New Implant - surgery and recovery

[round3]

Here is a photo from yesterday, when I first could see the "surgical glue." The outlines of the glue were not apparent when I removed the clear plastic dressing and gauze in the shower. The little bits of white detached glue were visible, but looked like they could have been left from the clear plastic dressing. It wasn't clear that they were part of the glue now visible in this photo. This also made me realize that the glue had been mostly removed from the upper incision.

IMG_3819.jpeg (656.09 KiB) Viewed 627 times

[gjmjoe017]

Looks like a good outcome!I had a lot more swelling than you for about ten days!Good luck and be patient!I love mine after 8 months I am comfortable when flaccid and love it when it’s hard!Works great!

[round3]

Today is day 17 since surgery, my first post here since day 4. Things have gone quite well overall. I’m lucky to have been able to take all this time off work and just rest at home.

Week 1
I spent a fair amount of time reading through many different threads here on FT, especially the first week after surgery. My partner and I joked that it was “all penis, all the time” around here.

I found some good post-op tips on FrankTalk. There are numerous members from whom I’ve gained helpful info and I wish I could remember them all, but a special shout out to Merrix and especially LostSheep for their detailed and knowledgable postings. Here are some of my experiences:
-I had been peeing into the bathtub by doing a ‘plank’ pose, because I was still partially inflated and couldn’t point my dick down to pee. After reading about the need to take it easy with working out, avoiding squats etc, I realized it wasn’t a good idea to do planks. So I had my partner get me a urinal, which made it much easier to pee. (It’s a hand held plastic bottle made for the purpose.) On the drugstore website it showed “in stock” but it wasn’t actually in the store. So I called another store, they checked and had it. (They explained that it’s one of the most commonly shoplifted items, which seemed bizarre. But the reason is that homeless people need them, which makes sense.)
-I had read about baby socks, so my partner looked for them and found something that worked well: women’s running socks that are super soft, with a fuzzy fabric. They make a really soft sleeve over my dick for night time, and sometimes inside the SAXX underwear during the day.
-I also tried the toilet paper roll cardboard tube as a sleeve around my dick, to use inside the SAXX underwear. (The SAXX have fabric panels inside that form very defined pouch, making a kind of vertical hammock, which works well to hold it all upright.) I found that while the cardboard tube did provide a firm structure to hold everything in place and keep the underwear and waistband from constricting my dick, I couldn’t wear it for too long without the bottom of the cardboard tube chafing and irritating at the pubes.
-All this experimenting made me wonder why no one offers a medical grade underwear with a well fitted, firmly held-in-place vertical sleeve with a soft finish! (Anyone care to bring this to market?!) But now, a week later with things settling down and getting more comfortable, I’m realizing that it’s a pretty limited market, and maybe this is a temporary stage you just have to get through. We’ll see when I return to work in a week - I have to wear a suit with slacks. I will probably wear the SAXX underwear with a jockstrap over the top for extra structure to hold it firmly upright. I can now comfortably walk around the house in just my underwear with my dick pointed down, but I think for a long work day it will be better to wear it up.

Because anesthesia and narcotics cause constipation, it was really helpful to have a good remedy for that, since there’s already enough discomfort going on in the neighborhood without adding to it. I found Dulcolax suppositories did the job nicely. I used one on two occasions, on the 2nd and 4th nights after surgery. After that I began having normal function again, starting on the 6th day. I drank prune juice every morning, which got things moving. I also drank kefir every day, to promote beneficial flora since the antibiotics can strip you of that.

I switched from the narcotic Hydromorphone to just Tylenol on the 2nd night, and used only Tylenol for the next week, then stopped that. My doc said no Ibuprofen, aspirin or NSAIDs for the first week after surgery as they are blood thinners, and I’d get better incision healing without.

Follow-Up Appointment
I had my Follow-Up appointment a week after surgery. I was more nervous going in than I had been for the surgery itself, mostly because he was going to deflate me after being 50-60% erect for a week, and I imagined it was going to be quite painful, since my scrotum and penis were so tender. (While we’re on the subject, I gotta say that being erect for a week is … challenging. As much you could jokingly say “What guy wouldn’t want an eternal boner?” I’m here to testify: it’s no fun.) But the deflation wasn’t as painful as I feared. It was 5 long seconds of pressure and discomfort as he squeezed the deflate button hard. But I just looked at the ceiling and breathed deeply, didn’t need to scream or anything.

After the deflation I asked him questions and we talked about everything. I found out that my stitches will dissolve on their own. He put internal stitches, then external ones, then covered it all with the surgical glue, which is still attached. I’ve trimmed the excess glue back as it slowly peels away, which he said is fine. But he said I should just let the remaining glue come off on its own.

