Group of questions from someone weighing implant decision

The final frontier. Deciding when, if and how.



Fran4524
Posts: 194
Joined: Sun Dec 13, 2020 3:33 pm

Re: Group of questions from someone weighing implant decision

Postby Fran4524 » Tue Apr 06, 2021 4:27 pm

Markc2008 wrote:No problem. It’s Post SSRI Sexual Dysfunction. Sometimes it’s just long standing and sometimes it’s permanent. After two years I’m starting to think for me it’s permanent. I have a large loss of sensation in my penis although sex is still pleasurable although some of that may be other senses and stimuli helping. I have a hard time getting aroused even though I like what I see etc. it’s like emotions and arousal become dull.


Thanks for the answer, man! I wish you recover.
-1993
-Erection problems since 4 years
-I did jelqs and it is posible I injuried, but I hace to say that ED episodes began before I did jelq.
-Having sex with 30mg of tadalafilo

Gt1956
Posts: 3194
Joined: Fri Apr 05, 2019 2:47 pm

Re: Group of questions from someone weighing implant decision

Postby Gt1956 » Tue Apr 06, 2021 5:18 pm

I pretty much agree on skipping the scans. Ask your doctor if the scans will make getting insurance coverage easier. If not, then why waste the time, heart ache & co-pays to get a diagnosis of something that can't be fixed?
I guess it kind of boils down to what my wife has said. She just wants it to work. I don't think the mechanical nature of it or the pumping action bothers her in the least bit.
I would suggest to keep your eye on the goal. Don't get distracted by the "why" of your ED. Just my opinion. When you get to the point of thinking seriously about an implant. Focus on it, the rest is of no matter
Best of luck to all of you..
69yo, HBP @ 40, high triglycerides @ 45. Phimosis @ 57. Type 2 @ 60. Dr. William Brant May 1, 2023 CX 21cm w/no rte's penoscrotal 6" girth @ 6 months.

hectorm64
Posts: 90
Joined: Thu Dec 31, 2020 11:46 am

Re: Group of questions from someone weighing implant decision

Postby hectorm64 » Tue Apr 06, 2021 5:22 pm

Markc2008 wrote:Hey guys, I’m 38 years old and have posted here a couple of times. I have PSSD from stopping an antidepressant too suddenly and have had it for two years with no improvement. This means my sensation is not normal, and I have severe ED because it is hard for me to translate arousal to an erection. With that being said you can imagine that pde5s don’t work well for me. They seemed to work the first year although unreliably, and now they don’t hardly work at all unless I take well over the maximum dose. I also have flaccid shrinkage like where my blood doesn’t flow there like it should? All these problems arose at the same time. Anyways, I’m about to start trying injections but I’ve already been told it can cause scarring and larger issues so I’m not far off getting the ball rolling on an implant. I’m hoping some of you guys can weigh in on these topics and put my mind at ease:

What is the deal about no glands engorgement? I’m not even sure I understand what people are referring to. The head doesn’t get hard? In pics I’ve seen on here people look completely hard? Wouldn’t it just flop around otherwise? Is this common?

I know it’s been worn out but how likely am I to lose significant size(more than 1/2”)? I’m only between 5 3/4” - 6” Depending on how you measure so don’t want to lose a lot.

I’ve read a lot of people mentioning almost a “third ball” with the pump in there. Is it that big and noticeable? I always envisioned something pretty tucked away and smaller. I get you could feel it in there but how visually noticeable is it?

How are people traveling? Are many people having issues with airport security?

Does insurance generally cover the majority of the cost if you have tried other options first and doctor gives a referral?


