my doctor said cycling doesn't work

The final frontier. Deciding when, if and how.
EricDraven
Posts: 28
Joined: Tue Feb 01, 2022 2:23 pm

my doctor said cycling doesn't work

Postby EricDraven » Sun May 28, 2023 1:14 pm

I am 3 months out, post implant. I saw my doctor last week. She did a thorough exam. Keep in mind, this is a VA doctor.

I have had swelling issues, and my pump is riding very high. She said to just leave the pump as is, and live with it. She said I could still try to pull the pump down, but it may not work.

The biggest take away for me was, I told her I couldn't cycle the implant because of the swelling and how would it hurt me in the long run. She said cycling is just to help you learn how to inflate and deflate. She said there is absolutely, 100% no increase in girth or length, no matter how much you cycle. I think I am 4 inches soft, so that's all I will ever have according to her. My girth actually DECREASES when I inflate. I am 6 inches deflated, and it decreases to 5.5 inches when inflated, because everything tightens up and becomes thinner. I'm very confused. I really thought that I might get back to 5 inches or so if I aggressively cycled every day.

I have the coloplast titan
54 yo, type 2 diabetes, open heart surgery. Used Viagra for 10 years, then it stopped working. Been celibate for 10 years because I couldn’t get approved for an implant. Implanted on 2-16-23 by the Veterans hospital, titan 24cm, infrapubic

peyroniesjr
Posts: 162
Joined: Thu Jul 18, 2019 8:30 am

Re: my doctor said cycling doesn't work

Postby peyroniesjr » Sun May 28, 2023 1:22 pm

Good Afternoon,

I was measured at 4.5" prior to my initial surgery, I had PD & a Ralp prior to the implant. I am now 5/14 flacid & 5/12-5 3/4 erection. I cycle faithfully, I need a revison now because the pump failed. I have an 18MM titan coloplast. I began cycling on the third day.

Junior
Implant Titan 2/21/2020 / 67 yrs / Married 44 yrs /ED / Peyronies 70 degrees - Xiaflex/ Low T / & RALP 4/1/2019 (Nerve Sparing)

Journeyman
Posts: 456
Joined: Fri May 12, 2023 3:46 pm

Re: my doctor said cycling doesn't work

Postby Journeyman » Sun May 28, 2023 1:45 pm

My understanding is that the cycling is to expand the " surgical capsule " your body is currently making around the cylinders and reservoir. This surgical capsule forms over months and if you don't cycle your length and girth maybe limited . Dr Clavell has a video on YouTube explaining the importance of cycling.
54 - Coloplast Titan 22cm , Implanted by Dr. Clavell in April 2023

Randalltx
Posts: 167
Joined: Sun Jan 01, 2023 4:27 pm
Location: Texas - Austin/San Antonio

Re: my doctor said cycling doesn't work

Postby Randalltx » Sun May 28, 2023 2:30 pm

EricDraven wrote:I am 3 months out, post implant. I saw my doctor last week. She did a thorough exam. Keep in mind, this is a VA doctor.

I have had swelling issues, and my pump is riding very high. She said to just leave the pump as is, and live with it. She said I could still try to pull the pump down, but it may not work.

The biggest take away for me was, I told her I couldn't cycle the implant because of the swelling and how would it hurt me in the long run. She said cycling is just to help you learn how to inflate and deflate. She said there is absolutely, 100% no increase in girth or length, no matter how much you cycle. I think I am 4 inches soft, so that's all I will ever have according to her. My girth actually DECREASES when I inflate. I am 6 inches deflated, and it decreases to 5.5 inches when inflated, because everything tightens up and becomes thinner. I'm very confused. I really thought that I might get back to 5 inches or so if I aggressively cycled every day.

I have the coloplast titan


Eric---

I was implanted same size--24cm titanxl this year. The tubes definitiely swell in circumference with increased pumping. I have measured multiple times. My op was Feb 9, I think. As previously stated. Dr. Clavell really emphasizes the cycling. So does my doctor.

What is swollen and why does it impact your ability to cycle, and by association to have sex or masturbate?

I have been concerned with the amount of pumping I have to do to get close to max hardness, and my length is shorter for sure so far, though the size of the implant is adequate at 24 cm plus probably a half inch or more at the glans and wherever the other end is.

Now I hae a bad rotator cuff and am having to be ambidextrous to add to the challenges (LOL.)

When you are able to use a normal health plan with coverage or get on Medicare, you can get a revision and fix whatever was/is incorrect. I don't know what to do about the excess pumping required. Talking over 100 pumps to get close to max and good enough to penetrate.

On the plus side, sensitivity is really coming back esp. since I started testosterone injections weekly. Also time to reach orgasm with masturbation has improved from 30 minutes to 15 and the quality is higher than pre ED.

