Implant Scheduled for Jan 24, 2023

The final frontier. Deciding when, if and how.
sswinsfba
Posts: 554
Joined: Sat Jan 07, 2023 3:08 pm

Implant Scheduled for Jan 24, 2023

Postby sswinsfba » Thu Jan 12, 2023 12:47 am

Note: I posted this introductory post in the "Introductions" section but I just realized that I should have posted it here instead. So, here it is. I'll treat this thread as my "journal" and will add relevant information as it arises.

------------------------------------------------

Hello: I've been lucking here for awhile, learning as much as I can from others here about penile implants.

I'm 72 and live in the SF Bay Area (SFBA). I've been sufferering from mild ED for several years but it only recently became more serious. I've taken daily 5mg Cialis for years but it recently has had no apparent effect.

I had no interest in injecting anything in my dick to induce an erection, given how painful and inconvenient that could be. That left a penile implant as the final option. I was pleased to learn that the procedure was covered by Medicare and that no proof of medical necessity was required for approval.

So, I did some research and intially found Dr. Perito's website and read/viewed everything I could find there. I contacted his office for a reference in the SFBA and he referred me to a Dr. Shu Pan in Walnut Creek, whose name I think they got from Boston Scientific's list of providers because I had previously seen his name there.

I met w/Dr. Pan several times and had a surgery scheduled with him for 01/19/2023 before I decided to go with someone else. My main reasons for choosing another surgeon were: 1) his limited experience, 2) his preference for the peno-scrotal approach , 3) poor office staff support and 4) the hospitals where he had surgical privileges which I did not like.

After looking around some more, I found Dr. Edward Karpman in Mt. View. Read & viewed everything on his website and met him in just before Xmas 2023.

I decided to go with him because of: 1) his knowledge/experience, 3) the quality of his answers to my questions, 3) his preference for the infra-public approach, 3) his statement that he tries to maximize length/girth when the size of the device falls "in between" sizes, 4) the quality of his support staff.

So, I'm scheduled for the surgery to be performed by Dr. Karpmen in just a couple of weeks early on Tue 01/24/2023. He'll be using the Coloplast Titan which was my preference. He said I could be released to drive my self home the following day but I am having someone pick me up anyway.

I've had a wide variety of surgeries and am not worried about the procedure but to say I am unconcerned would be untruthful. Of course, I'm anxious and hopeful that the surgery turns out well and that my recovery is quick and relatively painless but I am prepared for the worse if it happens.

I've read so much about the procedure that I really don't have any questions.

Just wanted to make my presence known but I plan to report on my progress after the surgery to address any concerns that may arise as well as to provide another data point for others out there, who have been lurking like me and who are still thinking about ungoing the surgery themselves.

Wish me luck! ;)
Last edited by sswinsfba on Thu Jan 12, 2023 2:25 pm, edited 2 times in total.
Age 72. On 5mg daily Cialis since ~2000. Minor ED started ~2 yrs ago. Major problem starting ~06/2022. Coloplast Titan Touch (20 cm w/1cm RTE) infrapublic implant done on 01/24/2023 by Dr. Edward Karpman (El Camino Urology Medical Group, Mt. View, CA).

crazyjoe
Posts: 553
Joined: Thu Feb 18, 2021 4:22 pm

Re: Implant Scheduled for Jan 24, 2023

Postby crazyjoe » Thu Jan 12, 2023 5:27 am

Sounds as though you’ve done some careful research and, based on opinions I’ve seen from the brothers, made an excellent choice among the high volume docs.
Glad you’re having someone pick you up the next day since it is unlikely you will want to be anything more than a passenger that soon.
All the best to you on the road to an exciting renewed sex life!
Last edited by crazyjoe on Thu Jan 12, 2023 10:14 am, edited 1 time in total.
75, used pills, injections -- all lost effectiveness. Titan implanted by Eid in Feb '22.

ThailandBound
Posts: 951
Joined: Fri Dec 16, 2022 5:32 pm

Re: Implant Scheduled for Jan 24, 2023

Postby ThailandBound » Thu Jan 12, 2023 7:45 am

Believe it or not, you’re probably going through the worst part of it all right now, the anticipation. All of us who undertake this journey have those days when the time is drawing nigh and the reality sinks in. I know this because i was implanted just 9 days ago. The longest day of my life, it seemed, was the day before the surgery. My mind filled with all the “what ifs”.

Well, since that day, i only have taken 1 pain pill and 3 Tylenol. That’s it. I have taken nothing in several days, am sleeping well, and am well enough to drive to the store and run simple errands. Because i iced heavily and laid flat the first 3 1/2 days as much as possible, i have experienced almost no bruising or swelling. And mine was penoscrotal. I expected so much worse.