Hi Mark
I 100% agree with Quincy response.
Finding a good surgeon is the key.
I was implant on 03-11-2021, My surgeon used a infrapubic approach. It means a smaller incision to make for a more minimally invasive surgical procedure. Two of the obvious advantages to the infrapubic approach are the ability to implant the reservoir more rapidly and under direct vision through the same incision and the avoidance of an extra incision on the scrotum, removing one obstacle to rehabilitation. I started cycling at the second week post_op to the max, 30 minus twice a day and 1 hour twice a day at third week everyday.
I have already my pre-op size and I have a feeling that it will increases through the year.
I had sex on day 16 post-op. It was the best sex in my entire life.
For the Glans engorgement, I use Cialis for increasing he flow of blood to the glande making it warmer and hard.
I believe 100% in the VED therapy it worked for me and for most guys here. Also I am planning to incorporate it to my daily cycling routine after 6 week, when all the tissues are healed completely.
Please take note from Quincy response and start your research from there.
Please feel free to PM me with any questions.
Please keeps us update with your progress, we are here to help each other.
Good luck
Hector
I live in Arizona my surgeon is Dr Shawn Blick great surgeon. He has a good Video in YouTube
57 yo, PHX, AZ. ED all my life.Used Viagra,Cialis,Trimix failed. Implanted AMS 700CX 21 cm +2 cm RTE on 03/11/2021. Dr Shawn Blick.
Pre/post-op size length 6.0"X 6.5" girth. Cycling at week 2,Sex at week 3.
Cycling full erected 1hr am, 1hr pm

frwmw1
Posts: 453
Joined: Thu Oct 01, 2020 7:38 am

Re: Group of questions from someone weighing implant decision

Postby frwmw1 » Tue Apr 06, 2021 5:53 pm

wolfpacker wrote:Whether they detect a veinous leak or not, the treatment is the same, so why even bother?


The problem I had is I wasn't taken seriously because I am relatively young.
45yo, venous leak. Pills increased tinnitus (very rare). Using bimix+atropine, 0.2 of:
Atropine Sulfate: 52MCG/ML, Phentolamine MES: 0.9MG/ML, Papaverine HCL: 26MG/ML

Markc2008
Posts: 229
Joined: Fri Jul 31, 2020 10:45 am

Re: Group of questions from someone weighing implant decision

Postby Markc2008 » Tue Apr 06, 2021 6:05 pm

Quincy wrote:I'll give you my opinions on your answers. I've had my implant for over 2 years. It's a big step to take, so it's good that you're doing research. This site is great for getting answers, so don't hesitate to ask.

1. Glans engorgement. Engorgement of the glans penis (that's the official term, often shortened to just "glans") is natural during erection. Some men with implants have indicated that their glans no longer gets larger and harder during arousal. Others indicate that they have lost some sensation in the head of their penis. We all want full sensation and arousal, but it's clear that not everyone with an implant gets that. Many implantees, however, are happy with the level of engorgement of the glans. YMMV. Lack of sufficient engorgement can make penetration more difficult. If you decide to go forward with an implant, you should talk this over with your surgeon. Most good implant surgeons will discuss this in whatever level of detail you want. FWIW, in my own case I don't feel I have as much glans engorgement as I did in my youth, but I'd had some level of ED for over 15 years when I got my implant. What I have now is far better than what I had during those years. In my case there is some engorgement with arousal, increasing as things move forward. and full engorgement of the glans happens just before climax.

The discussion of glans engorgement is separate from but related to another term used here - "floppy head". In some cases, an implant can be shorter than it should be, with the tips of the implant not reaching far enough into the head of the penis. This can allow the head to be under-supported and it can "flop" around making penetration very difficult. This should never happen with a good surgeon. As with many things pertaining to implants, getting the right surgeon can be very important.

2. Loss of size. IMO, no man should ever lose length from a penile implant if they have a competent surgeon and no complications. I'm sure some other men here will disagree with me, but this is how I feel and I'll give you my reasons.

Understanding and techniques have improved so much over the years that an implant should always get most or all of your length back. This is another, and critical, reason for picking the right surgeon. There have been many studies conducted that give "best practices" for ensuring maximum length restoration for IPPs. The best surgeons know and use these techniques and will talk with you about how they ensure maximum length. At the same time, these surgeons will NOT promise you more than you're likely to get. My own doctor, during a pre-op exam pulled hard on my dick, told me to look at the length, and said essentially, "that is how big you'll be, if you think you should be bigger please go to another doctor." Many of us fondly remember how big we were before ED and remember it incorrectly. My surgeon wanted to make sure my expectations were reasonable and rational.