Meanwhile, I ordered a vacuum pump from Amazon in a blind act of faith that it could help with restoring length.

Please keep us updated and advise what you are doing and or decide to do. It is definitiely a moving target. You are not alone.
76yo, ED Venuous Leak since age 40. South Texas location.
02/09/2023 24 CM Titan Dr. Hofer, Stone Oak Meth San Antonio.
@OEM 7.5L x 6.0/Flaccid 2.0L x 6.0 (Grower)
@8 months 7.50L x 6.0/Flaccid 6.0L x 6.0
@14 months 7.50L x 7.25/Flaccid 6.0L x 6.0

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

Re: my doctor said cycling doesn't work

Postby Lost Sheep » Sun May 28, 2023 3:21 pm

EricDraven wrote:I am 3 months out, post implant. I saw my doctor last week. She did a thorough exam. Keep in mind, this is a VA doctor.

I have had swelling issues, and my pump is riding very high. She said to just leave the pump as is, and live with it. She said I could still try to pull the pump down, but it may not work.

The biggest take away for me was, I told her I couldn't cycle the implant because of the swelling and how would it hurt me in the long run. She said cycling is just to help you learn how to inflate and deflate. She said there is absolutely, 100% no increase in girth or length, no matter how much you cycle. I think I am 4 inches soft, so that's all I will ever have according to her. My girth actually DECREASES when I inflate. I am 6 inches deflated, and it decreases to 5.5 inches when inflated, because everything tightens up and becomes thinner. I'm very confused. I really thought that I might get back to 5 inches or so if I aggressively cycled every day.

I have the coloplast titan
Scar tissue forming around a deflated implant (or a deflated reservoir) makes a "pseudo-capsule" that may prevent full inflation (or full deflation) if not stretched out or prevented from forming in the first place.

Early activation to prevent formation is the subject of this article.

Cycling in the weeks and months after surgery can stretch the scar tissue capsule, although is is often uncomfortable and takes a very long time.

This article refers to the differences that early activation vs no early activation of the inflatable prosthesis
Title" Pseudo-capsule “coffin” effect: How to prevent penile retraction after implant of three-piece inflatable prosthesis
Authors: Enrico Caraceni, Lilia Utizi, Giovanni Angelozzi; Department of Urology, Civitanova Marche Hospital, Italy.
Short Summary: http://www.ncbi.nlm.nih.gov/pubmed/25017596
Longer summary: http://www.ncbi.nlm.nih.gov/pubmed/25017596
with this sentence: "The result is a penis bigger in flaccid state but smaller in erect phase, when early activation is not performed"
Full article: https://www.researchgate.net/publicatio ... prosthesis


This article was obviously translated from the original Italian, so there may be some grammar issues to overlook.

Read the thread here.
viewtopic.php?f=6&t=6814&p=44451

I am a participatory patient and the surgeon I selected (courtesy of the VA, by the way) accepted me as part of my health care team. I hope your surgeon will do the same for you and consider that article as well as articles that other forum members have posted.

Did your surgeon mention the use of a Vacuum Erection Device (VED) for pre-op stretching? There are articles supporting VED use to maintain penile health, elasticity and size. Protocol of 60 days seems the most prevalent.
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

ThailandBound
Posts: 963
Joined: Fri Dec 16, 2022 5:32 pm

Re: my doctor said cycling doesn't work

Postby ThailandBound » Sun May 28, 2023 5:30 pm

Your doctor is in the distinct minority of doctors who say cycling is not effective. Distinctive as in the ONLY doctor i’ve read on hundreds of posts here. I think she is wrong.

I’ll take both the experience of Drs. Clavell, Perito, Kramer, et. al. as well as my personal experience that aggressive (as in, it’s physical therapy and is done to increasingly uncomfortable levels, until comfortable, DOES increase length.

The surgical capsule is a real thing. If you don’t cycle that capsule will form, limit your size, then you’re really screwed. Whether it’s a breast or penile implant, it will happen unless you prevent it through vigorous cycling.
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.

Cnidium
Posts: 453
Joined: Mon Oct 03, 2016 7:10 pm

Re: my doctor said cycling doesn't work

Postby Cnidium » Sun May 28, 2023 6:38 pm

Not to keep harping on the point, but every major implant surgeon instructs patients to cycle post op (varying timeframes based on the doctor). As the others mentioned, your body encapsulates the implant with tissue - it does this with any foreign object that enters your body. The encapsulation with become fixed if the cylinders aren't expanded out enough during a specific time frame. Hence daily cycling. Couple that with all the anecdotes on this forum, and there is concrete evidence on why it is important.

