Implant repair in lieu of replace

[Txagq8]

I’m going to run the risk of annoying Lost Sheep by asking a question probably addressed before but I’m too slothful to search. Also a good friend is hospitalized with the damned Covid and not doing great sort of too edgy to look.

Let’s say a guy has an implant. He uses it often. Really likes it. Things are great.

At 5 or 6 years he has a mechanical failure that disables it, but the doctor/manufacturer isolates the problem. Maybe the pump just quit. Or the reservoir has developed a leak and spilled the saline. Or God forbid our implanted guy lost his mind and decided to get a PA piercing and they nicked a cylinder and put a leak there. No, I’m not contemplating a piercing. Between the age and the implant I dribble enough. A second hole in my urethra would wreak havoc on hardwood bathroom floors.

Instead of re-doing everything, which might be smart given the expected lifespan of the equipment, has anyone ever heard of just replacing a single bad component? I’m thinking if the cylinders are intact, and uninflected, it might be wise to leave well enough alone and just put a new pump in the nutsack and call it a day.

I can see advantages and disadvantages in both courses if action. I’ll ask doc next time I’m in. In the meantime what is the medical community’s normal behavior?

[LuisFernandez]

Replace everything. Don’t want to risk an infection.

[Gt1956]

My guess is as you have speculated. Not much sense in having 2 vintages of parts in there. Especially since the time, cost & discomfort between a partial & full replacement probably isn't much.
Also, in reading about members that have had revisions. I think some surgeons might be superstitious. Like if they have to answer questions & provide "service" for the whole thing. They want the whole thing to be their work.
Just my opinions & observations.

[Flounder]

My guess is as you have speculated. Not much sense in having 2 vintages of parts in there. Especially since the time, cost & discomfort between a partial & full replacement probably isn't much.
Also, in reading about members that have had revisions. I think some surgeons might be superstitious. Like if they have to answer questions & provide "service" for the whole thing. They want the whole thing to be their work.
Just my opinions & observations.

Exactly my thoughts. At 5-6yrs out I would seek a full revision. In addition to resetting the life expectancy with all new equipment, you also stand a good chance of being upsized with a full revision. IMO, that is ample payoff for any marginally added time, cost, and discomfort for a revision vs a parts replacement.

[Lost Sheep]

I’m going to run the risk of annoying Lost Sheep by asking a question probably addressed before but I’m too slothful to search. Also a good friend is hospitalized with the damned Covid and not doing great sort of too edgy to look.

Sorry to hear of your friend. I pray he recovers completely, and soon.

Please forgive the appearance of annoyance. I will try to do better and not be "that guy". I do not want to be an enforcer, really.

In my defense, I am not trying to be "judgey". What I am trying to do is point out the most efficient and effective way a member can get the information desired.

[Lost Sheep]

In my opinion, based on limited research, risk of infection if only the pump is replaced is fairly low. You open up the scrotum, remove the failed pump, splice in a new one. Minimally invasive compared to a full revision.

Removal of a failed component deep in the abdomen (the reservoir) is sometimes skipped and a new reservoir is simply implanted.

Of course, failed tubes MUST be removed it they have failed. I read a paper wherein it was noted that a high percentage of removed implant tubes had a "biofilm" that had become encapsulated in the host's tissue. Great care had to be taken to prevent spreading. I note that they did not specify that it was a bacteria or not. Sorry, I don't have a link to the article. Now, I wish I had kept a copy.

I concluded from that last bit that if the tubes are intact, still working (and probably not too old), leaving them in place might be safer and more advisable than replacing them. But that is speculation on my part.

Automotive analogy: A partial revision is sometimes preferable to a full "rebuild". Say you have a failed transmission and a flush and filter change would fix it, or a full rebuild could be done. Factors in your decision might be cost, age of the other transmission components, etc. If the tranny is old or the model has known weak points (like reverse on certain models - I was looking at buying trucks recently) for instance.

[Txagq8]

Thanks LS. You answered my question pretty much head on. Kind of what I thought based on my experience early on (a couple of months after installation) when the pump was being ornery in terms of finding a convenient permanent location. The doctor said be patient, tug on it, but if all else failed he could open up scrotum, reposition pump, do it under a local, nothing terribly invasive or problematic to recover from. Then a week later I woke up and pump had seated itself at an ideal location and hasn’t moved since. I wondered...if they can do that, why couldn’t they put in a new pump. (The guy on another thread having issues with a Titan triggered me)

BTW I wasn’t trying to sound snarky. You really do stand out as sort of the sage, wise voice of truth on this website. I don’t think anybody sees it as judgmental. More of a reminder that we should have done things properly the first time.

[tomas1]

You got me to thinking about what I'd do.
I think if I had a choice in the matter, I'd leave the goddam reservoir alone.
That was the most uncomfortable part of my recovery and I believe it's not a high failure item.
Obviously, I could be wrong.

[cbinspok]

I would have loved to leave all well enough alone, Except bucking my seat belt and a host of normal operations were annoying with my reservoir sticking out my side. Had not the revision opt occurred i would have been home free assuming I could have beaten off the infection that came on a few weeks later.

[tomas1]

Ouch