Dr. Eid on RTEs (tip extenders)

[shooter1000]

A fascinating subject all around. I really enjoy all of the input. I'm not sure I understand the bit about the non inflatable portion dilating the tissue. By that I assume Dr.Eid is referring to the Crus being dilated and that if no RTE's are used, then the inflation will take up that gap. However, the Crus is surrounded by muscle. The name escapes me, but that should not dilate. The Titan if I remember has 5 CM of non inflatable material on the proximal end. In a patient like me with only 8 cm of depth in the Crus it would leave much inflation in the Crus even without RTE's. It would be interesting to compare the non inflating distal portion of the Titan and the AMS 700.

[merrix]

Glad to ser this ppt presentation is back in the limelight again. I linked to it about a year ago, but seems we have a larger pool of techy guys here this time around.

A couple of comments:
I discussed this with Eid around the time of my surgery. It was over a year ago and not easy to remember all details. But I am pretty sure he did say one downside of RTEs is that over time the crus will not 'fit' as tightly on the implant as from the beginning. More inflatable length will minimise the portion that is always 'stretched' by the fixed part. When the crus over time gets 'stretched', the erection will 'wobble' in the base.

Regarding the 'flaw' of the experiment related to crus depth:
Sure. But also, it doesn't mean results are useless. It still shows a higher inflatable portion is better. Then likely the effect varies with crus depth. But more inflatable part will be better no matter crus depth. Just more important on a shorter crus.

Great discussion!

[alibaba]

The depth of the crus gets brought up and everyone has watched the videos where the doc says 11 down and 12 up or some such thing but keep in mind, those measurements are not necessarily the crus depth and penis depth but measurements from where the doctor made the incision. Dr. Eid says he tries to make the incision as far back as possible so the pump and tubing sit further back and out of the way. Many doctors and you can see on some of the videos have the incision so far forward it looks like it is in their dick. They measure from a thread on the incision or one end of the cut. Wherever they cut rules what the length will measure thus whatever the forward and rearward numbers are.

[shooter1000]

Good point Ali !

[rahod1]

"Use of Rear Tip Extenders Results in Greater Inflatable Penile. Prosthesis Cylinder Deflection".

http://www.smsna.org/scottsdale2016/presentations/206.pdf

[ThePlumber1964]

Ali,

You are exactly right! That is why the surgeon's skills and experience guiding his decision as to where exactly do the corporotomies are extremely relevant, and proportionally related to the quality of the surgery outcome.

[alibaba]

Ali,

You are exactly right! That is why the surgeon's skills and experience guiding his decision as to where exactly do the corporotomies are extremely relevant, and proportionally related to the quality of the surgery outcome.

More reason to not have your work done by a doctor who learned the procedure from a Florida 1 day weekend 3 hour correspondence school. d

[shooter1000]

It appears to me looking at the photographs that the Titan without RTE's has a substantially longer non inflating proximal end than the AMS. The AMS with a 2CM RTE looks about like the Titan with none. Does anyone have any hard data to address this ? If that is the case, the Titan would be more compromised by the addition of RTE's than the AMS.

[ccrider]

...I e-mailed Dr. Kramer on this general RTE issue (which has been appearing of late on Frank Talk) yesterday and he requested that I call him for an extended conversation. Dr. Kramer told me that a lot of plus/minus patient factors have to be considered as to when/where RTEs are used. We spoke about my case as an example, wherein he placed a 21 cm AMS LGX w/ 3cm RTEs. He told me that while he could've used a special 24 cm LGX w/ no RTEs which he had on hand, the negatives outweighed the positives in my case. He said the biggest negative by using a 24cm device was pump placement...w/o RTEs, the pump would be situated far too high in my particular case. That would've entailed spending an extra 10-15 minutes to splice in extended tubing before closure of the scrotum and more time for a potential infection scenario to develop (said he hasn't had an infection in over five years). He also stated that by splicing the factory lines to the pump, you may run the risk of voiding the manufacturer's warranty which comes with the device...could be problematic cost-wise w/ a subsequent pump/cylinder failure down the line. Bottom line: according to Dr. Kramer, there appears to be little/no difference as to patient satisfaction down the line with judicious use of RTEs & that during each procedure, he makes the best determination in light of each patient's circumstances/anatomy. He also told me to tell everyone that he's considering doing a video on the RTE issue wherein he discusses what factors go into his final determination of whether or not to use RTEs with each patient.

[merrix]

Great post ccrider.
Talking to one of the experts and getting their view is a truly good addition to the debate.
Seems it verified some of what we 'knew'.

Less RTEs may be better if not considering any other factors, but it's not that simple. There ARE other factors to consider.

AMS do have an issue with the tubing insertion, and all else equal, AMS will often require more RTEs than Titans. As in your example. A 24 cm LGX would have given you a risk of a poor pump placement, so Kramer chose 21+3. With a Titan, probably 24+0 would have been ok. There are plenty of guys here (including myself) with Titans without RTEs and great pump placement.

But then again, of course he had his reasons for choosing an LGX in your case, so it is not only about RTEs.
Did you ever ask him why he preferred 21+3 LGX setup instead of 24+0 cm Titan?