Dr Karpman did my implant in Northern California.
Ultimately I would recommend him to a friend, but I do believe it’s important to know many facets of the doc’s techniques and procedures to best align them with your own needs and hopes.
I believe (and at least two medical articles support) that high volume implant docs have better outcomes (less infections, less need for removal and replacement, and larger implants done safely). Dr Karpman is the highest volume doc on the west coast so this is the main reason he aligned w my needs.
I had severe peyronies. Many docs will have an implant only address the curve. Or do implant with “release” of the plaque through incisions only. Dr Karpman recommended total excision and graftingvw implant. This is a lengthy procedure and I believe less profitable given the two hours vs. 30-60 mins of many docs IR tine. Some believe the less OR tine results in fewer infections but I believe it was worth the risk...as slong w the curve I had severe hourglassing which I believe can best be treated w excision and grafting. Additionally he reported only one infection in 13 years. Thus was a key factor in my decision.
He does infrapubic rather than scrotal surgical approach. I am not sure that this maximizes the length or minimizes tubing showing. However, he prefers it because one can go home 70% inflated and cycle after 10 days. I know there is at least one doc who cycles after 4 days w a scrotal approach but most seem to wait for weeks before going so. So, on balance I was in agreement.
Dr K almost exclusively installs AMS products. I had concerns about this as AMS products come in 3 cm increments while coloplast comes in 2 cm-therefore needing 2 to reach the next size vs 3. I consider this a consideration as it seems medical resaearch indicates the fewer the # of RTE’s the steeper the angle of erection. I was willing to sacrifice the angle if size was at least maximized.
He explained if after implant when the plaque was excised-if additional length could be obtained he would add RTE’s. Ultimately he installed 18cm + 3 RTE’s. I would have preferred being upsized to a 21cm e no RTE’s but realized there can’t be many docs willing to take the financial hit of having discarded an implant without reimbursement.
He also prefers general anesthesia. I would have preferred a spinal which Dr Eid believes increases blood flow allowing the maximum measurement for the implant. Given Dr K is a high volume doc, is on my insurance and local I didn’t believe the potential for perhaps 1 more cm would be worth my expense to travel and certainly not to lose my insurance coverage (100% for me).
Well, thus is just my thought process. Ultimately the more we know about each doc’s experience and techniques-the better we can match them to our needs.
Feel free to check out my diary for my thoughts and reactions as I journey through this process:
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