Getting an implant replacement after the first one failed - Info please

The final frontier. Deciding when, if and how.

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wolfsailor
Posts: 3
Joined: Sat Feb 09, 2013 8:48 pm

Getting an implant replacement after the first one failed - Info please

Postby wolfsailor » Tue Oct 08, 2019 3:20 pm

Hello everyone. I am implanted with a AMS 700CX, was done in 2013. So it failed 6 years later, apparently a leak. I am wondering if anyone went through a second surgery to get an implant replacement and if it was any difference between the first implant and the second. I am going to get the same implant (AMS 700CX) since my doctor only use that type of implant, he says they are more reliable and last longer. I am wondering if he will have to remove anymore flesh, i am concerned about the girth because I have to use viagra in order to get a feeling...in other words, my dick is pretty much insensitive unless i use viagra during intercourse. Does anyone has the same problem ?
And my other question is, can the doctor add any length to the 2nd implant ?
I hope, someone can reply my message, i am a little bit anxious and to be honest i am wondering if I should just keep my curent implant even it does not get hard anymore...
thank you for any info / help.

Lost Sheep
Posts: 2517
Joined: Mon Jul 04, 2016 11:16 pm

Re: Getting an implant replacement after the first one failed - Info please

Postby Lost Sheep » Tue Oct 08, 2019 4:19 pm

Welcome to the forum, WolfSailor.

If you have no use for an erection, leaving it in place would be OK, but if coital sex may be important to you in your future, I would suggest replacement now is a good idea.

Often, a longer implant is used for a replacement (also known as a revision). There is some question if this means there is more usable length to your erection or not. Insertion of a longer implant MAY be possible for some other reason (for example, compression of tissues in your pelvic crus letting the replacement implant sit deeper). But the implant length is not an elective choice by the surgeon. The surgeon MUST use judgement to fit the available space inside your penis and there is little that can be done other than that fit.

If the leak is only in the pump or tubing (accessible without removing the implant's inflatable tubes), your surgeon might be able to just replace the leaking part and refill the reservoir with the lost saline solution. A much less invasive surgery.

I wonder about your comment on "remove anymore flesh". Did you have complications that required removal of flesh for your first implant surgery? Most first implants do not require such removal. Removal of additional tissue (flesh) is unlikely, I think. But I am not a medical professional.

I have read many reports that recovery from second surgeries are usually more comfortable for the patient than recovery from the first surgery. Often, the reservoir does not have to be replaced as there is little wear and tear on it. Sometimes the inflatable tubes do not have to be replaced (but sometimes they are just because newer ones do not have the wear and tear of ones that have been in use for years. Very few second surgeries are more complex than first surgeries.

I don't have any answers for your loss of sensitivity. I don't know how viagra can affect that, either. Viagra can help with engorgement of your spongiosum tissues (glans and shaft) which do not contribute to erection rigidity, but do contribute to the feeling of firmness and tumescence. That tumescence and engorgement can contribute to sensations, I suppose. Is that what you are talking about?
Lost Sheep
Born 1948 AMS LGX 18+3 implant Nov 6, 2017 by Dr Tavis Shaw. Spent 14 months researching in effort to optimize outcome. After 30 yrs of progressive unrecognized ED I will do this RIGHT; no second chance with one's first.
Anchorage AK, USA

