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Hello Everyone!

I want to thank everyone here and the FT Forum in general. This has been my go-to place to navigate the ED waters especially now as I enter the final frontier of implants! Hopefully my little journal here can give back and help a few guys too with their questions and experience with implants.

BACKGROUND:
Let’s start with a little background on me. Until age 36 I never really took care of myself. In fact I strongly believe now I was doing unrepairable damage to my body in regards to my ED starting at childhood to age 36. Anyway, My normal diet for as long as I could remember was fast food 2-3 times a day and a 6-pack of soda/coke. I was basketball fit from high school but that went away quickly after graduating and not exercising any more. At age 36, I had a physical with my employer that pushed me over the edge to do something about my health for me and my family. Let’s just say I was a mess - overweight, high glucose, high cholesterol, high triglycerides, high BP. It was time to do something so I bought P90X, changed my diet, started working out and lost about 40 lbs. My first round of P90X about killed me from an energy perspective and I just thought it was because I was out of shape. Then on the second round of P90X I knew something was wrong as I was falling a sleep at the dinner table and my mood was all over the place. Went to the Doctor and I had a testosterone level of 130! My doctor went over all the symptoms of low testosterone including ED which at the time I honestly did not think I had. It was then that my beautiful gracious wife told me that my erections had been declining for some time now and I began to understand there are many forms of ED. Mine specifically was that at the time I could get erect for penetration but I would go soft pretty quick. Anyway, at 36 I realized and accepted I had ED and began the roller coaster of possible remedies and cures.

THINGS I TRIED:
Moving forward, I changed from P90X workouts to riding and racing mountain bikes in order to stay fit and be motivated to eat healthy. I started testosterone injections for my low T as well. The hope was that by continuing to take care of my body and heal it really while on testosterone, I could cure all the low T symptoms including the ED, but that didn’t happen.
The ED was better but not gone. It was hit or miss and really the hits weren’t that great. So since T injections were not enough for ED, I went the usual path of dealing with ED trying just about everything: pills/cialis, VED/Vacuums devices, cock rings, Super TriMix injections, etc. I came across FT Board when I was looking for guidance on hitting the spot more consistently with my TriMix injections. They seemed so hit and miss.

ME AND MY WIFE ACCEPTING THE IDEA OF PENILE IMPLANT:
Over time of course as I had to keep increasing the dosage, the hits became less and less with TriMix. It was then that I began to entertain the idea of getting a penile implant. As I continued to read FT on implants I became more comfortable with the idea and I also began to share more with my wife. At first, my wife was like me: no way are we doing that! Then at the beginning of last year (2023) my wife began to change her mind about the penile implant. We knew I had a venous leak and based on my research that the venous leak repair surgery or even the shockwave treatments were just bandaids like the rest where the ED might be lessened but would return later. So last summer (2023) we knew that a penile implant was the one and only next step to put ED behind us!

INSURANCE COVERAGE:
I will just say that insurance coverage or non coverage can really suck. I had Cigna with my employer last year. I went through doctors visits and even had a surgery date for 11/11/23 only to have Cigna deny me 3 weeks before surgery. Later I found in the details of the benefits of coverage for Cigna they have a written exclusion to not cover penile implants for any reason. The written exclusion part is key when looking at insurance coverage as I found out later. Fast forward to March 2024 where I resign and decide to move into self-employment. Part of that process was choosing an insurance plan from Obamacare/Marketplace. It was then that I reached out to my doctor and talked to their finance department about what plans they have seen to cover the penile implant. They were extremely helpful and gave me a run down of pros and cons of all the plans available to me based on their past experience of trying to get the implant covered. Here is what I found out that I hope helps someone else. Based on what plans were available to me in Marketplace - the following plans were a no-go and virtually impossible to get approved for penile implant coverage: Advantage Blue Cross Blue Shield, Value Ambetter and United Healthcare (Group, Texas One and Charter) - all these plans were a no-go and rarely if ever covered penile implants. The only outlier with possibility of coverage was with Baylor Scott and White plans since the doctor’s office had seen BSW cover the implant but hard to tell which plan covered it and which one didn’t under BSW.The finance department explained that the big thing is to avoid plans with an explicit written exclusion to penile implants, or the diagnosis code or the treatment code for the procedure.

The diagnosis code for ED: n52.9.
The ED coverage code for the implant: 54405.

