Pseudo-coffin #2

[wallyworld]

Would you mind telling me the name of the video and confirming it is an AMS video?

Thanks!

Mark

[David_R]

Is "pseudo-coffin" the same as "turtling" (which means -- when flaccid at least -- the glans is pulled inside the shaft skin of a circumcised penis)?

[Happy Toy]

Know what that's like Use to be a problem, no more thanks to my implant

[wallyworld]

The "coffin effect" as explained to me is the encapsulation of the cylinders and the reservoir by scar tissue. The problem - the "coffin effect" - is when the tissue heals around an uninflated or underflated cylinder or reservoir thus preventing or inhibiting the cylinder or reservoir expansion without interference. Like being in a coffin and not being able to move because you are restricted on all sides.

Mark

[FreddyFree]

I don't know if this is off topic. I can't cycle until Dec. 10th., when surgeon will instruct me how. But I have been exploring around my sac and have noticed what may be scar tissue.

My pump seems to be attached to the front of the pump, from the bottom up to the rectangular part at the top. (AMS CX) The outline of the pump is not very defined. I can not feel any release button for what seems to be scar tissue. The back of the pump is easy to define the parts.

Will this fix itself? I try to pull the sac from the pump but it is super painful and unproductive.

I have no desire to cycle at this point, since I want this to work out properly and follow doctors orders.

I'm rambling, can anyone help?

[Dave52]

I can’t understand how any doctor could leave his patients in a state where they need to wait 4-5 weeks to actively start the recovery process. The time that is wasted doing nothing may be the most important time line of having an implant. There are studies that say that delaying activation results in lose of length due to scarring from the formation of pseudo capsule. Don’t these docs follow there continuing education information or are they just so full of themselves the don’t give a $hit.

[Larry10625]

I don't know if this is off topic. I can't cycle until Dec. 10th., when surgeon will instruct me how. But I have been exploring around my sac and have noticed what may be scar tissue.

My pump seems to be attached to the front of the pump, from the bottom up to the rectangular part at the top. (AMS CX) The outline of the pump is not very defined. I can not feel any release button for what seems to be scar tissue. The back of the pump is easy to define the parts.

Will this fix itself? I try to pull the sac from the pump but it is super painful and unproductive.

I have no desire to cycle at this point, since I want this to work out properly and follow doctors orders.

I'm rambling, can anyone help?

Do you just have to wait that long because it was his next available appointment? The typical wait time is 3 weeks or less.

Larry

[DougAnd]