wolfsailor
Posts: 3
Joined: Sat Feb 09, 2013 8:48 pm

Re: Getting an implant replacement after the first one failed - Info please

Postby wolfsailor » Tue Oct 08, 2019 5:37 pm

Lost Sheep, thank you so much for your time and reply. I apologize if some of my explanations weren't clear. I do need an erection to provoke enough stimulation for viagra to work, as you said, the engorgement contributes a lot to the sensation. I lost 90% of the sensation after the implant surgery. So, the implant alone do not cause my penis to engorge...viagra and the implant combine each other, I need an erection for viagra to work but viagra alone often will not work, not to mention the side effects, especially the headaches are very strong.
Regarding the flesh removal....I did not have any complications but my penis erected is a lot thinner than it was prior to the surgery (also shorter), I always thought that my surgeon removed some flesh in order to fit the tubes(2) of the implant, I also saw some videos in youtube that suggested that...maybe i am wrong.
My surgeon is Dr. Hakim by the way. I am under the impression that he wants to replace the whole implant and not just the leaking part. I will visit him again on 10/21 and thanks to you, i will know better what to ask him. You definitely make me feel better about the recovery time and pain.
If you don't mind, I have another question....the tips of the 2 tubes are located inside the head of the penis (almost at the extremity, they feel hard and pointy to the touch, it's okay when my penis is engorged but not so okay if it is not, I feel like i am hurting my girlfriend, I asked my doctor but according to him, the tips are exactly where they should be. Do you know anything about that issue ?
Again, thank you.

Lost Sheep
Posts: 2517
Joined: Mon Jul 04, 2016 11:16 pm

Re: Getting an implant replacement after the first one failed - Info please

Postby Lost Sheep » Tue Oct 08, 2019 6:48 pm

wolfsailor wrote:Lost Sheep, thank you so much for your time and reply. I apologize if some of my explanations weren't clear. I do need an erection to provoke enough stimulation for viagra to work, as you said, the engorgement contributes a lot to the sensation. I lost 90% of the sensation after the implant surgery. So, the implant alone do not cause my penis to engorge...viagra and the implant combine each other, I need an erection for viagra to work but viagra alone often will not work, not to mention the side effects, especially the headaches are very strong.
Regarding the flesh removal....I did not have any complications but my penis erected is a lot thinner than it was prior to the surgery (also shorter), I always thought that my surgeon removed some flesh in order to fit the tubes(2) of the implant, I also saw some videos in youtube that suggested that...maybe i am wrong.
My surgeon is Dr. Hakim by the way. I am under the impression that he wants to replace the whole implant and not just the leaking part. I will visit him again on 10/21 and thanks to you, i will know better what to ask him. You definitely make me feel better about the recovery time and pain.
If you don't mind, I have another question....the tips of the 2 tubes are located inside the head of the penis (almost at the extremity, they feel hard and pointy to the touch, it's okay when my penis is engorged but not so okay if it is not, I feel like i am hurting my girlfriend, I asked my doctor but according to him, the tips are exactly where they should be. Do you know anything about that issue ?
Again, thank you.

I will assume you know something of the inner workings of erections. But will review a little bit here: Tunica Albuginea is tough fibrous tissue formed in two cylinders that reach from your pelvic crus to your penis tip (the glans penis). Inside the tunica is corpus cavernosum tissue supplied with blood through arteries and drained by veins. TShe blood pressure inflates the cavernosum, thereby erecting the tunica (and the penis). Because the tunica is flexible but not elastic, it does not stretch but merely gets stiff. Corpus spongiosum surrounds the tunica and fills the glans. Spongiosum engorgement is similar to cavernosum engorgement, but it is not needed for an erection, and because it is not constrained by inelastic tissue (like the tunica) does very little to produce an erection. But it does contribute to fullness. If your spongiosum is not getting full/engorged/tumescent, that may give the illusion or appearance of tissue loss.

Corpus cavernosum tissue is sometimes removed from inside the tunica when implanting the implant's tubes. Sometimes the cavernosum tissue is spared. Depends on the surgeon and condition of the patient. But even if the tissue is spared, it is vanishingly rare for the cavernosum to function to produce an erection without also inflating the implant. So, some surgeons do remove some or even all the cavernosum tissue. But with the implant inflated fully and your spongiosum fully engorged, I would expect your girth to be similar to your pre-surgical dimensions. Did you measure yourself (erect as you could get) the day before surgery? Men's memories of their size is often more generous than factual. I measured my length very carefully before surgery (I could get an erection with pills and vigorous stimulation before surgery, but the erection never lasted more than a minute). After surgery, I was very much the same length as immediately before surgery. I did not measure girth, but I seem to be about the same.

