Why so many negative comments on IPPs on Medicine Net ?

[TANGERINE]

I a also surprised at the number of negative comments, though, they are not unheard of issues that we have learned about here on franktalk. Overall, 92% of men are happy....8% will bring up the comments in the medicine net comments section (ie, length and girth issues, being able to feel tubing, pump issues, postoperative pain, etc). I think that being able to feel the tubes on the penile shaft would bother me, and this is a known issue for infrapubic surgery installation with rear tip extenders. If you get peno-scrotal surgery with no rear tip extenders (which is what I have) then no woman will be able to detect the tubing as they go into the cylinders.

Basically it comes down to getting a very competent surgeon. Super expert surgeon can give you a "cosmetically pleasing and almost undetectable implant".

[defiant]

It is a shame and a detriment to the surgery itself, however, that it HAS to be done by someone extremely experienced and high volume to guarantee a good result.

It shouldn’t be so nuanced and hard, as it were, to give a man a good result. There will be many countries and areas that lack a ‘world class’ surgeon and I just find it a shame that any procedure should be in such a state that it’s widely regarded as fact that you really need a world class surgeon on your case to get that good result.

[crazyjoe]

I share the shock of those patient reviews. I did a bit of checking around and found that when it comes to rating drugs, MedicineNet was rated by Rutgers as follows:

MedicineNet was identified as the least reliable website, with the
lowest average score, deficiencies in safety information, and the
highest number of statistically significant differences favoring other
in our pair-wise comparison.
https://www.aacp.org/sites/default/file ... -adams.pdf

Of course this is a different measure than the patient reviews of IPPs, however for me it does put something of a cloud over the reliability of the website.

And while not wanting to get into a websites reliability duel, these success rates from other sources seem worth noting:

National Library of Medicine
The results of our study suggest that excellent long-term reliability and high patient satisfaction rates make the implantation of an inflatable penile prosthesis a recommendable surgical treatment for refractory ED
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462637/

Houston Methodist Hospital
"Studies have shown that the satisfaction rate of men with a penile implant, as well as their partners, is between 90 and 95%," says Dr. Starke. "The vast majority of men respond that they're likely to recommend the procedure to someone else and also have no regret over their decision to get a penile implant."
https://www.houstonmethodist.org/blog/a ... e-implant/

Mayo Clinic
Although penile implants are the most invasive treatment for erectile dysfunction, most men who have them and their partners report satisfaction with the devices. In fact, penile implants have the highest rate of satisfaction of all erectile dysfunction treatments.
https://www.mayoclinic.org/tests-proced ... c-20384916

[TANGERINE]

This question has come up in the past regarding the 90 percent of ecstatic guys here on franktalk and the scare stories and unhappy patients at another site. This was addressed previously at the following thread:
https://www.franktalk.org/phpBB3/viewtopic.php?f=6&t=14804&p=130834&hilit=avoid#p130834

Back in may 2020, I answered that thread, and I am pasting my response below:

Here are my answers:

question #1:
1) I’ve heard a mix of good/bad stories on penile prosthesis. .....The many bad stories ..makes me question if the positive data from other sources I've read is just a complicated form of sales marketing? .....

The published satisfaction rate with implants is around 92%. So 8 percent are not satisfied.

I will paste below my answer regarding the multiple scare stories that are out there and the stories that are also here on frank talk (frankly, if I read about all the troubles men are having here on frank-talk, I would be feeling pretty low, but, based on all those negative stories, I will paste my ansewr from a post written in December 10 2017 by me:

The "scare stories" I think emerge from three subsets of unhappy implantees with the following common characteristics:

1) "Impantees who had unreal expectations"
Men who did not do their homework and just signed on for an implant; then later complain because "they feel the cylinders all the time" of that "the significant other misses the natural process of erecting" or "my erection is a little shorter than before; I had hoped for larger -- like a boob implant"
TO AVOID BEING IN THIS GROUP: read franktalk discussions on complaints regarding the implant. My local urologist told me that "implants have issues" and you need to be ready and willing to address those issues or adapt to those issues

2) "implantees who have faced real surgical complications"
There are complications from implants. Infection is the most problematic one (0.6% to 3% rate depending on your surgeon and your immune system). But there are a number of other complications which lead to the need for more surgery, and possibly, length loss. Surgery does not always go as hoped; you need to realize that you are playing "dick roulette" which means that you really should have exhausted the other options (pills, injections, etc) so that if you lose, then you can console yourself knowing that "your dick was total crap before the operation anyway --at least I tried." In other words, it is best if you go into surgery knowing that you have little to lose since your erections are dead anyway.
TO AVOID BEING IN THIS GROUP: go into surgery healthy (ie, no smoking, weight ok, take all your prescriptions, follow ALL doctor instructions absolutely and to the minute) and find a surgeon with proven track record.

3) "implantees who were sized incorrectly"
This includes undersizing in length (surgeon not aggressive enough), disappointment in girth (surgeon chose implant that wasn't ideal for your particular penis) and oversizing in length which lead to "SST deformity" or weird bowing of the cylinders. Also, placement of the tubing or pump can sometimes be such that it gets in the way of sex.
TO AVOID BEING IN THIS GROUP" carefully vette your surgeon. Choosing a high volume surgeon with a string of satisfied patients is paramount.

