Comprehensive List of Questions for your Surgeon

The final frontier. Deciding when, if and how.



Headair123
Posts: 10
Joined: Mon Apr 07, 2025 11:22 am

Comprehensive List of Questions for your Surgeon

Postby Headair123 » Thu Apr 17, 2025 11:22 am

Dear all,

I am still in the R&D and surgeon evaluation phase of journey.

I am likely three months away from my "conversion".

I have done a lot of research. A lot of it reflected circumstances that are specific to me and my desired outcomes.

Nonetheless, I have been able to create an extensive list of items to be discussed with the surgeon before making any decisions. If any of you feel that I missed anything, please add your recommendations.

The list:

Here’s a focused, surgeon‑friendly checklist you can take to your pre‑op visit. I’ve grouped the questions so you can tick them off quickly while you’re in the exam room.



A. Intra‑operative measurements & device choice
1. What was (or what do you expect) my measured corporal length—from pubic bone to distal tip—in centimetres?
2. Which AMS 700 LGX cylinder length would that translate to?
3. Can you implant the longest cylinder that fits (≤ my corporal length) and keep rear‑tip extenders (RTEs) to 0–1 cm per side?
4. If more than 1 cm RTE is needed, what factors would make that unavoidable, and how much will it drop the erection angle?
5. Do you ever perform “no‑RTE” builds, and are they realistic for my anatomy?



B. Expected erect length—day 1 and long‑term
6. Immediately post‑op, what loss (if any) in visible length should I expect compared with my natural 6.75 in (17.1 cm) erection?
7. With disciplined cycling, what length range do your patients typically reach at 6 months and 12 months?
8. Have you documented gains of 1 cm or more with the LGX in your own series, and what cycling protocol do you prescribe?



C. Cycling protocol & follow‑up
9. When will you clear me to begin cycling, and how many minutes/sets per day do you recommend?
10. Do you provide a written schedule or smartphone reminders to help patients stay consistent?
11. At what post‑op visits will you re‑measure erect length to verify progress?



D. Erection angle & rigidity
12. Given my anatomy, what erection angle (degrees from horizontal) do you expect once the implant is fully inflated?
13. If angle is sub‑optimal, what surgical or post‑op strategies do you use to improve it (e.g., ventral phalloplasty, RTE reduction in revision)?



E. Contingencies & revision planning
14. If I do not regain my pre‑op length after 12 months, what options exist (e.g., cylinder upsizing, sliding technique)?
15. What is your revision rate for malposition, angle issues, or patient dissatisfaction, and how soon can revisions safely be done?



F. Adjuncts & preparation
16. Would a pre‑op vacuum‑therapy or traction regimen improve intra‑op length or ease dilation?
17. Should I continue VED use right up to the night before surgery, or stop earlier?



G. Device specifics & documentation
18. Will you give me a printed operative report listing cylinder length, RTE length, and reservoir/ pump details?
19. Which model and lot number of the AMS 700 LGX will you implant, and are there any recent updates or recalls I should know about?



H. Lifestyle & long‑term care
20. How soon after surgery may I resume intercourse, sports, and cycling exercises?
21. What precautions (e.g., antibiotic prophylaxis before dental work) will I need for the life of the implant?

58 year-old male. Married. on TRT since 2013.
Length = 6.75". 8.25" in a vacuum tube. girth (with silicone filler) is 6.5".
Pills , Trimix in high concentrations, PRP and Gainswave therapy stopped working.

pjt1958
Posts: 47
Joined: Tue Apr 16, 2024 2:28 pm

Re: Comprehensive List of Questions for your Surgeon

Postby pjt1958 » Thu Apr 17, 2025 11:35 am

excellent! thanks for compiling for others
65 with ED for >10 years. Failed pills, not happy with injections. Implanted 6/24/24 (AMS CX 21 cm) with Dr Darshan Patel at UCSD.

