of time between the RAP and my implant, I did invest in a good VED device and used it prior to surgery.

Good luck with whatever you decide.
Age 55, Ohio - Implant AMS 700 LGX, 21+ 3 following RAP for prostate cancer (Gleason 6). Implanted June 2021 and loving it!

oldbeek
Posts: 2476
Joined: Sun Sep 10, 2017 1:46 pm
Location: Los Angeles area

Re: Implant after RP

Postby oldbeek » Tue Oct 03, 2023 2:17 am

Now the bad news. It depends on how much nerve damage they do during RARP> I got an implant soon after the rarp because the uro said he removed ALL my nerves. If your glans is cold and white before the implant, it will be cold and white after the implant. Cold and white but still felt good to be able to fuck and orgasm. 4 years after the RARP I started to get color and warmth in my glans. Recovery from RP all takes time, but you may be cold and white. At first I called mine popsicle on a stick.
82, good health, RP 7-2017, all nerves taken , PSA 0.05, 4-18,, .07 1/19,.05 4/19, .03 11-21, .04 11-23, implanted 4-1-18, Infra-pubic, AMS lgx 15 cm with 5cm rte. Implant at USC Keck. Dr Boyd and Dr Loh Doyle 6.5 x 5, 800 AUS 7-21-20

buddypayne
Posts: 83
Joined: Sat Jan 29, 2022 3:26 pm

Re: Implant after RP

Postby buddypayne » Tue Oct 03, 2023 4:18 am

My main concern is without glans engorgement how will sex feel.

Thanks for the information.

Lost Sheep
Posts: 6151
Joined: Mon Jul 04, 2016 11:16 pm

Re: Implant after RP

Postby Lost Sheep » Tue Oct 03, 2023 5:08 pm

buddypayne wrote:My main concern is without glans engorgement how will sex feel.

Thanks for the information.

Some men have reported disappointment in how sex feels without glans engorgement. For that matter, even some men have reported their partners reporting some degree of disappointment as well. A small portion. Very small.

Keep your perspective.

A small chance of less glans engorgement is nothing compared to the fact that you have enough rigidity to have penetrative sex with which to detect that tiny loss. Provided you are among the minority who experience that loss.

When I have sex, my glans engorges, but if we continue sex without engorgement (but, of course, I am still rigid enough to actually continue) neither of us feel the lack and often enough, engorgement returns with continued stimulation.

So, the summary of this post of mine is that glans engorgement is 98% certain to be a non-issue. And if you can even detect it, negligible compared to the ability to be erect in the first place.
Lost Sheep
AMS LGX 18+3 Nov 6, 2017
Prostate Cancer 2023
READ OLD THREADS-ask better questions -better understand answers
Be part of your medical team
Document pre-op size-photos and written records
Pre-op VED therapy helps. Post-op is another matter

Stupid
Posts: 45
Joined: Tue Sep 13, 2022 2:40 am

Re: Implant after RP

Postby Stupid » Wed Oct 04, 2023 4:28 am

2015 to 2022 RP killed the little guy. Pills then injections finally AMS
You lose some feeling but gain the supernatural power to bring your partner to the ir happy ending every time. One less thing to worry about. I love to see her face afterwards and tell her don't go anywhere people can tell by the glow
What she was doing
RP 2015. all downhill real fast. 2022 consulting doctor at USC. Apptmt is in November going bionic??

SteveD
Posts: 42
Joined: Thu Jun 02, 2022 1:34 pm

Re: Implant after RP

Postby SteveD » Wed Oct 04, 2023 11:27 am

I'll 'second' Lost Sheep's words - in our experience with or without engorgement trying some different 'angles and depth of penetration' makes quite a difference. With an implant there's the reality of experimenting without the loss of an erection as long as you and your partner like - increase your repertoire of skills - and enjoy them all!
Somewhere on the journey after prostate cancer surgery 2019 - AMS 15/5 IPP 2 years later - saved by a very supportive wife and a great surgery team at Johns Hopkins.

Flounder
Posts: 263
Joined: Mon Jul 23, 2018 3:17 pm
Location: PA

Re: Implant after RP

Postby Flounder » Wed Oct 04, 2023 4:19 pm

buddypayne wrote:I'm looking for information from men who have Radical Prostatectomy with no returning erections.
What has your experience been like after being implanted?
Some of my questions/concerns are.

1) With no glans enlargement how is sex?
2) Will the penis feel cold after the implant?
3) Does sex feel natural?
4) Do you have any regrets?
5) Any recommendations?

I'm considering an implant.


My story is slightly different but I can relate to where you are. I had some erectile function return after my nerve-sparing RALP. Recovery was slow and I never fully recovered to pre-surgery conditions. It took 15 months and 100 mg of Viagra for successful PIV sex again. For the next 2-1/2 years there were good times and disappointments. I remained depend on PDE5s for roughly 60-70% penetration success. Then came the diagnosis that PCa returned. SRT fried the nerves spared during the surgery. That started a 6yr progression of increasing strength & dosages of trimix injections. I called time when quad mix started loosing effectiveness. So I’ve been through all the commonly prescribed progressions of ED treatments. I exhausted all options when arriving at the implant decision you are considering now.

1) With no glans enlargement how is sex?

Been discussed here ad nauseam. Type “glans engorgement” in the search bar above. Over 1,600 comments for reading. I was like many others have reported. It was an issue in the early months of recovery. I useTriMix Gel, which helps, but now natural engorgement is coming back so I don’t plan to refill the prescription.

2) Will the penis feel cold after the implant?

Yes - but not when it matters most. When aroused and pumped I can’t tell any difference from before. Adding to Lost Sheep’s thermodynamics explanation; the cooler touch is most noticeable when I’ve been deflated for hours and Lobito is low. Before implant I was a grower. Since implant I’m a 24/7 shower even if not aroused. My theory is the additional flaccid length keeps the penis away from the core body heat. Plus there’s more surface area cooling the saline water left in the cylinders. So yes there are times, such as at the urinal, that it feels cooler (and bigger) than preimplantation. IMO, it’s a trivial thing which has not been an issue when things heat up in the bedroom.

3) Does sex feel natural?

More natural than sex with no erection! We are again enjoying spontaneous sex which feels more natural than scheduling sex to happen when the Pills/Injections kick in - or don’t.

4) Do you have any regrets?

Not sure this is a regret but if I could go back in time, knowing what I know now, I would get the implant as soon as possible after the Prostatectomy. It’s frequently said here on FT that there is nothing like a blood filled Dick. I have no argument if that’s possible and sustainable. But the bitch about prostrate cancer is, you’re left 100% impotent leaving the operating room. In my case, I spent a decade fighting a loosing battle. So no regrets getting the implant, just wish I had done it earlier.

5) Any recommendations?

A lot of good recommendations already given. I will just add; Don’t get yourself too involved in the rare occurrences of every potential problem so that you loose sight of your situation or the benefits of an implant as a whole.
A-69, M-44, Battling ED since partial NS-Prostatectomy 2012 plus SRT for PCa return 2016
Pills & injections ran their course. Implant 11/11/22 by Dr. Eid.
Titan Classic 22cm, LH cylinder trimmed, Ectopic reservoir placement.

buddypayne
Posts: 83
Joined: Sat Jan 29, 2022 3:26 pm

Re: Implant after RP

Postby buddypayne » Wed Oct 04, 2023 6:06 pm

All of the posts have been very helpful and useful information....

I'm very tired of current situation and plan to get the penis implant.


I would like to thank everyone for the information!


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