Surgical Sizing

The final frontier. Deciding when, if and how.
Hawkman
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Re: Surgical Sizing

Postby Hawkman » Sun Sep 16, 2018 7:25 pm

SW0110 wrote:I actually had one urologist surgeon tell me that it does not matter who does the implant. They all just go in and measure with the rods. It was not rocket science so whoever did the job should all come out with the same length, whatever it happened to be.


It does not matter. That is why we have scores of men complaining of being undersized, That get an unstable erection after a few years, that have a floppy tip that will not penetrate, that have infections, that have tubing tethered around their shaft that is easily palpitated.

To plagiarize a comment by Merrix, if your 5-year-old daughter needed heart surgery would you take her to a surgical center and let them assign some cardiologist that is next in rotation or would research surgeons carefully? It is a question that is so obvious it should not need to be asked. What is the point of researching surgeons? That answer should also be obvious and non-controversial. All surgeons have different degrees of natural talent just like pianists, They all have different degrees of experience with specific procedures, They are not all the same. Just like carpenters or mechanics. There are good ones and those at the other end of the scale. There are those with different philosophies on taking calculated risks versus a conservative approach. To suggest they are all the same is to suggest there are no good, better, and best mechanics or carpenters, or none that are just inferior. Does this mean there is a "best surgeon on earth"? Probably not. Are there even a top 3 surgeons on earth? Again probably not, but with a very specialized uncommon surgery, you soon get to a point where the great practitioners are limited. While you can get a good surgery from a lesser surgeon and you can get a bad surgery from a great surgeon that proves nothing. Clinical studies demonstrate better outcomes with high volume surgeons who specialize just like studies show that cancer patients have better outcomes in major cancer centers of excellence.

As someone who has been a patient advocate for several cancer patients and had cancer surgery myself, a person is a fool that does not take an active roll in researching and carefully selecting his doctor. There is simply nothing controversial about this, especially on a patient forum.
Prostatectomy 2004-Bimix caused Peyronies-Viagra had little effect. Active sex life with wife of 50 yrs- been dependent on a VED for 10 yrs. 22cm Titan w/Dr. Eid Aug 7th See my Implant Journal -> http://www.peyroniesforum.net/index.php/board,56.0.html

Tsanchez12369
Posts: 227
Joined: Fri Dec 23, 2016 7:52 pm
Location: SAN Francisco

Re: Surgical Sizing

Postby Tsanchez12369 » Sun Sep 16, 2018 8:27 pm

I agree hawkman, and one of those clinical studies showed on high implant docs put in larger implants on average. I also wonder if most docs would remove an undersized implant (wouldn’t they have to pay for two implants then) and replace vs just adding RTE’s. My doc just did that, he said he found I could fit a longer implant so he added RTE. I wish he had installed the next size implant...21 cm vs 18 cm + 3 cm RTE. it seems both Dr Eid and Kramer recommend a larger implant rather than just adding the equivalent RTE’s.
Sept 11, 2018: excision, grafting (human cadever tissue) and implant. Doc is Dr Edward Karpman in Mountain View, surgery at El Camino Hospital, LOS Gatos CA. AMS 700 CX infrapubic 18 cm + 3 cm RTE. http://www.peyroniesforum.net/index.php

Hawkman
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Re: Surgical Sizing

Postby Hawkman » Sun Sep 16, 2018 8:31 pm

Tsanchez12369 wrote: it seems both Dr Eid and Kramer recommend a larger implant rather than just adding the equivalent RTE’s.


Dr. eid often sizes up and trims off some of the fixed tip of the cylinder rather than sizing down and adding a RTE
Prostatectomy 2004-Bimix caused Peyronies-Viagra had little effect. Active sex life with wife of 50 yrs- been dependent on a VED for 10 yrs. 22cm Titan w/Dr. Eid Aug 7th See my Implant Journal -> http://www.peyroniesforum.net/index.php/board,56.0.html

Donnie1954
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Re: Surgical Sizing

Postby Donnie1954 » Sun Sep 16, 2018 8:35 pm

My Urologist Surgeon told me why he used RTEs and I couldn't be happier. A 21 would never have completely drained and been a waste of useable implant. With RTEs my pump was placed perfectly. No need for a revision.
donnie1954@mail.com
Implant AMS 700 CX, MS (18cm x 12mm with 5.5cm RTEs) on 10\4\16. 64 Dr. Edward Kata of Orlando. Awesome surgeon. Check out, 'DD Bryan. My implant journey, Wit and Wisdom, Stretching routine, Implant Pics, Natural Hang. Live in Ga.
.