Loss of sensation is regrettable. I lost some, but after several months, it came back partially. I am still evaluating my before-and-after feelings. Surgery for an implant is severely traumatizing for one's nerves and it takes time for them to recover. Think of your nerves as scared rabbits. They don't come out to play right away after being traumatized. But 6 years suggests that whatever you might hope to regain has already been regained. I hope that your lack of sensation is only due to disappointment over lack of spongiosum engorgement and not actual nerve damage. The increased friction due to girth increase from spongiosum engorgement certainly helps the sensation. It is unfortunate that you need viagra to get that engorgement. Some men use a vacuum pump to fill the spongiosum (after the erection is produced by the implant) and then keep the spongiosum engorgement by a constriction band at the base of the penis or around the scrotum. Do this with caution. It was not too long ago that vacuum devices used in conjunction with an implant was regarded as a dangerous practice. Probably best to discuss this with your surgeon.

The tips of the implant should support the glans penis fully. about half-way from the coronal ridge to the tip of the meatus. Any further and you risk the tips eroding through the tip of your penis or (as you ask) being felt by your partner uncomfortably. Any less, and you can get the "SST Deformity" (named after the drop nose of the SST aircraft) which is also known as "floppy head syndrome". It sounds like your implant is perfectly sized and the tips right where they should be. I can feel my tips very much as you describe. Remember that a woman's internal tissues are soft and yielding. Only if you strike bone are you very likely to cause discomfort. But be gentle with you lover. Your penis is more rigid than natural and if your spongiosum in the glans is not engorged, the implant tips are not as padded as they should be.

As you experiment with coitus (or fellatio or masturbation) your sensations may return and engorgement of the spongiosum become better. Take notes and measurements as best you can. Do not depend on memory alone to gauge (and report to your surgeon) any progress.

I have heard Dr. Hakim's name mentioned a number of times and cannot recall any negative reports. I think you are in good hands.
Lost Sheep
Born 1948 AMS LGX 18+3 implant Nov 6, 2017 by Dr Tavis Shaw. Spent 14 months researching in effort to optimize outcome. After 30 yrs of progressive unrecognized ED I will do this RIGHT; no second chance with one's first.
Anchorage AK, USA

wolfsailor
Posts: 3
Joined: Sat Feb 09, 2013 8:48 pm

Re: Getting an implant replacement after the first one failed - Info please

Postby wolfsailor » Wed Oct 09, 2019 6:05 pm

Hello again Sir, thank you for your explanations, to be honest honest I did not know all that. I will ask my surgeon if he removed some or all of th corpus cavernosum tissue in order to install my implant. But I am positive about the fact that I lost about 1.5 inch in length and 1 inch in girth when fully erected. I am now about 5 3/4 inch in length and 5.5 inch in girth when achieving a full erection, so it's still almost okay I guess but I must say that I've been pretty affected emotionally. But i am still happy about getting the implant since before that, I could only rely on viagra which did not work all the time and as I mentioned before, the side effects used to make me think twice before using it, mostly the headaches could last 3 or 4 days. I tried to use a pump before I got the implant but it did not work for me. Thank you for reassuring me concerning the location of the tip of the implant, it seems they are indeed where they are supposed to be, the problem is that the head of my penis does not engorge without viagra. The reason for my ED is that my veins are too narrow and don't carry enough blood, I don't remember the name of that disease but I have always had that condition. Anyways, i don't want to bother you anymore, you've been so helpful...thank you from the bottom of my heart.
PS: English is not my first language, this to explain my lack of vocabulary when it comes to medical terms.

