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I have a question about preservation of the cavernosal artery.

Is it possible that the surgeon can preserve the erectile function by artery sparing dilation of the corpora cavernosa or do they cut it to implant the cylinders of the IPP? If so, what world class surgeons does this technique?

There's another study:
Inflatable Penile Prosthesis Implantation Without Corporeal Dilation:A Cavernous Tissue Sparing Technique

If the patient already has erectile function, wouldn't the best way to preserve it be by avoiding an implant altogether?

The cylinders go right into the same space as the spongy stuff that fills with blood. My understanding is that they don't actually remove the spongy stuff, but when the cylinders expand, they compress it so much that it's no longer going to work for a natural erection. Some people do feel like they can still get a bit of natural erection even without filling the implant. I'm not a doctor, so take this with a grain of salt, but my hunch is that this is mostly the other spongy parts of the penis filling, like around the urethra and in the head, but not within the corpora covernosa itself. In any case, I've never heard of any doctor doing anything on purpose to allow this, so whether my hunch is right or wrong, I don't believe there is any special thing for the doctor to do. You should assume that natural erections are gone.

I have a hunch. Maybe you still get some erection, but it's not reliable. Maybe it goes down too quickly for satisfying sex, and sometimes it doesn't come up at all, but sometimes it is there, so just getting rid of it feels bad. That's how I was. But after decades of "sometimes maybe", I decided that I'd rather have an erection that always works for sure, so I got the implant.

There’s several techniques I’ve read about and one of the big name Drs mentioned it in a video. For many years an Implanting Dr would use dilators incrementally to enlarge the inside of the cavernous body. What the newer techniques are now to use less dilation if I heard right in one of the videos. This would allow possibly some blood to fill in around the cylinders but when pumped up it would expand to the point of dilating the inside anyway. Not sure how it works. After sex I can inflate as much as I can squeeze out and still have a very full filled out dick that won’t lay down at all. But by the next morning it’s flat and flimsy

Based on my personal experience, my ability to get partial erections after first implant was good but not as good as before implant. I would have some morning wood (balsa wood more accurately) and occasionally chub up. After the revision I have no erection response at all. I’m guessing that with each insertion and intrusion into the corpora, more erectile tissue and vessels are damaged. I recall seeing a photo of someone who opted to have a repeatedly broken implant removed without replacement and his dick was basically just a flat tube of skin with a head.

Rider1400 wrote:There’s several techniques I’ve read about and one of the big name Drs mentioned it in a video. For many years an Implanting Dr would use dilators incrementally to enlarge the inside of the cavernous body. What the newer techniques are now to use less dilation if I heard right in one of the videos. This would allow possibly some blood to fill in around the cylinders but when pumped up it would expand to the point of dilating the inside anyway. Not sure how it works. After sex I can inflate as much as I can squeeze out and still have a very full filled out dick that won’t lay down at all. But by the next morning it’s flat and flimsy

That's what preservation of erectile tissue consists of. Someone told me that the cavernosal artery gets displayed or damaged while inserting the cylinders. I don't think is possible the the surgeon cuts it, that doesn't make sense.

Hrc714 wrote:Based on my personal experience, my ability to get partial erections after first implant was good but not as good as before implant. I would have some morning wood (balsa wood more accurately) and occasionally chub up. After the revision I have no erection response at all. I’m guessing that with each insertion and intrusion into the corpora, more erectile tissue and vessels are damaged. I recall seeing a photo of someone who opted to have a repeatedly broken implant removed without replacement and his dick was basically just a flat tube of skin with a head.

Thanks for the info.That means your cavernosal artery is intact.