Questions to ask DR

[Jage64]

haha, good point.

I think there is a perfectly valid benefit to experiences and opinions (if based in fact), I searched for those when I was researching too and tremendously appreciated those that had gone before me sharing their thought processes.

I just don't think opinions belong on a thread where the OP is asking for questions to ask....IMO that is NOT the place for opinions.

For many guys, they'll just go to the local urologist and sign up for a surgery date, in some ways I envy their ability to be so chill about it all. That's not me, I want to know everything I can know and rest my mind that there will be no 'coulda/shoulda' looking back. I can't even fathom the deep disappointment I'd feel every single day looking at a part of my body and wishing I had done something different.

[newbie443]

Guys, back again and going to take he wife with me to the urologist this week to discuss options. We've talked about it several times and the timing was just never right and we still had a passable sex life. Now I think we are both getting closer to making the real decision to go with an implant.

Looking for advice from you all of what questions to ask the doctor. They aren't one of the high volume providers, but did serve under a very well respected and mentioned one on this board. In prior conversations I've learned they do about 4-5 implants a month so I know that already.

What else should I be asking and what questions did your wives/girlfriends/significant others have?

All replies appreciated.

I would ask if the doctor did repairs or replacements. Those are more difficult and none of my local doctors do them. If the doctor does not do them then ask where they send men to have them done and that would be the next place I would go. Also ask to talk with a man they implanted. Then ask that man about size loss and how recovery went. Activation wait time, sensation loss, swelling ect....

As this kind of had a little side track about what type of device and the reason I have a different view. First of all tubing has been a week point of the Titan and as a result they are planning on new tubing sometime soon. There is a thread on this. The LGX cylinders are softer and have a higher failure rate than the Titan and the Titan has a higher tubing failure rate than the AMS devices. One thing to note is that the AMS devices come in preconnected tubing and cut to fit. My doctor used cut to fit and I am over 6 years with no problems at all. If you search back you will find more Titan tubing failures than AMS. I can only guess at the reason why there have been a few recent AMS tubing failures. Could be doctor skill or some problem with AMS in house manufacturing. Coloplast does or did not make the tubing for the Titan. There are no zero risks with this. So you will find that what you are doing is to reduce your risk. Same with infection. The AMS coating had a much lower infection rate when it came out. Coloplast came out with a cylinders that permitted the doctor to select a type of coating. The first solution they were using did not have as low infection rate but they changed to another solution that matches infection rate with the AMS coating.

I agree to try to find a doctor that does both devices or even all three now that Rigicon has joined the supplier of devices and let the doctor choose the best device for you. If you have size loss from ED the LGX is often selected. If you need a stiffer device to straighten then Titan is best. Although is the deformity is mild the CX is a good choice. Some men complain of the Titan bulge. And then in the longest size the LGX seems to have less erection angle. Not important to some but it is to others. So it is not a question as one device being better than the other. It is a question of which device is best for you. Both devices have advantages over the other. I have not done research on Rigicon to be able to form an opinion on them.

I either wanted a Titan or an LGX. My doctor choose LGX. I like to leave my LGX not completely deflated. Kind of just below what I think a Titan would be. It is more comfortable and easier to pee.

[exr001]

Thanks all for your replies, couldn't get back here yesterday to see where things went but do appreciate all of the feedback. I agree, I really wanted this thread to be about questions to discuss with my doc, not opinions on various methods or models. I do appreciate those comments also, so maybe other threads can be made with those topics.

[newbie443]

Thanks all for your replies, couldn't get back here yesterday to see where things went but do appreciate all of the feedback. I agree, I really wanted this thread to be about questions to discuss with my doc, not opinions on various methods or models. I do appreciate those comments also, so maybe other threads can be made with those topics.

A question I asked my local doctor was what brand and model he recommended and why. He did not want to answer and wanted me to pick the device. Seems to me that any good doctor would be able to know which is best for me after a review of my medical history and an examination. Maybe the doctor would want to ask some questions but should have good medical reasons on which brand and model to use for me. The local guy just said AMS when pushed and the reason was he had done more of those than Titans. Another reason I passed on my local doctors.

