My Journal

The final frontier. Deciding when, if and how.

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Waynetho
Posts: 782
Joined: Wed Nov 27, 2019 11:22 pm
Location: Addison, TX

Re: My Journal

Postby Waynetho » Sat Mar 07, 2020 1:07 pm

barrybj_98 wrote:Thanks Merckx and LS, just 1 follow up please. I guess I am confused on the RTE. my impression is that is the piece(s) that are inside your body? Why do some people have RTE’s and some don’t? Thanks again for all your help

Implants come in specific lengths that may not fit every patient exactly. The rear tip extenders are available in small increments to allow more sizing freedom for those patients who are either in between sizes or their anatomy requires the tubing to exit more distal than it would otherwise with the cylinder alone.
59 yo, married 38 yrs. Urolift (x4) 8/12/19. AMS 700CX 15cm (no RTE) penoscrotal 10/28/19 Dr. Mark Allen, Frisco, TX. PD 1995/ED 2011. Cialis helped but hinged. (1995)L:6/G:5.5+, (2019)Pre-op L:5/G:4.5, (2/2020)L:6.0/G:5.0

oldbeek
Posts: 1310
Joined: Sun Sep 10, 2017 1:46 pm
Location: Los Angeles area

Re: My Journal

Postby oldbeek » Sat Mar 07, 2020 2:00 pm

I have a deep cruse and it goes almost to my anus. I have an lgx700 15cm with 5 cm rte. The 5 cm rte ends right below my pubic bone. When completely deflated the 15 cm cylinders hang straight down off the rte, just like a natural dick. The pressurization tubes exit the implant right at the hing point on the upper portion of my penis. When erect the pressure tubes are right forward of my pubic bone. I have no fat pad at all.
78, good health, RP 7-2017, all nerves taken , PSA 0.05, 4-18,, .08 11/18,.07 1/19,.05 4/19, .06 2/20 Pain with trimix, implant 4-18, Infra-pubic, AMS lgx 15 cm with 5cm rte. Implant at USC Keck. Dr Boyd and Dr Loh Doyle 6 x 4.5

LookingUp
Posts: 121
Joined: Wed Aug 08, 2012 9:16 pm
Location: The Villages, FL

Re: My Journal

Postby LookingUp » Sat Mar 07, 2020 2:25 pm

Happy Toy wrote:I have a Coloplast with no RTI's, I'm 5.5" erect and 4" flaccid. When completely flaccid I hang at about 5 o'clock. and I'm very happy with that.
I think the point is this, I have also had both knees replaced, are they just like my original knee's? NO! But they work and no pain. So what makes everyone think that after they have an implant, their dick is going to be just like it was when they were 20? It works now, and sure, there are going to be some trade off's, just as there are with any other replacement surgery. If it tends to stick out a little and you don't want that (I'm kind of proud of it myself!), I'm sure there are ways to fix that. Just be thankful you have a working dick now.



Great analogy. Puts this in perspective.

Thanks,

LU
66, PCa 01/06 Proton Radiation Treatment, ED Pills 2005-2014, Urethroplasty 02/17, Tri-Mix 2014-2018 stopped due to indentation R side, VED until implant. 5.5Lx5G Planning June 2020 implant.

merrix
Posts: 951
Joined: Tue Oct 27, 2015 1:08 am

Re: My Journal

Postby merrix » Sat Mar 07, 2020 6:45 pm

Happy Toy wrote:I have a Coloplast with no RTI's, I'm 5.5" erect and 4" flaccid. When completely flaccid I hang at about 5 o'clock. and I'm very happy with that.
I think the point is this, I have also had both knees replaced, are they just like my original knee's? NO! But they work and no pain. So what makes everyone think that after they have an implant, their dick is going to be just like it was when they were 20? It works now, and sure, there are going to be some trade off's, just as there are with any other replacement surgery. If it tends to stick out a little and you don't want that (I'm kind of proud of it myself!), I'm sure there are ways to fix that. Just be thankful you have a working dick now.


OK, there it was. One guy saying he has a nice hanging flaccid with a Titan with a dick below 6 inches.
So then we can possibly scrap MK's theory.

Greg - interesting point. Probably a very good one.

More theories?
43 yo, ED forever from VL
Fit and active
Implanted 151215
Titan XL 24 cm, no RTEs
Dr. Eid
Activated day 13
Sex after 3 weeks
Gained length and girth
So far It works perfectly
Only one advice: Find a world class surgeon

merrix
Posts: 951
Joined: Tue Oct 27, 2015 1:08 am

Re: My Journal

Postby merrix » Sat Mar 07, 2020 7:20 pm

barrybj_98 wrote:Thanks Merckx and LS, just 1 follow up please. I guess I am confused on the RTE. my impression is that is the piece(s) that are inside your body? Why do some people have RTE’s and some don’t? Thanks again for all your help


If you have read theis journal, you will know my stance on RTEs, but here goes again, and I'll keep it as short as I can...