Gt1956
Posts: 279
Joined: Fri Apr 05, 2019 2:47 pm

Re: Getting an implant replacement after the first one failed - Info please

Postby Gt1956 » Wed Oct 09, 2019 6:53 pm

I think that upon a revision. You might regain some of your lost length. Most doctors in the USA are using a new method of measuring for the implant length. This new aggressive method usually means that a slightly longer implant is used. Thus you could have slightly more length after a reasonable length of recovery time. Wish you good luck.
63 HBP at 40 high triglycerides at 45 Type 2 at 60

Lost Sheep
Posts: 2517
Joined: Mon Jul 04, 2016 11:16 pm

Re: Getting an implant replacement after the first one failed - Info please

Postby Lost Sheep » Wed Oct 09, 2019 8:51 pm

Please, you are no bother at all. Stay on the forum (your command of the English language is pretty good, by the way).

You will learn more as you read what is posted here and you certainly will be able to help other men who come here with the experience you are having.

Your continuing story will be educational for us here. Especially if you regain some of that lost length.

Did you measure your penis (erect) before your implant? How long before? Years of E.D. can shrink a man. An implant cannot restore lost size if it was long ago.
Lost Sheep
Born 1948 AMS LGX 18+3 implant Nov 6, 2017 by Dr Tavis Shaw. Spent 14 months researching in effort to optimize outcome. After 30 yrs of progressive unrecognized ED I will do this RIGHT; no second chance with one's first.
Anchorage AK, USA

radioradio
Posts: 1010
Joined: Tue Aug 09, 2016 2:44 pm
Location: Philly Burbs

Re: Getting an implant replacement after the first one failed - Info please

Postby radioradio » Sun Oct 13, 2019 8:58 am

Wolf,

Sorry to hear that your device has failed. I agree that after six years your doc would probably want to replace the cylinders even if the leak was in the tubing. I have read that the reservoir is often not replaced unless it is the cause of the problem.

I had my pump removed and replaced after four months to reposition it lower in my scrotum. Coincidentally, the new pump was MUCH easier to squeeze right from the beginning. Relatively minor procedure and the recovery was a snap compared to the original implantation.

I can relate to your situation re the lack of engorgement of the glans and spongiosum. I have to be really, really aroused/stimulated to get them engorged, which often works better with masturbation than with coital sex. I have lost some sensitivity on the underside of my penis, and at 2+ years, I don’t think I’ll see any improvement. The sensations with full engorgement are definitely better.

Wish you the best, and please do keep us posted.

Bob
Born '52. Married '79. RALP 3/1/17. ED 50+% prior to surgery even w/ meds. VED, Injections, ineffective. Considering implant even before PCa diagnosis. Dr. Kramer 8/2/17. LGX 21cm+0.5 RTE. Kramer replaced/repositioned pump 12/13/17. Willing to Show/Tell.

ocitgo
Posts: 389
Joined: Wed Jan 01, 2014 8:48 pm
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Re: Getting an implant replacement after the first one failed - Info please

Postby ocitgo » Mon Oct 14, 2019 5:19 am

"Hello everyone. I am implanted with a AMS 700CX, was done in 2013. So it failed 6 years later, apparently a leak. I am wondering if anyone went through a second surgery to get an implant replacement and if it was any difference between the first implant and the second."

Mine was replaced this year. It is an AMS 700 that also had a leak. No difference.
ocitgo (Bob F), Bremerton, WA
Implanted 11/13/2017 AMS 700LGX 15 cm, leak, 3 cm rear tip
Implanted 06/17/2019 AMS 700LGX 18 cm, 1.5 cm rear tip

David_R
Posts: 1857
Joined: Mon Nov 02, 2015 1:03 pm
Location: Northeast Maryland

Re: Getting an implant replacement after the first one failed - Info please

Postby David_R » Mon Oct 14, 2019 8:14 am

I originally had a CX model. After over 10 years of use it "wore out" and was replaced by an LGX, I liked both of them, but they were different so it's hard to compare (I mean it is "difficult" to compare). ;)
Age 70. Prostatectomy in 2000. My urologist (for over 20 yrs) has been Dr. Marc Siegelbaum of Chesapeake Urology in Baltimore, and Chief of Uro. at Univ. of Md. St. Joseph Medical Center. I have LGX, and have regained my original length. Nice n hard!


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