My doctor keeps it inflated 60% for 6 weeks. Since i decided to do the surgery while i still had some ability to achieve erection prior (i took to heart what the doctor said about waiting too long), i guess i still had a pretty healthy penis, and i appears to me i will lose no length.

Just a little soreness, which i feel mostly when i sit. I bought a donut cushion to mitigate this and it helps a lot. I’m told it’s my scrotum getting used to its new neighbor and will go away, i trust that to be true. Now mostly i’m just patiently doing not much of anything physical at home, allowing mother nature to work her healing magic.

So i’m just one guy out here. You’ll read many stories here of course, but that’s mine so far. Best wishes to you.
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.

tomas1
Posts: 1946
Joined: Tue Jul 23, 2013 5:12 pm
Location: Tempe, AZ

Re: Implant Scheduled for Jan 24, 2023

Postby tomas1 » Thu Jan 12, 2023 10:49 am

To each his own, but I don't understand your bias to infra-pubic.
I like that all tubing is in my scrotum.
I think it may take a bit more talent to insert the reservoir from the scrotum.

Good luck with your surgery.
Just an aside, but injections aren't put into the glans.
85 years
Inject testosterone weekly.
Implant on 1/22/19 by Dr Avila.
Scrotal, hor. incision just over 1"
18cm AMS 700 CX, 3.5cm RTE 100cc res
Gleason 6 prostate cancer. Monitoring it for now.
Update: On my last biopsies the cancer wasn't found.

sswinsfba
Posts: 554
Joined: Sat Jan 07, 2023 3:08 pm

Re: Implant Scheduled for Jan 24, 2023

Postby sswinsfba » Thu Jan 12, 2023 12:56 pm

tomas1 wrote:To each his own, but I don't understand your bias to infra-pubic.
I like that all tubing is in my scrotum.
I think it may take a bit more talent to insert the reservoir from the scrotum.

Good luck with your surgery.
Just an aside, but injections aren't put into the glans.


Thanks to you and the others above for your "best wishes."

I studied the procedures and info available for both methods: "infra-pubic" (IP) and "peno-scrotal" (PS)

Apart for the comparative lack of experience of the PS surgeon, I felt IP would be "better" for me because the surgery takes much less time (30 mins for IP vs 2.5-3 hrs for PS which were the time estimates for the procedures stated by the surgeons involved themselves) and because the recovery time is reportedly shorter for IP as well.

While access to the corpora cavities is easier w/SP, placement of the reservior can be more difficult than w/IP, which is relevant for me because I've had double hernia surgery using mesh which I have been told can be more problematic with SP. In fact, the SP surgeon told me that he'd have to place the reservoir "blind;" the idea of which I did not find appealing.

The only thing I don't like about IP is the visible scar that will be left behind because (as a naturist) I'm totally hair free down there by choice but, if it's like my many other scars, the surgical scar left behind will fade w/time. I also tan a in summer and that'll also diminish it's visibility.

There is also a reportedly greater possibility of nerve damage w/IP as opposed to SP but that risk should be diminished significantly by the skill of the surgeon, who in my case reportedly does about 100 IP surgeries per month. In fact, he's got 6 IP surgeries scheduled for the same day as mine. So, I'm not worried about this.

As for the injection, I should have said "dick" instead of"glans" (and I've edited my initial post to reflect that) but that really wasn't the point of my comment.

I just didn't want to bother injecting Trimix in my dick, given the possible pain (which was been reported) and the inconvenience of that method of achieving an erection before attepting sex, which you never really know when sex is going to happen and the idea of planning to use an injection was even less desirable.

More later . . .
Last edited by sswinsfba on Thu Jan 12, 2023 2:28 pm, edited 2 times in total.
Age 72. On 5mg daily Cialis since ~2000. Minor ED started ~2 yrs ago. Major problem starting ~06/2022. Coloplast Titan Touch (20 cm w/1cm RTE) infrapublic implant done on 01/24/2023 by Dr. Edward Karpman (El Camino Urology Medical Group, Mt. View, CA).

frank66665
Posts: 1247
Joined: Wed Mar 25, 2020 11:18 am

Re: Implant Scheduled for Jan 24, 2023

Postby frank66665 » Thu Jan 12, 2023 1:07 pm

sswinsfba good luck to all of us, on the 23rd I will have mine too, it will also be my infrapubic, I will open my diary on the 21st when I leave by plane when I land in rome, yes the pre-implantation days kill you with the preparations for the exams of the blood/chest x-ray/cardiological visit and everything you need to bring, with the fear of forgetting something, I'll bring a lot of medicines with me, my implantologist wants me to stay in Rome for a week without leaving the hotel, I'll stay inflated to 70 % for 7 days, on Monday the 30th he will deflate me and send me home, the rule is 6 weeks to use it but he says that in 3 weeks I will start using it, I would sign it in 5 weeks
56, ED since 2010, pills work but not always and well, trt in progress improved but not so much, myocardial infarction january 2016, new stent september 2016, hypertension, venous on 1/23/23 titan one touch 22, no rte dottor Gabriele Antonini Italia

frank66665
Posts: 1247
Joined: Wed Mar 25, 2020 11:18 am

Re: Implant Scheduled for Jan 24, 2023

Postby frank66665 » Thu Jan 12, 2023 1:42 pm

ThailandBound wrote:Believe it or not, you’re probably going through the worst part of it all right now, the anticipation. All of us who undertake this journey have those days when the time is drawing nigh and the reality sinks in. I know this because i was implanted just 9 days ago. The longest day of my life, it seemed, was the day before the surgery. My mind filled with all the “what ifs”.

