Post Op Gains

[2435tjklAS]

I was looking at a study you once mentioned in the forum (i don't remember if it was in this thread or another one), where patients using VED with the LGX gained 3cm compared to pre-op. I actually looked at the study in details (as often things are hidden in the small print).

I found something interesting which may be misleading. The study claims patients gained 3cm vs their stretched length pre-op. However, their erection size pre op with intracavernose injection was much bigger than the stretched length (and this is what really matters, you have sex while erect at the end of the day).

You can see the chart in page 4

Preop Stretched length: Median 14cm
Preop Intra-Cavernose-Injection (ICI) Median Size 17cm.
Median Size erection after 48 weeks: 17cm.

In other words, the median erect length gain compared to pre-op was zero.

Let me know if i am missing something in the study.


https://irp-cdn.multiscreensite.com/d88 ... action.pdf

Sorry it's taken me so long to reply. Been having some personal, uh, problems (drugs, probably). But have learned too many lessons that prove addictions are lots of fun while they last but are inherently unsustainable and will spiral out of control ending poorly every time for every one. Great time for me to wrap that up nicely. Other reasons it's taken me time is I saw your message and figured it would be over my head, so I put it off. Few days ago I finally got around to looking at the tables, and guess what, it's over my head!!!!

This is all I know and welcome anyone else to share their knowledge.

These are the facts. The doctors write,

Penile shortening after inflatable penile prosthesis for erectile dysfunction is a common postoperative patient complaint and can reduce overall satisfaction with the procedure. In this prospective study we report our results regarding penile dimensions and patient satisfaction outcomes after 1 year of follow-up from AMSTMLGX700® penile prosthesis implant with 6 months of vacuum erectile device therapy. Seventy-four selected patients with medically refractory erectile dysfunction underwent AMSTM LGX 700® IPP placement. Postoperatively, patients were assigned vacuum device therapy for 5 min twice daily. Follow-up continued for 1 year after surgery. Dimensional and functional results were assessed. Baseline median preoperative stretched penile length and girth were 14 cm (range 10-17) and 9 cm (range 7-12), respectively. At the end of the study penile median dimensional outcomes were 17 cm (range 13-23) for length and 11 cm (range 10-13) for girth while a median number of 24 pumps (range 18-29) to fully inflate the device was seen. Baseline median International Index of Erectile Function (IIEF-5) score was 9 (range 5-11), at 6 months 20 (range 18-26) and at 1 year was 25 (range 20-27) (p<0.0001). Median Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) score at the end of the follow-up was 74 (range 66–78). Our postoperative rehabilitation program is feasible and should be recommended after prothesis surgery in order to increase overall satisfaction with the procedure. Penile postoperative dimensional outcomes were statistically significant improved and complications were negligible.

74 patients had a pre-implant size at baseline of 14cm stretched flaccid length and 9cm flaccid girth. Those are completely average sizes from calcSD:

Postoperatively, after being implanted with an AMS 700 LGX and 11 months of VED treatment, their sizes increased to 17cm flaccid length and 11cm flaccid girth. That increased their sizes from average to top 98%.

For those tables to be wrong, the 14 doctors who performed the study, one of whom is Dr. Perito...

...have to be violating the scientific method and lying about the data by making up facts, and the extensive peer review process has to include lots of scientist who, just like me, skip over the tables because they never understand them either.

Someone please share your thoughts on how these tables correlate to those facts. Using erect instead of flaccid? Anything else I can't figure out?

[thx1138]

2345,

Look at the “Pre Op ICI” which to me suggest a minimal difference. Also; as cycling was recommended,
to what degree is cycling a contributing factor ?

[2435tjklAS]

2345,

Look at the “Pre Op ICI” which to me suggest a minimal difference. Also; as cycling was recommended,
to what degree is cycling a contributing factor ?

What the doctors wrote clearly indicates a very significant difference - from average to top 98%. They're not lying. I just don't understand how the data is correct to their writing either. ChatGBT says this:



Adding: this is too long to screenshot. Apparently the study is incredibly misleading.

