Great Consultation.....

The final frontier. Deciding when, if and how.
Jage64
Posts: 559
Joined: Sat Oct 22, 2022 9:38 pm

Re: Great Consultation.....

Postby Jage64 » Sun Dec 24, 2023 9:58 pm

Notice in my post I said "out of the box" in terms of infections? If you soak the Titan in Rifampin/Gentamicin prior to installation, the infection rate is similar to the AMS Inhibizone-impregnated implant.

Dhabuwala et al. studied the infection rates between different types of penile implants and different antibiotic preparations of the devices. Coloplast Titan® penile implants coated with vancomycin/gentamicin, Coloplast Titan® penile implants coated with rifampin/gentamicin, and InhibizoneTM-impregnated AMS penile implants were all compared. The implants coated with vancomycin/gentamicin had an infection rate of 4.4%, the InhibizoneTM-impregnated AMS penile implants had an infection rate of 1.3%, and none of the implants coated with rifampin/gentamicin developed an infection. The study did not make any claims about the superiority of certain types of penile implants over others but did suggest that all Coloplast Titan® penile implants be prepared with rifampin/gentamicin [11]. In other words, out of the box, the AMS had 1/4 the infection rate.

Significant differences, however, were found in three questions. More patients were satisfied with the 700TM CX (P=0.0001). Only 4% with the 700TM CX were dissatisfied with the deflation compared to 24% with the Titan® (P=0.0031).


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7719505/
2/22/23 AMS 700 CX 21cm + 1.5cm RTEs. 58 yrs old, wife of 37 yrs. Penoscrotal. 100ml Conceal reservoir. Dr. Clavell. Pills failing and went right to implant, skipped the injections. 12 mos. later: 7 1/2" x 5 3/4"

Bent Ben
Posts: 141
Joined: Sun Jul 02, 2023 4:21 am

Re: Great Consultation.....

Postby Bent Ben » Sun Dec 24, 2023 11:30 pm

ceekay87 wrote:
Bent Ben wrote:Thanks for the reply BentBen. I see you have the titan. Im leaning towards the AMS to avoid dog ears. However I like the size of the titan pump...but dont care for the pump noise. Talk about those issues if you would please.


Dog ears are real.. I have them my flaccid penis feels like there is something unnatural inside. I dont care, I didnt do this to have a great flaccid penis.
Also, my situation was PD first and ED second. It appears most good Surgeons lean Titan for PD correction. I spoke to Clavell and Hakky, both didnt recommend Titan but just told me that was what they would use as it had a strong track record for PD.
I find the pump is not terribly large or noticeable. It is fairly easy to inflate but deflation take some practice
51yo, ED 5 years, 45-50° curve/PD. 22cm Titan, IP with no RTE by Dr Hakky on 9/12/2023.
My comments, suggestions, ideas or routines are for entertainment and satirical purposes only. Do not use any of my ideas, suggestions, routines or advice.

Tokyo_123
Posts: 260
Joined: Tue Mar 01, 2022 3:02 am

Re: Great Consultation.....

Postby Tokyo_123 » Sun Dec 24, 2023 11:42 pm

Jage64 wrote:-more natural and comfortable flaccid, which is the state it will be in 99.8% of the rest of my life
-silent pump, no squeaks or honks
-girth is dictated by your tunica, not necessarily the implant. The difference in diameter is negligible.
-rare reports of auto-inflation, after nearly a year I've never experienced it
-almost zero dog ears, although someone here on FT reports they have them. I never have.
-by far the most implanted system worldwide, by a WIDE margin. Proven technology
-AMS has lower infection rate vs Coloplast out of the box, 1.3% vs 4.4%
-CX has similar rigidity to the Titan, just a touch less so. LGX is far less rigid, I did not consider LGX (come to find out it's too rigid at max for my wife, so we use it at about 80%. More rigidity would have been useless to us)
-CX has the lowest dissatisfaction rate vs. Titan. 2.4% vs 7.7%
-CX dissatisfaction with deflation = 4%, Titan dissatisfaction with deflation = 24%



The only stat I agree with is the AMS having better deflation satisfaction than the Titan. Suspect also the Titan might have higher rate of dog-ears, since it's just a larger unit.

However, rest of these stats I find extremely questionable: For start, my OTR (unlike the Genesis) makes no noise. Also the rest of these "stats" look rather dated and/or more like advertising types of statistics. I've never heard of higher or lower rates of infection for either model. Infection rates would probably be based upon the individual surgeon (and how well they use the no touch technique). Also, never heard of auto-inflation problems for either of the current models.

