Surgeon choice: local vs. travel

The final frontier. Deciding when, if and how.
Franklin_F
Posts: 53
Joined: Tue Nov 10, 2020 3:55 pm

Surgeon choice: local vs. travel

Postby Franklin_F » Mon Jan 30, 2023 10:45 pm

Hi guys. I am a young member (31), suffered from ED since 14 years old. Pills worked for 7-8 years but then failed in 2019, and even if I take 300 mg of Viagra, the outcome is still hit or miss. That was when I found Franktalk. After a few years of self loathing and procrastination, finally decided to go Bionic in 2023 (didn't want injections due to dating needs). Thanks to all members for the invaluable information and kind attitude on this forum.

Here is my question right now:
I had my surgery scheduled with Dr. Eid in mid March, but his office has informed me that he is currently unwell, and the surgery might be postponed indefinitely. I am considering switching to a different surgeon. One obvious choice is Dr. Levine, since I live in Chicago and he is very well respected. My biggest fear is infection, and my understanding is that he has a low infection rate (1.2%), but there are other higher volume surgeons in the country with even lower infection rates. Money is not an issue, and I wonder how much benefit there is for staying local, compared to flying to a higher volume surgeon. A secondary consideration is future revisions. I wonder whether it would be valuable to choose a younger surgeon so that I can stick with the same guy for future revisions.

Sorry for the long post. I understand that ultimately this is a very personal choice. But any input from you would be greatly appreciated! Thank you!
31 yrs old. ED from since puberty due to venous leak. Pills worked for 7-8 years and then stopped. Skipped injections, got implanted on 3.11.2023 with Titan Genesis pump 20cm+1.5cm RTEs by Dr. Levine.

Gt1956
Posts: 2881
Joined: Fri Apr 05, 2019 2:47 pm

Re: Surgeon choice: local vs. travel

Postby Gt1956 » Mon Jan 30, 2023 11:08 pm

Its my opinion that at your age of 31. Your implant future needs will exceed 1 surgeons career. So don't worry about finding a very long term (for you) surgeon.
About Eid. The forum has speculated about his age, health or retirement several times. I wish him the best of luck with his own health issues.
Only my opinion, if Eid does return to surgery. He'll likely be swamped by men wanting his sevices. Also, there is a good chance that he might only work part time. This might push you way down the waiting list. Living in fear that he falls ill again before your surgery. In other words. My advice is to move on in your search.
Since you mention Levine. See if you can contact some of his members here on FT. Past patients can be a great source of information.
If that doesn't work out for you. Try searching for a quality surgeon within 500 miles of you. If that fails, try 1,000 miles.
The reality of this surgery is that every year another couple of quality guys will show up. You only need to find 1 of them.
I wish you the best luck.
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

sswinsfba
Posts: 572
Joined: Sat Jan 07, 2023 3:08 pm

Re: Surgeon choice: local vs. travel

Postby sswinsfba » Mon Jan 30, 2023 11:52 pm

Franklin_F wrote:I wonder how much benefit there is for staying local, compared to flying to a higher volume surgeon. A secondary consideration is future revisions. I wonder whether it would be valuable to choose a younger surgeon so that I can stick with the same guy for future revisions.


There probably are people here who will disgree w/me but, if you are willing to travel, I suggest picking a surgeon who does infrapubic (not penoscrotal) implants.

The main reason is that recovery from infrapublic surgery is shorter and less traumantic.

You can drive yourself home (or to the airport) the day after infrapublic surgery. I did it; drove myself home the day after. An overnight stay in the hospital is advisable because the hosptial staff can help manage any post-op pain and also provide additional post-op antibiotics which, again, is what they did for me.

If you're willing to fly anywhere, consider contacting my surgeon who is named in my signature line. He is a high volume surgeon who mainly does infrapubic. He told me his infection rate is less than 1%. There is no indication of any infection yet in my case 6 days post-op.

Normal recovery time for my doc's patients is 3 wks. 1 wk to heal from the surgery and 2 wks of cycling before sex can begin. Penoscrotal recovery generally is much longer. I'm due to start cyciing in 3 days.

My doc is also relatively young and will be around for a long time if you need any revisions done.

Good luck!

