Young Patient Journal - Titan Classic with Dr. Clavell

[returntocenter]

Hi guys,

I'm 27 and I have been dealing with ED for 11 years. I'm currently single, primarily due do this issue. This past Tuesday, after having tried every conceivable treatment under the sun, conventional and alternative, I received a Titan Classic (21 CM, no RTEs) penile implant by Dr. Clavell in Houston. I ended up choosing this implant model and doctor after a number of months spent analyzing my options. Special thanks to FT member sambalamba here, as my discussions with him were crucial to making a choice.

Other than Clavell, I had appointments with Dr. Eid and Dr. Hakky. They are both excellent doctors, and extremely personable. What turned me off from Hakky is that when he does penoscrotal incisions (which is the modality I wanted) he does them as horizontal incisions instead of vertical ones along the natural midline of the scrotum. This scar would obviously be more noticeable, and I don't want a noticeable scar on my scrotum when that can easily be avoided. Dr. Eid was my first choice since I formally got diagnosed by him in 2020, but I was unconvinced about the benefits of spinal anesthesia vs general, apprehensive about the trauma of a catheter, and very skeptical of the safety of getting into a tub of water on only the third day after surgery. He is also getting up there in age, and it would be nice to have a doctor I can go back to when I need a revision. For these and a few other reasons, I chose Clavell.

There's a lot of debate here around the pros and cons of choosing an implant model, so on that topic, I'll just say I went in with an open mind between the AMS CX and Titan Classic/OTR, learned everything I could about them, and decided that the Titan Classic was the best option.

Journal:

Day 0
Woke up from surgery with 5/10 pain. Had morphine and oxycontin administered and it came down to 2/10. I was rolled to recovery where I was encouraged to stand up and pee. Definitely get help to sit up. You don't want to strain your abdomen because you could migrate/herniate the reservoir. Have someone push on your back from behind. I stood up, dizzily walked around and thankfully managed to pee into a receptacle. That meant I would not need to get catheterized and I could go home.

Clavell's post-op instructions say he wants you moving around as much as possible. Got home and alternated between walking around a little bit and lying down. I had some pain in my abdomen and noticed a bump there, where the reservoir would be. I sent Clavell some pictures, worried that it might have herniated or migrated, and he was able to confirm that it hadn't and looked normal. That set my mind at ease, although along with the risk of infection, it has been a constant concern of mine for the past few days.

Note: the reservoir can be placed in the Retzius space (sort of behind your pelvic bone), or ectopically under your abdomen muscles. There are pros and cons to each which you can read about, but one of the cons of ectopic placement is that the reservoir is more palpable to touch. Dr. Clavell does ectopic placement and I can definitely feel mine by pressing my stomach. I'm not sure how much of an issue this will be in terms of keeping the whole thing concealed through hook ups and so on, but I'm not worrying about it too much right now. Just something to consider. Dr. Hakky, on the other hand, does placement in the Retzius space, but then again he'll leave you with a sideways scar on your scrotum. I'm not sure what Dr. Eid does. I'm not sure if any of them are flexible in doing alternate placements - you'd have to ask them.

Day 1

Didn't get much sleep. Taking antibiotics like clockwork and pain meds (tylenol and ketorolac) as needed. Rolling out of bed is the hardest thing for me right now. Using my abdomen hurts, and I try to avoid it as much as possible. I felt frustrated because I needed to have a bowel movement but couldn't strain. I took some stool softeners. Was finally able to go. I recommend taking them starting on the night of day 0, or on day 1. Dr. Clavell said it was ok to take them.

Throughout the day, I'm icing the area. It's not really feasible to ice the scrotum and penis because of the bandages, so I'm mostly icing the lower abdomen which has a lot of swelling due to the reservoir placement.

Note: having one of those receptacles to pee in is key in the early days.

Day 2
Pain comes and goes, nothing over a 5/10 before I take pain meds though. Overall the recovery isn't too bad. Finally I'm able to take a shower. I take the bandages off and my dick looks like it stepped on a landmine. Penis has edema, is curved downward, snake eyes on the head, also bruised along the shaft. The hunchback of notre dick. My balls are very swollen, sporting a gnarly sunken incision down the middle of it. Incision looks clean though.

In the shower, I rinse the incision area and gently move my soap-lathered fingers over the incision, then rinse again. In retrospect, don't directly wet the area, but rather let water trickle over it indirectly instead. The incision is spotting blood a little bit. I let Dr. Clavell know and he says this is normal.

Day 3
Uneventful. Another shower (incision is still spotting blood on the towel). More pain management, icing, etc. It's getting easier/hurts less in the abdomen to get out of bed.

Day 4
The day I'm writing this. Today, for the first time, I haven't felt like I need to take pills to manage the pain. Discomfort in abdomen from getting out of bed is down. For the past few days, I have been walking with the swinging gait of an orangutan to avoid squishing my balls between my legs. As the pain subsides, I'm slowly evolving back into homo sapiens.

Mentally, this has been easier to deal with so far than I expected. I haven't had any of the "what have I done" thoughts that you sometimes read about on FT, and I'm trying to understand all the pains and bumps as temporary parts of the healing process. I am inflated to 60% and I can visually tell I have lost some size, but I trust I can get all or most of it back in time.

