FrankTalk.org

Hello all, I had a radical prostatectomy almost 2 years ago which left me with ED. Ive tried pills, VED, Injections, vibrators, etc., some work some don't. Most don't. The injections are cumbersome and not as effective now as they were. I'm considering an Implant, and I've been reading good and bad stories here on FT. How does one really know who's good and who's not? Is there a way to find out the truth about infection rates, failures, etc., of the good and not so good surgeons? I know that everyone is different, and so may be your outcome, but where can I go to find out the real truth about the doctors? Is there a website that will tell you about malpractice suites pending, true infection rates and truly happy patients? Do you go with the "high volume" for profit surgeons, or a surgeon who works as a teaching professor at a major university with no financial incentives? I've heard some of the for profit, high volume surgeons are similar to assembly line factories and some of their results are far less then desirable. I've also heard the opposite, that they do so many they can foresee any problems as the may arise. This surgery is frightening to say the least, but its appears to be the only alternative as I do not want to live with ED the rest of my life. I'm only 50. Any advise would be helpful from those of you that have been through the procedure. I would like to hear the pros and the cons. In other words the guys here that have had great results and the guys that haven't, and why they think the outcome was great or not so great.
I thank you all in advance, this journey is one I never ever expected and I have the utmost respect for all the brothers on here who had the guts to proceed.

Top volume doctor.... I was 2.5 years post-RP when I decided on an implant. My wife had been very happy with her urologist. He told her 'I do them all the time. I did three last week.' I think he lied. He sure botched mine.

I consulted another doctor (in Nashville) who said 'I can fix this but, as you live in South Florida, I'd recommend you see Dr Paul Perito in Miami' . While you may see some comments about Dr Perito's "other interests", he is definitely the "Top Dog" in my area. He identified and ultimately fixed all my problems. Among other problems, I has a "cross", where both "balloons" ended up in one "cavern". Dr Perito surgically reopened the "healed shut" cavern. He said 'I'd never done that before'. But he knew what to do and had the confidence and skill to do it.

After my first implant, I did two scripts of Oxy and months of Tramadol. Upon release from the hospital, Dr Perito prescribed NO pain medication. As I started to panic, I realize he was telling me 'I really am that good'. He really Is!!!!

During one of my followup appointments, I asked if he thought I had a legal case against the doctor who "fucked me up". He smiled and said 'no... because I fixed you'.

Profit motive or not, a "top guy" is up to unexpected challenges during your surgery.

Perito, Eid, whoever..... go with a "top guy"!

And Dr Perito is " My Hero".... Thank you again Dr Perito!!!!!

Karpman, Kramer, Garber, Eid, Perito. These are probably the only surgeons I would ever consider for implant surgery.

Watch Dr. Kramer videos on YouTube and learn all you can. Read write up about doctors and read stories here from people who used other doctors. My trip through the implant (March 2nd) is under implants and called "My Journey" which goes into detail with photos after surgery. It took me over a year to select Dr. Kramer and glad I did. Great beside, answers ALL my emails and have his cell if needed.

I liked the fact no drain, didn't have to have penis upright and all the unusual things other doctors have their patients do. Catheter came out first day after at the hotel I went to the day of surgery when I was released. Minor pain and good recovery. Blood flow to the head and morning minor erections. Everything I wanted from the implant is working and very pleased. Intercourse is good and very very firm when inflated.

Good luck and if you have questions, will try to answer.

What questions should I ask the doctor? Again, I'm new here so please be patient with me. I thought I saw a good list of questions on one of these threads, but now I can't find them??? Can anyone direct me to them or make any suggestions?

I'm sure that it is always good to go with the top guys, but I went with Dr. Robert Kaplinsky of Uropartners, who was also the surgeon who did my Radical Robotic Prostatectomy, and he did a fantastic job. He is at various locations in the Chicagoland (North) area.

Boulder wrote:What questions should I ask the doctor? Again, I'm new here so please be patient with me. I thought I saw a good list of questions on one of these threads, but now I can't find them??? Can anyone direct me to them or make any suggestions?

Some good questions are what method they use for the procedure. There are 2 different methods. Also pre op and post op protocol. Ask what device they prefer as there are 2 different brands. They should do a stretch test and measure your flaccid stretched penis. Ask if you will lose any size from this length. Barring any scarring and or peyronies, you should lose nothing from this length. If you are told you will lose size, I would recommend a second and or even a third opinion.

