Implant Surgery A Bust

[Texas75008]

I was implanted with an AMS 700 LGX on November 11, 2019. I had a fair amount of pain and more so, discomfort, falling the surgery, but all of that mostly subsided in the many weeks subsequent to surgery. The last to subside was the pain in my scrotum which delayed attempts at cycling the device. About 2-3 weeks ago, the surgeon attempted to inflate the device for the second time post surgery, and was unable to do so. I was still a bit soar, so we waited until today to re-attempt, for what would now be the third time. The pump was working, the pain in the scrotum substantially less. Yet, the cylinders would still not inflate, essentially the same issue we had 2-3 weeks ago. The surgeon has been consulting with Boston Scientific/AMS (both several weeks ago, and then today while I was at his office). Based on the consultation, he made several successful attempts to reset the system, deflating the cylinders, returning any saline to the reservoir. Boston Scientific/AMS advised him that it was possible the reservoir had either folded over, or there was a leak in the system. He then did an ultrasound where he was able to measure the size of the reservoir, perform another reset, and yet another measure of the reservoir size. Shape of the reservoir was as expected, so no fold over. However, the reservoir is suppose to have 100cc of saline, and both times measured 67cc. I was able to see both my bladder and the reservoir on the ultrasound. The assessment is that there is a leak somewhere in the system. Surgery is a bust.

After much discussion, I will continue on with this surgeon and repeat the implant. He is in a large, highly regarded, urology group in the Dallas/Fort Worth area, and does about two of these a week, second only to one other doctor in that practice. He has also done a prior urology procedure on me, and I have not lost my confidence in him, despite this outcome. He is a solid individual, with impressive credentials and is a highly competent surgeon. I don't know whether the device was "nicked" during the original procedure, or, whether the device had a leak to begin with. When they suspect a device problem during surgery, they immediately go to a new device. In my case, where the leak was discovered post surgery, they will replace 100% of the device to ensure there are not any remaining leaks. He indicated recovery should be a bit easier, as the nerve damage done in the surgery has now already been done with the prior surgery. Nerves just don't regenerate that quickly.

Honestly, I have mixed emotions. This has been a tough recovery, made worse by an unsuccessful outcome. I have suspected for the last 2-3 weeks this might be the outcome, so I was not overly surprise today. I was both prepared and disappointed. Yet, my choice is to either (i) give up, or (ii) press on. I am choosing to press-on.

Next step is to get this scheduled (in about six weeks) and understand what insurance will cover. The first time through my out-of-pockets were minimal; I am on Medicare with a good supplemental policy, and had met all of my 2019 deductibles. Never in a million years did I see my 2020 spending coming into play, until today!

[Waynetho]

Good luck in the revision surgery and you will be in my thoughts in the upcoming weeks through the date of surgery and beyond. I'm sure everyone here is pulling for you to have a rapid recovery and finally be able to use a working implant for the first time.

In the future you will see this only as a speed bump on the road to recovery from ED.

[Txagq8]

It hurt to read that. I’m truly sorry .

For wheat it’s worth if I were facing the same thing I’d be doing the same thing as you .

I’m sure youve thought of it but I would contact someone...another physician, maybe a lab.....to take possession of the original implant once it has been removed so that the true nature of its failure can be determined .

I’m neither a doctor nor a lawyer and I concur with getting this done then sort out who owes how much to whom. But if the system was flawed out of the box AMS has some liability for defective device but the doc is guilty of simple negligence by not testing it prior to closing. And if it was cut or nicked during installation, there’s another act of negligence.

As a guy on day 3 I know all you want to do is get this problem behind you. But the behavior of your doctor and AMS might be real interesting. I can envision every scenario from “we screwed up. It’s free” to them trying to extract the full cost of another surgery less device. Lots of folks are gonna be in CYA mode .

Regardless, you have every right to demand and expect a thorough, independent, and impartial analysis of what really happened. As President Reagan always said...trust but verify .

[Agfa13]

*I* truly feel for you.
My 1st surgery was in Aug. of '19. Right after surgery, I got that nagging feeling that something was wrong and that I let my caretaker know about it. We both just shrugged it off as pain to be expected because of the traumatic experience to 'Fred', but as it turns out, after 4 mos., it was confirmed as an infection.
The bulb block was actually stuck to my ballsac. I could not move the pump freely like you do your balls. It was like a clock.
My 3-piece was replaced with a 1-piece malleable. I am keeping a journal of this because someone else is thinking of getting a malleable, he has a 3 piece right now, but does not like it.
I am a very tiny fish in a very big pond, lol. I have tried the search function on here, and could not find anyone who has a malleable that I could swap stories with and learn, but I am the case.
Only 55, so I have to pay $7k out of pocket for insurance to cover surgery if I want a 3 piece. Some guys have it much worse, but a fucked up surgery...make sure to tell doc to video your surgery, as well as pump.

