What would you do

The final frontier. Deciding when, if and how.
irishguy
Posts: 229
Joined: Sun Oct 28, 2012 12:04 pm

What would you do

Postby irishguy » Mon Oct 12, 2020 10:31 am

So basically I have found out today that my health insurance will completely cover a revision here in Ireland and the urologists name is Dr Cullen he trained under Dr Ralph the doctor that put my implant in.. I am 8 years now with the implant so feeling it could be within the next couple of years I will need a revision so my question is what would be your requirements of an implanter to do a revision what questions should I ask him and what should I realistically accept as good enough credentials. I have got from people on frank talk that local urologist seem to undersize the implant but if I was getting a revision surely he would at least put in the same size implant as he is taking out? So any suggestions and opinions would be greatly appreciated
Age 34 Implanted with a 20cm Titan, Mar 19 2013, By Doctor David Ralph in London England,
8 years with implant and after a rocky start I’m very happy with the implant

LeRoastBeef
Posts: 678
Joined: Mon Sep 17, 2018 11:09 am

Re: What would you do

Postby LeRoastBeef » Mon Oct 12, 2020 11:54 am

Implants can last longer than 8 years no?
I understand your logic, but i would hold off.
Every surgery is more trauma, and you're young, you're going to go through a few in a life time.

i realise that I'm saying this without an implant, so i have a limited insight into how it would feel. You've been so helpful here though, felt i had to be honest.

I say hold off.
Implanted with AMS 700 lgx, 2021.
30's
UK

DaveKell
Posts: 531
Joined: Tue Sep 04, 2012 7:39 pm
Location: Texas

Re: What would you do

Postby DaveKell » Mon Oct 12, 2020 12:15 pm

My implant surgeon is the chair of the urology department of a university hospital. He conducted a survey recently of revision statistics and concluded the average revision has a minimum 3 centimeter increases in length. I’m happy with my size but truthfully wouldn’t mind needing a revision!
Became DaveKell 2.0 on July 18th with Dr. Allen Morey in Dallas, TX. AMS 700 CX implant. 18cm with 5.5 RTE's.

newbie443
Posts: 1841
Joined: Fri Dec 01, 2017 9:41 pm
Location: Sedgwick county, Kansas USA

Re: What would you do

Postby newbie443 » Mon Oct 12, 2020 12:19 pm

This will very a lot. A lot of men just go local and do no checking or research. I tell everyone who asks to check and research locally first for after care. I feel after care is really important but not more important than a really good doctor. I reasearched local and did not find any doctors in my area who had a great interest in implant surgery. They all do just 2-3 a year and do not do revisions. So research your local doctor(s). If you find one you trust for this then go to that doctor. If not expand your search. The questions are the same. How many does the doctor do. Is the doctor concerned about infection to the point that they use a no touch or other type of surgery to reduce infection rate. Ask about sizing. I contacted patients of my local doctors and they all said they lost size. One other thing to consider is will the local doctor provide after care if you have doctor Ralph do the revision. A lot of doctors will not. Other doctors have a relationship with the top implant doctors and will.

This is somethig that we should all include in our research for our first implant as a revision can be needed at any time after the initial implant. So I would say to move ahead with this now and keep checking back as new very good doctors could be added locally and local doctors can gain experience before you need a revision. I feel it is never to early to have a plan for a revision.
Injections failed. Implanted 3-21-18 AMS 700 LGX 21 + 1 RTE 100 cc reservoir 6.5" L 5" G Dr. Kramer.

Proximal Perforation Sling Repair 4/13/21 Dr. Broghammer

66 years young.

Will show and tell and talk with others.

