Realistic Size Expectations

[Gt1956]

Lost Sheep, I'd like to thank you for posting the links. I followed the second one using my phone. It helps to try selecting the file type on the right of the screen to get a format that fits your phone's screen the best.
About 2/3's the way down the writer uses a phrase that confuses me. Basically he says that the Titan has unlimited length & growth potential. Only limited by the Trunica. Am I mis reading that sentence because that is a huge difference to my previous understanding. Obviously there has to be a limit but.... The writer makes it sound like the Titan is far superior for any patient who's Trunica will support lots of girth.

[Lost Sheep]

Lost Sheep, I'd like to thank you for posting the links. I followed the second one using my phone. It helps to try selecting the file type on the right of the screen to get a format that fits your phone's screen the best.
About 2/3's the way down the writer uses a phrase that confuses me. Basically he says that the Titan has unlimited length & growth potential. Only limited by the Trunica. Am I mis reading that sentence because that is a huge difference to my previous understanding. Obviously there has to be a limit but.... The writer makes it sound like the Titan is far superior for any patient who's Trunica will support lots of girth.

That has puzzled me since I first read it. I believe I am not alone in this, either, nor have I gotten a succinct and specific answer from any doctor I have asked. The patient liaisons for each maker SHOULD know, but I have little faith in my region's rep. He could not/would not answer the simple question of "What are the dimensions of the implant tips?", much less such a technical question about how the implant expands when inside a human being.

What I DO know is that the individual elements I believe to be true are contradictory.

In which of the links did you find that phrase? I do not recall and I am sure others would like to read that one.

[Gt1956]

I mention which link I read in the first paragraph.
I guess that there is a chance that none of the doctors or reps are willing to not follow the "company line". But if these researchers are correct, that is a large revelation. My guess is the top implanters have figured this out from either reading that report or real life experience.
It would be interesting to learn how this correlates to FT members experiences.
Oh, did you notice that they say the AMX expands "up to". Like it won't expand past that point. Interesting!

[DougAnd]

Here is the quote
Early in our observations we catalogued the various cylinder types manufactured by the two US companies to see if there was a difference in outcomes between the various cylinder models. AMS manufactures the LGX cylinder, which increases in girth to 18 mm and lengthens up to 20%. Coloplast Titan is a cylinder that is unrestricted in girth and length expansion. Only the tunica limits Coloplast cylinders expansion and length. We wondered if the lengthening cylinder or the unrestricted expansion cylinder would have different outcomes after our vacuum protocol

[Lost Sheep]

The AMS devices are made of a Dacron cloth weave. The LGX is woven so it can expand in length, but that is a factor of the weave (I surmise). What I do know about Dacron thread is that it does not stretch like Nylon thread does. They use Dacron for sails because of that property. Sails need to retain their shape, so stretch is a no-no.

Coloplast devices are made of a material they call "bioflex" about which they are close-mouthed.

Here, I enter into fact-based speculation, so take that into account when evaluating what I write.

Apparantly bioflex will expand enough to press against the inside of the Tunica Albuginea, which stops it from expanding any further. No material can expand indefinitely (which obviously is why Coloplast does make different sizes).

It is apparent, then, that AMS devices may not squish any Cavernosum tissue the surgeon leaves in place, but the Coloplast may well do that. If you are a believer in leaving residual (if there is any) tumescent function in the tunica, the AMS device may be preferable. If your surgeon intends to evacuate all the cavernosum, the Coloplast may well be the preferable device.

Comments? I invite anything that might confirm my thoughts or correct them.

[DougAnd]

The more studies I read the more confusing things become.
I'm going to couple this study with the used cylinders study where more than 1000 AMS LGX and CX and less than 1000 Titans were measured after being replaced. The LGX had grown twice as much longer within a calculated time frame as the CX and Titan but all had grown longer over time.
Coupled with this VED study and my experience there can be no doubt that my success is a combination of both the LGX expansion and VED. The LGX alone does not have the strength to stretch scarring very efficiently using only the tips. The VED does no good to stretch you if your prosthesis does not maintain that length.
Both must work together in tandem. That is exactly what I have done.
Example. My wife and I have mutually agreed to back things way down until after my coming surgery and healing. So I have not regularly fully inflated (7 pumps at night to sleep) and have not regularly used VED. This AM I decided to check things out after yesterdays excitement. waited a few minutes and measured. 6 3/8 inches tight bone press. Quite a loss. Got in a hot tub still fully inflated and started VED. Stretch and release for 20 minutes then measured again. 6 7/8 inches. Had I continued for an hour I'm sure the 1/8 would have come back too.
Just goes to show use it or lose it even after your implant.
LostSheep this seems to speak to Dr Eid's claim of Tunica dependent vs tunica independent, no?