... of course, I could be wrong.
Venous Leakage (which I believe caused by my overuse of the Bathmate VED)

Dr. Clavell, August, 2022. Titan One-Touch, 24cm XL cylinders and trimmed off 0.5cm

Gt1956
Posts: 2911
Joined: Fri Apr 05, 2019 2:47 pm

Re: Great Consultation.....

Postby Gt1956 » Mon Dec 25, 2023 1:19 am

Tokyo_123 wrote:
Jage64 wrote:#1 -more natural and comfortable flaccid, which is the state it will be in 99.8% of the rest of my life
#2 -silent pump, no squeaks or honks
#3 -girth is dictated by your tunica, not necessarily the implant. The difference in diameter is negligible.
#4 -rare reports of auto-inflation, after nearly a year I've never experienced it
#5 -almost zero dog ears, although someone here on FT reports they have them. I never have.
#6 -by far the most implanted system worldwide, by a WIDE margin. Proven technology
#7 -AMS has lower infection rate vs Coloplast out of the box, 1.3% vs 4.4%
#8 -CX has similar rigidity to the Titan, just a touch less so. LGX is far less rigid, I did not consider LGX (come to find out it's too rigid at max for my wife, so we use it at about 80%. More rigidity would have been useless to us)
#9 -CX has the lowest dissatisfaction rate vs. Titan. 2.4% vs 7.7%
#10 -CX dissatisfaction with deflation = 4%, Titan dissatisfaction with deflation = 24%

The only stat I agree with is the AMS having better deflation satisfaction than the Titan. Suspect also the Titan might have higher rate of dog-ears, since it's just a larger unit.
However, rest of these stats I find extremely questionable: For start, my OTR (unlike the Genesis) makes no noise. Also the rest of these "stats" look rather dated and/or more like advertising types of statistics. I've never heard of higher or lower rates of infection for either model. Infection rates would probably be based upon the individual surgeon (and how well they use the no touch technique). Also, never heard of auto-inflation problems for either of the current models.
... of course, I could be wrong.

I took the liberty to number Jage64's post. Him & I have the same implant. He has had his a little longer
#1 Mine doesn't show a bulge in my clothes. Wife doesn't think my flacid is now larger. I think its is slightly larger. Definitely larger than I would be if it was cold outside. So no shrinkage but no surprise at that.
#2 Same, inflating & deflating is very easy. Deflate button is easy to find & operate. Was fairly easy from about 2 weeks in.
#3 Right now I'm at 6" girth. Pre ED I was slightly above 6". I think that at the one year mark I shoud at least hit my previous girth.
#4 No auto inflation either.
#5 I did have 1 dog ear on the left. It hurt off & on for the first week or so. Not now, I can feel a small one on the right but it has never hurt.
#6 I do not remember where I read the stat. Boston Scientific out numbers Coloplast by quite a large margin. Perhaps BS has been in that market longer.
#7 No idea.
#8 CX is used to treat peyronies also. I will agree that very severe peyronies might be best served by Titans. But my dr does a lot of implants using AMS only. I can't believe he doesn't have peyronies patients. Actually, in my state there is basically only two implant drs. The other dr does use a few Titans but mainly AMS. A Titan reunion here might have a small turn out.
#9 No idea. I'm happy, can't say that I can remember any unhappey AMS patients. Even Rodsmen (AMS CX 24 cm + 1cm rte) with a very large dick seems very happy. Oh, he is sporting a 8" dick with a 7" girth already, around 7 weeks post surgery. So much for AMS not being appropriate for the bigger boys.
#10 No idea.
68yo, HBP at 40, high triglycerides at 45. Phimosis at 57. Type 2 at 60. Dr. William Brant May 1, 2023 CX 21cm w/no rte's penoscrotal 6" girth @ 6 months

Bent Ben
Posts: 141
Joined: Sun Jul 02, 2023 4:21 am

Re: Great Consultation.....

Postby Bent Ben » Mon Dec 25, 2023 5:27 am

I just thought about the squeaking part.. Mine doesnt squeak. It does make a slight vibration a few pumps at the beginning of the cycle. I have a Titan Touch pump. I have also not dealt with auto inflation, but Im only 3 months in.
Im happy with it.
I think there are pros and cons to both units but when you look at the satisfaction rates they are very low for both.
I think there is a bit of Chevy-Ford rivalry psyche between patients.
51yo, ED 5 years, 45-50° curve/PD. 22cm Titan, IP with no RTE by Dr Hakky on 9/12/2023.
My comments, suggestions, ideas or routines are for entertainment and satirical purposes only. Do not use any of my ideas, suggestions, routines or advice.