I ask: Explain what the preop ICI data means

The “Preop. ICI” row in the table refers to penile measurements taken before surgery (preoperative), but after an intracavernosal injection (ICI) was administered to induce a pharmacological erection. Here's what it means and why it's relevant:

What is ICI (Intracavernosal Injection)?
ICI involves injecting a medication (typically alprostadil, papaverine, or phentolamine) directly into the penile corpora cavernosa to create an erection. This is a standard method to evaluate maximal erectile potential before choosing a treatment like an IPP.

What the Preop. ICI Data Shows in the Table:
Length
Median (range): 17 cm (11–19)

Mean (SD): 16.2 cm (±1.7)

Girth
Median (range): 11 cm (9–12)

Mean (SD): 11.0 cm (±0.5)

These numbers represent the best possible erection that the patient's natural erectile tissue could achieve with pharmaceutical help before surgery.

Why Is This Important?
Baseline Benchmark: This gives the highest natural pre-surgical size, showing what was once achievable without an implant.

Outcome Comparison: Post-implant size is compared to this “max potential” to see if the implant can restore or exceed what the patient had with ICI.

Expectations Management: If post-op outcomes match or surpass the ICI numbers, satisfaction is typically higher. If they fall short, dissatisfaction may arise—even if the prosthesis technically works.

Bottom Line
Preop. ICI measurements show each patient’s maximum natural erectile size before IPP surgery. These values serve as a gold standard to assess how well the prosthesis, combined with rehabilitation like VED use, restores or exceeds prior erectile dimensions.

You said:
do they indicate there was little increase post implant and 11 months of VED treatment?

ChatGPT said:

Yes, the data clearly indicate that there was little to no increase in penile dimensions post-implant, even after 11 months of VED (Vacuum Erection Device) rehabilitation, when compared to the preoperative ICI (pharmacologically induced erection) measurements.

Let’s compare the key measurements:
Measurement Preop. ICI 48-weeks Follow-up Change
Length (Mean) 16.2 cm 16.7 cm +0.5 cm
Length (Median) 17 cm 17 cm No change
Girth (Mean) 11.0 cm 11.3 cm +0.3 cm
Girth (Median) 11 cm 11 cm No change

Interpretation:
Length:

Mean length increased only 0.5 cm after nearly a year of VED therapy and daily cycling.

Median length did not increase at all (17 cm before and after).

Girth:

Mean girth increased by 0.3 cm—a small gain.

Median girth remained unchanged (11 cm before and after).

What This Means:
VED therapy did not produce meaningful dimensional gains beyond what was already achievable pre-surgery with ICI.

These results support the notion that IPP + VED therapy may help maintain or slightly improve dimensions, but will not typically increase size beyond a patient’s natural erectile potential.

Bottom Line:
Yes—post-implant size after 48 weeks of VED therapy remained virtually the same as the patient’s best pre-op size with ICI. The data shows no substantial gains in either length or girth, which is important for setting realistic expectations for IPP outcomes.

You said:
Explain why the doctors wrote about significant size increases here: "Baseline median preoperative stretched penile length and girth were 14 cm (range 10-17) and 9 cm (range 7-12), respectively. At the end of the study penile median dimensional outcomes were 17 cm (range 13-23) for length and 11 cm (range 10-13) for girth while a median number of 24 pumps (range 18-29) to fully inflate the device was seen."

ChatGPT said:

The “significant size increases” described in the quote are technically accurate, but they’re based on a comparison between different types of measurements—not an apples-to-apples comparison. Here's a breakdown of what they did and why it's a bit misleading if not understood properly:

What Are They Comparing?
Baseline measurements:

"Baseline median preoperative stretched penile length and girth were 14 cm and 9 cm."
⟶ These were stretched flaccid measurements.

Final measurements (after implant + VED):

"17 cm for length and 11 cm for girth."
⟶ These were postoperative inflated implant measurements (likely during full inflation).