RTE means Rear Tip Extender. Name describes exactly what it is. Extenders stacked on the rear end of the implant to adjust length. RTEs are not inflatable, but rather just pieces of plastics stacked to the implant cylinders.
An implant has a part of it which is inflatable and a part which is non-inflatable.
For AMS, the non-inflatable part is 4.5 cm and for Titan it is 5 cm.
In theory, the more of your implant which is inflatable, the better. Has been shown in lab environment to give better rigidity.
So for example, an 18 cm AMS will have 13.5 cm inflatable silicon and 4.5 cm fixed plastics (at the rear end). An 18 cm Titan will have 13 cm inflatable Bioflex and 5 cm fixed plastics.
The fixed plastics is needed to allow the doc to place the rear end deep back in your crus. If it was 100% inflatable, this would be very difficult, if not impossible.

Most of the top docs, definitely Eid and Kramer, believe that the less RTEs the better for the outcome. Why? Because more RTEs give less rigidity, worse angle, and more "wobbly" erections.
This is partly because the RTEs have smaller diameter than the implant itself.
Titan RTEs are 13.5 mm and AMS only 9. Over time, this will, especially with the very thin AMS RTEs, create a less tight fit in the crus. Imagine you have cylinder at a 45 egree angle. Then you stick a long rod into that cylinder. If the diameter of the rod is same as the inner diameter of the cylinder, the rod will extend in the exact same angle as the cylinder. A tight, snug fit.
If the rod has a substantiall smaller diameter, it will hang on the lower edge of the cylinder and come out of the cylinder at a lower angle.
Also, the rod with the tight fit will be very stable, no room for wobbling. The thinner rod will be able to move around and wobble.
This effect will not be pronounced from the beginning, but will gradually present.
My doc told me he has done plenty of revisions of guys complaining that their angle and firmness of the implant has reduced over the years. The solution is to remove the implant and all the RTEs and insert an implant of the correct length with as short RTE length as possible.

Why are RTEs used then?
Main reason should be to adjust the implant length to your dick and crus. Titans come in 2 cm increments, AMS in 3 cm increments. So on average, a Titan dick should have 1 cm RTEs, with a range from 0.5 to 1.5. AMS dicks should have on average 1.5 cm RTEs, with a range from 0.5 to 2.5.
Any doc putting in 2 cm RTE or more with a Titan, and 3 cm or more with an AMS, should have a very good explanation why.
I have been told that in some cases doctors do use RTEs for other reasons than what is best for the patient. Such as:
Their job is easier with long stack of RTEs. Just easier to insert the implant in the crus with longer fixed part in the rear end.
They don't have the right size cylinder at hand.
They insert an implant and then after installation realizes that there was actually room for a larger implant. They just pull out the implant from the crus, add RTEs, and put it back in again. Instead of inserting another cylinder of the right length.
Finally, with AMS, many patients require more RTEs to get the adjust the tubing insertion point so that the pump can be placed at the right height. With Titan, this seems to be a non-existing problem.

The last issue with RTEs is mathematical logic. Nobody wants the joint between inflatable cylinder and fixed part to be in their dick. It would mean that they get a natural bending point in their dick. It would mean that when flaccid, the point where the implant (and the dick) bends will be somehwere along the shaft. Not good. You want the joint as deep inside you as possible.
Already an implant with no RTEs has this joint fairly close to shaft of the dick.
Let us take myself as an example.
My erect dick is about 17.5-18 cm long. Let us use 17.5 cm for this exercise. Cylinder tips reach till about 1 cm from my glans tip. So I have 16.5 cm implant in my dick. It means I have 24-16.5=7.5 cm inside me. Since my implant already without RTEs has 5 cm fixed non-inflatable length, I have 7.5-5 cm = 2.5 cm of inflatable length inside my body only.
If my doc would have given me a 22 cm implant with 2 cm RTE instead, I would have had 7 cm fixed part, and the joint would have been only 0.5 cm inside me.
If my doc would have given me a 20 cm implant with 4 cm RTE, I would have had 9 cm fixed part, and the joint would have been 1.5 cm into my dick! Which would have been crap.

Then of course, at this forum most people are biased towards what they have. Guys with half-foot long stacks of RTE will claim their doc is the champion of the world, that their inflated dicks point to their abs, has no wobble whatsoever and gives them fame, fortune, cures cancer, and make their wives boobs bigger. However, according to the top docs, more RTEs on average equals lower quality erections than with no RTEs.
We can all choose who we believe.

