Implant questions

The final frontier. Deciding when, if and how.
Davegb
Posts: 33
Joined: Tue May 12, 2020 11:08 pm

Implant questions

Postby Davegb » Sat Jul 04, 2020 6:07 pm

Is the corpora cavernosa completely removed?
Which is best infrapubic or scrotal procedure?

Gt1956
Posts: 2859
Joined: Fri Apr 05, 2019 2:47 pm

Re: Implant questions

Postby Gt1956 » Sat Jul 04, 2020 6:44 pm

Davegb wrote:Is the corpora cavernosa completely removed?
Which is best infrapubic or scrotal procedure?

1: Haven't heard of a complete removal. But never say never. A round or ball shaped tool is pushed thru it on most of the YouTube video's that I've seen. This facilitates the implant cylinder placement. I highly suggest watching some of videos. It will make talking to your surgeon easier to understand what he means. I believe Kramer has the most videos online. He uses scrotal most if not all the time.
2: Lots of debate on the procedure. There is pro's & con's to both. The infrapubic method has the saline lines exit the penis on the top side & wrap around down into the scrotum to meet the pump. Some men don't like that cause under some circumstances the tubing can be felt. I've read the instruction papers from AMS. They don't address which method to use. So it looks like it is a surgeons choice. People claim that the healing time on the scrotal method is a little longer on average.
Again, watch Kramer's videos. He will talk about the scrotal approach sometimes while he is working. But be advised. The surgeon that you choose might not give you a choice on how he will install it.
68yo, HBP at 40, high triglycerides at 45. Phimosis at 57. Type 2 at 60. Dr. William Brant May 1, 2023 CX 21cm w/no rte's penoscrotal 6" girth @ 6 months

Lost Sheep
Posts: 6133
Joined: Mon Jul 04, 2016 11:16 pm

Re: Implant questions

Postby Lost Sheep » Sat Jul 04, 2020 6:46 pm

Some surgeons remove the corpora cavernosum and some use a tissue-sparing technique. SOMETIMES the tissue sparing technique results in preservation a little bit erectile function, But it is FAR from guaranteed, so counting on it is a ridiculously bad idea.

Going in either direction has advantages and disadvantages.

Read through old posts (when I first joined, I read through a couple years of posts and gathered a LOT if information in a very short period of time, much quicker than if I had waited for members to deliver it to me).

After you have educated yourself, you will be able to ask your surgeon incisive questions that will do two things.

Gain his/her respect for how seriously you take this and make yourself a part of your medical care team

Put him/her on notice that your expectations are both realistic and to be taken seriously. (Many patients have unrealistic expectations and this is a problem for surgeons sometimes).

There is also the sub-coronal approach.
Lost Sheep
AMS LGX 18+3 Nov 6, 2017
Prostate Cancer 2023
READ OLD THREADS-ask better questions -better understand answers
Be part of your medical team
Document pre-op size-photos and written records
Pre-op VED therapy helps. Post-op is another matter

Waynetho
Posts: 1767
Joined: Wed Nov 27, 2019 11:22 pm
Location: Dallas, TX

Re: Implant questions

Postby Waynetho » Sat Jul 04, 2020 7:15 pm

In none of the videos I have seen has any tissue been removed during dilation of the corpora. The doctors are usually quite vigorous in their dilation attempts, ramming the dilation rods quite hard into the corporotomies but other than blood there have never been deliberate tissue removals in any of the literally dozens of videos I watched, both before my surgery in October, and since then. This includes the ones that involved sub-coronal circumferential incisions and degloving to excise plaques and/or repair/patch damage to the tunica albuginea.

I think some get the misguided idea that the destruction of corporal erectile tissues due to dilation is actually removal of the corpus cavernosum, although that structure is just spongy material and blood vessels inside a capsule in either the left or right chamber (corpus) inside the tunica.