Why This Matters:
These are two completely different physiological states:

Measurement Type What It Represents
Stretched flaccid length A proxy for erect length, but not fully engorged
Inflated implant length Full mechanical inflation—maximum possible size

So of course the implanted and inflated penis will be longer and thicker than a stretched flaccid one. But this does not mean the implant made the penis bigger than it was pre-op when erect.

The Real Comparison That Matters
If you look at the preoperative ICI erection data (from the table you posted), which simulates a natural erection:

Pre-op ICI length (mean): 16.2 cm

Post-op (after 48 weeks): 16.7 cm → only +0.5 cm

Pre-op ICI girth (mean): 11.0 cm

Post-op (after 48 weeks): 11.3 cm → only +0.3 cm

These are modest improvements, not dramatic gains, and likely within measurement variance.

Summary:
The "significant increases" mentioned by the doctors are only significant when comparing a flaccid-stretched penis to a fully inflated implant—a biased comparison. When comparing pre-op pharmacologically induced erections (ICI) to post-op inflated IPP size, the increases are minimal to none, even after nearly a year of VED therapy.

This highlights the importance of understanding what kind of measurement is being referenced when evaluating claims of size gains.

You said:
what was the complete size increase they found and not the misleading stats

The true size increase they found—not the misleading comparison of flaccid-stretched vs. inflated—comes from comparing:

Preoperative ICI (injection-induced erection)
This simulates a real erection before surgery.

48-week Follow-Up Post-Op (after IPP implantation + 11 months of VED therapy)
This measures the fully inflated IPP after the full rehab period.

Actual Size Changes (Mean Values):
Length
Pre-op ICI: 16.2 cm

Post-op 48 weeks: 16.7 cm

True increase: +0.5 cm

Girth
Pre-op ICI: 11.0 cm

Post-op 48 weeks: 11.3 cm

True increase: +0.3 cm

Summary of Real Outcomes:
Measure Before (ICI) After (48 wks) Change
Length 16.2 cm 16.7 cm +0.5 cm
Girth 11.0 cm 11.3 cm +0.3 cm

These are the true postoperative increases—modest but real—after combining the AMS 700 LGX with a structured vacuum erection device (VED) program for 11 months.

The doctors used stretched flaccid baseline vs. fully inflated final size in their headline numbers to make the results sound more impressive. But the real gain in erect-like dimensions is less than 1 cm.

[2435tjklAS]

That's way too much for my brain to understand. Looks like Dr. Perito got paid for it too. There still are other studies reporting significant increases. Look at the details for these too. These are ones that I believe are specifically concerning post-implant VED use:

Soderdahl, D. W., Petroski, R. A., Mode, D., Schwartz, B. F., & Thrasher, J. B. (1997). The use of an external vacuum device to augment a penile prosthesis. Techniques in Urology, 3(2), 100–102. https://pubmed.ncbi.nlm.nih.gov/9297771/

Tsambarlis, P. N., Chaus, F., & Levine, L. A. (2017). The use of vacuum devices as adjuvant therapy before and after penile curvature surgery in patients affected by La Peyronie’s Disease: Results from a comparative study. The Journal of Sexual Medicine, 14(1), Article 1. https://doi.org/10.1016/j.jsxm.2016.11.304

Canguven, O., Talib, R. A., Campbell, J., De Young, L., El Ansari, W., & Al-Ansari, A. (2017). Is the daily use of vacuum erection device for a month before penile prosthesis implantation beneficial? A randomized controlled trial. Andrology, 5(1), Article 1. https://doi.org/10.1111/andr.12258

Cai, T., Capece, M., Ceruti, C., Tiscione, D., Puglisi, M., Verze, P., Gontero, P., & Palmieri, A. (2023). The use of vacuum devices as adjuvant therapy before and after penile curvature surgery in patients affected by La Peyronie’s Disease: Results from a comparative study. Clinics and Practice, 13(5), Article 5. https://doi.org/10.3390/clinpract13050112

Nice catch Discovernew

Edit: Attached full-text of the third and fourth studies. Getting the first two. And second and fourth have like the same title but are actually two different ones. My brain is done.