Both these codes are needed for coverage and both cannot be excluded in any way of the insurance plan/evidence of coverage benefits. So with this information I reached out to Baylor Scott and White insurance to discuss the plan I was interested in and I had them do a search through the evidence of coverage for penile implants, n52.9 and 54405 to see if anything came up. Nothing did so I thought I was in the clear and signed up for the plan. Month later I got a denial letter for the implant only this time they didn’t reference any specific exclusion but a general exclusion paragraph on plastic surgery. I then reached out to Boston Scientific/AMS insurance hotline (855) 284-1676 for help on what if anything I could do since there was no specific exclusion. If you call AMS for insurance help be sure to choose the option for doctors not patients! That is the only way to talk to someone without a callback that will never happen. Anyway, the lady I talked to was really nice and didn’t know I selected the option for doctors. She had me email her the denial letter and evidence of coverage and plan benefits. We went over everything and could not see any form of exclusion for penile implants or the codes needed for diagnosis/treatment from above! Baylor Scott and White had sent me an appeal letter I could fill out and with the help of AMS, I filled it out and used their evidence of coverage against them so to speak in the sense that the part they reference for the reason of exclusion was false and not documented in the evidence of coverage mentioned by BSW and that the same document showed approval of coverage for medically necessary prosthetics and I ended the appeal requesting BSW to look over again my enclosed denial letter and evidence of coverage. 3 weeks later after sending the appeal letter in by UPS overnight with tracking I noticed in my BSW online account that they reversed the decision! My doctor's office would not move forward until they had received the approval letter of course. That took another week where I finally got my surgery date of 7/23/24 a couple days ago!

DR MOREY AND WHY I CHOSE HIM:
My main criteria for an implant doctor was they had to be a high volume center of excellence doctor that was within driving distance of my home. I wanted to make sure I had someone that had done thousands of these type surgeries preferable with a good track record here on FT. I originally wanted to use Dr. Clavell in Houston, but the 9 hour drive for appointments and surgery just didn’t sit well with me. I came across Dr. Allen Morey a few times on FT who was a Professor at University of Texas Southwestern. It seemed from searching FT that Dr. Morey’s personal track record was great but his students not so much. The consensus was if you have to go with Dr. Morey be sure to see if you can get in writing that he is doing the work and not his students! So initially I was skeptical of reaching out to Dr. Morey, but when I did I was pleasantly surprised that he retired from being a Professor and joined Urology Clinics of North Texas for his practice! So I met with him and I do not regret at all going with Dr. Morey. I highly recommend him! He is older than Dr. Clavell if that matters to you - and he is very personable with a sense of humor that tells you that you are in good hands. He does seem to be a little more conservative on things which I actually like - I will share later how he really tried to look out for me in this entire process and do everything he can for complete success. I’m sure Dr. Clavell would have done the same, but right now I cannot recommend Dr. Morey enough and I hope there are more on FT that use him now that he is no longer a Professor.

WHY AMS CX:
So originally I thought I wanted the Coloplast Titan since it seemed like after reading and researching on FT that the Titan had arguably the hardest erection when fully inflated. Dr. Morey changed my mind on that and after reading more on FT I realized that all three implants - Coloplast Titan, AMS CX and AMS LGX had great reviews as far as erections go. The difference between them came from flaccid states, reservoirs, and longevity of use. Dr. Morey explained that I could go with the Titan but that he preferred the Titan for the guys that needed the extra size that AMS didn’t offer. Dr. Morey explained that the Titan potentially would not be as comfortable as the AMS implants in the flaccid state especially for me who was a cyclist/mountain biker. He also said he had fewer complaints from his AMS patients compared to his Titan patients. Another thing he brought up was the reservoir and that he preferred the AMS conceal reservoir for guys like me due to my low body fat. So I then asked about going with the AMS LGX since it grew in length, right? Dr. Morey said in his experience with both the LGX and the CX - the CX had a little stronger erection when fully inflated and that the LGX didn't really increase length of the anatomy. The LGX is still limited by the anatomy and really all it is doing is reducing the size in the flaccid state to make it a little more manageable, maybe in the flaccid state. Dr. Morey again said we could go with the LGX but that he preferred the CX based on patient feedback. Another thing we talked about is the longevity of how long the implants will last. Dr. Morey explained that even though he installs far fewer Titans, the Coloplast Titan has had the most failures for him. The tubes of the Titan are usually what go out being rubbed against each other due to a poor design. He went on to say that when the AMS fails it is usually in the pump/valve which has been resolved in the new Tenacio pump. Most of this has been confirmed in one way or another on FT. I also know and I am aware that Dr. Morey probably gets a kick back of some sort to push AMS over Coloplast. Here’s the point - they are all great implants based on reviews here at FT but you need to find a doctor that can help you choose the one best for you and your total anatomy in both an erect and flaccid state and that you feel comfortable with in how long it will last. For me, it turned out to be the AMS CX with Tenacio Pump and 100ml Conceal Reservoir.

