Titan Revision by Dr. Kramer

The final frontier. Deciding when, if and how.
BillinAL
Posts: 92
Joined: Sun Mar 16, 2014 10:25 pm
Location: North Alabama

Re: Titan Revision by Dr. Kramer

Postby BillinAL » Sat Aug 26, 2017 11:16 am

Zxyplk
Best to you on the revision. I will be following your reports. Has Dr Karpman talked to you about how will help insure the pump stays lower/better position?

Bill
75 years old, Severe ED since Robotic Prostatectomy in 2010. Titan implanted 2014 by Dr Milam. Titan failed (tubing leak near cylinder) May 2017. Revision by Dr. Kramer on 7/26/17. Replaced cylinders and pump - upsized to 22 cm Titan, 1 cm RTE.

Zxylpk
Posts: 156
Joined: Mon Apr 17, 2017 12:58 am

Re: Titan Revision by Dr. Kramer

Postby Zxylpk » Sat Aug 26, 2017 8:30 pm

Bill, Dr. Karpman says my pump is actually in a pretty good position. It's the swelling from my epididymitis that makes it difficult to get at. And when it turns into a full blown infection, it's impossible. I think this is true because after 10 days of antibiotics and ibuprofen the swelling goes down and it's much easier to get at - especially in a hot bath which loosens everything up dramatically. I didn't think to ask him when he said he'd move the pump to my left side, about accessibility. Seems to me that would shorten the tubes and pull it even higher. I intend to ask him about this. Btw, I was told by his assistant that it's not uncommon for the bulb to rotate in the other direction. He said it still works fine, just a little different way to operate. Sounds like shooter can testify to that. Do you think you are still swollen enough that that could be causing your problem? And yes, I highly recommend the hot tub for easing pump difficulties.
74 y/o Implant 21cm, 1cm rte ams 700 CX, Feb 21, 2017, Dr. Karpman, Mt View, CA

BillinAL
Posts: 92
Joined: Sun Mar 16, 2014 10:25 pm
Location: North Alabama

Re: Titan Revision by Dr. Kramer

Postby BillinAL » Sun Aug 27, 2017 3:28 am

I don't think there is much swelling left. I can pretty easily grab the bulb of the pump in a hot tub. It is located about the upper half of my balls. It is the release that is stuck, grown to whatever to the base of my penis and is so "buried" that it is almost impossible to feel. I can feel the release somewhat from the backside of my scrotum. I guess I was spoiled since my first implant had what I thought was perfect positioning - the bulb was slightly lower than my balls and the release was easy to get to and operate quickly with one hand.

I will interested to follow how you progress.

Bill
75 years old, Severe ED since Robotic Prostatectomy in 2010. Titan implanted 2014 by Dr Milam. Titan failed (tubing leak near cylinder) May 2017. Revision by Dr. Kramer on 7/26/17. Replaced cylinders and pump - upsized to 22 cm Titan, 1 cm RTE.

BillinAL
Posts: 92
Joined: Sun Mar 16, 2014 10:25 pm
Location: North Alabama

Re: Titan Revision by Dr. Kramer

Postby BillinAL » Wed Aug 30, 2017 2:07 pm

I am 5 weeks post surgery today. Soreness mainly inside of incision where it is rubbing on extra curled up tubing that exists because of high pump. My pump is firmly fixed to the bottom of my penis at an odd angle so that I can feel the release from the high backside of my scrotum, but the other side of the release assembly is buried up in the flesh underneath my penis. The bulb of the pump is about even with top of my balls. The "extra" tubing is all over - some is pushing out the side of my scrotum on the right side and some is curled up under the release portion of pump. I have an unsatisfactory mess. I contacted Dr Kramer at the two week point as soon as I could tell that the pump was way too high and at an angle. He told me 90% correct themselves over the next 3-4 weeks as healing takes place. I am part of the 10% that does not correct itself. I believe because of the swelling everything was pushed up together and some of it grew to where the incisions were made in the corpora. I tried pulling the pump down as early as two weeks post op but it was too late - it was firmly fixed. In its present location it is all but unusable and is very uncomfortable - feels like I am sitting on a golf ball. Dr. Kramer has set me up to see Dr Christine, a friend of his in Birmingham next week to get a diagnosis. He says we need to wait 2-3 months before we do a another revision. I think that is how long it takes for the body to encapsulate everything. I am thinking it may be difficult to cut all this loose since it scattered about grown to other objects. We will see. Biggest concern is how to avoid the same issue next time.

I know where the pump is supposed to be - location on first implant was ideal - slightly lower than balls -easy one handed operation. First implant was done infrapubically so not much swelling in the scrotum - was able to gently pull it down early post op so it was in a good place. Because of swelling, I was unable to feel the pump this time until 2 weeks post op but it was too late - already fixed in place.

We'll see what Dr Christine says.
75 years old, Severe ED since Robotic Prostatectomy in 2010. Titan implanted 2014 by Dr Milam. Titan failed (tubing leak near cylinder) May 2017. Revision by Dr. Kramer on 7/26/17. Replaced cylinders and pump - upsized to 22 cm Titan, 1 cm RTE.

