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I had a 22cm Coloplast Titan OTR (no RTE's) installed exactly one week ago today at the Center for Specialty Care by Dr Francois Eid, NYC, NY. I don't think there is anything unique in my experience, nor do I think this account will add to the general knowledge base here. But, when considering an implant I found it tremendously beneficial to read as many different accounts as possible, even if they were somewhat redundant. So I offer this for the benefit of those who, like I was, are considering an implant and want to read different accounts.

Travel & Hotel

I flew to NYC alone from my home in the midwest, and at the recommendation of Dr Eid, stayed at the Bentley Hotel, which is a block from Dr Eid's office. Dr Eid's staff strongly recommended I stay 3 nights post-op (day of surgery plus two more), which I did, and with hindsight, was glad I did. I know of some who traveled and stayed less, but in my case I really wasn't ready to leave sooner, and that length of stay turned out to be just right.

The Bentley is ok, not great. Surprisingly, only room service for dinner. Breakfast is available if you go to the restaurant, and no lunch at all. There was no refrigerator in the room, but after asking, they brought in tiny one. The Bentley's suggestions for food delivered amounted to chinese carry out. But, if you search nearby restaurants almost all offer free delivery, and you can have breakfast, lunch and dinner delivery. In my case, I shopped at the Food Emporium, 60th and 1st (compared to 62nd and York for the Bentley) the evening before surgery and stocked up on some prepared food in the refrigerator. Then used room service for dinner post-op, and on day 2 and day 3, had breakfast in the hotel restaurant.

I found solo travel very feasible. Dr Eid's office will supply a medical companion for the trip back to the hotel post-op, but other than that, I didn't feel any need for assistance. Dr Eid had suggested taking 2 percocet for the trip home, but just took some Advil instead and that was more than adequate. The trip home was no problem, though I arranged for a driver rather than try to drive myself upon return.

Diagnosis

It was servere organic erectile dysfunction plus peyronnies disease. The planned surgery was insertion of penile prosthesis plus correction of angulation. Dr Eid's OR notes indicated the proximal aspect of the left cavernosum was "obliterated with scar tissue", and the left distal portion fibrotic. It appears the right cavernosum was less damaged. Pre-op sonogram had also detected venous leak. I hadn't been able to have an erection for some years prior, by any means. Orgasm with a more or less flaccid penis (some engorgement) had still been possible some of the time, but not always.

Pre-op Testing & Office Visits

I had visited Dr Eid in December for a consultation. At that time he also did a sonogram. During the sonogram he showed me, by stretching my injected, slightly engorged but not erect penis, what he expected my size to look like. However, he didn't explicitly measure size. He also guessed a 20cm Titan. He strongly recommended the Titan over the LGX/CX. I was pleased when he ultimately installed a 22cm Titan.

The afternoon before surgery he also did a bladder cystoscopy. Some have indicated this was a horrible experience for them, others not so bad. I'm sure YMMV,but for me it was not so bad. He also took time to answer any questions. I also spent some time with his nurse Silvia who went over the post-op instructions in detail, and assured my of her availability for questions at any time. Dr Eid also supplies his private cell phone number for any questions outside of normal office hours.

Surgery & the Center

The Center is a mile from the Bentley, and it was a nice (50 deg & sunny) day so I walked to the Center in the morning, arriving an hour ahead of the scheduled time of 10:15. The Center is an ok facility. The recovery room, where you are parked both pre and post op, is ok but small. 8 beds, very close quarters, and curtains between the beds but otherwise not much privacy. But, this is NYC and space is at a premium, so I guess I shouldn't complain.

The nursing staff was pleasant, attentive and professional. I had a pre-op consult with an anesthesiologist who described the options, basically spinal or general, indicated he and Dr Eid were recommending spinal but that a general was quite viable, and left the final decision to me. Of course, I went with their recomendation. The anesthesiologist for the procedure was a very pleasant woman, who I met moments before being wheeled to the OR. In addition to the spinal, they also gave me a sedative. The only thing I remember was being positioned for the spinal, and being transferred from the OR table to a gurney afterwards. Zero recollection of anything in between. Either I was out from the sedative or it acted as an amnesiac (probably a combo). I'm not sure what time the surgery started, but I think it was delayed by close to an hour. The procedure took 1.5 hours.

The OR notes indicated Dr Eid measured my cavernosa at 22cm and that he installed a 22cm Titan. However, verbally he told me the actual measurement was closer to 21cm, and that he feels the measuring instrument slightly understates the size plus he prefers to very slightly oversize the unit. He uses a scrotal incision which he closes in a watertight manner since recommends (actually "requires") several warm baths daily starting on day 3 post-op.