PS: My doc charges around $19k for out of pocket IPPs, which is on the low end for such surgeries but, of course, you'd have to add in any travel/lodging costs.
Last edited by sswinsfba on Tue Jan 31, 2023 12:34 am, edited 4 times in total.
Age 73. Started taking 5 mg Cialis daily in 2000. Minor ED started in 2021. Major ED problem started in 2022. Coloplast Titan (20 cm w/1cm RTE) implanted infrapublicly on 01/24/2023 by Dr. Edward Karpman (El Camino Urology Medical Group, Mt. View, CA).

Txagq8
Posts: 714
Joined: Tue Oct 01, 2019 4:41 pm
Location: Texas Hill Country

Re: Surgeon choice: local vs. travel

Postby Txagq8 » Tue Jan 31, 2023 12:11 am

If there is a relatively high volume guy within a hundred miles or so, I would not discount some of the benefit of keeping it local.

I understand wanting the best. I really do. It’s your junk being sliced & diced. For me Eid was a non-starter due to insurance. I did look in to going up to Baltimore. Ultimately I ended up 60 miles down the road in Austin. Great outcome.

Not everybody needs or wants it but I found the best feature of my surgical experience to be service after the sale. My doc was an early cycle advocate (like day 3). I was swollen,clumsy, and occasionally scared shitless. I made 3 follow up visits the first week. The doctor’s PA was outstanding and they basically coached me thru the entire process until I was totally at ease,comfortable, and pretty proficient in its use.

You can drive an hour, hour and a half to see the doc. Going 1500 miles isn’t quite as easy.

For some guys once the drain is out and the Vicodin Rx is written the job is done. I went ahead and turned all my urology needs over to my implant surgeon’s clinic so I get a follow up twice a year. I believe that my high degree of satisfaction is tied to after care received.

Something else to think about,anyway.
Robust, adolescent 65 year old. Venous leakage forever. Used shots, shots+pills 30+ years. Married to same wife ~35 yrs. Implanted 31Dec2019 in Austin Tx. AMS 700 LGX 18 cm with 5 cm RTE.

frwmw1
Posts: 422
Joined: Thu Oct 01, 2020 7:38 am

Re: Surgeon choice: local vs. travel

Postby frwmw1 » Tue Jan 31, 2023 12:24 am

sswinsfba wrote:
There probably are people here who will disgree w/me but,if you are willing to travel, I suggest picking a surgeon who does infrapubic (not penoscrotal) implants.

The main reason is that recovery from infrapublic surgery is shorter and less traumantic.



Dr Ied said that he finds penoscrotal offers a better angle during surgery, which helps particularly in getting the length optimised.

Infrapubic is argued as better for reducing the infection rate which seems to be somewhat like a performance indicator in some fellowships - infections are their number one concern.
45yo, venous leak. Pills increased tinnitus (very rare). Using bimix+atropine, 0.2 of:
Atropine Sulfate: 52MCG/ML, Phentolamine MES: 0.9MG/ML, Papaverine HCL: 26MG/ML

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

Re: Surgeon choice: local vs. travel

Postby Lost Sheep » Tue Jan 31, 2023 1:01 am

Welcome to the forum, Franklin_F.

Nationwide top-notch surgeon with whom followup might be problematic or local surgeon with whom continuity of care would be easier? That was my question posted in 2016-2017. Plenty of discussion you might not get from current members, so I recommend reading old topics. You will get discussion quicker than waiting for responses to trickle in contemporaneously.

viewtopic.php?f=6&t=8236&p=60200
viewtopic.php?f=6&t=8572&p=65253
viewtopic.php?f=6&t=13524&p=117852
viewtopic.php?f=6&t=17600&p=160052
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

Franklin_F
Posts: 53
Joined: Tue Nov 10, 2020 3:55 pm

Re: Surgeon choice: local vs. travel

Postby Franklin_F » Tue Jan 31, 2023 1:44 am

Thank you all for the great inputs! Super helpful.
I am aware that there have been previous discussions on this issue. One difference is that Dr. Levine is clearly a lot better than a typical local doctor.
So I guess another way to put my question is that, in terms of minimizing infection risk, other than Dr. Eid (0.4% infection rate), is there any other top surgeon that does significantly better than 1.2%? I couldn't find stats on this, other than a few old posts saying certain doctors were "below 1%."
I wonder if there is anyone that's close to Dr Eid's 0.4%? If it's more like 0.9%, then I won't consider that to be too different from 1.2%...
Thanks!
31 yrs old. ED from since puberty due to venous leak. Pills worked for 7-8 years and then stopped. Skipped injections, got implanted on 3.11.2023 with Titan Genesis pump 20cm+1.5cm RTEs by Dr. Levine.