Well, since that day, i only have taken 1 pain pill and 3 Tylenol. That’s it. I have taken nothing in several days, am sleeping well, and am well enough to drive to the store and run simple errands. Because i iced heavily and laid flat the first 3 1/2 days as much as possible, i have experienced almost no bruising or swelling. And mine was penoscrotal. I expected so much worse.

My doctor keeps it inflated 60% for 6 weeks. Since i decided to do the surgery while i still had some ability to achieve erection prior (i took to heart what the doctor said about waiting too long), i guess i still had a pretty healthy penis, and i appears to me i will lose no length.

Just a little soreness, which i feel mostly when i sit. I bought a donut cushion to mitigate this and it helps a lot. I’m told it’s my scrotum getting used to its new neighbor and will go away, i trust that to be true. Now mostly i’m just patiently doing not much of anything physical at home, allowing mother nature to work her healing magic.

So i’m just one guy out here. You’ll read many stories here of course, but that’s mine so far. Best wishes to you.

hello ThailandBound, is the third ball in the car annoying? did it give you limitations if you wanted to drive 3/400km? to walk gave you limitations? Have you started cycling? what did he recommend you not to do and until when?
56, ED since 2010, pills work but not always and well, trt in progress improved but not so much, myocardial infarction january 2016, new stent september 2016, hypertension, venous on 1/23/23 titan one touch 22, no rte dottor Gabriele Antonini Italia

ThailandBound
Posts: 951
Joined: Fri Dec 16, 2022 5:32 pm

Re: Implant Scheduled for Jan 24, 2023

Postby ThailandBound » Thu Jan 12, 2023 3:01 pm

Well, I'm only 9 days post-op. I'm following the recommendations of my surgeon to the letter. As you've noticed here on the forum, different doctors take different approaches, so what I do, your doctor may not. Of course you will want to follow whatever directions your surgeon gives you.

My doctor left me 60% inflated. I will remain 60% inflated for 6 weeks. At that time, I will activate the pump and begin cycling. I think the logic here is that by healing in the partially inflated state there is less stretching (and discomfort) when the cycling to full-mast begins. As i mentioned, I iced heavily for the first 3 1/2 days and layed flat as much as possible. I've had almost no swelling and little bruising whatsoever.

Regarding driving, my longest drive to date has been about 80 km. That was from the airport to my house. After I arrived home, (3 days after surgery), i immediately laid down and began icing again. I started driving to the grocery store, about 8 km away on the 6th day. I have no intention of any drive more than 50 km for the foreseeable future. That is just my preference, not an order from the doctor.

The new neighbor is the scrotum accounts for the soreness when sitting. I cannot feel it at all when walking or lying down on my back. (I sleep on my side often, and so at night i've learned to put a fluffy pillow between my legs. If i accidentally roll over onto my stomach, i'm aware of it almost immediately and roll back onto my side. No big deal). When sitting, it's more sore on a hard surface chair, understandably. However, I put my donut pillow down on all surfaces when sitting. It creates space between the chair and the scrotum and is MUCH more comfortable. Yes, i use it when driving.

I am not in the least alarmed by this soreness. Many here have related similar and almost without exception this discomfort disappears in short order and the owner is not even aware of it.
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.

sswinsfba
Posts: 554
Joined: Sat Jan 07, 2023 3:08 pm

Re: Implant Scheduled for Jan 24, 2023

Postby sswinsfba » Thu Jan 12, 2023 3:11 pm

frank66665 wrote:sswinsfba good luck to all of us, on the 23rd I will have mine too, it will also be my infrapubic, I will open my diary on the 21st when I leave by plane when I land in rome, yes the pre-implantation days kill you with the preparations for the exams of the blood/chest x-ray/cardiological visit and everything you need to bring, with the fear of forgetting something, I'll bring a lot of medicines with me, my implantologist wants me to stay in Rome for a week without leaving the hotel, I'll stay inflated to 70 % for 7 days, on Monday the 30th he will deflate me and send me home, the rule is 6 weeks to use it but he says that in 3 weeks I will start using it, I would sign it in 5 weeks


My doc claims that the incision(s) should be be healed in 1 wk, that cycling can begin in wks 2-3, and that I can begin using it in wk 4 but I'm skeptical.

