IMPROPER IMPLANT SIZING

[LGX_Man]

Hi guys. A friend of mine, Jack, has a blog and has become well-known for his writings on penile implants. He shared this with me and gave me his permission to copy it here for anyone that might learn something from it. The response at the end is from Todd Doran, Dr. Milam's assistant at Vanderbuilt University. Many guys on here know of Dr. Milam and a few have had him implant them. Here are Jack's postings:


On Sep 13, 2011, at 2:55 PM, Jack wrote:

I posted this on my blog August 26th. With all the discussion on sizing implants now is a good time to post it here.

Jack http://jackp-penileimplant.blogspot.com/

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Friday, August 26, 2011 IMPROPER IMPLANT SIZING

It has recently come to my attention that some doctors are not implanting the AMS 700 LGX properly. They are not putting in a full length implant with the rear tip extenders, when needed, to fit the corpora's. This will quickly lead to problems.

This is a copy of an email I received recently regarding implanting an AMS 700 LGX or a Titan. Also a response from Todd Doran of Dr. Milam's staff at Vanderbilt. The only editing I did was the doctors name.

This is how some doctors give the LGX a bad name. Be aware and put it on the list of questions you ask your doctor.

Jack

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An entry on Jack's blog:

Hi Jack,
Did you say you'd be seeing Dr. Milam soon? I wonder if you could ask him a certain question for me? When I talked to Dr. Mxxxxxxx, he said he could do either a Titan or a AMS700LGX, but he said if he put in an AMS700LGX, he'd have to put one in that was shorter than the corporas (because of the expansion in length).

I wondered if you might be able to ask Dr. Milam if he does the same thing, or something different, such as filling the corporas, which is what would be done with the Titan, I believe.
I just wonder if all doctors do this, or only Dr. Mxxxxxxx, or what.

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Jack sent this to Dr. Milam's assistant, Todd Doran MS PA-C

Here's the bottom line regarding RTE/corporal length, etc. Dr. Milam's philosophy is to measure the corporal length from rear tip to distal tip. We then place a cylinder that equals that length but sometimes RTE (rear tip extenders) are used because the cylinders typically come in 2 cm increments and I can add RTE in 0.5 cm increments so we have infinite possibilities to accomplish the goal. Here's an example: Patient measures 15 cm so we place a 15 cm LGX cylinder with no rear tip because it's available in that size. We'd add 1.5 cm RTE if corporal body was 16.5 cm since next cylinder size is 17 cm. Hope that clarifies a simple concept that is complex for patients to understand and another concept that is misconstrued by surgeons and patients. The advantage of an LGX is that if you need 0.25 cm which is unavailable then we know that the expansion properties will achieve the desired goal where a Titan or CX wouldn't. That's our philosophy. Never agree with placing a device that's too short or too long, you're setting yourself up for disappointment right out of the box.

Todd Todd J. Doran, MS, PA-C Associate in Urologic Surgery Vanderbilt University Dept of Urologic Surgery

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Note: RTE is the acronym for rear tip extenders. They are used to custom fit your corpora's. They are placed at the distal (pubic) end of the implant. Say your corpora's measured 16.5cm. A 17cm implant would be to long and the 15cm implant to short. So they use a 1.5cm rear tip extender (RTE) for a custom fit. He sends that to me from his blackberry so he abbreviates "pts" is for patients.

FYI only AMS come in .5cm increments.. Coloplast only come in 1cm increments.