oldbeek wrote:If you have a 5cm deep cruses, do the pressure tubes on a 20cm implant enter the cylinder down in your perineum area? Surely have to be a scrotal installation. Would the pressure tubing be inside the cruses area then run parallel to the inflatable till they exit into your scrotum. Mine was pubic entry and the tubes exit right at my pubic bone. Some body with a deep cruses and no RTE please enlighten me on how their tubing runs. Very curious.
What does this even have to do with anything? As i expected, you totally disregarded my comment you hanging a towel on your penis and showing us factual proofof it .Kind of reminded me of other times in this board when we had a guy claiming that his stretching routine increased his penile size a great deal and when he was called out on it to show proof, he ran away from it for ages, eventually showing us nothing; (because there was nothing to begin with?)
Whilst i don't doubt your implant gets hard, and you can still have pleasure with it, claims like yours pass on the impression that RTE'S don't matter and don't affect the quality of the erection when that is actually not the case. Not only there is proof of it, as i have link here on the initial post, as there on the post that the images were linked, and here (
https://www.smsna.org/scottsdale2016/presentations/206.pdf. Also, i've spoken with guys that had AMS with RTE's and had revisions for Titan's with NO RTE's and they said that there is definitely a difference for the better in terms of stiffness.
This nonsense should be combated at all cost. Everybody should be informed of this, given that it may impact their doctor selection, since we all know, certain doctors care more about this particular item than others.
The study ends like this, as you can see for yourself:
Conclusion:
•Greater bending deflection was associated with the use of greater RTE length
•Use of RTE decreases the inflatable portion of the cylinder that is supported by the crus
•This data supports the notion that minimizing RTEs improves cylinder stiffness and overall erectile rigidity dynamics
•Decreasing the length of the non inflatable proximal portion decreases the bending deflection
•These observations could possibly improve the design of the next generation of cylinders
I come back to edit this post, because as i was browsing through pubmed i came across this very informative paper:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7108986/It is well established that surgical outcomes tend to improve as surgeon volume increases (13,14). In a simplistic sense, this may relate to an increasing expertise and efficiency on the part of the surgeon, but it is equally likely that improvements in systems (e.g., operating room staff that are knowledgeable about the procedure, established treatment pathways for surgical patients, etc.) also contribute to these superior outcomes (15). Penile implants are no exception to this general rule of surgical outcomes; ergo, it may be preferable that penile prosthesis surgery not be performed by “dabblers” but rather by individuals who have had intensive training and/or extensive experience with implant surgery. A greater depth of experience and knowledge enables the implant surgeon to recognize and manage problems and potential solutions. This “center of excellence” concept is well recognized in the realm of urologic oncology, but there is no reason it cannot be applied to benign urologic surgeries such as penile implant placement.
Crucially, the enhanced ability of an experienced surgeon to recognize and manage potential problems applies in terms of both pre-operative counseling and intraoperative management. Most experienced implant surgeons have cared for patients with unreasonable or unattainable expectations. Trost et al. summarized these sorts of patients in an excellent review paper using the acronym “CURSED Penis”, referring to patients with tendencies to be Compulsive/Obsessive, Unrealistic, requesting Revision, Shopping for numerous surgeons, Entitled, in Denial, or carrying a Psychiatric diagnosis (e.g., mood disorder, body dysmorphic disorder, substance abuse) (16). Standards of medical professionalism dictate that even patients with these disorders not necessarily be denied management of ED with a penile implant; however, when there is abundant evidence that the patient’s perceived outcomes are likely to be poor, the surgeon is best served to defer management until such time as reasonable expectations about post-operative functional status can be set with the patient. Pre-operative expectations are a very strong predictor of post-operative outcome (17); it is essential that the patient approach penile prosthetic surgery with a reasonable idea of what a penile implant can and cannot do.
Go to:
Trends in operative management
Interestingly, the measured length of penile corpora and implant length shows a trend towards slight but significant increase over time. These findings were obtained from manufacturer data so causality cannot be inferred; whether this represents (ranked of in order of decreasing likelihood based on our collective opinion) a trend towards more aggressive sizing on the part of surgeons, a trend towards greater desire for implants among patients with larger phallus size, or a shift in population penis size over a very short interval of time is unclear (18). Regardless of cause, there is obviously an upward limit on the size of implant that can be placed without major risk, so we do not foresee this as a trend that will continue indefinitely.
Increasing mean penile length also begs the question of how to size prostheses appropriately. Although clinical data are not conclusive, experimental data indicate that greater a utilization of rear tip extenders is associated with lower axial rigidity of the activated penile prosthetic, particularly in larger size implants (19,20). This may relate to instability at the interface between the inflatable and non-inflatable device components and/or the relatively smaller size of the inflatable device itself when rear tip extenders are used to constitute the corporal length. The benefits of minimizing rear tip extenders must be balanced against technical challenges accessing the proximal portions of the crura and/or burying implant tubing with the corpora itself. Optimal use of rear tip extenders in the future is likely to be driven largely by surgeon preference and patient factors.
