A few more questions consolidated into one post

[Markc2008]

Hey guys! Hope everyone is doing well and as always I appreciate this group.

I finally have an appointment with Dr Clavelle the 18th and I’m a little nervous. I would like some input on a few things. I wanted to clarify first, so that you guys understand where I’m at with my situation. I have had what I assume to be pssd for six years which is side effects from an ssri antidepressant, I was fine on them but my stupid self decided to stop them and I have permanent issues. A bladder sphincter muscle that doesn’t relax during urination— so weak stream, little to no libido, Ed and worst of all arousal issues along with low genital sensation. I don’t react to sexual stimuli like I should. I also have hard flaccid symptoms that fluctuate. I have tried meds to fix some of this with little success and a lot of times worsening of the symptoms. I still enjoy sex with my wife once we get going but the uncertainty of function makes me stressed out. Pills are sometimes successful at higher doses( usually my daily cialis 5mg along with either 100mg viagra or 25mg vardenafil) will work although it’s hit or miss especially if I have any alcohol. I’ve been using injections off and on over the last few years if needed as well but their painful, hard to plan, and I prefer edex to travel with which is extremely expensive. I am 42 years old. All of this being said, I am thinking it’s time to move on with my life and get the implant. Insurance will not cover it but I can pay out of pocket. I do have some concerns that I just cannot get out of my head and I wanted to hear how much of an issue and how common some of these are.

My largest concern is the look. I keep reading about more of a flat look especially when erect if you are not aroused. Keep in mind my largest issue is I have a hard time getting aroused or turned on. Would this mean I would never have a normal looking penis after surgery? Could I just take a daily pill and resolve this?

I also have concern with the squeaky pump. I do not want to sound like an angry duck everytime I want to pump the thing up. How common is this?

Lastly I do worry about size. I’m very average on size and just do not want to lose an inch to an inch and a half permanently. It does sound like most gain it back with cycling which is reassuring.

Glans not engorging— again since I have a hard time getting aroused will this be a problem after surgery??

Thanks guys for all the feedback!

[Kodixx]

Markc2008, sorry to hear about your challenges, and sending best wishes for your appointment and path forward.
The look -- sounds like you've already read some about this maybe here, maybe somewhere else. Yes the shape is different depending on engorgement. But I'd offer this :
1) I've read that married guys (myself included) find their wives don't care considering the value of restoring reliable sexual function in their relationship. And I've read that single guys find their partners don't care given their newfound sexual performance.
2) Shape also seems to be heavily influenced by engorgement and/or sensitivity, which return in varying degrees. But it is amazing what an on-demand, reliable and hard erection will do for confidence, which lowers stress, and helps with other sexual responses. That's not a guarantee -- just a general observation. Early on my engorgement wasn't great, but my wife and I still had incredibly enjoyable PIV sex.
Squeaky pump -- I've read that most guys who experience this find it easy to minimize or conceal. Things like music or a trip to the bathroom are common and easily conceal the sound.
Size -- there are volumes in this forum on size. To summarize what I've read, most guys experience some initial loss. Most guys get most of that back with cycling. And some guys go above and beyond with exercises and/or VED to get all or more size.
Glans -- there are also volumes on glans. This kind of goes back to #2 above. Plus I've read lots of guys have found treatments to encourage engorgement in the glans.

I guess one of the questions you have to ask yourself is whether you and your wife would be better off with an on-demand, reliable and hard erection -- regardless of level of engorgement. Again best wishes, and the members of this forum are a great resource for information and perspectives.

- Chuck

I finally have an appointment with Dr Clavelle the 18th and I’m a little nervous. I do have some concerns that I just cannot get out of my head and I wanted to hear how much of an issue and how common some of these are. My largest concern is the look. I also have concern with the squeaky pump. Lastly I do worry about size. Glans not engorging— again since I have a hard time getting aroused will this be a problem after surgery?

[tomas1]

So much depends on having a competent surgeon.
I don't believe you need one who does 800 in a year; just someone who takes his craft seriously.

I have no surfboard at all and my girth is 5.1"
I think it's pretty round flaccid and pumped.

My hearing isn't good at high frequencies (thanks US Army), but I can't hear any pump sounds nor has my wife ever mentioned that.

If you have no pre-existing condition like Peyronies or fibrosis, a competent surgeon will not have you lose any length.

If you have a good result, you'll be a happy guy, and your wife will love the experience. I know mine does and she's 84. A young 84 though lol.

Good luck to you.