RayChez
Posts: 336
Joined: Sat Mar 17, 2018 11:25 pm

Re: Surgical Sizing

Postby RayChez » Sun Sep 16, 2018 10:58 pm

The surgeons will not use a longer cylinder then what is measured. They have special tools that come with the kit from AMS to measure after they make the incision. If the cylinders are to long on LGX and once fully inflated, the chances of erosion is possible and could pierce right through the gland. Also the possibility of getting a crooked penis because the cylinder can not extend fully.

They will install the cylinder that fits and if it is short, then they add the spacers at the base. The surgery is really very simple. I have had two and I have been happy with both.

Some here in this forum seem to think that you have to be a John Holmes in order to satisfy a women. Not true! Actually what excites a women is the clitoris and that is not deep at all. So actually a five inch penis with a big gland would excite a women more then a long penis. So I laugh when I read some of these posts where some want a large penis. Be happy with what you have and learn how to use it and that women will love you to death.
age: 75 First implant around 2001, 59 at the time. AMS 700 Ultrex
revision Dec 2016. 2ND implant 21CM, 1rte AMS 700 LGX MS pump

merrix
Posts: 1188
Joined: Tue Oct 27, 2015 1:08 am

Re: Surgical Sizing

Postby merrix » Sun Sep 16, 2018 11:00 pm

Donnie, we know you love your implant and we know your dick somehow measures way longer than your implant size. We also know your doc is best of the universe.

But I say your praise of RTEs is most likely wrong.
Fact is that all the top docs try to avoid them if possible. Of course, they could all be wrong and you could be right, but it’s fair to say the odds are against that.

The common understanding is that inflatable part gives the erection a firmer base in the crus than RTEs, especially for AMS with its thinner RTE diameter.

Both implant brands have their pros and cons of course, and one well known con of AMS is the insertion point of the tubing, which often requires RTEs to avoid a high pump.

You may think you have a super erection with your stack of RTEs, but when you go against the top
authorities in the field and say RTEs create a better outcome, someone should point out the controversy of your statement.
43 yo, ED forever from VL
Fit and active
Implanted December 2015
Titan XL 24 cm, no RTEs
Dr. Eid
Activated day 13
Sex after 3 weeks
Gained length and girth
So far It works perfectly
Only one advice: Find a world class surgeon

Larry10625

Re: Surgical Sizing

Postby Larry10625 » Mon Sep 17, 2018 9:36 am

SW0110 wrote:I actually had one urologist surgeon tell me that it does not matter who does the implant. They all just go in and measure with the rods. It was not rocket science so whoever did the job should all come out with the same length, whatever it happened to be. Then wanted to know when I wanted to do the implant or excision surgery if I preferred that route. I said I would get back with them.

I did not get a real good feeling about it especially since he never even measured my dick first. Not one inch on a ruler. I realize no doctor can give you a guarantee, but they should be doing it long enough to give me a general idea.

FYI, I have gone to three so far and still not gotten any good feelings from any one of them. Only one actually measured me. One actually told me most of his patients would love to have a dick my size, but still no measurement. Not the comment I was looking for. Maybe I am a bit picky, but I really like this body part and if I got to spend some of my kids inheritance to get a good job done, so be it. My wife got me an appointment with doc number 4 up in Ohio. I figure since I have to wait probably till spring, one more opinion will not hurt. Otherwise, as I posted elsewhere, when my wifes surgery is done, and she is recovered, I plan on heading to Baltimore.



