First day inflating...disappointed with girth and erection

[hopefuluser]

Hello! So today was a happy day. I learned how to inflate/deflate my Titan at my urologist’s office. Bulb placement was great and I got the hang of it within minutes.

However, I was somewhat shocked that a) I had definitely lost girth and b) the erection still hung at around 4 o’clock. The PA said it’s normal and “it’s not like the videos” (Coloplast demo videos) where erections are at least 90 degrees from body. He also said that when it gets harder to pump I’m getting close to exhausting the reservoir supply.

I call BS. I’ve seen photos here of erections that are at 90 degrees and read posts of being able to pump more over time.

I’m also (more) concerned about missing girth. I’m now only at 3.5” width and my pre-op erection was definitely at least an extra inch. I should mention the surgeon noticed I had “the beginning stages” of Peyronies, if that factors into this.

Now, my surgeon was one of the best in the country (Dr Ricardo Munarriz) who’s done thousands of these. I doubt he’d do me wrong.

So that leads to getting more out of the pump. Right now I can only get about 9 pumps before it hurts. If I soften the pump with hot baths will I be able to pump more and thus get more girth back? My PA also said I don’t have to worry about breaking the implant (or my dick!) by over-inflating because the amount you can inflate is limited to how much fluid is in the reservoir. Correct?

Thanks!

[oldbeek]

All my nerves were removed in a prostatectomy. One set of nerves fill the tunicas which creates the erection. Separate nerves cause blood flow that fills your glans and plumps up the rest of your dick. Those nerves and blood flow create most of the girth. I lost girth also because I have no blood filling. What caused your ED. Did you have natural filling before your implant?

[hopefuluser]

Yep I had natural (albeit reduced) filling before implant and my ED was caused by arterial insufficiency as evidenced by a Doppler test.

[Old Guy]

It'll take time but you'll regain some of your girth and length. Start inflating once or twice a day. Stay inflated for as long as you can tolerate up to 30 minutes. In the early days it's going to be painful, but as the weeks pass you'll have less pain. Bottom line is you have a working penis now, isn't that better than nothing?

[Waynetho]

Hello! So today was a happy day. I learned how to inflate/deflate my Titan at my urologist’s office. Bulb placement was great and I got the hang of it within minutes.

However, I was somewhat shocked that a) I had definitely lost girth and b) the erection still hung at around 4 o’clock. The PA said it’s normal and “it’s not like the videos” (Coloplast demo videos) where erections are at least 90 degrees from body. He also said that when it gets harder to pump I’m getting close to exhausting the reservoir supply.

The 4 o'clock is dependent on the individual's personal anatomy. The condition of your suspensory ligament, the depth of your crus, etc.

The doctor was (hopefully in your case) incorrect about the "exhausting the reservoir supply" related to the bulb firmness. What a firm bulb means is that the tunica albuginea of the corpora cavernosa is expanded as much as possible. This means the cylinders will not expand any further at that time. Through repeated cycling this may change as the cylinders succeed in stretching the tunica a bit. If the reservoir is nearing depletion, the bulb will get soft because it's pumping air. This is the opposite of what it appears the doctor told you.

I call BS. I’ve seen photos here of erections that are at 90 degrees and read posts of being able to pump more over time.

I’m also (more) concerned about missing girth. I’m now only at 3.5” width and my pre-op erection was definitely at least an extra inch. I should mention the surgeon noticed I had “the beginning stages” of Peyronies, if that factors into this.

Now, my surgeon was one of the best in the country (Dr Ricardo Munarriz) who’s done thousands of these. I doubt he’d do me wrong.

So that leads to getting more out of the pump. Right now I can only get about 9 pumps before it hurts. If I soften the pump with hot baths will I be able to pump more and thus get more girth back? My PA also said I don’t have to worry about breaking the implant (or my dick!) by over-inflating because the amount you can inflate is limited to how much fluid is in the reservoir. Correct?

