To-Do List Pre-Op & Post-Op

[LP31_Europe]

Hello together,

I am 31 years old and I've been struggling with ED for a very long time. Recent examinations revealed that I have a veno-occlusive dysfunction. Therefore there will be a time to make the decission when to get the implant (unfortunately).

I am very happy that there are so many people here trying to help each other. However, I have not found overall articel what to consider before and after the implant surgery. So I will start to summerize the different knowledge from various posts. I would be very glad, if you could give me further advice or when im wrong, please correct me.

Here are my main concerns:
- Loss of length
- Loss of girth
- Loss of sensation
- Glans does not engorge

If you have any advice how to prefent those outcomes, I am very thankfull.


a) Pre-Op Implant
1. Using a VED for three weeks before surgery: I have read in an article that the usage of a VED would help to make the tissue flexible and would increase the size of the cylinders to be placed in (https://file.scirp.org/Html/3-1990021_27133.htm)
-> For me this means 2 months before surgery a daily usage of VED for 10 minutes a day.

2. Asking the right questions before implant
I have read many threads on what to consider before getting an implant:
- What approach is used (infrapubic vs. penoscrotal). I personally favour the penoscrotal approach, as I heard the nerves go on the top of the penis. However, I also heard that the healing takes longer. As earyl cycling is important with regard to reduction of the loss of lengt, I would be happy to hear some ideas.
- Are there any other questions I have to consider before the implant?
- Are there any other considerations to take into accout to keep the penis at length and girth?


b) OP Implant
1. I am not sure about the measurement of the penis. I have heard it is best, when the penis is erected when measuring the length. How can this be conducted or how is this apporach called?

c) Post-OP Implant
1. Early Cycling prevents the penis from shortening: When is the earliest possible time to cycle after surgery? Is it a problem to cycle when the scrotum is still sore and swollen for example or can I cause damage by cycling?
2. Using a special underware (I dont know the name) to keep the penis pointing up right. This helps the healing to keep the direction.
3. Cycling twice a day for 1 hour to enlarge the cylinders and regain or keep the length. Is there a limitation on cycling a day or could I also do 3 hours cycling (morning, lunch, evening)?
4. Cycling aggressively: Can i do damage, when I cycle to aggressively?
5. Is there a rule on how often and how long I have to cycle daily after the surgery?

Thank you so much for your help in advance.

Best regards

[hopeful_future]

Sorry you're going through this. First of all, my suggestion would be to look into what doctors are available to do your surgery, and find one who is experienced with this operation, who can introduce you to people they have implanted to ask questions at the least, and to see a demonstration if the person is willing to show and tell.

All of the concerns you listed are at least much less concerning with the correct doctor. Of course there's no guarantee there, issues happen even with the best doctors...But your chances are better.

a) Pre-Op Implant
1. Using a VED for three weeks before surgery: I have read in an article that the usage of a VED would help to make the tissue flexible and would increase the size of the cylinders to be placed in (https://file.scirp.org/Html/3-1990021_27133.htm)
-> For me this means 2 months before surgery a daily usage of VED for 10 minutes a day.

VED is most useful for people who have issues with Peyronie's or have not been able to have nocturnal erections for a long time...That is, if you have lost size, it will help you regain it. I'm not an expert here though. Some others may have more/better advice.

2. Asking the right questions before implant
I have read many threads on what to consider before getting an implant:
- What approach is used (infrapubic vs. penoscrotal). I personally favour the penoscrotal approach, as I heard the nerves go on the top of the penis. However, I also heard that the healing takes longer. As earyl cycling is important with regard to reduction of the loss of lengt, I would be happy to hear some ideas.
- Are there any other questions I have to consider before the implant?
- Are there any other considerations to take into accout to keep the penis at length and girth?

Dr. Karpman did infrapubic on me. I was able to operate the implant 1 week after surgery (he demonstrated operation at his office). I have been cycling since. I have had no loss of sensation, aside from some numbness in the first couple of weeks that has fully cleared up. He said anyone who knows what they're doing can and should avoid the nerve bundle.

Ask your doctor how many of the operations they do each year, and whether they have any patients that are willing to talk to prospective implantees.

b) OP Implant
1. I am not sure about the measurement of the penis. I have heard it is best, when the penis is erected when measuring the length. How can this be conducted or how is this apporach called?

Regarding length/girth, your doc should do a stretch test with the flaccid penis to get an initial measurement, but if they're following the correct procedures, they'll be using a measurement tool during the surgery to ensure you have the correctly sized implant. Measure and take pictures of your flaccid penis length stretched as far as it will go, and if you can achieve any erection, get a picture and measurement of that too. Keep records, and if there is dramatic loss of size, you must be willing to call it out.

If your doctor implants you correctly, you should lose very little size, if any.

c) Post-OP Implant
1. Early Cycling prevents the penis from shortening: When is the earliest possible time to cycle after surgery? Is it a problem to cycle when the scrotum is still sore and swollen for example or can I cause damage by cycling?
2. Using a special underware (I dont know the name) to keep the penis pointing up right. This helps the healing to keep the direction.
3. Cycling twice a day for 1 hour to enlarge the cylinders and regain or keep the length. Is there a limitation on cycling a day or could I also do 3 hours cycling (morning, lunch, evening)?
4. Cycling aggressively: Can i do damage, when I cycle to aggressively?
5. Is there a rule on how often and how long I have to cycle daily after the surgery?

All of these questions depend entirely on the details of your procedure and how your body heals. Your doctor is the person to ask. Taking the advice of random people on the internet over your doctor, even well-meaning ones, is a recipe for disaster.

[LP31_Europe]

Thank you so much for your reply.

As you said you had an infrapubic surgery, did you have any loss in size? Is you scar very visible? Do you know how easy an replacement is with infrapubic surgery?

Before I do the implant, I am currently getting checked my blood vesels in the diagnostic radiology. However, getting an appointment is a nightmare.

In my case, the ED is position dependent. I have read a study handling similar problems. In the mentioned case the cause was an inheren malformation.

But if this is not applicable in my case, I will definitely want to change sth.

Thank you so much.