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The old rule of thumb was that infrapubic was better for reservoir placement and penoscrotal was better for pump placement. But with a really good doctor neither of those apply. So it depends on the doctor. The less skilled doctor the more issues that come into play. Scarring and tubbing visible and there is a nerve bundle that needs to be avoided with infrapubic.

Thanks a lot guys, I am using Australia's best implant surgeon.. I do believe he uses infrapubic but I spoke to Dr Eid who said Scrotal preserves the most size (i have loss of size and hinging/dents due to peyronies)... I am just confused on whether I should go with it or think about switching to a different Dr.

aussiePeyronies wrote:Thanks a lot guys, I am using Australia's best implant surgeon.. I do believe he uses infrapubic but I spoke to Dr Eid who said Scrotal preserves the most size (i have loss of size and hinging/dents due to peyronies)... I am just confused on whether I should go with it or think about switching to a different Dr.

All the Australian surgeon's use the infrapubic method, as far as I'm aware. Love, Katz, Chung, Chee, and the rest, they all use infrapubic.

But the Australian surgeon you are speaking of, I've not heard of anyone losing size with him, albeit I've only read of 3-4 people here using him, yet none of them complained about a loss of size, one person has a complaint about the pump placement but otherwise has a very good result, particularly in regards to length.

What I'm about to say is not medical advice. It's my own opinion based of experience.

I think some of the answer to this is it depends on YOUR BODY. E.g., infrapubic may be good for some. What I've learned is that infrapubic may be more problematic if you have a small scrotum as it's harder to position the pump and possibly harder to position the tubing which (may?) resut in a need for glansplexy (happened to me). Advantage however would be if you're of slim build because infrapubic means easier resevoir positioning than penoscrotal. Slim build means harder to position resevoir. Less space to maneuver. Infrapubic provides more direct access.

Thanks guys, really appreciate the advice.

If all the Aussie docs use infra pubic - I guess that is my only option.

A lot of guys have only had IPP here for ED and not PD and ED, so I am also not always sure of the overall outcome of someone with PD and ED getting an implant with each surgeon.

Is reservoir placement (and how well it's hidden) with penoscrotal a problem for skinny guys without fat pad?

Flip_5 wrote:What I'm about to say is not medical advice. It's my own opinion based of experience.

I think some of the answer to this is it depends on YOUR BODY. E.g., infrapubic may be good for some. What I've learned is that infrapubic may be more problematic if you have a small scrotum as it's harder to position the pump and possibly harder to position the tubing which (may?) resut in a need for glansplexy (happened to me). Advantage however would be if you're of slim build because infrapubic means easier resevoir positioning than penoscrotal. Slim build means harder to position resevoir. Less space to maneuver. Infrapubic provides more direct access.

Bingo. Too bad this isn’t a TV game show. You could have hit the daily double.

Yes, sizing and placement of cylinders is key to a terrific outcome.

So is having a reservoir to pump fluid from without difficulty. I’m not sure where I read it but somewhere I’ve seen that early revisions were frequently due to pump and reservoir problems instead of anything to do with the cylinders.

In my case I was 63. I hit the gym 5x weekly, on average, and over 4 years had gone from a 38” waist to a 31” waist, only losing 10 lbs in the process. Right at 10% body fat.

Throw in scar tissue from 5 hernia surgeries-2 inguinal, 2 epigastric, 1 umbilical. I asked the doc beforehand if it was going to be trouble and he assured me he would make it all work. And he did. Truth be known, I don’t REALLY know for sure where reservoir is.

If you trust a doctor enough to let him slice and dice your junk, then you ought to be able to trust him enough to choose the best approach to result in a happy ending. Pun partially intended.

@Nuance I am a thin guy waist 29 and have had no issues with the pump or resevoir. Pic of me before implant. Now my Speedo is a lot tighter.

aussiePeyronies wrote:What are the ups n downs of each?

I've been told by Dr Eid that Scrotal approach helps conserve size ?

Penoscrotal access allows better placement of the Cylinders in the corpora cavernosa, in the scrotal pump. This allows the implant to last longer and break less often.

Dr.Menshchikov wrote:

aussiePeyronies wrote:What are the ups n downs of each?

I've been told by Dr Eid that Scrotal approach helps conserve size ?

Penoscrotal access allows better placement of the Cylinders in the corpora cavernosa, in the scrotal pump. This allows the implant to last longer and break less often.

Are there studies showing more failures with Infrapubic?