OR notes indicate that after installation of the Titan, the resulting erection had a mild curvature to the left. He had expected this. He used a combination of superficial incisions and blunt modeling of the tunica albuginia to correct this. OR notes indicate success at this.

I was ready to leave shortly after 3PM, though waited quite a while for the medical companion to arrive, and went back to the hotel with her by cab.

Post-op Pain

Dr Eid prescribes 2 percocet every 4-6 hours for strong pain, and Tylenol III for moderate pain. I took 1/2 percocet before leaving the Center, and another 1/2 at 7PM the first evening. I had major nausea problems starting in the cab ride back. I took no more of anything until 2AM. Nausea had gone away completely by that point, but was having trouble sleeping. The pain was unpleasant but not unbearable at that point. I had had a kidney stone a few years prior and that was MUCH worse. So tried percocet again in 1/2 pill increments. Nausea was ok if I didn't stand. Finally slept. I don't think I ever had more than the equivalent of 1 percocet in me at once, and in total took only 4, most in 1/2 pill increments. By midday on day 1 post-op I gave up on all the narcs and just used Advil every 4 hours. I was able to sleep with that, and the nausea was finally gone by about 4PM day 1. After midnight day 1, I only took Advil as needed, which was only occasional. That's still the case now, day 7 post-op.

Silvia as well as the post-op instructions indicated that pain might increase as activity increases, but should gradually subside when lying down. The post-op instructions are bed rest with only 3 short walks until day 3, then slowly increase activity. Day 2 and the morning of day 3, when lying down, the pain was basically zero. It was and still is true that pain increases somewhat with activity but subsides with rest and warm baths (which feel great). I never feel the need for anything more than Advil, and even that is more luxury than necessity.

Catheter

I was sent home with a foley catheter, which is standard I believe. Dr Eid suggested I leave it in for 2 days, whereas normally it is out the next day. I was thoroughly and repeatedly instructed by the nursing staff at the Center on how to remove it myself. Also, Silvia called me on day 1 to say if I had any issues at all to call her and she would guide me through over the phone. Plus, I was only a block from their office, so I could have walked there if needed. Removal was a breeze and pain free.

Appearance, Size, etc

Apart from a pencil size spot (bruise?) on my glans, there are no marks, or bruising on any part of my penis. For the first day or two the needle marks on my glans were visible where they run sutures to pull the cylinders into place. Now gone. My scrotum has a small bruise about 1/4 inch by 1 1/2 inches. Otherwise pristine apart from the barely noticeable scar and the sutures. I feel there has been some swelling in my scrotum, which seems to increase a bit with activity. However, its pretty minimal.

I was expecting a major change in flaccid appearance, but even so I was a bit surprised. Pressing against the pubic bone, it is now 5.75 inches long and 4.5 inches girth just before the glans and about 5 inches at the base. Dr Eid told me it was totally deflated. The OR notes indicate a slight buckling of the cylinders in the totally flaccid state (which he states indicates correct sizing), and I'm pretty sure I can feel that now at the base, which is why I think the girth is larger there. Due to fibrosis and scarring, Dr Eid told me that initially I would be somewhat narrow, but that should improve with daily inflation when that is started.

Pre-op I measured my VED inflated length, including full glans engorgement at 6 3/8 inches (pressed to the pubic bone) and girth at 4.75 inches. I'll be pretty surprised if I don't get to at least 4.75 in girth on inflation and to at least 6 inches in length, especially if its a little buckled now. In short (well no in long ) I'm very happy sizewise. I never had a good pre-ED measure, though I did measure it once at 5.5 long. However, I don't think that was pressed to the pubic bone, and I do carry a modest fat pad. Based on visuals I felt my VED size and pre-ED size were pretty close.

I can feel the tips of the cylinders well into my glans even in this flaccid state. My understanding is that the relationship between glans and cavernosa is a little like a mushroom cap and stalk. It feels like the "stalk" is filled.

As instructed I keep my penis pressed against my abdomen and pointed vertically toward my navel, except when using the toilet and getting into and out of the tub for warm baths. When allowed to hang naturally it hangs left, but that doesn't worry me since I can easily push it straight or right. It sometimes has a slight left curve, so I take a lot of care to make sure I get it straight or even slightly curved right when pressed against my abdomen to the jock strap they provided. At first right after the catheter came out it would hang at about 3 o'clock. Now it varies between about 4 o'clock when there is some scrotal swelling, and about 5 o'clock in the morning and after the warm baths. Even at 5 o'clock its pretty prominent. Or should I say pretty and prominent.