ThailandBound
Posts: 962
Joined: Fri Dec 16, 2022 5:32 pm

Re: Surgeon choice: local vs. travel

Postby ThailandBound » Tue Jan 31, 2023 10:17 am

I considered and consulted with Dr. Perito who is only 80 miles from me. My insurance did not cover the operation and he charged $31,000. While awaiting the insurance appeal i consulted with Dr. Clavell in Houston. Great youtube channel and very high patient reviews. $21,000.

I’d had concerns about the travel home to Florida after the surgery. It just seemed almost unfathomable that this could be done 2 days post surgery, but in the end, it was not really a big deal. The nerve block he uses to control pain for the first 3-5 days really either well, and pain after that was no biggie at all. 1 pain pill and 3 Tylenol through the entire recovery.

I’m almost a month in, 60% inflated, and perfectly comfortable. Now walking 3 miles daily and looking forward to hitting the gym again in 2 weeks. Cycling starts at 6 weeks. Yes, infrapubic guys start sooner generally.

One thing about my penoscrotal is that the pump
placement is perfect. Never required “pulling it down”. With the swelling gone now i can clearly feel the pump and release valve. Just waiting now for the next phase, cycling.

In a nutshell, the travel was not a big deal to me and so far has been well worth it.

Final note. You are absolutely correct to seek a high volume guy. My local urologist kind of casually mentioned he could do it. I asked how many a month he does and said “4 or 5”. Contrast that to my doctor who did 5….that day. And he operates 2-3 times per week. At this point there’s not much he has not seen. It’s your only penis. Choose quality.

I was just lucky on the price really, but not my primary concern.
Active, athletic 63 years old. Sexually, still 33 in my mind and spirit. Pills and injections all worked, until they didn’t. Diagnosed with veinous leakage in 2022. Coloplast Titan. 22 CM. No RTE. Peno-scrotal. Implanted 1/4/23. Dr. Clavell.

Time2Change
Posts: 416
Joined: Sun Sep 13, 2020 7:32 am

Re: Surgeon choice: local vs. travel

Postby Time2Change » Tue Jan 31, 2023 7:09 pm

Franklin_F wrote:Thank you all for the great inputs! Super helpful.
I am aware that there have been previous discussions on this issue. One difference is that Dr. Levine is clearly a lot better than a typical local doctor.
So I guess another way to put my question is that, in terms of minimizing infection risk, other than Dr. Eid (0.4% infection rate), is there any other top surgeon that does significantly better than 1.2%? I couldn't find stats on this, other than a few old posts saying certain doctors were "below 1%."
I wonder if there is anyone that's close to Dr Eid's 0.4%? If it's more like 0.9%, then I won't consider that to be too different from 1.2%...
Thanks!


It seems to me that, at 31, if you are in good health other than your ED, your chances of getting an infection are slight.

But, that's only if you follow your doctor's instructions before and after the surgery. My doctor gave me clear directions for what I had to do before and after surgery to minimize the chances of getting an infection. I followed his directions to the letter and didn't have any problem.

I don't know if the studies take into account patients' carelessness or not. But I would take that into consideration if I were you.
55; ED for 22+ years; Coloplast Titan implant on 10/26/20; Dr. Martin Gross; Happy to share my experiences in private messages

Stupid
Posts: 43
Joined: Tue Sep 13, 2022 2:40 am

Re: Surgeon choice: local vs. travel

Postby Stupid » Tue Jan 31, 2023 10:51 pm

I recommend USC Doctors Loh-Doyle and you might get Dr Boyd..semi retired. High Quality. Since 1982. Research and decide. Just get a place to recover local good luck
RP 2015. all downhill real fast. 2022 consulting doctor at USC. Apptmt is in November going bionic??


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