Again, the limit to how much you can pump is (hopefully in your case) not limited to the reservoir's supply but rather check-valves in the pump that will put any excess fluid back into the reservoir if you continue to pump when the cylinders can't take anymore. If the doctor put precisely as much as he thought your cylinders could take, you may run into shortage as your tissues start to expand, limiting the amount in which you can recover lost size and girth. I hope this is not the case.

[544kenmatt]

Don't give up. I almost passed out on first inflation by the surgeon. I had to lie down for twenty minutes as my blood pressure bottomed out. Keep at it. It will improve. It may sometimes feel like you are at the upper limit but you may able to get one or two more compressions if you use both hands (thumb over thumb and index over index). AMS has a video online of different techniques.

[implant1959]

If the reservoir is nearing depletion, the bulb will get soft because it's pumping air. This is the opposite of what it appears the doctor told you.


Again, the limit to how much you can pump is (hopefully in your case) not limited to the reservoir's supply but rather check-valves in the pump that will put any excess fluid back into the reservoir if you continue to pump when the cylinders can't take anymore. .

I have to disagree with these statements.

The pump is NEVER going to pump air, during the implant they make sure there is only fluid in the system and no air. If the bulb doesn't refill after a pump then there isn't enough fluid in the reservoir for the pump to refill.

I don't believe there are check valves in the pump that direct excess fluid back to reservoir. When the cylinders are full and your penis can't hold anymore you are not going to be able to pump anymore fluid at that time. But waiting a few minutes may allow additional pumps as things stretch.
Looking at diagrams of the Titan pump there are two one-way valves, one valve allows fluid to enter the pump bulb(when releasing pressure on the pump} and the other valve allows fluid to enter cylinders(when pressing on pump bulb).
Then there is the deflation valve that bypasses the other two valves to allow fluid to flow from cylinders to the reservoir. This valve closes upon pumping, that is why after deflation we do one pump to close this valve. There is no way for fluid to flow from pump to reservoir during the pumping process, the fluid is directed to the cylinders and when they are full you can't pump anymore.

[hopefuluser]

Thanks everyone! UPDATE: I was able to pump it to 4” length and 3.75” girth. Still nothing great, but better. The upper limit was quite painful though. I’d assume the pain from the upper limit will lessen over time right?

Thanks!

[hope794]

Ehy bro some questions:

1) Which was your size (lenght and girth) before the implant in full erection?
2) Is the titan flaccid cumbersome, boring or painful ?
3) Did your glans engorge before the surgery? And does it engorge now?
4) Regarding the erection at 4 o'clock, i'm really really worried about that too.. How was your erection angle before?

[Waynetho]

If the reservoir is nearing depletion, the bulb will get soft because it's pumping air. This is the opposite of what it appears the doctor told you.


Again, the limit to how much you can pump is (hopefully in your case) not limited to the reservoir's supply but rather check-valves in the pump that will put any excess fluid back into the reservoir if you continue to pump when the cylinders can't take anymore. .

I have to disagree with these statements.

The pump is NEVER going to pump air, during the implant they make sure there is only fluid in the system and no air. If the bulb doesn't refill after a pump then there isn't enough fluid in the reservoir for the pump to refill.

I don't believe there are check valves in the pump that direct excess fluid back to reservoir. When the cylinders are full and your penis can't hold anymore you are not going to be able to pump anymore fluid at that time. But waiting a few minutes may allow additional pumps as things stretch.

Correct on the first point, I misspoke. It doesn't pump softer but rather it refuses to fill again which indicates you've reached the extent of the fluid in the reservoir because there is no more to fill the bulb.

There are valves in SOME models (maybe Titan, maybe AMS, I don't recall) that will redirect the fluid back if squeezing too hard with too much resistance on the cylinder (no more room to inflate).

I can't cite any references other than to state that "Lost Sheep" frequently mentions this "feature" or at least he did a year ago, after I first joined the board.