[2435tjklAS]

So this is the conclusion:

The doctors used stretched flaccid baseline vs. fully inflated final size in their headline numbers to make the results sound more impressive. But the real gain in erect-like dimensions is less than 1 cm.

But I don't entirely understand that either. I could stretch flaccid to 8.75" before. I can to 9.5" now.

I don't know what to say.

[Discovernew]

I was looking at a study you once mentioned in the forum (i don't remember if it was in this thread or another one), where patients using VED with the LGX gained 3cm compared to pre-op. I actually looked at the study in details (as often things are hidden in the small print).

I found something interesting which may be misleading. The study claims patients gained 3cm vs their stretched length pre-op. However, their erection size pre op with intracavernose injection was much bigger than the stretched length (and this is what really matters, you have sex while erect at the end of the day).

You can see the chart in page 4

Preop Stretched length: Median 14cm
Preop Intra-Cavernose-Injection (ICI) Median Size 17cm.
Median Size erection after 48 weeks: 17cm.

In other words, the median erect length gain compared to pre-op was zero.

Let me know if i am missing something in the study.


https://irp-cdn.multiscreensite.com/d88 ... action.pdf

Sorry it's taken me so long to reply. Been having some personal, uh, problems (drugs, probably). But have learned too many lessons that prove addictions are lots of fun while they last but are inherently unsustainable and will spiral out of control ending poorly every time for every one. Great time for me to wrap that up nicely. Other reasons it's taken me time is I saw your message and figured it would be over my head, so I put it off. Few days ago I finally got around to looking at the tables, and guess what, it's over my head!!!!

This is all I know and welcome anyone else to share their knowledge.

These are the facts. The doctors write,

Penile shortening after inflatable penile prosthesis for erectile dysfunction is a common postoperative patient complaint and can reduce overall satisfaction with the procedure. In this prospective study we report our results regarding penile dimensions and patient satisfaction outcomes after 1 year of follow-up from AMSTMLGX700® penile prosthesis implant with 6 months of vacuum erectile device therapy. Seventy-four selected patients with medically refractory erectile dysfunction underwent AMSTM LGX 700® IPP placement. Postoperatively, patients were assigned vacuum device therapy for 5 min twice daily. Follow-up continued for 1 year after surgery. Dimensional and functional results were assessed. Baseline median preoperative stretched penile length and girth were 14 cm (range 10-17) and 9 cm (range 7-12), respectively. At the end of the study penile median dimensional outcomes were 17 cm (range 13-23) for length and 11 cm (range 10-13) for girth while a median number of 24 pumps (range 18-29) to fully inflate the device was seen. Baseline median International Index of Erectile Function (IIEF-5) score was 9 (range 5-11), at 6 months 20 (range 18-26) and at 1 year was 25 (range 20-27) (p<0.0001). Median Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) score at the end of the follow-up was 74 (range 66–78). Our postoperative rehabilitation program is feasible and should be recommended after prothesis surgery in order to increase overall satisfaction with the procedure. Penile postoperative dimensional outcomes were statistically significant improved and complications were negligible.

74 patients had a pre-implant size at baseline of 14cm stretched flaccid length and 9cm flaccid girth. Those are completely average sizes from calcSD:

Postoperatively, after being implanted with an AMS 700 LGX and 11 months of VED treatment, their sizes increased to 17cm flaccid length and 11cm flaccid girth. That increased their sizes from average to top 98%.

For those tables to be wrong, the 14 doctors who performed the study, one of whom is Dr. Perito...

...have to be violating the scientific method and lying about the data by making up facts, and the extensive peer review process has to include lots of scientist who, just like me, skip over the tables because they never understand them either.

Someone please share your thoughts on how these tables correlate to those facts. Using erect instead of flaccid? Anything else I can't figure out?

@2435, i didn't mean to confuse you. What i mean is that the pre-op erect length, and the length after 48 weeks is the same. So they didn't gain anything while erect. (if i understood this properly)

I attach an image here and mark it in red to avoid confusion.

preoplength.jpeg (66.21 KiB) Viewed 457 times

Note that "ICI" means intracavernose injection. So, an erection caused by an injection before the surgery.

