Dr. Eid and the corpus cavernosum

[Rider1400]

I think what he was referring to was just opening up the cavernoso to insert implants. Old school and other less experienced Drs used to open it up with dilators and then bigger dilators so the implant would slide in. Clavel,Perot and Eid talk about using minimal dilators to leave as much of the cavernous tissue alone so that possibly some blood can still flow.

[ready2go]

this is from a medical site on implants ;To preserve as much of the corpora cavernosa as possible, it is important to minimize the use or not use of dilators during the penile prosthesis implantation process. The use of dilators to perform prosthesis implants harms the corpora cavernosa, which can result in loss of residual penile filling quality.

The conservation of the cavernous bodies as possible is essential so that the patient can enjoy the residual penile filling that he had before the implantation of the prosthesis. For this preservation, instead of inserting the penile prosthesis in the middle of the penis, it is necessary to make a separation between the cavernous bodies and the tunica albuginea where the prosthesis is implanted.

Thus, when the patient has a cerebral erotization and penile vasodilation, he will be able to enjoy the filling and heating of the penis closer than he was able to before undergoing an implantation process.

After creating the space between the tunica albuginea and the corpora cavernosa, a malleable or inflatable penile prosthesis is inserted, which aims to provide the vertical rigidity necessary for the sexual act.......end quote
you will not be horny 24/7 with a malleable ,but you might be more aware of sexual situations due to the malleable and the knowledge you can perform with no doubt of success, giving the opportunity.
Strangely the reason for the implant is usually not being able to achieve an erection or keep one long enough, for what ever reason . And after i had a malleable i didn't expect engorgement of the shaft, but after months , i notice the shaft does swell and stays that way until i orgasm. Not a lot ,but any is good . i used to be a 6 inch girth and now maybe 5 1/4 . it would be great if it would swell back to 6" .
But i think the proper method was not used as outlined as mentioned in the medical post above . Time will tell, if it doesn't , and i assume it won't .ill get HA filers one of these days .
The good thing is, according to a doctor who does both types of implants and HA fillers , more of the filler is retained long term compared to a person without a implant .

[LastHope]

The Journal of Sexual Medicine, Volume 16, Issue 3, March 2019, Pages 474–478

Spontaneous Penile Tumescence by Sparing Cavernous Tissue in the Course of Malleable Penile Prosthesis Implantation

Adham Zaazaa, Taymour Mostafa
https://doi.org/10.1016/j.jsxm.2019.01.012

Abstract
Introduction
Spontaneous penile tumescence after penile prosthesis implantation has been sporadically reported in the literature.

Aim
To preserve residual erectile function of patients’ spontaneous penile tumescence by sparing cavernous tissue in the course of malleable penile prosthesis implantation.

Methods
Overall, 92 patients were randomized into 2 equal arms; patients undergoing conventional malleable penile prosthesis implantation, and patients undergoing the cavernous tissue–sparing technique. 1 month after surgery, these patients underwent penile duplex examination to assess the maximal cavernous tissue thickness around the implant cylinders. Additionally, they were asked about the occurrence of any spontaneous or arousal-induced penile tumescence.

Main Outcome Measures
Postoperative changes were compared with the preoperative ones.

Results
The mean maximal cavernous tissue thickness was shown to be significantly higher in the cavernous tissue–sparing group compared with the conventional surgery group (5.2 ± 0.8 mm vs 2.2 ± 1.04 mm, P < .01). In the cavernous tissue–sparing group, 41 of 46 patients (89.13%) reported having a significantly higher incidence of residual penile tumescence vs 7 of 46 patients (15.2%) in the conventional surgery group (P < .001). The postoperative penile girth was significantly higher in the cavernous tissue–sparing group than in the conventional surgery group (11.16 ± 1.1 cm vs 10.11 ± 1.15 cm, P < .001).

Clinical Implications
This study provides a step-by-step approach to maintaining post-implantation penile tumescence and preserving penile girth in a reproducible manner.

Strengths & Limitations
This is the first study to demonstrate the benefits of implanting a penile prosthesis while the penis is in a pharmacologically induced tumescent state. It is also the first to make use of ultrasound imaging in assessing postoperative corporal tissue. The main limitations are the short postoperative follow-up period and the non-blinding of measurements.

Conclusion
It could be concluded that the cavernous tissue–sparing technique is a reproducible technique that has the added value of preserving residual erectile function in the form of retained postoperative penile tumescence and preserved penile girth.