[Texas75008]

It hurt to read that. I’m truly sorry .

For wheat it’s worth if I were facing the same thing I’d be doing the same thing as you .

I’m sure youve thought of it but I would contact someone...another physician, maybe a lab.....to take possession of the original implant once it has been removed so that the true nature of its failure can be determined .

I’m neither a doctor nor a lawyer and I concur with getting this done then sort out who owes how much to whom. But if the system was flawed out of the box AMS has some liability for defective device but the doc is guilty of simple negligence by not testing it prior to closing. And if it was cut or nicked during installation, there’s another act of negligence.

As a guy on day 3 I know all you want to do is get this problem behind you. But the behavior of your doctor and AMS might be real interesting. I can envision every scenario from “we screwed up. It’s free” to them trying to extract the full cost of another surgery less device. Lots of folks are gonna be in CYA mode .

Regardless, you have every right to demand and expect a thorough, independent, and impartial analysis of what really happened. As President Reagan always said...trust but verify .

I was told by the doctor to expect that AMS will replace the device at no cost. However, AMS will retain the device and determine exactly what went wrong. I expect to be advised on what they find. Essentially, that is a manufacturer’s warranty, and it make sense to me that they would want to do that. No, it’s not an independent lab, but in the end, assuming what the doctor is correct, they will replace the device, and they, along with the doctor, more than anybody need to understand why their device failed.

My doctor’s behavior was to factually review what could have gone wrong, and then work with me to reschedule the surgery. He was open and honest, and didn’t seem to place blame on AMS nor remove blame from himself. If he had not reacted in this manner, I would have a different view of all of this.

I have two paths I can take here. One is a high road, the other possibly not. Right now, everything is on the high road and I believe that will result in the best outcome for me. The surgery is now rescheduled, and I have asked the doctor’s surgery administrator to spell out the financial responsibility. That will help me better read which path we are all following. I am not overly consumed with concepts of “negligence” at this point, and candidly hope to avoid or even threaten that path. My focus is on successful outcome with minimal new cost to me. If everyone deals fairly with one another and takes responsibility for the prior outcome, then the new outcome should be a positive.

The unknown is the surgery center, and that is largest cost exposure. I hope my approach to this carries over to the surgery center as well.

[tomas1]

I'm unsure how your surgery and postop went, but I was left inflated overnight the first day,
On the second morning a doc deflated the device.

I wonder if that protocol would have shown a problem with the device?

[Texas75008]

I'm unsure how your surgery and postop went, but I was left inflated overnight the first day,
On the second morning a doc deflated the device.

I wonder if that protocol would have shown a problem with the device?

During the surgery the doctor fully inflated the implant cylinders. He sent me home with them 60%-70% inflated, which is mainly to control bleeding, and will not be needed on the replacement surgery. 2 weeks after surgery he delated the cylinders. Whatever the leak was, it appears to have been very slow, and was absorbed within my body. It likely has more to do with the device (manufacturing issue or damage during surgery) than the post-op protocol.

[Agfa13]

I'm unsure how your surgery and postop went, but I was left inflated overnight the first day,
On the second morning a doc deflated the device.

Tomas1...damn, I was left inflated for 3 weeks, without being told I was inflated, so I just figured it was par for the course, lol.
When Dr. deflated me, it really did feel good not walking around with the hardon, lol.

[tomas1]

I guess we'll never know where the leak occurred. I don't believe we can ever take possession of the apparatus even though we pay for it.
I've always believed the weakest part of all of this is when the doctor puts in a connector to connect tubing.

[krh9999]

Honestly, I have mixed emotions. This has been a tough recovery, made worse by an unsuccessful outcome. I have suspected for the last 2-3 weeks this might be the outcome, so I was not overly surprise today. I was both prepared and disappointed. Yet, my choice is to either (i) give up, or (ii) press on. I am choosing to press-on.

\

Hey man. I feel for you! All this effort and roadblocks are hard to deal with mentally.

Good luck to you.