Penile size after prosthesis implant, “the pseudo-capsule coffin effect”: how to prevent penile retraction after implant of three-component inflatable prosthesis
Enrico Caraceni1, Giovanni Angelozzi1, Lilia Utizi1
1 A.S.U.R. Area Vasta 3, U.O. di Urologia (Civitanova Marche)
Objective
Following 3-component implantation of a penile prosthesis, some patients are dissatisfied with their penile length. This may be due to the procedure per se or pre-existing risk factors (neglected priapism, Peyronie’s disease, radical prostatectomy, or overhanging supra pubic fat) or psychological reasons in relation to unrealistic expectations of the implant. We suppose that a too small pseudo-capsule due to a late prosthesis activation can reduce the available space into the pseudo-capsule (coffin effect of the pseudo- capsule) in order to create a constriction, a kind of inextensible wall, which prevents the system to expand later. On the other hand we believe that there is a true dimensional lack of the penis caused by the “Coffin Effect”. This effect justifies the patient’s complaint about the too small penile size after three-component penile implant .
We try to identify the presence or absence of penile retraction after implant with three-component prosthesis and the possible opportunity to prevent it without use of other device before or after the operation, but simply activating the prosthesis immediately after implantation
Methods and results
Forty-six patients who have had penile prosthesis implanted were enrolled in this study: studied retrospectively and operated between 1998 and 2012 with three-piece inflatable penile prosthesis ( AMS 700 CX o LGX). 27 patients did the first activation prosthetic four weeks after surgery (NEA group) and 19 Patients have activated the prosthesis for the first time immediately after surgery (DEA group) . Length and girth of the penis was detected before ( in DEA group) and after the surgical procedure.
Penile length was measured with the prosthesis activated and deactivated from the pubic bone to the urethral meatus along the dorsum of the shaft (erect and flaccid state) and expressed in centimeters to two decimal place and the circumference was measured in the middle third of the penis and expressed in the same way .
The average post implant dorsal length of the erect penis was found in the group NEA equal to 11.70 cm and ± 1.4 s.d. ( range 9-15 cm) , in the group DEA equal to 14.98 ± 1.7 s.d. (range 12-19 cm ) with a difference corresponding to 3.28 cm more for the group with early activation (DEA).
In the Early Activation Group (DEA), the average length of pre-operative stretching (14.57 cm) is almost identical to the average length in post operative erection (14.98cm).
The Pseudo-Capsule determines the dimension of the penis and the prosthesis can only move inside the pseudo-capsule forward during activation, and backward when deactivated like a sliding door. The result is a penis bigger in flaccid state but smaller in erect phase, when early activation is not performed
Discussion
Our data clearly confirm a true dimensional lack of implanted penis in the NEA group. This finding is no present in the DEA patient . The reduction in length of the penis in patients implanted seems real: 11.70 cm in the NEA group. The cause of the phenomenon is the pseudo-capsule that arrests the potential prosthesis and penis elongation. The creation of a too narrow pseudo-capsule
the 'coffin effect' which is produced by the late activation of the prosthesis is the cause of the missing extension of the penis after implantation. In addition to this, the penis is less elastic, that is to say that it presents a lower dimensional excursion between flaccid state and erect state. The Implanted penis in NEA group appears not only smaller in erection but also with a lower circumference and less variation in length between the flaccid and the erect. This effect related to the pseudo-capsule is also present in the DEA group even if with a smaller dimension. Our data demonstrate ,as far as we know for the first time in literature, that it is the pseudo-capsule, through the “coffin effect” and not the prosthesis to determine the final size of the penis and its elasticity.
The timing of activation seems to be the key to prevent this “Coffin effect” phenomenon.
The early activation is identified also as the best technique to maintain the length of the pre implant erect penis after the prosthetic hydraulic implant.
If the LGX implant is not activated early it does not provide any advantage over the CX in terms of dimensions.

This pretty much confirms that there are a lot of out dated idiots out there using improper techniques designed for implants no longer available on modern day prosthetics. The CD video given to me by my AMS rep together with my card and practice pump confirms that the manufacturer completely agrees. I warned Jamie Matson several times before my implant that there were many rogue Doctors who were not following the recommendations set forth by AMS Boston Scientific. Apparently they are more worried about pissing of surgeons than they are about patient safety.

[DougAnd]

You know what? I have severe Peyronies, scarring up the yang. They screwed up my implant could not pump for a month. Had to deflate on day 5 I think. So I should have a permanent coffin shrunk penis. But guess what? Using my VED I can become as long or as short as I want to be.
I came out stuck at 5.5". I can't use my cylinders to stretch becuse the right tip has already torn me up inside. My only choice is to flaccid stretch very ineffective for length but it saved my penis from more harm and VED. Right now I let the VED stretch me and the cylinders follow them. I know you guys feel duty bound to your doctor and I respect that. If I were you and insurance would pay for it I'd be searching for a doctor who knew how to effectively use VED to sustain ED and stretch the penis and then leave the other guy in the dust.
You do all realize that you still have ED right? And that your implant has done more damage to your penis than a thousand lifetimes of ED could ever possible do. Just ignoring the reality never makes it better. Your penis is still dying from lack of proper blood flow. But unless it turns green and falls off I guess doctors don"t really care.
Well except for Larry's doctor and a very few intelligent others.

[Lost Sheep]

Is "pseudo-coffin" the same as "turtling" (which means -- when flaccid at least -- the glans is pulled inside the shaft skin of a circumcised penis)?

No, it is not.

Turtling, as I understand it is the outward appearance of the flaccid penis wherein the glans (penis head) is drawing back into the penis shaft. In its most extreme, there is virtually no measurable penis length.

Coffin Effect is internal, wherein the implant is imprisoned (as inside a too-small coffin) inside scar tissue and not allowed (and thus, the penis not allowed) to achieve its full design length.

The two MAY both occur in a single individual, but they are not the same phenomenon.