That's all on the RTE issue from me for today...
43 yo, ED forever from VL
Fit and active
Implanted 151215
Titan XL 24 cm, no RTEs
Dr. Eid
Activated day 13
Sex after 3 weeks
Gained length and girth
So far It works perfectly
Only one advice: Find a world class surgeon

MK1965
Posts: 286
Joined: Thu May 24, 2018 5:32 pm

Re: My Journal

Postby MK1965 » Sun Mar 08, 2020 9:48 am

Merix,
Once again, I saw Happy Toy’s flaccid angle which he mentioned its 5 o’clock and to me, that angle sticks out also, just a bit at lesser degree then mine.
Nothing less then 6 o’clock angle, can be nice normal flaccid hung.
Yours and Smetro’s have that 6 o’clock angle which is very normal.
We can argue on and on, but some guys here, myself included, have issues with our flaccid angle and flaccid look. All of us are with Titan 18 cm or less with up to one or two RTE except one AMS guy.
Go figure. It is not nice to discredit other people issues just because yours looks perfect.
MK
IPP 9/5/18; Coloplast TITAN OTR 18 cm 1cm RTE, Dr. Khera Baylor Houston,Prostate Ca at 51 y/o; RARP 11/2/16, ED Post RP, Cialis, Viagra, VED no usable erection, April 2017, TRIMIX painful, BIMIX tolerable but ineffective,lost 2+ inches of length after RP

Waynetho
Posts: 782
Joined: Wed Nov 27, 2019 11:22 pm
Location: Addison, TX

Re: My Journal

Postby Waynetho » Sun Mar 08, 2020 12:14 pm

MK1965, I've got what I believe is a 5:00-5:30 hang with my 15cm AMS and I'm more than happy to show it at nudity-optional events. Maybe that's just me but it seems quite natural in how it hangs, in my eyes. Pre-op I was a 1.0-1.5" grower so now with my 5'ish deflated length, I'm proud to show it whenever I can.
59 yo, married 38 yrs. Urolift (x4) 8/12/19. AMS 700CX 15cm (no RTE) penoscrotal 10/28/19 Dr. Mark Allen, Frisco, TX. PD 1995/ED 2011. Cialis helped but hinged. (1995)L:6/G:5.5+, (2019)Pre-op L:5/G:4.5, (2/2020)L:6.0/G:5.0

barrybj_98
Posts: 17
Joined: Fri Jan 31, 2020 2:58 pm

Re: My Journal

Postby barrybj_98 » Sun Mar 08, 2020 12:48 pm

Thanks merrix,
I guess I’ll just ask my doc what his experience has been with using RTE’s. I wonder do docs have standard that they use for the actual implant I.e., titan vs ams. Or do they look at each individual patient and make recommendations after evaluation? I was actually leaning toward tactra because of fewer moving parts but after researching on this board, I am leaning away from this due to erosion and constant hard on issues

Agfa13
Posts: 752
Joined: Thu Oct 31, 2019 6:03 pm
Location: Laurel, Maryland

Re: My Journal

Postby Agfa13 » Sun Mar 08, 2020 12:50 pm

I have no idea if I got any RTEs. All I got was a lousy T-shirt that says I got a Titan and a key chain!
I guess I have to get the notes from the clinic on the operation.

User avatar
Happy Toy
Posts: 713
Joined: Fri May 11, 2018 9:30 am

Re: My Journal

Postby Happy Toy » Sun Mar 08, 2020 2:17 pm

merrix wrote:
Happy Toy wrote:I have a Coloplast with no RTI's, I'm 5.5" erect and 4" flaccid. When completely flaccid I hang at about 5 o'clock. and I'm very happy with that.
I think the point is this, I have also had both knees replaced, are they just like my original knee's? NO! But they work and no pain. So what makes everyone think that after they have an implant, their dick is going to be just like it was when they were 20? It works now, and sure, there are going to be some trade off's, just as there are with any other replacement surgery. If it tends to stick out a little and you don't want that (I'm kind of proud of it myself!), I'm sure there are ways to fix that. Just be thankful you have a working dick now.


OK, there it was. One guy saying he has a nice hanging flaccid with a Titan with a dick below 6 inches.
So then we can possibly scrap MK's theory.

Greg - interesting point. Probably a very good one.

More theories?


I'm just saying, be happy that it works for what your dick it was intended. I know that some guys have had problems with their implants, I'm not talking about them. I talking about the ones where the surgery went well and it gets hard now but is just not the same as it was before they started having ED problems. It comes down to the old question, which is better a Chevy or a Ford? Colopast or AMS? Just my thoughts, take them or leave them.
Andy
Implanted 6/26/2018, Coloplast Titan 20cm, no RTE'S, infra pubic, Dr. Rhee, Kaiser :o 8-) 76yrs., married 53 yrs. ED for over 20 yrs.


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