[RESOLVED] Concerns if my implant was sized correctly

[Waynetho]

I think I just figured out why I have "morning wood" feelings along with pressure and pain at the base, and urinary difficulty most mornings.

I've been puzzling about the apparent shortness of my implant cylinders at 15cm (5.9") without the addition of any RTEs, when my length is near or at 5" now. I think I figured it out and I'm concerned I may need to undergo revisions by another surgeon at some point to correct this. Here's what I've figured out:

The doctor told me he ran into challenges during my surgery, in regards to the scarring of my proximal corpora cavernosa from Peyronie's. I was under the impression that he would use the "surgical scissors" approach to snip through the fibrosis then dialate the incised fibrosis to 12mm to properly implant the proximal tips of the cylinders. Apparently that was the challenge he ran into. My length is at or near 5" (4.75+) of my pre-op 5" length, but he only implanted 15cm CX cylinders (5.9").

The cylinder tips are about 0.125" below the surface of the glans penis. If my length from pubic bone to tip is 5", subtracting 0.125" from that to get 4.875" from pubic bone to cylinder tip. Subtract 4.875 from 5.900" (15cm) will give 1.025" of proximal corpora depth for the rear tips of the cylinders. I'm concerned that 1.025" is not deep enough to extend under the pubic bone sufficiently.

Back to my "morning wood" feelings: since the cylinders only go just over 1" into the crux but they should go about 2.5" for a 5" distal penis length, that means I've apparently got 1.5" of corpora cavernosa within the base that is still capable of tumescence, thus causing the morning urinary difficulties and pressure/pain in the mornings.

Does this sound like I may need revisions to at least add between 2-4 cm of RTEs and work to incise through the remaining fibrosis?

[vajim1]

When you are pumped up feel below your scrotum and you can tell how far the cylinders go. They should just about reach your anus.

[Waynetho]

When you are pumped up feel below your scrotum and you can tell how far the cylinders go. They should just about reach your anus.

That's just it, they seem to stop literally at the public bone. Nothing goes further under the bone, into the perineal area. I can't feel the end of the tips so there's no gap, but they stop right at the bone.

I did a test while inflated yesterday evening and I may just be an anatomical aberration. I pushed on my penis while inflated to see if there was any play in the implant and whether I could feel the end of the tips. Pushing did not result in any movement beyond the public bone or any slack or play. Pulling outward does show a little give but not so much as to feel the end of the tips.

It may be just the way my anatomy was designed, that my corpora cavernosa don't anchor completely under the public bone like the average adult male human, but instead they go right up to the bone (and slightly under it) and stop. In fact it's probably been 30 years or longer since I hung at the 1:30 to 2 o'clock position (if I'm even remembering correctly). I've almost always been about the 3:00 position or lower when erect.

I'll be talking to the AMS patient liaison and possibly my doctor next week to ask questions and try to get some answers.

[tomas1]

I wonder if some kind of scan would get the answer?

[Waynetho]

I wonder if some kind of scan would get the answer?

Yes, possibly but it would most likely require a CT scan or MRI to see the corporal bodies. That's probably an expensive proposition -- Oh wait! I got my implant surgery for free because I had already met my Out-of-Pocket maximum. Now I just need to get a doctor to sign off on a CT or MRI with a reason that the insurance company would buy!

[tomas1]

I was afraid an ultra-sound wouldn't work.

[Waynetho]

Hopefully this won't be needed but I just started thinking that I may need to start researching for a surgeon who can do revisions in my specific unique case. I'm considering contacting Dr. Allen Morey at UT Southwestern in Dallas to see if he would be able to do an RTE add-on revision. What sucks is I'm not even cleared for sex yet and I'm already thinking that revisions may be necessary to properly anchor my implant.

Since I have severe corporal fibrosis (my doctor said "he ran into difficulties"), I need someone who not only does revisions but believes he would be able to properly add RTEs to my implants and get them into the fibrotic corpora. All of this I need to accomplish under the policy requirements of my insurance company.

[vajim1]

Could you feel where your penis started before your surgery? Mine was always just above my butt hole and I assume this normal. I had a loot of crap that had to be remove also but my doctor got just about all of it out. My right cylinder does not go done as much as my left does. This causes some kinking on the right side especially when I am deflated.
The main thing is to have a good working DICK!!!

[Waynetho]

Could you feel where your penis started before your surgery? Mine was always just above my butt hole and I assume this normal. I had a loot of crap that had to be remove also but my doctor got just about all of it out. My right cylinder does not go done as much as my left does. This causes some kinking on the right side especially when I am deflated.
The main thing is to have a good working DICK!!!

Not sure if what you were referring to is spongiosum tumescence rather than cavernosa tumescence but it sounds like it.

The spongiosum surrounds the urethra and also includes the glans. When erect, a healthy male will have a swollen urethra all the way through the perineum. I've never been able to feel the cavernosa in my perineum but I have ALWAYS felt the tumescence in my urethra when erect, all the way down to my anus. As a matter of fact, of the many porn videos that I've seen since I started puberty, I've never seen any males who when erect, had visible erectile swelling in that area except for the urethral area that I mentioned above.

[Waynetho]

I've been replaying in my mind, my last 10-20 years of one situation that repeatedly occurred during that time and I believe my "treatment" to relieve the condition may have been what lead me to being short-sized due to the fibrosis in my proximal corpora.

For years I've had issues with painful morning erections and they were so troublesome that I could not get back sleep until it went down. Unfortunately after I was conscious of a nocturnal/morning erection, I was unable to completely eliminate it unless I got up and started my day. Once erect, I was at least partially erect and in discomfort until I acted on it or got up.

At some point I discovered that if I had an erection and couldn't get back to sleep, I could place my thumbs on the base of my penis and press down, against the suspensory ligament with sufficient force as to get a faint "POP" or "CLICK" after which the erection would quickly subside (almost instantly!)

I employed this newfound method to relieve nocturnal and morning erections frequently over the remaining years until it got progressively more difficult to get the "POP" and release of the erection. I believe now that this act was gravely irresponsible and was most likely 100% responsible for the inability of my doctor to penetrate fully through the proximal corpora. I believe now that every time I heard a "POP", I was perforating or tearing a tiny hole in one corporum cavernosum or the other. In my theory, this allowed the erection to quickly abate and in thus doing, caused corporal scarring to form, over and over.

The one flaw in my theory is that I never experienced any bruising, edema or hematomas so I might be wrong. Nonetheless, the pressure against the suspensory ligament probably went a long way to injury to the tunica and possibly the corpora that caused my problem.

I can only say that this was in retrospect, very irresponsible even though it gave me instant relief. I am paying for it now, apparently.