Thisworld
Posts: 209
Joined: Sun Sep 06, 2020 3:01 pm

Re: Comprehensive List of Questions for your Surgeon

Postby Thisworld » Thu Apr 17, 2025 11:36 am

The dental work thing is for life or just after the few months after surgery?
Hard flaccid syndrome since 2019. Trying to get better with conservative treatments but an implant is on my radar

irishguy
Posts: 261
Joined: Sun Oct 28, 2012 12:04 pm

Re: Comprehensive List of Questions for your Surgeon

Postby irishguy » Thu Apr 17, 2025 1:58 pm

How many implants do you do per year??
This is important as many studies have found far more problems with low volume implanters compared to high!!!

What surgical technique do you do?
I would only go penoscrotal, Ralph who is the best in Europe and Eid who seems to be the best in America go penoscrotal


These 2 are very important questions to ask
Age 39
Original implant: 18cm Titan with 2cm rte on right 1.5cm rte on left
Mar 19 2013, Professor Ralph
12 years with implant
Feb 2025 implant leak from the resevoir
Implanter: Professor Ralph
11-Apr-2025 titan otr 22cm revision implant

Headair123
Posts: 10
Joined: Mon Apr 07, 2025 11:22 am

Re: Comprehensive List of Questions for your Surgeon

Postby Headair123 » Thu Apr 17, 2025 2:48 pm

Thisworld wrote:The dental work thing is for life or just after the few months after surgery?


That is a good question. I think I will ask it of the surgeon as you have suggested it.
58 year-old male. Married. on TRT since 2013.
Length = 6.75". 8.25" in a vacuum tube. girth (with silicone filler) is 6.5".
Pills , Trimix in high concentrations, PRP and Gainswave therapy stopped working.

Headair123
Posts: 10
Joined: Mon Apr 07, 2025 11:22 am

Re: Comprehensive List of Questions for your Surgeon

Postby Headair123 » Thu Apr 17, 2025 2:55 pm

irishguy wrote:How many implants do you do per year??
This is important as many studies have found far more problems with low volume implanters compared to high!!!

What surgical technique do you do?
I would only go penoscrotal, Ralph who is the best in Europe and Eid who seems to be the best in America go penoscrotal


These 2 are very important questions to ask


My doctor is supposed to do perform between 150 and 200 surgeries a year. Not sure how many of these are implants.

A quick search on him gave me the following summary:

Dr. Alex Shteynshlyuger
• Practice: Founder of New York Urology Specialists.
• Experience: Over 20 years in urology. 
• Surgical Volume: Performs approximately 150 to 200 penile surgeries annually, including penile implants, Peyronie’s disease corrections, and related procedures.
• Expertise: Specializes in complex cases, including patients with severe Peyronie’s disease or a history of priapism.
• Patient Feedback: Generally positive reviews, with patients highlighting his thoroughness and professionalism.
58 year-old male. Married. on TRT since 2013.
Length = 6.75". 8.25" in a vacuum tube. girth (with silicone filler) is 6.5".
Pills , Trimix in high concentrations, PRP and Gainswave therapy stopped working.

User avatar
SWorks17
Posts: 784
Joined: Sat Jan 15, 2022 4:33 pm
Location: Garden Ridge, Texas

Re: Comprehensive List of Questions for your Surgeon

Postby SWorks17 » Thu Apr 17, 2025 8:49 pm

Headair123 wrote:
Thisworld wrote:The dental work thing is for life or just after the few months after surgery?


That is a good question. I think I will ask it of the surgeon as you have suggested it.


I only had to take antibiotics when I had dental work for my knee replacements, my urologist didn't say anything about taking antibiotics to prevent infection for my Bionic Dick, but it wouldn't hurt to ask.

SWorks
Age 67, Garden Ridge Texas, Boston Scientific Rezum procedure for benign enlarged prostate 19 May 21, AMS LGX 18cm with 3cm RT's installed 5 Nov 2021 by Major Dr Shane Barney, BAMC, San Antonio, Texas, Married 36 years.
DOD Pg 131, Faces Pg 27

User avatar
SWorks17
Posts: 784
Joined: Sat Jan 15, 2022 4:33 pm
Location: Garden Ridge, Texas

Re: Comprehensive List of Questions for your Surgeon

Postby SWorks17 » Thu Apr 17, 2025 8:58 pm

Headair123 wrote:Dear all,

I am still in the R&D and surgeon evaluation phase of journey.

I am likely three months away from my "conversion".

