Suspensory-ligament-tightening + Penile-implant

The final frontier. Deciding when, if and how.
London lad
Posts: 60
Joined: Fri Apr 20, 2018 6:43 pm

Suspensory-ligament-tightening + Penile-implant

Postby London lad » Sat Apr 21, 2018 6:42 am

Hello Frank Board,

I am a 35yo man.

Two life-long issues I've had ongoing:
1. My erections have never in my lifetime been hard enough to penetrate.
FOR THIS, A PENILE-IMPLANT IS BEING EXPLORED
2. In addition, the base of the penis has remained too loose and floppy – and so unable to hold the penis rigidly in-place to enable any sort of penetration. As a consequence, my angle of elevation has never been above 20-30 degrees.
FOR THIS, A SUSPENSORY-LIGAMENT TIGHTENING/STITCHING MAY BE NEEDED.

So I am now considering penile-implant + suspensory-ligament-tightening in a single procedure. I would be having this done in London by Mr David Ralph.

[I have already in the past tried less invasive cures, such as Cialis, Muse, caverject, psychosexual counselling, rings, vacuum pumps - all to no avail].

My questions for the Franktalk board:
1. Has anyone out there also had their suspensory-ligaments tightened simultaneously to having a penile-implant inserted? Is this a common occurrence for people to have both issues?
2. What has been people’s success of having their suspensory ligaments tightened – has it helped achieve the rigidity at the base needed for penetration? And has it raised their angle of elevation to above 90 degrees?
3. Would people recommend having suspensory-ligament tightening done at same time to penile-implant, or is it better to do them in separate operations?
4. Has anyone out there had their penile-implant/suspensory-ligament-repair done by Mr Ralph before in London? Was it success?

Your help and opinions appreciated!
37yo. Implanted for 1st time in 2018 with Titan. I’ve had ED my whole life, & was born with Phimosis & Congenital Downward Curvature - both of which corrected in 2009 (with Nesbitt's & Circumcision). ED remained until 2018 implant.

Spikepork
Posts: 290
Joined: Sat Oct 21, 2017 10:49 am

Re: Suspensory-ligament-tightening + Penile-implant

Postby Spikepork » Sat Apr 21, 2018 7:59 am

Hi. Ralph did my implant December 2017. Feel free to get in touch.
Now Implanted 9/12/17. 52 years old with ED for over 20 years. Tried all the pills and injections. Update. Implanted with Titan 22 + 1. by DR Ralph Dec 9th London. Now in recovery and at 3 months feeling the journey was worth the pain.

ED2013
Posts: 1217
Joined: Tue Mar 05, 2013 8:15 pm

Re: Suspensory-ligament-tightening + Penile-implant

Postby ED2013 » Sat Apr 21, 2018 12:58 pm

The issue of not being hard enough probably causes the low erection angle. Not the ligament. Just something to think about.

livinglarge
Posts: 6
Joined: Mon Dec 25, 2017 12:35 pm

Re: Suspensory-ligament-tightening + Penile-implant

Postby livinglarge » Thu Apr 26, 2018 9:55 pm

i have had susp. ligament repair. Feel free to ask questions as well
Young 26 year old, nerve damage ED, Considering implant

newbie443
Posts: 1827
Joined: Fri Dec 01, 2017 9:41 pm
Location: Sedgwick county, Kansas USA

Re: Suspensory-ligament-tightening + Penile-implant

Postby newbie443 » Thu Apr 26, 2018 10:50 pm

Thank you for posting this. I would like to know more about this. With my implant fully pumped I am just able to make 45 degrees. If I pull up on my pubic fat pad I will go to 90 degrees. I thought of having the fat lipo'd and my skin trimmed and reattached at the belt line but was concerned it would just stretch back down. Might be that I was looking at this wrong.
Injections failed. Implanted 3-21-18 AMS 700 LGX 21 + 1 RTE 100 cc reservoir 6.5" L 5" G Dr. Kramer.

Proximal Perforation Sling Repair 4/13/21 Dr. Broghammer

66 years young.

Will show and tell and talk with others.