[Jage64]

This is a good point newbie443.

When I met with my first doctor, the doctor that would have literally cost me only a copay 1/100 of what I paid out of pocket, he wasn't sure of the manufacturer Kaiser used, but assured me it was reputable. He then had me stand up and with his gloved hand held my penis out and stretched it to about where he said I'd end up after surgery and I decided right that moment that he was not my surgeon. First, it was laughably short. Second, I knew enough from my own research to know that he could have no idea what my final length would be until he measured me in surgery. Even making a guess can be a red flag, if the surgeon is top notch, you're going to be the maximum you can be, no sense in making any type of guess. I did ask this Kaiser surgeon if he erred on the side of smaller to protect against erosion and complications, or if he stretched the envelope just a little to make sure the maximum implant was used. He wrongly chose the first option, I believe he thought that was what I wanted to hear (which is why I worded the question that way that I did, to see if he'd take the bait)....He did, further sealing my decision to never see him again.

I ultimately ended up with Dr. Clavell, 2000 miles from home and paid out of pocket. During my consultation with him I asked his opinion of which implant he thought would be better FOR ME, at first he was hesitant since I think he could tell I was very well educated on the pros and cons of each option and corrected some of the things I had wrong, and he didn't want to sway me, but he ultimately said he thought the AMS would be better FOR ME. I was already leaning that way anyway, so his recommendation sealed the deal to choose that option.

I believe that our discussion about my lifestyle, my partner, my goals, and seeing that my natural penis was of average girth was plenty of information for us to make a well educated decision (your tunica albuginea determines your girth, not the girth of the implant). Had my lifestyle been different, my natural penis of a different shape, or any type of Peyronies or scar tissue damage an issue, both his and my thoughts MAY have been different.

15 months later and I couldn't be happier, I attribute my happiness to 1) a fantastic surgeon that spent time with me to discuss my personal situation 2) spending hours and hours researching and developing questions that I got my own answers for 3) many contributors here on FT that encouraged and helped me work through it both pre and post op.

This is why I believe that it's important to see a doc that can offer you both options. There are differences between them. I know for a fact that Dr. Clavell performed an extensive repair on a man that had been mangled by a surgeon in another country the same morning of my surgery, then installed a Titan on another patient, and then installed my AMS. During my surgery Dr. Clavell ran into a complication that was unexpected, and I'm extremely grateful he was in charge and had the experience to address the issue (a story for another thread). I shudder to think what would have happened with the Kaiser doc in that same situation.

[LastHope]

Hey doc, which brand of implant have you had your hands in the most?

[Daveman]

BigDog provides a great list of Q's to ask your doc. Jage64 & Journeyman also make good points.

FWIW, there has always seemed to be a preferential bias towards AMS & penoscrotal implants on this site. However, I got a Coloplast Titan that was implanted infrapubicly without any problems whatsoever.

You can read about my experience in the "15 Month Update" thread that I just posted and in my post-op diary where you can find a link to that thread.

I'm not here to trash AMS or the penoscrotal method but here's what I know & have to say:

1) My surgeon -- Dr. Karpman in Mt. View, CA -- previously used AMS but switched to Coloplast because his patients were having too many problems w/AMS -- mainly due to leakage at various connections which have been reported by men here who also got AMS implants -- which required revision which he got tired to having to do.

So, I agree w/Jage64 that you should consult w/a doc who has used both AMS & Coloplast to understand the differences pro/con between AMS & Coloplast.

2) I considered but rejected the penoscrotal method mainly because it takes more surgical time to perform (which means you are under anesthesia longer which puts you at greater risk) and also because the recovery time was longer &, based on what I read, possibly more problematic than for infrapubic.

Before I found Dr. Karpman, I consulted w/a surgeon who only did penoscrotal but who had relatively little surgical implant experience which is mainly why I chose to go w/Karpman (who has a lot of experience & only did infrapublic) but I also did a lot of research on the penoscrotal method and it just didn't appeal to me when compared w/infrapubic.

3) Also, based on my research, I felt that there are fewer risks of post-op complications w/the infrapubic than penoscrotal method. You can read up on both methods and decide about that for yourself.