I will continue to provide updates as time goes on.

[Implant2025]

Greetings, Brother!

I had my surgery by Dr Clavell on 1/29/25, so I'm now 10 days post op. At this point my scrotal edema is gone, and the penile swelling is resolving. At this point the head of my penis has become super sensitive - even the slightest rubbing hurts. Weird. The rest of my pain comes just from healing stitches.

I discussed implants with him, and though I originally wanted an LGX I agreed to go with an AMS CX instead. One of the reasons why I picked Clavell was his willingness to go along with either AMS or Coloplast - no prejudice. I also like that he sends you home without a catheter or drain requiring another visit to get it removed. Turns out I would have had to have a CX anyway because during surgery he discovered I also had Peyronie's disease - so to fix that I also have stitches all the way from my scrotum to my glans.

Let us all know how you're recovering going forward, and post some before and after pics if you're comfortable with doing that.

[returntocenter]

Greetings, Brother!

I had my surgery by Dr Clavell on 1/29/25, so I'm now 10 days post op. At this point my scrotal edema is gone, and the penile swelling is resolving. At this point the head of my penis has become super sensitive - even the slightest rubbing hurts. Weird. The rest of my pain comes just from healing stitches.

I discussed implants with him, and though I originally wanted an LGX I agreed to go with an AMS CX instead. One of the reasons why I picked Clavell was his willingness to go along with either AMS or Coloplast - no prejudice. I also like that he sends you home without a catheter or drain requiring another visit to get it removed. Turns out I would have had to have a CX anyway because during surgery he discovered I also had Peyronie's disease - so to fix that I also have stitches all the way from my scrotum to my glans.

Let us all know how you're recovering going forward, and post some before and after pics if you're comfortable with doing that.

Hi there! Good to hear you’re recovering well. I read your journal shortly before going to surgery myself and it helped me understand what to expect - thanks for sharing it.

I think it’s a good thing you got a CX, independently of your Peyronie’s disease. It is considered to be a better implant model than the LGX, and Hakky, Eid and Clavell seem to agree on that.

I will keep you guys posted on my progress! Not sure about posting pictures yet lol, I’ll think about it.

[Implant2025]

Can't speak for Hakky or Eid, but Clavel is no fan of the LGX unless your penis is short and narrow. The whole marketing hype about growing length "up to 25%" with an LGX is total BS. And the LGX cylinders are narrower than both the CX and Titan.

[Thisworld]

So wouldn't Clavell place the reservoir in the Retzius space not even if specifically asked by the patient? Did the alternative placement require an additional incision in the abdomen area ?

[Implant2025]

So wouldn't Clavell place the reservoir in the Retzius space not even if specifically asked by the patient? Did the alternative placement require an additional incision in the abdomen area ?

My 100 cc reservoir was placed in the R sub muscular space. No additional abdominal incision was required. I don't feel it at the moment since I'm 60% inflated. That might change in the future when I'm fully deflated... then the reservoir is fully inflated.

[returntocenter]

Day 8

The swelling has come down a lot, but I'm still pretty sore. My penis gets occasional pins and needles, but it's not a huge issue. The really pain comes from the balls right now, specifically the sides. If I stand up, I get this 3/10 ache that over time becomes really uncomfortable. As soon as I sit or lie down, the pain goes down to zero. This has led me to spend most of the day in bed.

I can feel the outer surface of the pump now. The part that is against my scrotum. I would not be able to pump it because of the pain though.

[IndianRasputin]

Day 8

The swelling has come down a lot, but I'm still pretty sore. My penis gets occasional pins and needles, but it's not a huge issue. The really pain comes from the balls right now, specifically the sides. If I stand up, I get this 3/10 ache that over time becomes really uncomfortable. As soon as I sit or lie down, the pain goes down to zero. This has led me to spend most of the day in bed.

I can feel the outer surface of the pump now. The part that is against my scrotum. I would not be able to pump it because of the pain though.

Length pre implant?

[returntocenter]

Day 8

The swelling has come down a lot, but I'm still pretty sore. My penis gets occasional pins and needles, but it's not a huge issue. The really pain comes from the balls right now, specifically the sides. If I stand up, I get this 3/10 ache that over time becomes really uncomfortable. As soon as I sit or lie down, the pain goes down to zero. This has led me to spend most of the day in bed.

I can feel the outer surface of the pump now. The part that is against my scrotum. I would not be able to pump it because of the pain though.

Length pre implant?

17 cm erect and bone pressed. Eid's and Clavell's stretch test showed 16 cm though.

[IndianRasputin]

Day 8

The swelling has come down a lot, but I'm still pretty sore. My penis gets occasional pins and needles, but it's not a huge issue. The really pain comes from the balls right now, specifically the sides. If I stand up, I get this 3/10 ache that over time becomes really uncomfortable. As soon as I sit or lie down, the pain goes down to zero. This has led me to spend most of the day in bed.

I can feel the outer surface of the pump now. The part that is against my scrotum. I would not be able to pump it because of the pain though.

Length pre implant?

17 cm erect and bone pressed. Eid's and Clavell's stretch test showed 16 cm though.

Nice man. So you got it all back and more !