Question #2:I’m considering Dr. Francois Eid or Dr. Andrew Kramer, but am open to researching more doctors. Recommendations? Anyone regret getting penile implants, especially from these 2 docs?

Those two doctors will give you a list of happy patients to call (once you have shown that you are a serious surgery candidate) and you will find that many men believe that the implant has been life changing and among the best decisions of their lives. I think it is rare to find an unhappy Eid patient (though I am sure that it happens), and most of the kramer patients seem reasonably happy (though some needed a minor revision of their bulb position)

QUESTION #3
3) I’ve mostly seen data of high satisfaction rates reported by mostly elders, and not much data on how satisfied a young person still is with implants 10-35 yrs later. Are you aware of such data?

I have not seen the data. But the young guys on this site who have been implanted by the master high volume surgeons seem to be ecstatic, they mostly have disappeared from franktalk since they spend all their time chasing, and bedding, super models

4) I read the device need repair/replacement after a couple yrs. After each repair/replacement:
4A. Does the chance of infection increase? If so, how much and how severe can infection be?
4B. Does the penis shrink further? On average, how much?
4C. Is there additional pain? If so, how much?

as per a recent post, half of the implants last at least ten years. But their is an element of luck here . Chance of infection increases with a replacement--yes, this can be managed and you read about infection all the time here on franktalk. With replacement, there is a chance that you get a bigger implant with subsequent surgery. But this is a maybe, because your penis is only whatever size it is, and it is hard to make it longer. The pain of a replacement is LESS than the original surgery

5) How do most patients describe their pain level and how long it took before they can satisfyingly use the implant with none-moderate pain?

I had minor pain which was controlled by naprosyn and tylenol for a week or two. I did not need any narcotics, but surgeons will tell you that you should figure on being on narcotics for a week at least, and maybe two.

6) Are there any other health risks for someone young that I should be aware of?

The biggest risk is that you go to a surgeon who is not a great expert. So, choose your surgeon very carefully. Their was a paper written about patients who tended to be a problem when they got implants, I will quote a line from that paper:

.....Using this model, a high-risk scenario includes one in which a low-volume surgeon performs a complex case in a patient with limited psychological capacity and high expectations. In contrast, a high-volume surgeon performing a routine case in a male with low expectations and abundant psychiatric reserve is more likely to achieve a successful outcome. To further help identify patients who are at high risk for dissatisfaction, a previously published mnemonic is recommended: CURSED Patient (compulsive/obsessive, unrealistic, revision, surgeon shopping, entitled, denial, and psychiatric).

This paper was published for surgeons and can be found at:
http://tau.amegroups.com/article/view/15699/16225
REFERENCE: Surgical patient selection and counseling
Matt Ziegelmann, Tobias S. Köhler, George C. Bailey, Tanner Miest, Manaf Alom, Landon Trost
Department of Urology, Mayo Clinic, Rochester, MN, USA

[TANGERINE]

and one more remark, I do discuss this in chapter 16 of my implant pamphlet (available here on franktalk).
That chapter is titled implant risks and complications, scare stories, the link is below

https://www.franktalk.org/phpBB3/viewtopic.php?f=6&t=16298&p=146385&hilit=wiki#p146385

[Craigohbig]

Good doctor = good result
Bad doctor = iffy result

Never heard of a doctor held in high regard having any awful result?

[tomas1]

I believe it does happen, but usually they own it and fix it.
I could be wrong?

[68CatFan]

It seems like a place like FT should have its own section titled "Surgeon reviews" that provides information found in sites like healthgrades. Men who've had implants could contribute a review of their surgeon. New members or even older ones when it comes time for an implant could check that section to see what surgeons are listed and see what their overall rating is. Right now, you have to spend hours and hours digging through countless posts looking for members who used a certain doctor and send them PMs to get more info. Then come to find out they no longer visit FT. I've been looking at a local surgeon here in St. Louis, but I've only had one FT member share his experience. Can't get a really good impression of a surgeon from one person. Would of been nice to have a page dedicated to each surgeon where previous FTers could of left reviews for future FTers to see.

[MK1965]

It seems like a place like FT should have its own section titled "Surgeon reviews" that provides information found in sites like healthgrades. Men who've had implants could contribute a review of their surgeon. New members or even older ones when it comes time for an implant could check that section to see what surgeons are listed and see what their overall rating is. Right now, you have to spend hours and hours digging through countless posts looking for members who used a certain doctor and send them PMs to get more info. Then come to find out they no longer visit FT. I've been looking at a local surgeon here in St. Louis, but I've only had one FT member share his experience. Can't get a really good impression of a surgeon from one person. Would of been nice to have a page dedicated to each surgeon where previous FTers could of left reviews for future FTers to see.

That is great suggestion. Would love to see it.
If necessary, it could be I’m Members only section so lurker would need to sign up to be able to see Members only section.
I am sure, this would help any newbies lookin for surgeon recommendation.
MK

[frwmw1]

Surely it's obvious though, that those sites only attract negative posts and very little discussion, because their format is more conducive to medications than reviews on surgery.

Why would the format only attract negative posts?

Those sites are often not a discussion site but a review site, with the idea that
people write a review on a medicines efficiency and side effects.