Pump

The pump is at the way back and somewhat higher than I expected. Dr Eid takes great care to place the pump where he thinks it should go. Post-op instructions are basically do everything possible to not knock it out of place for the first 7 days while scar tissue secures it in place. During my December consult, when he learned I was single, he told me he would be sure to place the pump where my "girlfriends would never find it". He said it would be still accessible but slightly less convenient. I can feel the bulb and the release valve, though it would be more convenient if it was a little lower. I guess he was true to his promise.

I think a lot of guys who are implanted pubicly need to actively work the pump into place, but I understand its a lot easier for the surgeon to do precise placement of the pump when the scrotal approach is used.

Sensitivity

This has yet to be fully tested. But on day 5 I was feeling good, so tried masturbating on my "flaccid" penis. Orgasm was fairly easy, and felt great. It worked better than on my pre-surgery flaccid, thats for sure.

Overall

I realize its still early, and there could still be issues that arise, most worryingly, infection, though there are not signs of that,

I agonized up to the last day about Titan vs LGX, and even quizzed Dr Eid about it during the cystoscopy. At this point, I have NO regrets about choosing the Titan.

I spent a lot of time deciding between traveling to NYC for Dr Eid and staying local with the best local surgeon I could find. Dr Eid and NYC were about twice as expensive, and my insurance won't cover it either way. At this point, I have NO regrets about choosing Dr Eid and NYC.

I spent several years deciding whether to even do an implant. It was suggested as the only real option for me about 4 years ago. At this point, I have NO regrets about my decision to go ahead. I'd say I wish I had done this sooner, but I guess I just wasn't mentally ready until now.

I will give a couple more updates as time goes by. I'm happy to answer question, if you want via PM, or by phone if you PM me.

This is excellent and valuable information, rlm, and well written to boot. This is a "must-read" for everyone considering an implant. Well done!

Greg
Baton Rouge

Rim,

Thank you for an excellent and detailed account of your Coloplast Titan OTR Penile Implant experience to date.
I developed ED Post-Prostatectomy in February 2004 and was implanted with the Coloplast Titan in December 2007.
Thankfully, the Titan completely corrected my ED and restored my sex life and the emotional intimacy with my wife of 45 years.
Wishing you and your wife the same pleasure my wife and I have enjoyed with my Titan Implant over the past 4+ years.
Again, thanks for the great service you have provided to the many men who are now considering an IPP
(Inflatable Penile Prosthesis) and for a truly Professional Post.
Best of luck!!

Bob

Good for you Rim for taking matters in your own hand 5 days out! Good to see that you healed quickly and were up and about and ready to rock and roll.....

Your report was very thorough and will be helpful all who venture into the bionic world. There are many out of towners that seek Dr. Eids expertise in the field and this gives them a picture of the whole process.

Wishing you a speedy recovery.

Mike

I'm having surgery 3/21and this has been a great help to me Thanks and keep us updated.

I'm now 14 days post-op. The last 7 days have been uneventful. I had stitches removed locally on day 12. Dr Eid supplied a letter to the local doc with instructions. I had discussed with Silvia and Dr Eid local vs returning to NYC, and neither saw any reason to return unless I had some issue or concern, in which case I could have changed plans and daytripped back.

I did discover a little more bruising than I first reported. The far underside of my scrotum was bruised some, which I could only see with a mirror. I think it was related to the pump, since when I pressed on the bruise I hit the pump right away. At this point though, bruising is basically gone. Also, swelling is down, though it was never that significant to begin with.

I'd say pain/discomfort was pretty much steady state between day 2 and day 12. The occasional Advil was sufficient, and rest plus warm baths would drive pain to basically zero. The only exception was that I started some longer walks at day 6, and that led to more steady pain. After stopping that for a day, and with 3 instead of 2 warm baths, I was back to being able to zero out pain. On balance though, my activity level has been increasing, so I felt there was actually some improvement in the sense that pain was steady in the face of increased activity. BTW, the warm baths really work, and are better than Advil for me. Note that Dr Eid closes the incision in a water tight manner to expressly allow for warm baths. If you use another surgeon you would obviously want to check to see if baths are ok.

