Second Surgery Next Week

[kickit40]

I was originally implanted on 12/30/20 and unfortunately I am having a second surgery on 4/21.

It appears my left cylinder has "slide" down and is significantly lower than my right cylinder. This is causing a curve in my penis to the left and pain in my left groin.

The doc thinks he might be able to put a larger implant in because my penis has probably been stretched out through cycling.

If he can do a bigger implant, my options would Titan 24cm w/ 2 RTE's or a 26cm Titan.

The doc said he would go with the RTE option because over time you would lose fluid and might not be able to get the 26cm Titan 100% inflated.

I was reaching out to see what everybody's thoughts are.

[newbie443]

I was always of the opinion that if you trust the doctor to do the surgery you should follow his instructions and advice. I have no knowledge on the issue. You could always contact another very good doctor for a second opinion.

Sorry for your trouble and I hope this works out well for you.

[wolfpacker]

Not sure what he meant about losing fluid over time... If a 26 cm titan didn't work or lost fluid over time I imagine coloplast would not make them.

[nuance]

I was originally implanted on 12/30/20 and unfortunately I am having a second surgery on 4/21.

It appears my left cylinder has "slide" down and is significantly lower than my right cylinder. This is causing a curve in my penis to the left and pain in my left groin.

The doc thinks he might be able to put a larger implant in because my penis has probably been stretched out through cycling.

If he can do a bigger implant, my options would Titan 24cm w/ 2 RTE's or a 26cm Titan.

The doc said he would go with the RTE option because over time you would lose fluid and might not be able to get the 26cm Titan 100% inflated.

I was reaching out to see what everybody's thoughts are.

Does anyone know how a cylinder can "slide" down? Is this cause of proximal perforation?

[Agfa13]

Sorry to hear about you going through another surgery so quickly. I went through 3 in a year's span, so I really do feel for you!

Now, as for one cylinder sliding down, if you look at the set up of the implant, it is not one, solid piece. Everything is connected, so they have joints. The joints themselves can break. If they break completely, there is nothing supporting the cylinder into the penis. The complete break will also cause you to lose fluid. The fluid will leak into the body, thankfully, its saline, and can easily be absorbed by the body.
Think of a sink. You have the elbow joint at the bottom. if that elbow joint was disconnected from the pipe that lead to the sink itself, the pipe would fall if it was not held in place at the other end. In our case. cylinders are pushed in, but nothing to hold it in place except whatever you have at the ONE end.

[Gt1956]

Nuance: I can't say for sure that the name you give is correct for Kickit40's symptoms. But to me, the name sounds correct for a perforation. Are perforations common? Not very but they do happen. The human bodies have lots of variations in their structures. My gallbladder surgeon remarked that he had a little trouble accessing a large vein during my surgery. I asked how abnormal my vein was. He said perfectly normal. Said his reference book had over 50 pages of pictures of that vein. The book didn't begin to show all the variations. Mine was "normal". Whatever you want to call normal.
Back to harping about the search function. It will answer lots of your questions. You just need to use the correct words to search for.
A few years ago a member had one cylinder slip out of his crus. Next inflation it curled into a bow shape in his groin area. He posted a good picture of the MRI showing it curled up.
It took him some time to get it diagnosed (that showed to me that it was kind of rare) & to find a surgeon to repair it. FWIW, I think its called a "sling" repair. Somehow a sling is fabricated, attached in the correct area & the rear implant tip is nested into it. To the best of my memory his repair was very successful.
So try using sling as a search word. Scroll through the posts about 2 years ago. The member made lots of posts but he might of not used the word sling very often. Btw, I think there is a mens bladder repair that has the words sling in it also.
Good luck.

[nuance]

Nuance: I can't say for sure that the name you give is correct for Kickit40's symptoms. But to me, the name sounds correct for a perforation. Are perforations common? Not very but they do happen. The human bodies have lots of variations in their structures. My gallbladder surgeon remarked that he had a little trouble accessing a large vein during my surgery. I asked how abnormal my vein was. He said perfectly normal. Said his reference book had over 50 pages of pictures of that vein. The book didn't begin to show all the variations. Mine was "normal". Whatever you want to call normal.
Back to harping about the search function. It will answer lots of your questions. You just need to use the correct words to search for.
A few years ago a member had one cylinder slip out of his crus. Next inflation it curled into a bow shape in his groin area. He posted a good picture of the MRI showing it curled up.
It took him some time to get it diagnosed (that showed to me that it was kind of rare) & to find a surgeon to repair it. FWIW, I think its called a "sling" repair. Somehow a sling is fabricated, attached in the correct area & the rear implant tip is nested into it. To the best of my memory his repair was very successful.
So try using sling as a search word. Scroll through the posts about 2 years ago. The member made lots of posts but he might of not used the word sling very often. Btw, I think there is a mens bladder repair that has the words sling in it also.
Good luck.

Thanks for your reply, I'm still researching to see what all can go wrong with implants. Proximal perforation seems scary as there's no way to fix the perforation itself, have to rely on "sling" repair like you mentioned. I don't know how robust that is and if it can be re-used during revisions. Without perforations, the cylinder should be held in place right even if the implant itself breaks? If anyone knows, how likely can such a perforation occur during surgery? When making space for the cylinders, the surgeon uses a dull instrument to create space for inserting cylinders. I hope they are gentle when doing this and don't cause a perforation.

