Two different ways to install an AMS CX cylinder involving tubing issues

The final frontier. Deciding when, if and how.

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oldbeek
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Re: Two different ways to install an AMS CX cylinder involving tubing issues

Postby oldbeek » Wed Feb 26, 2020 7:48 pm

Waynetho wrote:No, based on the illustrations the OP posted, method A is infrapubic with the tubes on top. Method B is penoscrotal with the tubes on the bottom.
Wayneetho, The top illustration is A , the bottom illustration is B. Wish a big A was marked on the top photo and a B on the lower. "A" would be used on scrotal approach with tubes exiting down into the scrotum. Method "B" is used on pubic cut approach. Tubes going into the top of the cylinders. I had a deep cruse so Dr attached 5cm RETs to get the entry point into my corpa out in front of my pubic bone. My inflation tubes do loop around and it is visible. The area around the tubes was tender during healing but now there is no pain there.
78, good health, RP 7-2017, all nerves taken , PSA 0.05, 4-18,, .08 11/18,.07 1/19,.05 4/19, .06 2/20 Pain with trimix, implant 4-18, Infra-pubic, AMS lgx 15 cm with 5cm rte. Implant at USC Keck. Dr Boyd and Dr Loh Doyle 6 x 4.5

Waynetho
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Re: Two different ways to install an AMS CX cylinder involving tubing issues

Postby Waynetho » Wed Feb 26, 2020 9:32 pm

I never went back to look again after the first time they were posted to the message. When I saw the photos, I could swear they were in the opposite positions with the DORSAL tubing shown on the top photo and the VENTRAL tubing shown on the bottom photo.

That's been my whole basis for B vs A.

To that end, my tubing on the PENOSCROTAL installation, is VENTRAL (below the corpora, or in my case about 45 degrees toward the outside edge). Whichever photo: A or B shows lower tubing connects, that's mine.
58 yo, married 38 yrs. Urolift (x4) 8/12/19. AMS 700CX 15cm (no RTE) penoscrotal 10/28/19 Dr. Mark Allen, Frisco, TX. PD 1995/ED 2011. Cialis helped but hinged. (1995)L:6/G:5.5+, (2019)Pre-op L:5/G:4.5, (2/2020)L:6.0/G:5.0

oldbeek
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Re: Two different ways to install an AMS CX cylinder involving tubing issues

Postby oldbeek » Wed Feb 26, 2020 10:25 pm

Mine entering the top, also go in at a 45 degree angle. All three come up the left side from the pump block. Line for the right cylinder loops over the top of my penis right at the pubic bone. I have heard it described as a freeway cloverleaf
78, good health, RP 7-2017, all nerves taken , PSA 0.05, 4-18,, .08 11/18,.07 1/19,.05 4/19, .06 2/20 Pain with trimix, implant 4-18, Infra-pubic, AMS lgx 15 cm with 5cm rte. Implant at USC Keck. Dr Boyd and Dr Loh Doyle 6 x 4.5

indusvalley
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Re: Two different ways to install an AMS CX cylinder involving tubing issues

Postby indusvalley » Thu Feb 27, 2020 11:57 am

oldbeek wrote:"A" would be used on scrotal approach with tubes exiting down into the scrotum.


This is what I expect too. But the OP mentioned he got the surgery done by Dr.Kramer via scrotal approach and his tubes are going up and then down (as shown in illustration B). How come?
Young guy in his early 30s with ED, researching and mentally preparing for implant soon from Dr.Kramer.

Waynetho
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Re: Two different ways to install an AMS CX cylinder involving tubing issues

Postby Waynetho » Thu Feb 27, 2020 12:39 pm

indusvalley wrote:
oldbeek wrote:"A" would be used on scrotal approach with tubes exiting down into the scrotum.


This is what I expect too. But the OP mentioned he got the surgery done by Dr.Kramer via scrotal approach and his tubes are going up and then down (as shown in illustration B). How come?

Doubtful... There's got to be another explanation. Maybe like mine, they are at 45 degree angles and with swelling (he's still quite early), it feels that way to him.
58 yo, married 38 yrs. Urolift (x4) 8/12/19. AMS 700CX 15cm (no RTE) penoscrotal 10/28/19 Dr. Mark Allen, Frisco, TX. PD 1995/ED 2011. Cialis helped but hinged. (1995)L:6/G:5.5+, (2019)Pre-op L:5/G:4.5, (2/2020)L:6.0/G:5.0

indusvalley
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Re: Two different ways to install an AMS CX cylinder involving tubing issues

Postby indusvalley » Thu Feb 27, 2020 4:59 pm

Waynetho wrote:
indusvalley wrote:
oldbeek wrote:"A" would be used on scrotal approach with tubes exiting down into the scrotum.


This is what I expect too. But the OP mentioned he got the surgery done by Dr.Kramer via scrotal approach and his tubes are going up and then down (as shown in illustration B). How come?

Doubtful... There's got to be another explanation. Maybe like mine, they are at 45 degree angles and with swelling (he's still quite early), it feels that way to him.