Regarding Jouneyman's concerns in re: infrapublic:

I don't think there is any risk of nerve damage if you have chosen an EXPERIENCED surgeon who does infrapublic implants frequently.

As for the scar, your public hair will regrow to hide it. If you happen to be "smooth" down there (like I am), while the scar is visible, it is hardly noticeable when I look at myself naked in the mirror everyday.

My squeeze ball placement is also fine. Right in the middle of my balls where it's supposed to be. My balls were never low hangers and do ride higher now but I don't find that a problem.

------------------------------------------------

Good luck in making the "right" choice for you but don't rush into it.

Take the time to do the research that you need to do and to find the "right" surgeon to do the job.

Don't choose a surgeon just because he's close by. Men here have flown thousands of miles to get the implant done by experienced surgeons. Jage64 was one of them.

Choosing the "right" surgeon is the most important decision that you have to make. So, make that choice wisely.

You won't regret it if you do but almost certainly will regret it if you don't.

Again, good luck & best wishes to you.

Thanks for the infrapubic point of view. Btw I had penoscrotal with a coloplast titan. Coming up on my 1 year

[Journeyman]

This is a good point newbie443.

When I met with my first doctor, the doctor that would have literally cost me only a copay 1/100 of what I paid out of pocket, he wasn't sure of the manufacturer Kaiser used, but assured me it was reputable. He then had me stand up and with his gloved hand held my penis out and stretched it to about where he said I'd end up after surgery and I decided right that moment that he was not my surgeon. First, it was laughably short. Second, I knew enough from my own research to know that he could have no idea what my final length would be until he measured me in surgery. Even making a guess can be a red flag, if the surgeon is top notch, you're going to be the maximum you can be, no sense in making any type of guess. I did ask this Kaiser surgeon if he erred on the side of smaller to protect against erosion and complications, or if he stretched the envelope just a little to make sure the maximum implant was used. He wrongly chose the first option, I believe he thought that was what I wanted to hear (which is why I worded the question that way that I did, to see if he'd take the bait)....He did, further sealing my decision to never see him again.

I ultimately ended up with Dr. Clavell, 2000 miles from home and paid out of pocket. During my consultation with him I asked his opinion of which implant he thought would be better FOR ME, at first he was hesitant since I think he could tell I was very well educated on the pros and cons of each option and corrected some of the things I had wrong, and he didn't want to sway me, but he ultimately said he thought the AMS would be better FOR ME. I was already leaning that way anyway, so his recommendation sealed the deal to choose that option.

I believe that our discussion about my lifestyle, my partner, my goals, and seeing that my natural penis was of average girth was plenty of information for us to make a well educated decision (your tunica albuginea determines your girth, not the girth of the implant). Had my lifestyle been different, my natural penis of a different shape, or any type of Peyronies or scar tissue damage an issue, both his and my thoughts MAY have been different.

15 months later and I couldn't be happier, I attribute my happiness to 1) a fantastic surgeon that spent time with me to discuss my personal situation 2) spending hours and hours researching and developing questions that I got my own answers for 3) many contributors here on FT that encouraged and helped me work through it both pre and post op.

This is why I believe that it's important to see a doc that can offer you both options. There are differences between them. I know for a fact that Dr. Clavell performed an extensive repair on a man that had been mangled by a surgeon in another country the same morning of my surgery, then installed a Titan on another patient, and then installed my AMS. During my surgery Dr. Clavell ran into a complication that was unexpected, and I'm extremely grateful he was in charge and had the experience to address the issue (a story for another thread). I shudder to think what would have happened with the Kaiser doc in that same situation.

Dr Clavell was also probably hesitant to make a recommendation is because he's a consultant for BOTH companies . Didn't want to put his finger on the scale . I also think that being that both products are so similar, and both will solve your main problem, ED . It really comes down to what secondary concerns a patient has ... type of pump , no rte's , softer flaccid, stronger erection. It's like car shopping, it really comes down to what the patient feels most comfortable with . I know there's a case that the Titan should be used for patients with peyronies disease ( me ) because of its axial rigidity strength may help straighten the penis out .