[newbie443]

I had a proximal perforation but my cylinder did not slide down out of my glans. Instead my erect angle was to the left \. The left rte or proximal end was unsupported and during sex (thrusting) the proximal end caused pain poking into stuff it was not supposed to. I had trouble with getting the repair due to local doctors not doing revisions or repairs. They just removed an implant if a man had problems and could not adjust to it. When I talked to the business office to inquire about going local with my insurance this was part of the counseling that a significant number of men did have the device remove due to poor results by my local doctors and that with insurance not paying for all the cost lead me to travel and pay out of pocket. There was another man that had a crossover perforation in the low shaft. We had both posted imagery of the perforations. As doctors are different the methods are also. Another repair is the Sail repair. That is where a piece of material is used in the repair. In the sling repair that I received my left cylinder only was removed and permanent suture material was used to create a stirrup for the proximal end and secured to the tunica at the corporotomy. That suture will need to be located and removed if i have a revision. This is one possibility for the OP's problem. My doctor had posted with at least another about his speed in this surgery. The idea was the faster the surgery the less time the wound was open and exposed to infection. And in difficult cases scaring can need aggressive dilation. And some men have had to have narrow implant models or less experienced doctors have not been able to insert the cylinders at all. Some doctors do not use the rounded device to dilate with. Weather for speed, difficult cases, or lack of interest in the procedure. And most likely other reasons I do not know of.

This is an old post (over one year) so not sure the OP will respond. It is possible if it is a perforation that that was not from surgery but happened later. And there are cases of that. And I guess it is possible that there was scarring in the Crus that limited dilation but over time one side had less scar tissue and with cycling opened up. So there is no perforation just less scaring permited the proximal end to work down. Imagery would be needed to show the cause.

[nuance]

I had a proximal perforation but my cylinder did not slide down out of my glans. Instead my erect angle was to the left \. The left rte or proximal end was unsupported and during sex (thrusting) the proximal end caused pain poking into stuff it was not supposed to. I had trouble with getting the repair due to local doctors not doing revisions or repairs. They just removed an implant if a man had problems and could not adjust to it. When I talked to the business office to inquire about going local with my insurance this was part of the counseling that a significant number of men did have the device remove due to poor results by my local doctors and that with insurance not paying for all the cost lead me to travel and pay out of pocket. There was another man that had a crossover perforation in the low shaft. We had both posted imagery of the perforations. As doctors are different the methods are also. Another repair is the Sail repair. That is where a piece of material is used in the repair. In the sling repair that I received my left cylinder only was removed and permanent suture material was used to create a stirrup for the proximal end and secured to the tunica at the corporotomy. That suture will need to be located and removed if i have a revision. This is one possibility for the OP's problem. My doctor had posted with at least another about his speed in this surgery. The idea was the faster the surgery the less time the wound was open and exposed to infection. And in difficult cases scaring can need aggressive dilation. And some men have had to have narrow implant models or less experienced doctors have not been able to insert the cylinders at all. Some doctors do not use the rounded device to dilate with. Weather for speed, difficult cases, or lack of interest in the procedure. And most likely other reasons I do not know of.

This is an old post (over one year) so not sure the OP will respond. It is possible if it is a perforation that that was not from surgery but happened later. And there are cases of that. And I guess it is possible that there was scarring in the Crus that limited dilation but over time one side had less scar tissue and with cycling opened up. So there is no perforation just less scaring permited the proximal end to work down. Imagery would be needed to show the cause.

Thanks for your reply. How would perforation occur after surgery and recovery? Hopefully implant tips are dull and won't punch through the tunica. How common is this?

[newbie443]

Thanks for your reply. How would perforation occur after surgery and recovery? Hopefully implant tips are dull and won't punch through the tunica. How common is this?

The short answer is I do not know. Proximal placement is a bit of a mystery to me. Distal placement can be felt and is pulled through the tip of the Glans with sutures. However this is not the case with proximal placement. And the Crus will fork or bend to an unknown degree depending on the mans anatomy. My repair surgeons notes stated it was not determined if the perforation occurred at the time of the first surgery or later indicating the possibility of this happening later. As the proximal tip is not pulled through the Crus and the shape can very I would suppose that the proximal tip could get caught a bit sideways and during cycling cause over time an erosion and a perforation. Or pulling down on the pump to hard could pull the proximal end up and out of the end of the Crus. All this is just speculation on my part to try and understand, like you, how this can occur and I have found no medical documents for the reason.

In my case the next morning after surgery, as I spent the night in the hospital, when my first surgeon's resident removed the cath my penis flopped hard left across my body. This to me means there was a problem then. Just a risk we all take with this.

Just a bit of information for you and others considering implant reading this. If you worry about everything that can possibly go wrong, you would be afraid to move. Falling out of bed or in the shower. Falling down stairs. tripping and falling just walking. And motor vehicle accidents are even more dangerous. The point is there is a risk with anything we do. Choke on a piece of food, ect. I my case medication did not work. I had only one option and that was implant. So I did the best i could do to go to the best doctor I could afford for this. That is pretty much the same for each of us. Find a good doctor and make a plan. If there are problems most all can be fixed. Odds are good of a really good outcome. Just like driving to the store or walking around the mall.

Best of luck to you.