Titan and Tunica

[Wizz93]

Hello friends

I am 28 years old, from Germany and will probably get an implant this year. I have had ED all my life. My erections only last a few seconds. I can't wait for the op and to finally have satisfying sex. First of all I want to thank this forum. Without you guys, I would not have gotten on the path of the implant.

However, I still have a few small questions. I had an online consultation with Dr Eid a few weeks ago, who was extremly competent, empathetic and overall a great human being and doctor.

Based on imaging, he suspected trauma to my tunica albuginea in addition to the venous leak (in the process of erection, you can clearly see this trauma as the front part of the penis swells more slowly and in the erect state, you can see some shrinkage on the front left part of the penis if you look closely). So abnormal elasticity of the tunica albuginea. Dr Eid recommends a titanium 22 or 24cm.

Now my question:
I have read here a few times that the tunica must be healthy for a Titan implant or that a damaged tunica makes a Titan implant impossible.
Is it possible that my trauma prevents me from getting a Titan or that I will end up with a smaller implant ?

Thank you all for your time. Take care.

[wolfpacker]

Did you ask Dr Eid these questions??

[Wizz93]

No. I only read here afterwards that there can/will be problems with a Titan if the tunica is damaged.

[newbie443]

I think this may be what the OP is referring to.

https://www.urologicalcare.com/contents ... enile-size

Choice of implant cylinder
The AMS cylinders are tunical independent and will only expand to 18mm girth (a mesh prevents further expansion). This is more than adequate for many patients. For patients requiring cylinder length of 20cm or more this lateral expansion may not be enough and better rigidity will occur with the wider Coloplast cylinders (the longer cylinders expand to 21mm plus). The Coloplast cylinders are tunical dependent and if the tunica is not healthy or thin, the rigidity will not be as good as with the AMS cylinders.

The Coloplast cylinders expand fully against the tunica and overtime this can cause thinning and atrophy the tunica albuginea which will cause the penis to become very wide and less rigid. On the other hand, use of the AMS cylinders in the larger and wider penises will cause inadequate rigidity of the penis as well as a flat appearance of the shaft of the erect penis. The urethra, which is usually at the bottom of the shaft, will instead nestle between the narrower AMS cylinders. It's important to have all types, makes and sizes of cylinders for every case, because often the surgeon may not have pre-operative knowledge of all the variables necessary to select the best cylinder option for that particular individual. For practical reasons, most urologists will use the same brand of penile implant for every patient.

[Lost Sheep]

In 2017 I corresponded with Dr. Eid, exchanging several emails. I agree fully with your assessment of Dr Eid's competence and humanitarianism.

He described the Titan as "tunica dependent" and told me that he would implant whatever device was appropriate for my penis. The final assessment of what was appropriate would be determined during surgery. During surgery is the time when the surgeon would actually be able to assess the condition of the tunica.

I would have complete confidence in his installation of whatever device he elects to implant.

As far as my opinion of the Titan in a damaged tunica, I suppose (in my uneducated but partly informed mind) it would depend on the type of damage and how well the surgeon is able to repair it. Titan implants are often used to straighten a penis damaged by Peyronie's disease. I imagine it could be a better choice to implant in your penis than either of the AMS devices. Depending on what Dr Eid finds when he opens you up. If you have plaque or a narrowing, that can be expanded with a dilator and the problem solved that way. If you have a small leak in the tunica which does not actually weaken the tunica walls, that my not be any problem at all. Again, I specify that this paragraph is the opinion of a layperson.

An email to Dr. Eid asking your question and especially focused on what he would do if he finds your tunica inappropriate for the Titan (or how certain he is that a Titan is appropriate for you).

I do know that in 2017 he wrote to me that he has available a full inventory of implants on hand so he is not limited in choice of what to install. Thus he has on hand the most appropriate implant, whatever he finds in his patient during surgery. He does enough implants per week that maintaining that inventory is financially feasible, one of the many advantages of going to a high-volume surgeon who specializes in implants.

[Waynetho]

Just one thought - the swelling around the penis during the short-lived erection may not be a weak spot in the tunica but rather a perforation allowing blood/fluids to escape into the surrounding skin and other tissues (like buck's facia, maybe). If there is merely a perforation but the structural integrity of tunica is unimpaired, I can't see any reason why a Titan wouldn't work well.

[Wizz93]

Thanks for the answers!

I am not sure yet if I will have the implant done by Dr. Eid, since here in Germany the health insurance might pay for the surgery. Nevertheless, I will eventually pay the money and have it done by Dr Eid, because I just have great confidence in him and the matter is too important to me.

Dr Eid has written to my urologist who would perform the surgery if I had it done in Germany that he believes the best option is a Titan with the wider Coloplat cylinders.

Logically, you only know after the operation, but until then you still have to think about the trauma and possible complications.

However, the fact that Dr. Eid recommends the Titan with wider cylinders makes me optimistic, although the abnormal elasticity of the tunica albuginea is clearly visible.

[Wizz93]

Just one thought - the swelling around the penis during the short-lived erection may not be a weak spot in the tunica but rather a perforation allowing blood/fluids to escape into the surrounding skin and other tissues (like buck's facia, maybe). If there is merely a perforation but the structural integrity of tunica is unimpaired, I can't see any reason why a Titan wouldn't work well.

Thank you for the insight!
However, since Dr. Eid suspects trauma to the tunica albuginea and abnormal elasticity, I would guess that there is a problem with the structural integrity.