Flounder
Posts: 267
Joined: Mon Jul 23, 2018 3:17 pm
Location: PA

Re: Great Consultation.....

Postby Flounder » Mon Dec 25, 2023 8:41 am

Bent Ben; I think there is a bit of Chevy-Ford rivalry psyche between patients


Exactly! What I got is the best.

OP starts a discussion about his consultations with two different surgeons. (Hakky/Clavell)
He never mentioned implant brands.

Thread spins into yet another Titan vs AMS debate, with bullet points nonetheless.
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.

Jage64
Posts: 559
Joined: Sat Oct 22, 2022 9:38 pm

Re: Great Consultation.....

Postby Jage64 » Mon Dec 25, 2023 11:05 am

ceekay87 wrote:Thanks for the reply BentBen. I see you have the titan. Im leaning towards the AMS to avoid dog ears. However I like the size of the titan pump...but dont care for the pump noise. Talk about those issues if you would please.



Maybe you missed this post by the OP.
2/22/23 AMS 700 CX 21cm + 1.5cm RTEs. 58 yrs old, wife of 37 yrs. Penoscrotal. 100ml Conceal reservoir. Dr. Clavell. Pills failing and went right to implant, skipped the injections. 12 mos. later: 7 1/2" x 5 3/4"

ThailandBound
Posts: 966
Joined: Fri Dec 16, 2022 5:32 pm

Re: Great Consultation.....

Postby ThailandBound » Mon Dec 25, 2023 11:06 am

Flounder wrote:
Bent Ben; I think there is a bit of Chevy-Ford rivalry psyche between patients


Exactly! What I got is the best.

OP starts a discussion about his consultations with two different surgeons. (Hakky/Clavell)
He never mentioned implant brands.

Thread spins into yet another Titan vs AMS debate, with bullet points nonetheless.


At least it’s not politics! :D

(please, don’t anybody start).
Active, athletic 63 years old. Sexually, still 33 in my mind and spirit. Pills and injections all worked, until they didn’t. Diagnosed with veinous leakage in 2022. Coloplast Titan. 22 CM. No RTE. Peno-scrotal. Implanted 1/4/23. Dr. Clavell.

Bent Ben
Posts: 141
Joined: Sun Jul 02, 2023 4:21 am

Re: Great Consultation.....

Postby Bent Ben » Mon Dec 25, 2023 3:58 pm

Jage64 wrote:
ceekay87 wrote:Thanks for the reply BentBen. I see you have the titan. Im leaning towards the AMS to avoid dog ears. However I like the size of the titan pump...but dont care for the pump noise. Talk about those issues if you would please.



Maybe you missed this post by the OP.

To be fair I did initially, however, I did several other posts addressing my personal experience with the Titan and squeaking and dog ears.
Recap: I have the Dog Ears but dont care and my pump doesnt squeak but does vibrate a bit at initial pumping
51yo, ED 5 years, 45-50° curve/PD. 22cm Titan, IP with no RTE by Dr Hakky on 9/12/2023.
My comments, suggestions, ideas or routines are for entertainment and satirical purposes only. Do not use any of my ideas, suggestions, routines or advice.

PCPilot
Posts: 5
Joined: Thu Oct 12, 2023 9:30 pm

Re: Great Consultation.....

Postby PCPilot » Tue Dec 26, 2023 12:49 pm

PM if you wish. Dr. Hakky did an AMS for me on 28 Nov. My “thank you” post has details of the first part of recovery and decision making.

Bottom line: Top few of hundreds of docs I’ve experienced or worked with.

I keep sharing with him and the team that this was among the best life choices I’ve made and I am so fortunate to have found him. I traveled from the Emerald Coast…I’m driving back today for the one-month check up and, hopefully, move to the next phase: put it to use!
54 y/o; G3+4 PSA 3.8 (>25% consumed); RARP 10/22; ED a small price; tried everything; Dr. Hakky 11/28/23 w/AMS 700 CX 18+1. Post RP; pre-implant: L5.2”xG4.4"; 30 days post: L4.72” x 4.33”; 70 days post: L:5.4” x 4.4”; still 9 mos left!


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