Boulder wrote:What questions should I ask the doctor? Again, I'm new here so please be patient with me. I thought I saw a good list of questions on one of these threads, but now I can't find them??? Can anyone direct me to them or make any suggestions?

You can find the answers to all you questions on FT. Do a search. There is a link to 90 questions to ask your URO on FT. I modified them and asked FT for answers. Asked Dr. Cornell the questions and received answers. After my IPP op I answered all the questions and posted them on FT. Do an Advanced Search for "roninhouston". Good luck!

As for as a doctor I would select a good one in your part of the country, i.e., east coast, middle US, west coast. Of course for obvious reasons I suggest Robert Cornell.
- he studied at the Scott Urology school where the IPP was developed by Dr. Scott in the Houston Medical Center. That patent is now held by AMS.
- he studied surgery at the DeBakey School, the famous heart surgeon.
- if you need to have a artifical urinary sphincter (AUS) to control bladder leakage he can put in both with one incision, one OP. BTW it was developed by Dr. Scott.
- he does enough IPP ops to be high volume but it does not seems to be like an assembly line, has excellent staff
- with a search on FT your will find cases of botched by some of the above mention URO that he came in behind them to fix their mistakes
- after your IPP op you spend the night in a hospital, not a hotel room.
- IMHO You do not want to be in a hotel room after your IPP op. If you need to have your meds changed because you are in pain. Easy to push the button and nurses get your meds rather than you trying to get a prescript and get it filled walking around just hours out of surgery. My meds were change twice before I was comfortable.
- Dr. Cornell removed my catheter the morning after the surgery and verified everything looked normal.
- offers concierge services for out of town patients

I would avoid any doc who does infrapubic. As a couple of the top docs I've consulted since my implant have stated, Infrapubic should only be used by doctors who have little experience putting in reservoirs, in people that have plenty of fat above the penis, and in average to small size dicks. The issues become more pronounced the thinner you are, more active you are, the younger you are and the larger your penis.
Perito would be tossed off the list immediately for doing infrapubic.
I was told the tubing would be buried deep so you could not find it. I can see it in the mirror across the room if pumped up. Wife can see it. You can feel it any time. The pump rides high. Sticks up enough to hold the skin up. Makes your dick shorter too. Easy to prove regardless of the the people who say it is the greatest thing since god created them.
Find out if your doc returns calls and emails. If he does not find another doctor. I mean multiple people tell you he returns calls or by your own experience. A doctor that tells you that you need an appointment and have to drive 6 hours each way to answer a question does not give a damn about you as a patient, only generating revenue. Some things they do have to look at, but they should still respond so that can be determined.

Boulder wrote:...I thank you all in advance, this journey is one I never ever expected and I have the utmost respect for all the brothers on here who had the guts to proceed.

There are numerous top notch high volume doctors who do this surgery. The trick is to make sure you get one. However, there are issues associated with doing just that. For example, do you have health insurance? If the answer is yes, does your insurance cover the procedure? If your insurance covers the procedure, are you required to stay "in network," that is, you can only be treated by doctors on the insurance company's list of preferred physicians?

If you're paying out of pocket the cost is generally $18,000 to $20,000 among the low end, high volume docs. Others charge a few thousand more.

If money is no object then do you want to travel or stay close to home? There are two companies that manufacturer the implant: Coloplast and Boston Scientific (formerly American Medical Systems or AMS). You can check out each's website to find out which doctors are in your area.

http://www.coloplastmenshealth.com/find-a-physician/

http://www.amsmenshealth.com/en-US/pati ... ician.html

Be sure to check the box for "Erectile dysfunction."

Now click "Find a Physician," type in your city and state and you should get a list of physicians near your area. (Typing in a zip code did not work as well.) Of course, from there please proceed with extreme caution. Some may or may not take your insurance, some may or may not have a great deal of experience in performing the surgery, etc.

You can find out if a doctor has been disciplined by a state's licensing agency by checking out that particular state's medical board website.

I disagree with one of our member's blanket condemnation of the infrapublc approach because several doctors successfully use it including Dr. Karpman in California, who is very highly respected.

Best wishes,

KMeister