Starting yesterday I felt there was noticeable improvement. Less pain, less Advil, I even forgot to do the warm bath twice. Before I looked forward to the baths for relief. Still some discomfort in the shaft, and once in a while in the scrotum. However, everything is starting to feel much more normal. I was instructed to keep everything pointed up with the jockstrap until the stitches came out, but I was allowed to have those out on day 10. Starting on day 10 thru 12 I alternated betweeen keeping everything up and letting it hang down wearing mid boxer briefs. Sometimes was more comfortable one way than the other, but it varied. Starting yesterday (day 13) I've just kept it down, and sometimes I'm not even aware of anything different. It is starting to feel somewhat natural.

I haven't tried pumping it yet, since everything still feels tender. I probably should wait until April 5 official activation, but we'll see.

I'm happy to answer questions. I'm planning on posting an update after activation, unless there is some noteworthy event in the meantime.

Hi Rim, I am also in the midwest, with no insurance. If you don't mind can you let me know the cost of everything? I am thinking of getting a loan for this if possible, thanks, Tom

Here is a pointer to a thread about costs:

viewtopic.php?f=6&t=940

The final cost for Dr Eid ended up being $29,248 (Dr Eid's fee, surgi center, Titan, anesthesiologist), not including hotel, airfare, cab fares, prescription drugs, medical companion for trip back to hotel ($100), pre-op consult and report with a cardiologist and my primary care physician, and associated lab work and EKG. I don't have all those other costs yet, but in some cases my insurance seems to be covering some of it. In the thread above I indicated a quote from Dr Eid of just under $29,000, but I was subsequently informed of a price increase for the Coloplast Titan unit itself. As noted in the thread link above, you can definitely get it done cheaper with surgeons who still have pretty good reputations.

Thanks for the information. I am having a phone consult Tuesday. I have had 3 implants to date. I pray Dr. Eid can help me!

It is now 6 weeks and 2 days post op. I went to NYC for a visit with Dr Eid yesterday, nominally "activation", I guess. I had already been experimenting, though. He examined me, pumped me up fully, made me show him I could deflate it, and that's pretty much it. I still had some curvature, though mild, and he bent the erection several times in a counter bend move. OUCH! The whole appointment lasted about 10 minutes. He recommended that I inflate daily. He also commented on the amount of scar tissue he could feel. So, I'm free to use it.

When I first pumped it close to the max a couple of weeks ago, it was painful, especially in the glans. I had thought I wasn't at the max, but after yesterday, I say I was. Anyway, there is still some mild ache when fully pumped, but much less. Probably I was too early before, and perhaps things needed to stretch out and the scar tissue needs to break up some. I can get a decent erection even without pumping to the max.

The last month has been uneventful. I played 18 holes of golf at day 21 (with permission from Dr Eid's nurse) riding in a cart, and 18 holes walking and carrying my clubs at day 25. In both cases I had no problem and no pain from the implant. The golf game and sore golf muscles are another matter. I have had occasional ache in the scrotum, as well as soreness, but I think that has been entirely due to the fact that I had made it a point to squeeze the deflate button daily for a while, along with less frequent pumping, usually not to the max. That's getiing better, and I think things are healing as well as toughening up.

Size wise I'm happy. Fully pumped, I measure 6 1/4, maybe even 6 3/8, compared to pre-surgery VED fully pumped with full glans engorgement of 6 3/8. Girth is 4 3/4 pumped, the same as VED pumped. Dr Eid has said I might gain girth with daily pumping, especially as the scar tissue stretches and breaks up. I'm saying definitely no size loss from pre-surgery. I never had a fully reliable pre-ED measurement, but I was pretty satisfied that my VED pumped size was roughly the same as pre-ED. I should note that I did VED "therapy" for 5 months prior to surgery, and my VED pumped size increased by 1 3/8 over that time, primarily all in the first few weeks. Before the VED therapy I definitely felt I had lost compared to pre-ED.

I think it will be a little while still before I can pump it to the max and leave it for a long time, eg an hour, without discomfort. I can go about 20 minutes now, up from basically nothing 2ish weeks ago.

When flaccid, it hangs naturally at about 5:30, and I have no problem with any bulges. Most of the time it feels natural and I'm not aware of it for long periods. At other times, I am aware of it, but its not a bother. Basically, its so much bigger flaccid compared to what I had before that at times I just notice the difference. I don't feel any tubing anywhere. The pump is rarely noticeable, though once in a while when sitting or laying down I will feel it. Once in a while I have to rearrange things to be comfortable, but then I sometimes had to do that pre-surgery too.

All in all, I'm very very pleased and don't really see how things could have turned out any better. I'm happy to answer questions, either here or via PM.