That said, there are some complications that can result in loss of size. Many of them include issues that happened before the implant but get blamed on the implant. Typical things like this include Peyronies Disease, prostate removal due to cancer, and atrophy/shrinkage from years of ED. Some can not be rectified by an implant but are blamed on the implant, not the original cause of the loss of length.

My personal experience includes many years of atrophy. I had lost some of the tissues in my penis (use it or lose it) and what was left was shortened significantly. Some of this type of loss can be rectified with stretching the tissues before the implant surgery. Under my doctor's guidance, I did 3 months of daily VED use and penile traction to stretch my dick and allow a longer implant to be inserted. Another technique in restoring lost length can be early and frequent cycling of the implant after surgery. I chose a surgeon that supported early "activation" of the implant, allowing me to start inflating/deflating just one week after surgery. He instructed me to pump the implant up to maximum for at least 30 minutes four times every day. He even gave me ideas about how to make sure I was at the maximum the implant could take. This early, full and frequent inflation helps make sure the penis does not heal in a smaller size or cause scar tissue to make it harder to stretch through later. I have regained all of the size I lost to atrophy and feel like I'm even a little bigger than I was before. I always felt like I was smaller than average. I was just shy of 5 inches in length immediately after surgery, about 5.5 a year later, and now over 5 and 3/4.

3. The 3rd nut. There is no question that the extra equipment in the scrotum is noticeable to touch. The pump is actually a little bigger than a regular testicle once you include the block at the top of the bulb, and someone feeling around in there will be able to notice that there are 3 items, not 2. However, depending on how your balls rest in the scrotum, the size of your sack, how tight things are, etc., it may or may not be noticed visibly. When things are really relaxed and warm down there I can look in a mirror and see 3 rounded areas, but I'm looking for it. I don't believe it is noticeable with a casual glance. I certainly have no trouble being naked in a locker room and no one that may have noticed has stared or said anything, not that most would. In my case, my right nut rides higher than my left and is often resting above the pump far enough that it looks like the pump is my right nut and my left nut is the other. It's certainly not enough of an issue to cause me concern. Your partner will know, of course, and the question about what to say to new partners is something talked about in other posts here.

4. Traveling. I've traveled a lot since the surgery and been through the very detailed scans used in many airports. Never a problem. I assume by now there are enough men with implants that security knows what the implant is. But perhaps the scans don't reveal anything. At any rate, it's never been a problem.

5. Insurance. This is one where you'll need to get information from your specific insurance. Medicare covered my implant, though they wouldn't pay for the cost of injections. Go figure. I don't believe my insurance before I retired would have covered an implant.

I hope this extremely verbose reply helps. Sorry it's so long. I come back to FrankTalk mainly because I got so much help and good advice here when I was researching implants that I want to help others and "pay it forward". If you have further questions or just want to talk, drop me a PM.

Best wishes on your decision. I personally am very happy with my implant and wish I'd done it sooner. But it's permanent and irreversible. You should be very sure before you take the step.

Q.


Thanks for the wealth of information. That helps a ton. I’m glad that it worked out so well for you! The moral of all this sounds like get the best surgeon you can.

Markc2008
Posts: 229
Joined: Fri Jul 31, 2020 10:45 am

Re: Group of questions from someone weighing implant decision

Postby Markc2008 » Wed Apr 07, 2021 10:07 am

Thanks everyone for the great responses. It means a lot to get so much input. Yeah I want to make sure I give myself the best chance to heal up as close to normal as possible if this is what I have to do. The blood flow to the head part still worries me. Is there anywhere on the forum that has pictures of a I guess “non aroused” erection? I’m still so confused on an erection without the head engorging. Is it noticeable? It still functions ok that way?

boots1959
Posts: 77
Joined: Wed Mar 24, 2021 7:01 pm
Location: Australia

Re: Group of questions from someone weighing implant decision

Postby boots1959 » Wed Apr 07, 2021 7:33 pm

Markc2008 wrote:Thanks everyone for the great responses. It means a lot to get so much input. Yeah I want to make sure I give myself the best chance to heal up as close to normal as possible if this is what I have to do. The blood flow to the head part still worries me. Is there anywhere on the forum that has pictures of a I guess “non aroused” erection? I’m still so confused on an erection without the head engorging. Is it noticeable? It still functions ok that way?