TENACIO PUMP:
In June of 2024, Boston Scientific finally began a soft release for the new Tenacio pump to only 10 high volume/center of excellence doctors to begin using in their patients. Fortunately for me, Dr. Morey is one of those Doctors. After reading about how the Tenacio pump was designed to correct the previous MS pump in both functionality and longevity - I was happy that I had been denied a couple times for the implant so I could get the new Tenacio pump. I could also tell after talking to Dr. Morey that he was really impressed with the Tenacio pump. As far as I can tell, I am one of the first on FT board to have the Tenacio pump. I will do my best to answer questions about the pump but keep in mind this is my first one so I don’t have another to compare to.

DAY 1/SURGERY DAY:
Surgery was at (BSW) Baylor Scott and White Medical Center in McKinney Texas. My wife and I had driven about 5 hours the day before and stayed in a hotel close by. BSW staff was amazing with the entire process. Dr. Morey came in beforehand and went over a couple things. He reminded me of the 36 hours numbing medicine he would have me on and went over a couple other things again with me. As he walked out he mentioned one last time - I can’t increase your size. I can only put in what your anatomy allows. I told him I understood as I know that comes up a lot here on FT and the thoughts of all men who receive a penile implant. I will be honest. I had been praying for at least a 21CM implant since based upon reading FT the 21CM had the closest chance to give me potential to get back to my 6 inch state before all this ED mess after cycling of course. When I was out of surgery I was pleasantly surprised to find out that Dr.Morey had implanted a 21CM AMS CX with 2CM RTE (Rear Tip Extenders) for a total of 23CM! So I am pretty excited about that since with cycling I have potential to ge back to my original size when I was younger. Surgery went great according to Dr. Morey. Dr. Morey is big on being able to place the pump and the reservoir in the exact location he wants them both so he does a vertical penoscrotal incision in the scrotum and he does a second small incision above the penis in the pubic area in order to better place the reservoir. This was important for me due to my low body fat and in fact he had to move the reservoir after placing it originally. He noticed in first placement of the reservoir that the bulge while lying on my back was larger than he wanted to see. So he repositioned it in a better place while having to make the incision larger than usual. Getting dressed was not bad. I brought all kinds of short and PJ pants not knowing for sure how my mummy penis would be wrapped and how to cover it. What worked best for me and is still working well is I first put on my boxer briefs and then a pair of old cycling chamois shorts over the top of the underwear then normal shorts over that. This has allowed me to change underwear and keep reusing the cycling shorts for support keeping the penis up against the stomach. Cycling chamois shorts are going to be way more supportive than any support underwear you can find. I highly recommend ordering a pair for your surgery and recovery. Anyway, everything went great from there traveling 5 hours back home. I kept ice on everything every hour for 20 minutes. Only thing that drove me nuts was not pain but the stupid catheter. I knew from reading FT that the catheter was a necessary evil at times and that it was only for a day. Overall the first day pain and discomfort was very manageable and almost non-existent. I did notice I had to be careful how I moved or else I would get sharp pain on left side pubic area due to reservoir tubing and larger incision for reservoir placement. I took meloxicam NSAID and my antibiotic before heading to bed.

DAY 2:
This catheter was nothing short of evil! It was uncomfortable and just painful like sandpaper inside my penis. Didn’t get much sleep of course. I thought you didn’t have to get up out of bed and go pee with a catheter? not so for me. I had to get up twice and go stand near the toilet like I was trying to pee just so my body would release the urine in the tube! It was nuts. And, no, there were not any kinks in the tubing. I was literally waking up needing to go pee while having a catheter! For good reason, I removed the catheter about an hour before I was supposed to as I woke up on day 2. Felt so good to get that thing out of me and also felt good to pee a little normally immediately and to have a bowel movement. My goals had been achieved for the day and it was only 8am! This was the first time being able to unwrap and see my penis and incisions. I was surprised to see that it didn't look too bad at all! I had very little swelling and only bruising on the left side where the tubing for the reservoir went up. Also, teh size wasn’t as big of shocker as I thought. It’s roughly 5 inches right now with the usual pump amount after surgery and I can tell my skin is not stretched to I am optimistic on my starting length once I am clear to cycle. Rest of the day I slept most of the day on the couch and stood occasionally for a few minutes after going to the restroom. Then about 6pm I could tell the 36 hour numbing meds were wearing off. The little pain I had on my left side due to reservoir and incision was now at a new level but only happened if I moved too fast or in the wrong way so it was manageable. Later that evening though, I went a little too far in trying to sit at the dinner table with my family to eat and almost died with a sharp stabbing pain near the reservoir due to me sitting there too long and getting up in a poor fashion. Thankfully the stabbing pain subsides within a few seconds so I can catch my breath and plan my attack to move forward. Took Meloxicam and antibiotics again before heading to bed. Dr. Morey also prescribed Hydro-Codone for me but I am trying everything I can not to take it. I know from past surgeries I do not like how that stuff messes with my mind and mood. Anyway, I was able to sleep decently but at only 2-3 hours at a time where I would wake and then have to think how to move and reset to go back to sleep. All in all not bad and still manageable.