You’re right. It is too early to judge. Maybe the tubes are being pushed upwards and to the sides due to swelling but I am glad this got mentioned. I am going to be discussing this with the Doc.
Young guy in his early 30s with ED, researching and mentally preparing for implant soon from Dr.Kramer.

young_and_impotent
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Re: Two different ways to install an AMS CX cylinder involving tubing issues

Postby young_and_impotent » Tue Mar 24, 2020 9:45 am

I had a penoscrotal approach but the strategy is clearly B.
In many Kramer videos he says he tries to avoid B. Search 'tubing' in his videos.

I feel tubing on both sides of my penis. The tubing starts a 45 degree angle. No the tubes can't be rotated to fix this manually.

The problems with this is are:

- Palpable tubing. Feels unnatural.
- Two set of tubings on the side of the reservoir.
- less sensation in those areas.
- pain and discomfort on both sides while inflating.
28 year old with severe lifelong ED.
Hadn't had erections good enough for sex in a decade.
Implanted in New Delhi on 26/12/19 with AMS CX (15x12) + 4cm RTE
Post op length 4.5 inches from ~ (5.5 to 6) inches. Disappointed!

Waynetho
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Joined: Wed Nov 27, 2019 11:22 pm
Location: Addison, TX

Re: Two different ways to install an AMS CX cylinder involving tubing issues

Postby Waynetho » Tue Mar 24, 2020 10:28 am

young_and_impotent wrote:I had a penoscrotal approach but the strategy is clearly B.
In many Kramer videos he says he tries to avoid B. Search 'tubing' in his videos.

I feel tubing on both sides of my penis. The tubing starts a 45 degree angle. No the tubes can't be rotated to fix this manually.

The problems with this is are:

- Palpable tubing. Feels unnatural.
- Two set of tubings on the side of the reservoir.
- less sensation in those areas.
- pain and discomfort on both sides while inflating.


"B" (tubing coming from ABOVE the corpora) is not possible when accessing them through a penoscrotal incision. The tubing are going to come out of the incision where it is placed. If the surgeon comes in from above the corpora (infrapubic), the incisions will be above and they will route up and over, then down the side of the penis as in "B". If the incision is below the penis (penoscrotal), the incisions will be underneath pointing "down". The 45 degree angle is apparently a necessary side-effect of avoiding the urethra when cutting the corporotomies. The tubing tends to come down away from the center line, near 45 degrees.

I too have the same palpable tubing, although where it exits and/or passes the penis is getting less and less palpable as time goes on (5 months). My body is growing tissue over the tubing and it is becoming embedded. The quick connects are still detectable but they can't be moved around under the skin as they could be 3 months ago.

My tubing comes out below the penis, at a 45 degree angle. I have two tubes on the left side where my reservoir is. I get a little pain in my corporotomies (both sides) when inflating to absolute max - it means I'm putting more pressure on the incisions and stitches than is comfortable. The tubes also harden up when pumped to max but since they're carrying the pressure of the hardened cylinders, that's understandable.
58 yo, married 38 yrs. Urolift (x4) 8/12/19. AMS 700CX 15cm (no RTE) penoscrotal 10/28/19 Dr. Mark Allen, Frisco, TX. PD 1995/ED 2011. Cialis helped but hinged. (1995)L:6/G:5.5+, (2019)Pre-op L:5/G:4.5, (2/2020)L:6.0/G:5.0

young_and_impotent
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Joined: Mon Apr 23, 2018 1:00 pm

Re: Two different ways to install an AMS CX cylinder involving tubing issues

Postby young_and_impotent » Tue Mar 24, 2020 2:09 pm

What you say makes sense, that the incision should be around 45 degree from below. But if you see the pics, this is clearly not the case.

You can see the tubing coming from the top.

https://ibb.co/89bB6vf
https://ibb.co/1JnmcW8
28 year old with severe lifelong ED.
Hadn't had erections good enough for sex in a decade.
Implanted in New Delhi on 26/12/19 with AMS CX (15x12) + 4cm RTE
Post op length 4.5 inches from ~ (5.5 to 6) inches. Disappointed!

Waynetho
Posts: 712
Joined: Wed Nov 27, 2019 11:22 pm
Location: Addison, TX

Re: Two different ways to install an AMS CX cylinder involving tubing issues

Postby Waynetho » Tue Mar 24, 2020 3:57 pm

It would almost require the doctor to stand on his head to install from the top by penoscrotal incision (not really, but just as nearly improbable and circuitous). Are you sure you didn't have any incisions just above your penis? There is bound to be another answer to what your seeing there other than the having the corporotomies on top of the penis.
58 yo, married 38 yrs. Urolift (x4) 8/12/19. AMS 700CX 15cm (no RTE) penoscrotal 10/28/19 Dr. Mark Allen, Frisco, TX. PD 1995/ED 2011. Cialis helped but hinged. (1995)L:6/G:5.5+, (2019)Pre-op L:5/G:4.5, (2/2020)L:6.0/G:5.0


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