Hi Mark, there is a "implant picture" topic in this Implant section of the forum.
Re the head of the penis not engorging; that is my situation. I had zero engorgement of the penis pre implant, post implant fantastic erections but still no enlargement at all of the head. My tips of my implants are halfway along the head of my penis. So no floppy head effect. When penetrating my wife I use some saliva to assist penetration, I find lubricant far to slippery and decreasing sensation while having intercourse. So in a nutshell even with no engorgement of the head intercourse is still pleasurable to me and I had my 1st orgasm during intercourse since my surgery this week 8-)
Implanted AMS 700 lgx, Jan 15th 2021. 18cm with 3cm rte.

oldbeek
Posts: 2580
Joined: Sun Sep 10, 2017 1:46 pm
Location: Los Angeles area

Re: Group of questions from someone weighing implant decision

Postby oldbeek » Thu Apr 08, 2021 1:14 am

Quincy wrote:I'll give you my opinions on your answers. I've had my implant for over 2 years. It's a big step to take, so it's good that you're doing research. This site is great for getting answers, so don't hesitate to ask.

1. Glans engorgement. Engorgement of the glans penis (that's the official term, often shortened to just "glans") is natural during erection. Some men with implants have indicated that their glans no longer gets larger and harder during arousal. Others indicate that they have lost some sensation in the head of their penis. We all want full sensation and arousal, but it's clear that not everyone with an implant gets that. Many implantees, however, are happy with the level of engorgement of the glans. YMMV. Lack of sufficient engorgement can make penetration more difficult. If you decide to go forward with an implant, you should talk this over with your surgeon. Most good implant surgeons will discuss this in whatever level of detail you want. FWIW, in my own case I don't feel I have as much glans engorgement as I did in my youth, but I'd had some level of ED for over 15 years when I got my implant. What I have now is far better than what I had during those years. In my case there is some engorgement with arousal, increasing as things move forward. and full engorgement of the glans happens just before climax.

The discussion of glans engorgement is separate from but related to another term used here - "floppy head". In some cases, an implant can be shorter than it should be, with the tips of the implant not reaching far enough into the head of the penis. This can allow the head to be under-supported and it can "flop" around making penetration very difficult. This should never happen with a good surgeon. As with many things pertaining to implants, getting the right surgeon can be very important.

2. Loss of size. IMO, no man should ever lose length from a penile implant if they have a competent surgeon and no complications. I'm sure some other men here will disagree with me, but this is how I feel and I'll give you my reasons.

Understanding and techniques have improved so much over the years that an implant should always get most or all of your length back. This is another, and critical, reason for picking the right surgeon. There have been many studies conducted that give "best practices" for ensuring maximum length restoration for IPPs. The best surgeons know and use these techniques and will talk with you about how they ensure maximum length. At the same time, these surgeons will NOT promise you more than you're likely to get. My own doctor, during a pre-op exam pulled hard on my dick, told me to look at the length, and said essentially, "that is how big you'll be, if you think you should be bigger please go to another doctor." Many of us fondly remember how big we were before ED and remember it incorrectly. My surgeon wanted to make sure my expectations were reasonable and rational.

That said, there are some complications that can result in loss of size. Many of them include issues that happened before the implant but get blamed on the implant. Typical things like this include Peyronies Disease, prostate removal due to cancer, and atrophy/shrinkage from years of ED. Some can not be rectified by an implant but are blamed on the implant, not the original cause of the loss of length.