Don't get so hung up on being measured. The ONLY measurement that counts is the one they take while you are on the OR table. I never got measured and my implant is FANTASTIC. While I am sure that there are great "High Volume" surgeons in Baltimore, I am equally certain that they have made mistakes before AND I am certain that there are great surgeons out there who are not considered "High Volume" A urologist that does 1 or 2 implants a week but also does, all of the other procedures, may not be considered a high volume implant surgeon but considering all of his or her experience, I would feel pretty safe in his hands. What is the general feeling out there about surgeons who were trained by these "high volume" surgeons?? :)

Larry

Hawkman
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Re: Surgical Sizing

Postby Hawkman » Mon Sep 17, 2018 10:56 am

If a surgeon is not even interested in knowing your penis length and documenting that prior to surgery because it is irrelevant, I wonder why many surgeons including all the well known high volume surgeons waste their precious clinical time with such unimportant issues. It must boil down to them being uninformed, or not placing much value on their time.

The other explanation is that they want to know and document the potential penis length prior to surgery so when (as in the case with Merrix) they put in a measured prosthesis and the results are a little substandard, they can regroup to at least consider a more aggressive approach. Combine that with a confidence that it shows to document pre-surgical size.

I guess if there is no medical record in existence documenting the size of my presurgical penis the surgeon can go into surgery more relaxed. In the minority of cases that his patient gets short-changed, he can always tell me I probably measured wrong or that I gained weight or I probably lost length since the last time I measured.

That is pretty hard to refute the presurgical penis size when that size is listed right in your presurgical notes - which is REASON ENOUGH why a surgeon that will not measure me, will never cut me........ but then, that is just me and my penis.
Prostatectomy 2004-Bimix caused Peyronies-Viagra had little effect. Active sex life with wife of 50 yrs- been dependent on a VED for 10 yrs. 22cm Titan w/Dr. Eid Aug 7th See my Implant Journal -> http://www.peyroniesforum.net/index.php/board,56.0.html

Larry10625

Re: Surgical Sizing

Postby Larry10625 » Mon Sep 17, 2018 11:07 am

Hawkman wrote:If a surgeon is not even interested in knowing your penis length and documenting that prior to surgery because it is irrelevant, I wonder why many surgeons including all the well known high volume surgeons waste their precious clinical time with such unimportant issues. It must boil down to them being uninformed, or not placing much value on their time.

The other explanation is that they want to know and document the potential penis length prior to surgery so when (as in the case with Merrix) they put in a measured prosthesis and the results are a little substandard, they can regroup to at least consider a more aggressive approach. Combine that with a confidence that it shows to document pre-surgical size.

I guess if there is no medical record in existence documenting the size of my presurgical penis the surgeon can go into surgery more relaxed. In the minority of cases that his patient gets short-changed, he can always tell me I probably measured wrong or that I gained weight or I probably lost length since the last time I measured.

That is pretty hard to refute the presurgical penis size when that size is listed right in your presurgical notes - which is REASON ENOUGH why a surgeon that will not measure me, will never cut me........ but then, that is just me and my penis.



OK, so if all the top "high volume surgeons" measure pre surgery and during, why is it that some patients are NOT measured correctly and require a revision? I guess the measure twice, cut once doesn't necessarily work hummmmm… :)

Larry

Hawkman
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Re: Surgical Sizing

Postby Hawkman » Mon Sep 17, 2018 11:11 am

Larry10625 wrote:
OK, so if all the top "high volume surgeons" measure pre surgery and during, why is it that some patients are NOT measured correctly and require a revision? I guess the measure twice, cut once doesn't necessarily work hummmmm… :)

Larry


If the best mechanic in your county is not perfect, then why take your car to him, hmmmm! ;)

In your instance above Larry, it makes my point as to exactly why you would want presurgical documentation of your penis size. I could not have made the point any better myself - thank you!
Last edited by Hawkman on Mon Sep 17, 2018 12:01 pm, edited 3 times in total.
Prostatectomy 2004-Bimix caused Peyronies-Viagra had little effect. Active sex life with wife of 50 yrs- been dependent on a VED for 10 yrs. 22cm Titan w/Dr. Eid Aug 7th See my Implant Journal -> http://www.peyroniesforum.net/index.php/board,56.0.html


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