I asked him if my girth will increase, as it’s pretty reduced now. He said it should increase some. He said “During the surgery I needed to decide between the LGX and the CX, I wasn’t sure which I would use. When it became clear that your available space needed the 21 cm + 2 cm (that is quite long) there was no question for either me or the AMS rep that we would use the CX, because it provides more rigidity to correct the Peyronies.” I asked him about curvature and if that will change. He said “time will tell” but that he thinks it looks really good at this point, and that the slight upward bend from the base is actually an improvement over my former slight bend downward.

I asked if there had been any scar tissue. He said "None whatever. Your physiology was ideal. Your tissues were exactly what we want to work on. It’s difficult to describe, but it’s like your tissues are buttery… the layers we need to separate, separate easily, the way they should. When I needed to dilate, your tissue dilated exactly the way we would want. I was very happy with the procedure.” Which was of course nice to hear.

I asked about the instructions in the AMS pamphlet to pull down on the pump 3 times a day. He said "Your pump is exactly where I want it. It’s easy to access, centered, behind. Just check on it every day. If it’s in the same place, no need to do pulling.”

I asked about a cycling schedule, and he said we would begin that at our next appointment 6 weeks post-op. I said that I had read a lot of examples of doctors and patients starting much sooner. He said it just hasn’t been the way he’s done it with his patients, and that he thought it would be painful.

I asked if I really need to wait 6 weeks to take warm baths, and he said yes, to prevent infection. I asked if I could go back to work this week and he said yes, if I feel up to it. Just don’t lift anything heavier than a gallon of milk. I asked about something I read on FT - that the most likely time for an infection to occur is between 2 and 4 weeks. He said "I think the most likely period for an infection to declare itself would be 7 to 14 days after surgery.”

Finally I told him about my difficult time with the post-op shower instructions, and that I had written a suggestion for improvements. He said he’d love to see it. So when I got home I sent it to him. He responded that he liked it very much and would incorporate it moving forward.

Week 2
After sleeping with underwear for the first week (to hold everything in place since it’s all so tender), I was able to go back to sleeping naked, which I prefer. The underwear is just uncomfortable between the binding and the irritation from the pubes growing out. I slept on my side with two firm pillows between my knees, a firm pillow for my torso/arms, and a small soft pillow as a little shelf for my dick, to keep it pointed straight up (towards my navel), with my soft fuzzy lady sock for a cocoon.

Each day I could feel improvement, was able to be more up-and-about. I took no pain meds for the 2nd week post-op. Everything slowly became a bit less tender. The pubes growing in were fairly irritating and I asked him when I could shave my sac. He said to wait, to avoid introducing any nicks or cuts by accident.

I asked for and received from the hospital the "Long Surgery Notes," which were fascinating. There are reams of checklists, medical history, hospital forms, etc. which are interesting to peruse. Then there’s a detailed narrative the surgeon wrote after the procedure, describing the whole thing. It was kind of thrilling to read.

The AMS packet they sent home with me from surgery contained a DVD. I finally got around to watching it (after hauling out a laptop from 4 years ago with a DVD player). It has detailed instructions for inflation, deflation and troubleshooting. It said different doctors have varying protocols for cycling (follow your doctor’s instructions). Then they gave a “sample” cycling schedule from one doc, which started in Week 1 and gradually increased. Seeing that AMS seemed to be advocating for early cycling I wrote my surgeon again and asked if there were downsides to cycling or downsides to not cycling. He said that as long as the incision is healed well I could try cycling sooner if I wanted to. I decided to wait for more incision healing.

I called the AMS rep listed in my packet and had a helpful conversation with her. I asked if starting cycling sooner was better than waiting until 6 weeks, that my doctor had said I could, and asked about downsides to waiting, etc. She said it really doesn’t make any difference. That if I wait to start at 6 weeks and then follow a cycling protocol, I will ultimately get the same result. She said the cylinders do not add length, my tissues will determine that. She sent me a document with a recommended cycling schedule for when I start.

In the couple days after I finished the antibiotics and stopped taking pain meds I started to notice a burning sensation when urinating. I wrote and asked my surgeon about it and he said let’s test for a urinary infection. I asked if it would test for STD’s as well as ordinary UTI’s. He said we could add that and I said let’s do. I just wanted to rule everything out so I wouldn’t have to wonder. So I left the house for the first time, drove myself to the lab to give 2 samples - the initial stream for the STD test, then a mid-stream, clean catch for the standard test. This was on Day 11 post-op. The STD sample came back negative that evening. It took 2 days to get the other result, as they do a culture. It was negative, which was a relief, but I still wondered why the burning.