If the corpus cavernosum was removed, how could the incision they make for the cylinder's introduction still be called a corporotomy ("incision of corpus cavernosum"). I've never heard of a doctor performing a "corporectomy" ("removal of corpus cavernosum") as a part of the implant surgery, only a "corporotomy".
62yo, married 41 yrs. Urolift (x4) 8/12/19. AMS 700CX 15cm (no RTE) penoscrotal 10/28/19, 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

Davegb
Posts: 33
Joined: Tue May 12, 2020 11:08 pm

Re: Implant questions

Postby Davegb » Sat Jul 04, 2020 8:06 pm

Thank you for the information and advise.
Just getting started on research. Local
surgeon's website states removal. Most
seem to do scrotal, so that I would ask.

Skier123
Posts: 183
Joined: Tue Aug 29, 2017 8:10 pm

Re: Implant questions

Postby Skier123 » Sat Jul 04, 2020 9:18 pm

Hi Davegb,

Welcome to the forum. There is a wealth of knowledge on here if you take the time to find it.

IMHO the most important thing you can do to increase your odds of success is to choose a really good implant surgeon. I'm not telling you not to consider a local guy ... but this procedure isn't for amateurs.

If you read through the posts on this site, you will read about some members who had a less than excellent results. But you will also see that in the hands of a really skilled surgeon, things almost always go well. So do your homework.
54 yr old single guy
Severe ED for over10 years; diagnosed with peyrones and venous leak
Implanted 12/23/19, Dr. Laurence Levine
Coloplast Titan w/ Genesis pump

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

Re: Implant questions

Postby RayChez » Sat Jul 04, 2020 10:44 pm

I have had both done. The first time was infrapubic worked great for fifteen years, then I had the revision and that was scrotal. Whether they removed what you are asking about, I am not sure, but if they did, then that is the way it is done. The thing is I was not a person that was patient suffering from ED and I did not hesitate about having the implants done. Both worked good for me. Now I do like the LGX much better then the Ultrex I had before. The LGX gives you full length and that is what makes it great. I was 58 when I had my first and now I am 77 and really I can have sex even now like when I was much younger.

So don't be afraid. Find yourself a good urologists and ask him questions. Ask if he has done that type of surgery and if he says yes, ask how many per month. To see if he is experienced. Tell him like I did that I did not want him to short change me on the length. LOL! You will like the surgery. ED is terrible.
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

Davegb
Posts: 33
Joined: Tue May 12, 2020 11:08 pm

Re: Implant questions

Postby Davegb » Sat Jul 04, 2020 11:16 pm

How do I locate a good implant surgeon? Hopefully in the
middle of the country. Has anyone traveled very far
for an implant and how did it go traveling after the surgery
and going back?

proctor
Posts: 171
Joined: Thu Feb 13, 2020 3:01 pm

Re: Implant questions

Postby proctor » Sat Jul 18, 2020 10:45 am

Davegb wrote:How do I locate a good implant surgeon? Hopefully in the
middle of the country. Has anyone traveled very far
for an implant and how did it go traveling after the surgery
and going back?


I can respond to you after September, when I hope to have the surgery and travel back on a 9 hour flight....
Rigicon Infla 10 AX , 18 Cm, 2 RTE, 110 ml. Dr Andrew Kramer

AussieFarmer65
Posts: 42
Joined: Tue Jun 02, 2020 4:39 pm

Re: Implant questions

Postby AussieFarmer65 » Sun Jul 19, 2020 5:03 pm

proctor wrote:
Davegb wrote:How do I locate a good implant surgeon? Hopefully in the
middle of the country. Has anyone traveled very far
for an implant and how did it go traveling after the surgery
and going back?


I can respond to you after September, when I hope to have the surgery and travel back on a 9 hour flight....


I've got my implant booked for September too. My surgeon has suggested one night in hospital and then two nights in a nearly motel because I have a 3 hour drive home.
Glad to be alive at 65 and living in OZ. RP 2015 and consequential severe ED. Tried meds (side effects!), injections 2 years (now effectiveness and injection problems) , VED (disastrous). Implanted with Titan One Touch on 12th October 2020.


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