[2435tjklAS]

@2435, i didn't mean to confuse you. What i mean is that the pre-op erect length, and the length after 48 weeks is the same. So they didn't gain anything while erect. (if i understood this properly)

I attach an image here and mark it in red to avoid confusion.



Note that "ICI" means intracavernose injection. So, an erection caused by an injection before the surgery.

You're not the one who confused me. You found an important weakness in the research no one else noticed. Trying to figure out why is when it got tricky. Would you follow my interpretation that their ICI pre-implant and LGX size post remained the same, probably because you can't physically make any parts of your body inherently larger and keep them that way, but more importantly that men who had average sized dicks used during sex before LGX implant and VED treatment now use very large dicks during sex? That's the only thing that matters to us. Not our dick's ICI size.

An LGX max inflated can stretch your tissues and tunica albuginea in ways not possible without (well, you could if you did intracavernose injections before each time you fuck). Is that wrong?

[2435tjklAS]

Wait, are ICIs the same thing you all refer to as simply injections? Now I am more confused why their injection sizes stayed the same before surgery and with a max inflated LGX but their baseline numbers did increase significantly. How were their baseline numbers measured? Would those men have gotten the same 48 week after LGX sizes if they got regular injections the day before surgery?

Current thought is they probably found their dicks max potential pre-surgery (that time from when were horny 22 year olds...) and that did not increase significantly with LGX, but it sure did when compared to their max reachable size as elderly men.

Is that wrong? I still don't understand how they did reach that pre-size if ICIs are the same as standard injections, though.

[2435tjklAS]

Sorry for multiple replies. There's just a lot of information to process here. This did remind me of question about Rider1400's experience that I always wondered. His frequent VED use returned his size to his early 20s size with injections. I share this often:



I have always wondered if he could get his max size with injections in his late 50s, why did he even need an implant? I assume because he couldn't keep the erection?

So now he has an implant and reaches his same ICI size easily. His dick never inherently got bigger (though it actually did maybe by a centimeter of two) but its useable size is now sustainable unlike injections. And a lot bigger than his pre-VED years. His VED size matches his injection size but the VED size isn't able to be kept that way anymore. Neither can his injections size. Which I realize might undercut my claim that my dick truly did literally get bigger, lol. All I can say, it stretches and gets erect to sizes it never once did before, 100%. If my penis had measured 9" before implant, I probably would have told the internet about my 9 inch dick a few (million) times. But I do have one now, and I can prove it.

I think it's due to getting LGX and frequently (excessively) using VEDs, which stretched my tissue and the tunica allowing them to expand. An LGX expands it in both length and girth a bit more also (but no bigger than 5.5" girth).

It's also due to taking thousands of mgs of Viagra for several months on many occasions before my implant. No VED was necessary. That cured me more than enough to get me back to my early 20s size after years of loss due to being a non-social Schizoid who only saw hookers occasionally and never had consistent sex with a partner.

No?

[Discovernew]

Wait, are ICIs the same thing you all refer to as simply injections? Now I am more confused why their injection sizes stayed the same before surgery and with a max inflated LGX but their baseline numbers did increase significantly. How were their baseline numbers measured? Would those men have gotten the same 48 week after LGX sizes if they got regular injections the day before surgery?

Current thought is they probably found their dicks max potential pre-surgery (that time from when were horny 22 year olds...) and that did not increase significantly with LGX, but it sure did when compared to their max reachable size as elderly men.

Is that wrong? I still don't understand how they did reach that pre-size if ICIs are the same as standard injections, though.

@2435. ICI measurement is just an erection caused by an injection.

However, The "baseline" measurement considered by this study is not an erection at all. It is just a flaccid stretched size. That means, when you are flaccid, you stretch your penis with your fingers and pull it and see how long it gets. But in my opinion, the real valid size is the erect size. Nobody has sex with a stretched flaccid.