Cycle daily + VED and you should be able to get way past your current measurements with a 24 titan. Back when I had a 24, i was clocking in some nice measurements, especially hen engorged.

The doctor game is a hard one. Especially if you have an incentive to go through the VA. Who to trust or even having the suspicion that your doctor may not have clue about what their talking about is a puzzle in itself.
Titan OTR. Dr. Hakky - successful surgery and very happy with outcome.
My advice: choose a world-class surgeon and make yourself the healthiest you can.

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

Re: my doctor said cycling doesn't work

Postby Lost Sheep » Sun May 28, 2023 7:32 pm

Cnidium wrote:(edited for focus)
The doctor game is a hard one. Especially if you have an incentive to go through the VA. Who to trust or even having the suspicion that your doctor may not have clue about what their talking about is a puzzle in itself.

I studied up on ED and when my PCP (Primary Care Physician - from the Veteran's Administration) suggested I could get an implant, he also said that I new more about ED than he did. Then I spent 14 months selecting a surgeon, interviewing Drs ramer and Eid (even went so far as to enroll in Maryland VA to gain access to Dr Kramer). Also interviewed two surgeons in Anchorage (where I live and where the Alaska VA would have sent me if I was OK with a local surgeon) and one in Seatte (where the V.A. sent me). At the final moment, a surgeon recently assigned to the nearby military hospital who was an expert in the procedure figuratively and literally fell into my lap. I interviewed him and we immediately "cllicked" and I scheduled my implant. He commented to me (and to his assistant, who told me separately) that I was the most informed patient he had ever had.

I had shared several medical journal papers with him and FrankTalk.org's address with him and am not unhappy I spent the extra time to find a surgeon who would talk to me about the procedure and follow-up practices.

My perennial suggestion is to educate yourself about your condition/disease/whatever and make sure your physician accepts you as part of your own medical care team. Accepts your thoughts, your desires and the facts you bring with you. It sounds like the original poster's surgeon was not one.
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

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SWorks17
Posts: 371
Joined: Sat Jan 15, 2022 4:33 pm
Location: Garden Ridge, Texas

Re: my doctor said cycling doesn't work

Postby SWorks17 » Sun May 28, 2023 11:44 pm

EricDraven wrote:I am 3 months out, post implant. I saw my doctor last week. She did a thorough exam. Keep in mind, this is a VA doctor.

I have had swelling issues, and my pump is riding very high. She said to just leave the pump as is, and live with it. She said I could still try to pull the pump down, but it may not work.

The biggest take away for me was, I told her I couldn't cycle the implant because of the swelling and how would it hurt me in the long run. She said cycling is just to help you learn how to inflate and deflate. She said there is absolutely, 100% no increase in girth or length, no matter how much you cycle. I think I am 4 inches soft, so that's all I will ever have according to her. My girth actually DECREASES when I inflate. I am 6 inches deflated, and it decreases to 5.5 inches when inflated, because everything tightens up and becomes thinner. I'm very confused. I really thought that I might get back to 5 inches or so if I aggressively cycled every day.

I have the coloplast titan


Eric, I'm sorry about your long journey with ED, and now you've been implanted by the VA and you're dealing with incompetent urologist surgeons. All the guys here on FrankTalk that have answered your post are correct about cycling and how important it is.

I had my implant done at Brooke Army Medical Center, in San Antonio, Tx, it's a joint military hospital with Army, Air Force and Navy personnel, they have treated and put back together many a soldier that have returned from the War Zone. My surgeon was an Army Major and he told me all about the importance of cycling to gain as much length and girth before the surgical capsule is formed.

Would you tell us what VA hospital you had your surgery at so that we can report this issue?
Age 66, Garden Ridge Texas, Progressive ED after Boston Scientific Rezum procedure for benign enlarged prostate 19 May 21, AMS LGX 18 w 3cm rear tips installed 5 Nov 2021 by Dr Shane Barney, Brooke Army Medical Center, San Antonio, Texas, Married 35 years

robcb1
Posts: 30
Joined: Sat Jul 16, 2022 6:48 am

Re: my doctor said cycling doesn't work

Postby robcb1 » Mon May 29, 2023 6:57 am

WatNext wrote:Complete horse shit. End of story.

They might be correct in saying the implant will never increase beyond your once natural size, but even that is incorrect.


Agreed. My doctor told me to cycle twice a day for at least 30 minutes. He said I could see gains up to a year after surgery. I’m nine months in, and I’ve gained about 3/4 of an inch since I first fully inflated. Am back to the size of my youth. That was my hope. I didn’t expect any more than that. Cycling most definitely works.
Implanted 8/23/22. Coloplast Titan 20cm, no RTE’s, infrapubic. Married 40 years.


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