Lost Sheep
Posts: 6144
Joined: Mon Jul 04, 2016 11:16 pm

Re: What would you do

Postby Lost Sheep » Mon Oct 12, 2020 12:25 pm

irishguy wrote:So basically I have found out today that my health insurance will completely cover a revision here in Ireland and the urologists name is Dr Cullen he trained under Dr Ralph the doctor that put my implant in.. I am 8 years now with the implant so feeling it could be within the next couple of years I will need a revision so my question is what would be your requirements of an implanter to do a revision what questions should I ask him and what should I realistically accept as good enough credentials. I have got from people on frank talk that local urologist seem to undersize the implant but if I was getting a revision surely he would at least put in the same size implant as he is taking out? So any suggestions and opinions would be greatly appreciated

It took me 14 months to find a surgeon to do my (virgin) implant. I interviewed several. It is likely that that surgeon will not be available to do my first revision if I outlive it. So, your question is one I may have to face, also.

So, when should I (or you) start to think about finding a surgeon to do a revision? It is not too early (at 8 years in) to think about such things. Would you have the opportunity to interview Dr. Cullen and perhaps establish a Doctor-Patient relationship with regard to your implant (and perhaps general urological health)? Within that relationship, you could determine his philosophy on how aggressively to size a revision if you ever need one.

Do you like him? Do you trust him? Does he trust you? Does he LISTEN to you and hear you? Will he accept you as a part of your medical care team? These are questions important to me as a patient. But I, by my nature, am a participatory patient.
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

SW0110
Posts: 648
Joined: Sun Sep 02, 2018 6:15 pm
Location: Central Kentucky

Re: What would you do

Postby SW0110 » Mon Oct 12, 2020 12:53 pm

A revision was not at the top of my list when I got my titan. At month 8 when my hernia showed up and it appeared to be right above my reservoir. Saw surgeons and talked to my implant doctor. The implant urologist surgeon did not fix hernias. Said to find a general surgeon. Ended up having hernia fixed after making sure general surgeon was aware of the parts.

Hernia surgery on a monday, saturday I tried to pump up. Nothing. Just figured that would happen. Saw my local urologist to get his advice. He was doing more implants and was trying to increase that part of his practice. He knew I went out of town for my initial implant but said he would do the revision if I wanted him to. I was in a lot of pain for some reason in my abdomen still. I was told to be safe all the parts of old implant would be removed. Then the hernia repair would have to be checked. I would need 2 surgeons available during surgery. I ended up staying local for logistics. I ended up with a great outcome.

I do not think it is ever to soon to check on surgeon urologists just in case a revision is necessary. It may be implant failure do to use or failure for another reason. I had my revision 1 year after my initial implant. I actually got 1 cm longer cylinders as well. Not sure about where you got information on getting shorter cylinders on a revision. Pretty much everything I researched and saw, said longer cylinders were normally implanted during a revision.

Hopefully your revision will be a long ways off, but no harm in being prepared for it. One thing you can do if it is a local doctor you use is pump that thing up and show him what it looks like when it works. He can see where tips are and if it looks like he could add a little more to it.
18 cm plus 1 rte titan installed March 2019. Revision March 2020 by Dr. Andrew Todd, Richmond KY. He replaced the titan with an AMS 700 LGX 18 cm cylinder plus 2 rte for 20 cm total length.

irishguy
Posts: 229
Joined: Sun Oct 28, 2012 12:04 pm

Re: What would you do

Postby irishguy » Tue Oct 13, 2020 8:46 am

Lads great advise when this Covid thing calms down I’m going to make a consultation with Dr Cullen and have a general chat with him also like one of ye guys said the revision could be years away and this doctor will have loads more experience by then also so to keep in touch with this Doctor. Also about after care I will ask about that but as I live in Ireland everywhere is not much more than a 3 hour drive away which is another beauty about not having to go abroad!! Also this doctor is young so if he is good he will able to deal with me for many many years. Saying that I will want to get a good feel from him good answers and his patients will want to have no complaints about size!!
Age 34 Implanted with a 20cm Titan, Mar 19 2013, By Doctor David Ralph in London England,
8 years with implant and after a rocky start I’m very happy with the implant


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