Zxylpk
Posts: 156
Joined: Mon Apr 17, 2017 12:58 am

Re: Titan Revision by Dr. Kramer

Postby Zxylpk » Wed Aug 30, 2017 6:24 pm

Bill - Sounds like you have some real issues on your hands. I hope Dr. Christian can fix this for you. I came down with a flu bug so my surgery got rescheduled to Sept 26. I will be interested in how your appointment with Dr. Christian goes. Best of luck to you.
74 y/o Implant 21cm, 1cm rte ams 700 CX, Feb 21, 2017, Dr. Karpman, Mt View, CA

Rob1961
Posts: 34
Joined: Sun Jan 22, 2017 1:48 pm

Re: Titan Revision by Dr. Kramer

Postby Rob1961 » Wed Aug 30, 2017 7:57 pm

Bill,

Check your private message.
Implanted by Dr. Kramer January 2017 with AMS LGX 18 cm with 4 RTE due to peyroines.

BillinAL
Posts: 92
Joined: Sun Mar 16, 2014 10:25 pm
Location: North Alabama

Re: Titan Revision by Dr. Kramer

Postby BillinAL » Wed Aug 30, 2017 10:42 pm

Rob,
Checked messages but found no new ones.

Bill
75 years old, Severe ED since Robotic Prostatectomy in 2010. Titan implanted 2014 by Dr Milam. Titan failed (tubing leak near cylinder) May 2017. Revision by Dr. Kramer on 7/26/17. Replaced cylinders and pump - upsized to 22 cm Titan, 1 cm RTE.

BillinAL
Posts: 92
Joined: Sun Mar 16, 2014 10:25 pm
Location: North Alabama

Re: Titan Revision by Dr. Kramer

Postby BillinAL » Thu Sep 07, 2017 3:04 pm

Shooter 1000,
You responded to this post earlier. I am now at 6 weeks plus one day and my pump sounds like it is in a similar position as yours. The pump bulb is very high about even with my balls. The release portion of the pump is attached to the base of my penis with the release pointing toward my ass. It is very very difficult to get to and my balls have not gotten used to the bulb rubbing against them with every move. I guess I was spoiled by my first implant - the pump was perfectly located lower than balls and toward the front of my scrotum - easy to get to one-handed.

I saw a Dr Christine in Birmingham yesterday (Dr Kramer had asked him to see me for his opinion in order to save the 1500 mile round trip to Baltimore). He basically confirmed that the pump was "stuck" in the high position and that it could be corrected by surgery or I could try to live with it. This may change but aside from the fact that it will be very difficult to use - it feels like I am sitting on a golf ball with pressure on my balls and penis underside when I sit.

I cannot walk that easily yet so I have not gotten back to the gym I have depended on exercise and oral meds to control my diabetes for 20 years. It is not very well controlled right now simply because I cannot do much in the way of cardio. Hopefully my body will adapt somewhat to the pressure of this object stuck up high in my scrotum and my balls rubbing against the bulb.

Dr Kramer wants me to wait 2-3 months in order for the encapsulation to be completed around everything before I consider a another revision. He plans to use the capsule to help hold the pump in position. Dr Christine says that even though the pump is stuck high around the area where the incisions were made in the corpora to install the cylinders - they should be ok and that the cylinders should not have to be replaced again. That is a relief to hear that -would really hate to have to go through two full revisions in 6 months.

I am just waiting at this point. Will likely schedule surgery again sometime in November.

Bill
75 years old, Severe ED since Robotic Prostatectomy in 2010. Titan implanted 2014 by Dr Milam. Titan failed (tubing leak near cylinder) May 2017. Revision by Dr. Kramer on 7/26/17. Replaced cylinders and pump - upsized to 22 cm Titan, 1 cm RTE.

junglemedic
Posts: 27
Joined: Thu Nov 12, 2015 5:23 pm
Location: Alabama

Re: Titan Revision by Dr. Kramer

Postby junglemedic » Thu Sep 07, 2017 3:29 pm

Dr. Christine did my surgery almost 2 years ago. I would trust him and his opinion. I have had zero issues and would highly recommend him to anyone in the Alabama area even though he likes to flirt with my Wife LOL.
Implanted October 2015 by Dr. Bryan Christine in Birmingham Al. AMS LGX 18cm with 2 RTE's

shooter1000
Posts: 276
Joined: Tue Apr 14, 2015 11:18 pm

Re: Titan Revision by Dr. Kramer

Postby shooter1000 » Thu Sep 07, 2017 5:26 pm

BIllinAl,

Although my release button faces my butt like yours, The pump is plenty low and not stuck. I can move it around in my scrotum. I can pump one handed. It is a good inch below my penis. Of course so are my testicles. I have no pain and no issues. The release button works beautifully in this position once you get used to using your thumb back there. I hope that over time you are able to get the pump down some more.

Best to you
Age 75 Implanted by Dr. Andrew Kramer 03/22/2017. AMS 700 LGX 18 CM with 2 Cm RTE for a total of 20 CM. Previously used injections over 1000 no scarring


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