Then when I was taking my daily hot shower I noticed a slight change in the pump. It had been kind of “free floating” inside the scrotum, but now felt like it might be adhering to the wall, down in the center bottom of the sac. I wrote him and he responded that in general the pump gets “encapsulated” so that it remains in a specific place in the scrotum, and to let him know if there was increasing redness, pain, pus from the incision, fever, or any other sign of infection. I didn’t have any of those, but I asked if he could take a look anyway, and he made an appointment for me the next day.

2nd Follow-Up appointment (unscheduled)
When I woke up the next morning, with everything in a more relaxed state, I could feel that the pump wasn’t really “adhered” - I could move the skin around somewhat. But it was more fixed in place, not as free floating. I just wanted to have him look at everything. I also thought maybe we could activate and cycle it, that I’d be safer with his supervision, in case I had any difficulty with the deflation. I took 2 ibuprofen in case we did activate it.

On Day 15 post-op at the appointment he examined everything and said "Your incisions look great and they are healing very well. The glue is still covering the incision completely, which is great. It will come off in its own time, leave it alone. You’re way ahead of many patients at this same timeframe. They often still have a lot of bruising, and you really have none. We’re past the point of likely infection. Your outcome looks excellent, I’m very happy with the result. I think it’s going to work very well. The pump is right where I want it. It is doing what it is supposed to: becoming “encased” in the scrotum. It is not adhering in any way that it shouldn’t.” He also commented on how the cylinders extend about halfway into my glans, which is great. He added “The cylinders extend as far into the glans as your natural corpora anatomy extends into the glans, which differs for every man.”

I asked about pressure on the tunica, and he said he is not concerned about it. I asked about using 21cm cylinders + 2cm RTE vs using 23cm cylinders without RTE. He said “The reason has to do with where we want the tubing for the pump to exit - if I used a 23cm implant, the tubing would be buried too deep in the corpora, which means the pump would exit too high from the corpora and therefore ride too high in the scrotum.” I had noticed a little ridge on the left side at the base of my dick, and he confirmed that it was one of the cylinder tubes. He said it’s more palpable because I have leaner body. It isn’t uncomfortable, or really noticeable other than to the touch. We’ll see how it settles out over the ongoing healing.

I asked about the burning sensation when urinating, and he said it is probably just nerve irritation from all the post-op tenderness, not to mention the new cylinders in close proximity. He suggested taking ibuprofen, which would be safe now, 2 weeks post-op. It has greatly decreased the burning sensation, and it has also made everything more comfortable. I can now sit up in a chair much more comfortably and for longer. He said I could take up to 800 mg every 8 hours. I started that for the first few doses (2 tabs every 4 hours) but a friend suggested I try less to see if it still worked, since ibuprofen can be hard on the stomach and kidneys. So I’ve been taking one 200 mg tablet every 4 to 6 hours, and it seems to work well enough.

Finally I asked if we could activate and cycle the pump. He said “Let’s not activate today. In fact, do me a favor and just leave it alone until your appointment on 8/30, and begin activation and cycling then. I know different doctors have different approaches to this, but this is how I’ve been doing it for 7 years, and I’ve had very good outcomes. If we cycle now, it puts a lot of pressure on the scrotum. There’s a chance we could force an opening in the incision, which would not be good. Just let it heal fully before starting.” I was honestly relieved, and agreed that I would wait.

I'm very grateful for this forum. I've gotten a lot of helpful and necessary education here. And, after spending a good part of the first 2 weeks of recovery delving into the Implant forum, I found that there is also a slight downside for me - I kind of reached a threshold of fatigue with all the info; it can lead me to a bit of overthinking things. I have been diligent in communicating with my surgeon about any & every concern I’ve had, and he’s responded to each of my concerns. Looking back, I can see that I’ve gotten consistent communication from him, and that some of my concerns were covered from the start. Don’t get me wrong, I think it’s totally okay if I’ve been more concerned than I needed to be, and asked the questions I felt I needed to ask - this is no small procedure to go through, and it’s appropriate to be thorough and comfortable with each step of the process. I just want to share that, for me, spending a lot of time in this forum, reading lots of different opinions, assumptions, fears, obsessions - it sometimes leads me a little bit into the weeds. Overall it’s a really valuable resource that I’m very glad I found. And I think it’s also good to step back, breathe, and understand that I will find my own way, and it might not always match what I hear from others.

[cbinspok]

Thanks Round3
Well written and informative sounds like our Docs are from the same school, I got an infection after third week after my first op and again at 3 weeks on my revision op. So cycling was put out almost 4 months, seems to be going well now. But was wanting to cycle at 2 weeks soooo bad. Drs do have our best interest at heart and we need to listen.
Keep the post going
Cb