DAY 3:
So I am writing all this and above on Day 3. Can you tell I am bored yet? Anyway, the day has gone as well as can be expected. I woke up and after going to the restroom I was able to get my first shower after surgery which was amazing. My scrotum and all the underside of my penis is now bruised but thankfully the swelling is still fairly low. I keep icing about every hour for about 20 minutes. For medicine I decided to add straight acetaminophen instead of the hydrocodone which is just acetaminophen plus codine. That has worked well for me and I don’t have to worry about the mind issues or moodiness. Overall I am finding my groove with recovery. I am thankful for the better reservoir placement, but I'm not a fan of the added pain and discomfort. The penis incision feels great. No pain at all. I have even felt around for the pump and found the Tenacio ridges. There is no way to mistake this thing for a testical like I have read on FT. Also, it feels very intuitive on what to do and where to place your fingers. Excited to try it in a few weeks but just need to heal right now. The only pain I am having right now is in the left side pubic area of the reservoir, reservoir tubes, and reservoir incision. I don’t remember reading anywhere on FT about pain in that area, but I could have missed it. I am not worried about it since it is not constant pain and it is self induced pain when I move wrong in some way getting up or sitting down. Dr. Morey warned my wife about moving the reservoir and that I would hate him for a week. It’s 6pm now and about time for dinner. I will add more here and there as I go.

IN CLOSING:
If you read this far - you are crazy. Just kidding. Thanks for reading and I hope this helps someone as we are all a little different in anatomy and perspectives on this final frontier journey. I will do my best to update things as I recover and go along. Please feel free to ask me questions about anything. I have already been hit up a few times about the Tenacio pump and Dr. Morey. I hope I have answered those questions here as well. Thanks

DAY 4:
Last night was my best sleep so far after surgery. Taking Acetaminophen plus Meloxicam is working great so I can avoid Hydrocodone. Last night I was able to get in a more comfortable position more on my side instead of my back which helped. My swelling has been low and manageable so I was ok risking some swelling to get more sleep. One thing I have noticed so far is that in the current artificial chubby state of the implant I can feel the cylinders as something different in me. Not bad but not normal of course. Well last night I woke in the middle of the night from a dream that got me a little aroused because my penis felt almost natural with a feeling of blood flow and my gland was engorged! I didn’t expect or hope for this until a few weeks from what I have read on FT! Anyway, it was a nice good feeling in my body telling me it is healing. After that I got up and took a dose of Acetaminophen, peed and went back to sleep. I’m still having the self-induced sharp pain at times due to incorrect movement of my left leg in the left pubic area of reservoir, reservoir tubing and reservoir incision - but it is much more manageable when the pain shoots and it is passing quicker. All good signs of healing I am going to claim! The swelling has gone down enough to feel the reservoir tube now. I don’t have a lot of fat here so I can only assume that between that and Dr. Morey having to reinsert the reservoir to a better location during surgery - I am naturally more tender and sore here on the left pubic side. I am only pointing this out because in all the other journals on FT I have read there is mostly talk about the pain or discomfort in the penis and scrotum area and not much talk about pain or discomfort in the line of reservoir and reservoir tubing. I have had almost no pain at all in the penis or scrotum, just some minor discomfort due to a little swelling and the fact that my body is getting used to a foreign object in my body.

I’m curious then - who else has experienced the majority of their pain/discomfort in the pubic area of reservoir tubing and reservoir?
Is it just me and probably due to relocating the reservoir to a better place?

I’m not concerned since it all seems to be getting better each day. Yesterday was a little rough in moments as I was no longer on the 36 hour numbing meds and I had to work out what pain meds would work best for me. I for sure feel my best today so far after surgery.