I have done a lot of research. A lot of it reflected circumstances that are specific to me and my desired outcomes.

Nonetheless, I have been able to create an extensive list of items to be discussed with the surgeon before making any decisions. If any of you feel that I missed anything, please add your recommendations.

The list:

Here’s a focused, surgeon‑friendly checklist you can take to your pre‑op visit. I’ve grouped the questions so you can tick them off quickly while you’re in the exam room.



A. Intra‑operative measurements & device choice
1. What was (or what do you expect) my measured corporal length—from pubic bone to distal tip—in centimetres?
2. Which AMS 700 LGX cylinder length would that translate to?
3. Can you implant the longest cylinder that fits (≤ my corporal length) and keep rear‑tip extenders (RTEs) to 0–1 cm per side?
4. If more than 1 cm RTE is needed, what factors would make that unavoidable, and how much will it drop the erection angle?
5. Do you ever perform “no‑RTE” builds, and are they realistic for my anatomy?



B. Expected erect length—day 1 and long‑term
6. Immediately post‑op, what loss (if any) in visible length should I expect compared with my natural 6.75 in (17.1 cm) erection?
7. With disciplined cycling, what length range do your patients typically reach at 6 months and 12 months?
8. Have you documented gains of 1 cm or more with the LGX in your own series, and what cycling protocol do you prescribe?



C. Cycling protocol & follow‑up
9. When will you clear me to begin cycling, and how many minutes/sets per day do you recommend?
10. Do you provide a written schedule or smartphone reminders to help patients stay consistent?
11. At what post‑op visits will you re‑measure erect length to verify progress?



D. Erection angle & rigidity
12. Given my anatomy, what erection angle (degrees from horizontal) do you expect once the implant is fully inflated?
13. If angle is sub‑optimal, what surgical or post‑op strategies do you use to improve it (e.g., ventral phalloplasty, RTE reduction in revision)?



E. Contingencies & revision planning
14. If I do not regain my pre‑op length after 12 months, what options exist (e.g., cylinder upsizing, sliding technique)?
15. What is your revision rate for malposition, angle issues, or patient dissatisfaction, and how soon can revisions safely be done?



F. Adjuncts & preparation
16. Would a pre‑op vacuum‑therapy or traction regimen improve intra‑op length or ease dilation?
17. Should I continue VED use right up to the night before surgery, or stop earlier?



G. Device specifics & documentation
18. Will you give me a printed operative report listing cylinder length, RTE length, and reservoir/ pump details?
19. Which model and lot number of the AMS 700 LGX will you implant, and are there any recent updates or recalls I should know about?



H. Lifestyle & long‑term care
20. How soon after surgery may I resume intercourse, sports, and cycling exercises?
21. What precautions (e.g., antibiotic prophylaxis before dental work) will I need for the life of the implant?



Headair, do you want some answers to some of these questions, that we can answer?

SWorks
Age 67, Garden Ridge Texas, Boston Scientific Rezum procedure for benign enlarged prostate 19 May 21, AMS LGX 18cm with 3cm RT's installed 5 Nov 2021 by Major Dr Shane Barney, BAMC, San Antonio, Texas, Married 36 years.
DOD Pg 131, Faces Pg 27

Headair123
Posts: 10
Joined: Mon Apr 07, 2025 11:22 am

Re: Comprehensive List of Questions for your Surgeon

Postby Headair123 » Thu Apr 17, 2025 9:27 pm

Hello Sworks,
Yes, any sharing of knowledge would be extremely appreciated.

Thank you,
58 year-old male. Married. on TRT since 2013.
Length = 6.75". 8.25" in a vacuum tube. girth (with silicone filler) is 6.5".
Pills , Trimix in high concentrations, PRP and Gainswave therapy stopped working.

ElbowRoom
Posts: 109
Joined: Mon Mar 17, 2025 1:58 pm

Re: Comprehensive List of Questions for your Surgeon

Postby ElbowRoom » Thu Apr 17, 2025 9:37 pm

One question I asked both surgeons I evaluated: what is your personal infection rate? He will know and if it’s low he’ll tell you instantly.
58yo in good shape looking at Coloplast Titan. Tri-Mix still works but is a drag.


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