My personal experience includes many years of atrophy. I had lost some of the tissues in my penis (use it or lose it) and what was left was shortened significantly. Some of this type of loss can be rectified with stretching the tissues before the implant surgery. Under my doctor's guidance, I did 3 months of daily VED use and penile traction to stretch my dick and allow a longer implant to be inserted. Another technique in restoring lost length can be early and frequent cycling of the implant after surgery. I chose a surgeon that supported early "activation" of the implant, allowing me to start inflating/deflating just one week after surgery. He instructed me to pump the implant up to maximum for at least 30 minutes four times every day. He even gave me ideas about how to make sure I was at the maximum the implant could take. This early, full and frequent inflation helps make sure the penis does not heal in a smaller size or cause scar tissue to make it harder to stretch through later. I have regained all of the size I lost to atrophy and feel like I'm even a little bigger than I was before. I always felt like I was smaller than average. I was just shy of 5 inches in length immediately after surgery, about 5.5 a year later, and now over 5 and 3/4.

3. The 3rd nut. There is no question that the extra equipment in the scrotum is noticeable to touch. The pump is actually a little bigger than a regular testicle once you include the block at the top of the bulb, and someone feeling around in there will be able to notice that there are 3 items, not 2. However, depending on how your balls rest in the scrotum, the size of your sack, how tight things are, etc., it may or may not be noticed visibly. When things are really relaxed and warm down there I can look in a mirror and see 3 rounded areas, but I'm looking for it. I don't believe it is noticeable with a casual glance. I certainly have no trouble being naked in a locker room and no one that may have noticed has stared or said anything, not that most would. In my case, my right nut rides higher than my left and is often resting above the pump far enough that it looks like the pump is my right nut and my left nut is the other. It's certainly not enough of an issue to cause me concern. Your partner will know, of course, and the question about what to say to new partners is something talked about in other posts here.

4. Traveling. I've traveled a lot since the surgery and been through the very detailed scans used in many airports. Never a problem. I assume by now there are enough men with implants that security knows what the implant is. But perhaps the scans don't reveal anything. At any rate, it's never been a problem.

5. Insurance. This is one where you'll need to get information from your specific insurance. Medicare covered my implant, though they wouldn't pay for the cost of injections. Go figure. I don't believe my insurance before I retired would have covered an implant.

I hope this extremely verbose reply helps. Sorry it's so long. I come back to FrankTalk mainly because I got so much help and good advice here when I was researching implants that I want to help others and "pay it forward". If you have further questions or just want to talk, drop me a PM.

Best wishes on your decision. I personally am very happy with my implant and wish I'd done it sooner. But it's permanent and irreversible. You should be very sure before you take the step.

Q.
Another great post, Quincy, Good to have you back.
83, good health, RP 7-2017, all nerves taken , PSA 0.05in 2025,, 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 at Keck

Rawness1111
Posts: 117
Joined: Fri Aug 09, 2019 11:53 pm

Re: Group of questions from someone weighing implant decision

Postby Rawness1111 » Thu Apr 08, 2021 8:51 am

Man that has to suck to have to use cialis after an implant. Taking Viagra has made me prediabetic. If I were to get an implant I don't want to have to take pills. Curious though is taking pills the norm for implanted patience?
32 yrs old. Newly developed ed with divorce and searching for solutions.

wolfpacker
Posts: 1319
Joined: Thu Dec 12, 2013 10:16 pm

Re: Group of questions from someone weighing implant decision

Postby wolfpacker » Thu Apr 08, 2021 8:52 am

Rawness1111 wrote:Man that has to suck to have to use cialis after an implant. Taking Viagra has made me prediabetic. If I were to get an implant I don't want to have to take pills. Curious though is taking pills the norm for implanted patience?


You don't have to take pills, the penis will be hard either way, but the pills help give extra blood flow so that your glans and shaft/veins get as full as possible.
Early 30s with ED from jelqing. Implant by Dr Eid on 24 June 2021 with a Titan 24cm with +1cm RTE on one side and -1cm cut off on the other side

Aug 2024 revision to AMS CX 24cm + 2rte

My journal: viewtopic.php?t=17202


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