[DougAnd]

LostSheep,
That second study is great! So they did not use LGX for peyronies patients. I assume that is because the vast majority of them have curving and soft tubes do not help keep the flaccid penis straight.
It makes perfect sense that the Titan has unlimited expansion while the LGX is designed to limit expansion. That has far reaching implications. If your tunicas are strong then using a VED after implant with your inflated prosthesis would have no bounds on restretching out your penile scarring. The Lgx however would stretch longer faster but only until the weave stopped it. So for me whose tunicas are thin and torn the Titan would have been disastrous while the LGX was able to hold itself together and stretch with me.
So if someone is shorted by their surgeon, just keep on stretching and beat them at the game.
It is sad that these guys only used the VED after implant on those about to upgrade to a new implant. Did I read that right?

[Lost Sheep]

LostSheep this seems to speak to Dr Eid's claim of Tunica dependent vs tunica independent, no?

I think so, but the subject is so nebulous I am at a loss to make any definite statement with certainty.

LostSheep,
That second study is great! So they did not use LGX for peyronies patients. I assume that is because the vast majority of them have curving and soft tubes do not help keep the flaccid penis straight.

While the Titan has a stiffer material, I would not characterize the LGX as having "soft" tubes. When inflated, they are plenty stiff.

It makes perfect sense that the Titan has unlimited expansion while the LGX is designed to limit expansion. That has far reaching implications. If your tunicas are strong then using a VED after implant with your inflated prosthesis would have no bounds on restretching out your penile scarring. The Lgx however would stretch longer faster but only until the weave stopped it. So for me whose tunicas are thin and torn the Titan would have been disastrous while the LGX was able to hold itself together and stretch with me.
So if someone is shorted by their surgeon, just keep on stretching and beat them at the game.
It is sad that these guys only used the VED after implant on those about to upgrade to a new implant. Did I read that right?

My ability to interpret the papers is not superior to yours.

Regarding the stretching, I would caution that it is only up to a limit. Even the Titan's bioflex material must have some point at which stretching will stop and tearing will begin. A rubber band stretches proportional to the tension on it over a very long range but at some point it stops stretching and simply resists until it breaks.

Thanks for the props.

[DougAnd]

DougAnd wrote:
LostSheep,
That second study is great! So they did not use LGX for peyronies patients. I assume that is because the vast majority of them have curving and soft tubes do not help keep the flaccid penis straight.

While the Titan has a stiffer material, I would not characterize the LGX as having "soft" tubes. When inflated, they are plenty stiff.
LostSheep,
I'm not talking about inflated penises but fully deflated and flaccid. The Titan has thicker cylinders hence it is much better to keep your flaccid fully deflated penis straighter than the AMS product. Makes sense why few surgeons use the LGX with patients who have scarring even though it is designed to stretch out shrunken penises. I think the disconnect with the AMS maker is that cylinders do not stretch very efficiently on their own. They need help in those guys who need the most help. That would be me. The guys who need the least help would do just as well or even better with a Titan as long as their surgeon gives them a good measurement.
Another point this study pressured the VED "until it burns". Most Doctors do not recommend that but it is exactly what I found to be the only effective way. They say to mark your progress on the vacuum tube. Exactly what I figured out too. That tells me that they are using similar pressure to mine. Doing what the Doctors typically recommend is a waste of time for stretching. No need to mark the cylinders you will never move beyond the first mark. Also my greatest gains came first and then it was slow going. After I reached 6 inches I just creeped ahead. And it took me 2 months just as they recommend.
This therapy matches what I did exactly. The only difference is that I did not stop VED after implant because in one hour I lost 3 inches was much worse off after my implant than I ever was before from decades of ED. Even using VED it took me 6 months to fully recover my pre implant longest VED length.
Thank you for sharing
DougAnd

[Lost Sheep]

LostSheep,
That second study is great! So they did not use LGX for peyronies patients. I assume that is because the vast majority of them have curving and soft tubes do not help keep the flaccid penis straight.

I did not think about the straightening effect of the stiffer Bioflex material when uninflated. I guess Peyronie's disease crooks the penis even when flaccid. I did not think of that aspect.