[Thisworld]

If you want to hear my opnion that i gathered in years frequenting this forum

Flat looks: already being said, it depends on how much residual engorment you have

Glans: the tips of the cylinders will go about 1/4 or 1/2 into the glans, this doesnt mean it will be looking like a good engorged glans, but surely it will not be small and shitty. Just look at pics of people implanted when they inflate without being aroused. It will be ok

Size loss: with clavell you will likely not loose any size (not sure if you meant "Clavell" with "Clavelle" or if you are referring to another Doc)

Pump sound: titan is loud, ams is silent

[Markc2008]

Thank you guys for the replies.
It sounds like maybe the shape and flat look varies person to person?
I get the fact that having something that just plain works is better regardless of shape. I guess my concern is with the surgery would I keep that shape since I rarely get aroused naturally?

It’s good to know I have the option if a quiet pump with the ams.
I do want my wife to have the perception that I have a normal penis, so shape and noise etc does matter. I know that is asking alot. But I feel like for the costs involved and it being 2025 it’s got to be an option right?

[ElbowRoom]

Remember also that oval doesn't mean unnatural looking. Many men have penises that are naturally oval-shaped, both aroused and flaccid. The important thing is that you have a working penis that is ready on demand. I think it's helpful to think in terms of "different" instead of "worse". For some women or in some positions, a less rounded penis could be an advantage for her.

Also, there are things you can do to help engorge the tissues that might round things out. Daily Cialis, PT-141, Trimix gel and others are all possible solutions. I'd definitely recommend taking the following supplements to boost nitric oxide, they helped me a lot with engorgement, and are safe and cheap to try:

L-Arginine 2000mg daily
Citrulline 2500mg daily
Beet Root Extract Powder 1/4 teaspoon daily

Good Luck!

[Markc2008]

That’s fair. But different still means not natural I would assume. I’m just confused because some complain about it and others do not. I’m fine with a little more oval but I hear some people reference a surf board.

[Tokyo_123]

Just a few points:

Hey guys! Hope everyone is doing well and as always I appreciate this group.

<snip>
Insurance will not cover it but I can pay out of pocket. I do have some concerns that I just cannot get out of my head and I wanted to hear how much of an issue and how common some of these are.

Ditto .... can anyone explain to me why when paying via insurance, that costs are three to five times plus the cost vs paying out of pocket ... other than pure corporate corruption and greed.

My largest concern is the look. I keep reading about more of a flat look especially when erect if you are not aroused. Keep in mind my largest issue is I have a hard time getting aroused or turned on. Would this mean I would never have a normal looking penis after surgery? Could I just take a daily pill and resolve this?

Mine looks normal.

I also have concern with the squeaky pump. I do not want to sound like an angry duck everytime I want to pump the thing up. How common is this?

The Titan OTR is silent. The Titan Genesis does squeak a bit.

Lastly I do worry about size. I’m very average on size and just do not want to lose an inch to an inch and a half permanently. It does sound like most gain it back with cycling which is reassuring.

Yes, I lost slight on length. Width is same or larger.

Glans not engorging— again since I have a hard time getting aroused will this be a problem after surgery??

Thanks guys for all the feedback!

No issues for me. As I understand it, if you have glan issues not engorging today, it will continue to remain an issue.

[Kodixx]

Markc2008, after I read your comment below I just continued reading the posts after that. Then I felt like I needed to come back and offer this under the heading of "For What It's Worth". I believe much of the success of transitioning to an implant in the context of a committed relationship is having appropriate expectations. And yes from outward appearances my implant looks like pretty normal stuff. I am more of a shower than I used to be (a good thing), and pretty normal. But my wife and I have had a lot of conversation about the differences in use between my implant and my OEM equipment. Pumping up is a different experience for both myself and my wife. I've learned that many women view the natural erection process as important validation that you're really into them -- it's an expected part of the experience. That changes with an implant, and probably doesn't qualify as a "normal penis". Instead my wife has learned to focus on other parts of our experience together in place of the natural erection. It's become just as good, but it is different. Also during post-surgery recovery, you may experience some pain that may limit the intensity of PIV sex, and/or positions that work well during that time. In addition, you may experience reduced sensitivity which delays or makes climax difficult. All that can last 6+ months.

All that said -- my wife has gained a real appreciation for an erection that is on-demand, reliable, is as stiff or flexible as she wants depending on position, and stays as hard as she wants for as long as she wants regardless of when I climax. As I've posted elsewhere, that is really "next level" capability compared to a normal penis. In total, my wife and I now consider the change in the erection process to be 'no big deal' compared to the huge advantage in capability. And we've figured out how to navigate the temporary issues during recovery. I think dealing with these issues is a function of realistic expectations and communication.

- Chuck

I do want my wife to have the perception that I have a normal penis, so shape and noise etc does matter. I know that is asking alot.