I'm in no rush and am willing to wait as long as need be to make sure everything is healed and working properly before I start actually trying to use it.

I have a new GF (a widow) who is hasn't had sex for a LONG time. She knows about the procedure (she's the one who's driving me to the hospital and picking me up) and is willing to wait as long as need be. So, there is no urgency to the matter for me.

My concern w/ED is relatively recent. I can still get nocturnal erections -- not to max stiffness but close -- but I cannot retain them. Sounds like a venous leak but I've never had an leak test or ultrasound. The reason just wasn't important to me nor to my docs who never ordered the tests. Just fixing the ED is important to me.

In the past few years, I was only having sex w/my long term GF at the time early the AM when I got a boner which lasted long enough to complete the job. Sex at other times then was hit and miss. However, now I can't keep an erection at all, nocturnal or not. Hence, my decision to go for the implant.

As I recall, the doc said that it will NOT be inflated during recovery but I'm not sure about that. I have a pre-op appt w/him on 1/19 and still have a lot of questions (including this one) to ask him then.

I'm not worried about losing length -- didn't have all that much to begin with at only 5 3/4" -- but I always had a sufficient girth at about the same 5 3/4" around. I'm actually hoping that the Titan will (as they say it will) will increase my girth even further which is what "they" say that women value more than length any way.

Length is great for show but no woman wants a man pounding on her cervix and IMO most men (not just me) would prefer to be able to insert his full length in and touch (& pound when the mood demands) pubes with his mate during sex.

My length has almost always been ideal to enable full entry and pounding just short of the cervix. So, I never had any complaints about this from my playmates. ;)

A potential problem that I'm worried about is that my new GF's vaginal cavity is REALLY tight. It grabs my finger like a Chinese Finger Trap and I was already concerned that I might hurt her w/my normal girth. We'll just have to see what if any problem this causes after I'm sufficiently healed to begin having sex again.

As for length, in order to maintain it prior to surgery, I am actually using a vaccum erection device (VED) for 10 mins 2s/day at 5 hg (which is a very low level of use) with a 1.75" ID tube (which is the smallest that I have) and plan to continue to do this until the day before surgery when I'll be checking into a motel nearby for the early morning surgery and when my dick should fully return to normal size.

I have always been a grower (nothing to show off). Using the VED makes it a show-er but does not significantly increase it's length or girth under pressure. I just wanted to keep it expanded prior to the surgery to faciliate the process but, in the back of my mind, I was also thinking that (if the length was between implant sizes) this would enable the doc to choose the larger rather than smaller size, as he said he would in that situation, but it's never going to be porno length whichever size he uses.

I'll just be happy if just remains the same size as it was before.

We'll see . . . LOL! 8-)
Age 72. On 5mg daily Cialis since ~2000. Minor ED started ~2 yrs ago. Major problem starting ~06/2022. Coloplast Titan Touch (20 cm w/1cm RTE) infrapublic implant done on 01/24/2023 by Dr. Edward Karpman (El Camino Urology Medical Group, Mt. View, CA).

sswinsfba
Posts: 554
Joined: Sat Jan 07, 2023 3:08 pm

Re: Implant Scheduled for Jan 24, 2023

Postby sswinsfba » Thu Jan 12, 2023 3:26 pm

ThailandBound wrote:The new neighbor is the scrotum accounts for the soreness when sitting. I cannot feel it at all when walking or lying down on my back. (I sleep on my side often, and so at night i've learned to put a fluffy pillow between my legs. If i accidentally roll over onto my stomach, i'm aware of it almost immediately and roll back onto my side. No big deal). When sitting, it's more sore on a hard surface chair, understandably. However, I put my donut pillow down on all surfaces when sitting. It creates space between the chair and the scrotum and is MUCH more comfortable. Yes, i use it when driving.

I am not in the least alarmed by this soreness. Many here have related similar and almost without exception this discomfort disappears in short order and the owner is not even aware of it.


My ball sack is always REALLY tight and I am worried about it being too tight to accomodate the pump bulb

I was thinking asking for an orchietomy to remove one of the "boys" to make more room for the pump bulb. Has anyone ever done that?

I've read of orchietomies performed at the same time as an implant here but a fake testicle was usually implanted as well which wouldn't solve the space problem. Testosterone production could also be an issue.

I guess if it's a problem down the road, I could ask for that to be done later but this is one of the pre-op questions that I have for my doc.
Age 72. On 5mg daily Cialis since ~2000. Minor ED started ~2 yrs ago. Major problem starting ~06/2022. Coloplast Titan Touch (20 cm w/1cm RTE) infrapublic implant done on 01/24/2023 by Dr. Edward Karpman (El Camino Urology Medical Group, Mt. View, CA).


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