London lad
Posts: 60
Joined: Fri Apr 20, 2018 6:43 pm

Re: Suspensory-ligament-tightening + Penile-implant

Postby London lad » Fri Apr 27, 2018 3:44 pm

newbie443 - have you ever in your life had great than 45 or 90 degrees elevation? If you have, my guess would be that it's not suspensory-ligament issue (but that's coming from another newbie here).

From my understanding, it's more the firmness-at-the-base that drives the decision rather than angle-of-elevation itself.

For me, I've never actually had a decent enough erection - so the confusing bit for me has always whether the lack of angle is driven by the lack-of-hardness or suspensory-ligaments. (I've not had penile-implant yet).

My suggestion might be to see a surgeon and try inflating infront of them so they can try ascertain what's going on. The other alternative would be a "general-anaesthetic-erection-test" (I don't know the proper medical name for it hence my putting it in inverted commas) - whereby you're artifically-induced under general-anaesthetic, so they can see the angle-of-elevation for themselves.

At my latest consultation with the surgeon, it turns out I infact had this "general-anaesthetic-erection-test" years back - which according to the medical notes suggest that my suspensory-ligaments are infact okay (which I of course wouldn't know as I've never had decent-erection). So the decision made for me is to do penile-implant and leave the suspensory-ligaments untouched.

livinglarge - interested to hear if the procedure worked well for you - whether it increased your angle-of-elevation / rigidity - and what was the process of determining you needed your suspensory-ligaments repaired as opposed to/before penile-implant.
37yo. Implanted for 1st time in 2018 with Titan. I’ve had ED my whole life, & was born with Phimosis & Congenital Downward Curvature - both of which corrected in 2009 (with Nesbitt's & Circumcision). ED remained until 2018 implant.

ThePlumber1964
Posts: 783
Joined: Sat Oct 15, 2016 10:03 pm
Location: Orlando, FL. USA

Re: Suspensory-ligament-tightening + Penile-implant

Postby ThePlumber1964 » Sat Apr 28, 2018 2:23 pm

I experienced a low angle after my first surgery. After the revision, it was clear that it was caused by underdilated/undersized on the proximal part, so it was a typical case of hinge effect.
54 years old, happily married for 30 years to a beautiful & outstanding lady. Onset ED at 49. Finally fixed on 11/08/2017 by the master Dr. Eid with a Titan XL 26, no RTEs! Previously had 3 AMS implants (LGX & CX), all botched.

Waynetho
Posts: 1767
Joined: Wed Nov 27, 2019 11:22 pm
Location: Dallas, TX

Re: Suspensory-ligament-tightening + Penile-implant

Postby Waynetho » Tue Mar 03, 2020 11:06 pm

All this recent talk on FT of pointing up when inflated makes me think I might need a suspensory ligament repair (lift). They do an infrapubic incision and use a non-absorbable monofilament suture between the tunica and the pubis symphysis to repair a slack, damaged PSL (penile suspensory ligament). I might have to wait for the PSL repair until I need a revision though, since it involves placing sutures into the proximal dorsal tunica albuginea which I would think would be risky to the cylinders.

One thing I read about a study of 35 patients who underwent this procedure included two men who had venogenic ED (ED caused by venous leakage), the PSL repairs resolved their ED. They surmised that "a functional PSL might be part of the veno‐occlusion mechanism required for the process of erection". This goes back to the technique I employed on many occasions to relieve myself of painful morning wood in the past 10 years - PRESSING DOWNWARD at the top of the base of my penis until I heard a CLICK. No doubt I was damaging the PSL each time I did that, thus adding to my ED and my low angle of erection now.

(Citation added): https://onlinelibrary.wiley.com/doi/ful ... 07.06551.x
62yo, married 41 yrs. Urolift (x4) 8/12/19. AMS 700CX 15cm (no RTE) penoscrotal 10/28/19, Frisco, TX. PD 1995/ED 2011. Cialis helped but hinged. (1995)L:6/G:5.5+, (2019)Pre-op L:5/G:4.5, (2/2020)L:6.0/G:5.0


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