One of the things I have learned with the implant so far is that you really do not lose anything with the implant. What I mean is that for some reason I thought I was going to lose the feeling of pushing pee out and I assume semen out later. I thought I would lose the reflex of using your pubic muscles to pull up on the penis. Not sure the correct way to say it but I think you know what I mean. What I am trying to say is the implant cylinders replaced a body of spongie blood in the tunica albuginea and not tied to any nerves or muscles that work the penis. The chubby state I am in is easy to get used to. I would say the only thing I feel different about my penis in the current chubby state is that before the implant I could squeeze and feel the sponginess of the inside of the tunica albuginea. Now it doesn’t feel spongie anymore and feels more solid now. This is not a bad thing, and just takes a little getting used to.

Another thing I wanted to say to anyone that is on this road in the future is to not be focused so much on length right after surgery. Your length is not who you are. Accept that at first after surgery it will not be what you expect or want it to be. Mine is about 4.5 inches right now I would say, but this is after surgery and only partially pumped up. I have read a lot of other guys freaking out after surgery on the length because of what it looks like after being cut on and only partially pumped up. You do realize that the doctors test and fully pump you up during surgery right to test the erection and length you can handle? Then they deflate you to a point they feel you will heal the best. If you have a good high volume doctor then you can trust them in giving you what is needed and best for you and your anatomy. After reading here on FT, I know that surgery has shocked and caused the tissue around my penis to retract due to trauma obviously. It’s up to me once I am clear for cycling on what size I end up with. I take this as a positive as I heal and work it out to get the most length and girth I can for me.

Just got out of the shower and I am feeling really good actually. I’m regaining flexibility around the pubic area quickly and it is just another sign of healing. Everything is moving along it seems. I just have to make sure and hold back. I tend to push the limits too soon on stuff like this. I noticed I am able to sit comfortably in my office stair now which is a great sign to actually get back to work on some things. For now I am sitting on the couch with my legs out so I can ice everything in the best way with my frozen peas. I will probably experiment later sitting at my desk and working some to see how I feel.

I may jump on here and add more later if time allows, otherwise I will post again tomorrow for Day 5. Feel free to shoot me some questions or share your thoughts on anything I have said so far. It’s somehow comforting when the brotherhood battles all this together. Thanks

The first few days I had some very sharp pains where my reservoir was placed, especially when trying to sit up from the bed or a chair. I had double hernia with mesh about 25 years ago and this pain is very similar to the pain I had from the orthoscopic hernia surgery. I also had little to no pain in my shaft and had very little to no swelling in my scrotum although I did have mine done infrapubic. Sounds like you’re on the perfect road to recovery!! Just wait! It just gets better with time. Keep your present attitude and all will go well!

thank you TruthEdge for your diary, congratulations for telling your story, have you asked your doctor about the differences between the tenacio pump and the ams ms pump?

Great journal, please keep us posted, i like your writing and descriptions. The first time uses were very special, hope you let us know.

DAY 5:
I hate that recovery is not always linear. Ups and downs and you have to focus on the whole rather than the point or day in time. Anyway, yesterday I was guilty of pushing it too far when later in the day I sat in my office chair to work some for a couple hours getting up here and there as I thought was needed. About 5 pm I could tell something was not right. I started to get that kind of lingering nauseous feeling after being racked in the balls and I started to have a deep uncomfortable ache in my reservoir location area. Off to the couch I go for the rest of the evening trying to recover from the self-inflicted abuse of doing too much. Didn’t really get much better the rest of the night as I tried to enjoy pizza and a movie with my family. I went ahead and took the Hydrocodone for the first time ever at about 8pm. Thankfully it didn’t seem to affect my mind and mood like it has in the past. Honestly though, it didn’t feel it worked any better than straight Acetaminophen. As we finished up the evening and I gingerly got into bed trying to avoid the sharp pains in the left groin/pubic area I was praying to God to myself to be my grace in doing too much and praying I didn’t do some kind of damage to the healing process or worst something that has to be resolved by my doctor. You know how it goes - the mind can go into some dark places at times when we know we messed up.

I am happy to say that sleeping was actually pretty good overall! The Hydrocodone wore off about 2AM and I woke up about 4AM. I’m still taking the 24HR pill of Meloxicam in the evening, but I'm not sure how much it is doing for pain really. So going two hours past Hyrdocodone wearing off is a win in my book! What woke me up was when I tried to shift my position and got the sharp pains again in the left grown/pubic area of the reservoir and tubing. So glad it is just a stab and not lingering as the pain is in the 8-10 territory. If that pain was there all the time I would throw up and need to go to the doctor. Anyway, my mind started playing tricks on me. I was not sure whether to try to get up and get more pain meds risking the sharp pain again or just stay still and go back to sleep since the pain had stopped in the current position. I chose to stay in bed in hopes to fall asleep after a couple observations on how to deal with and resolve the stabbing pain and racked nausea feeling.

For the stabbing pain, I found out if I stuck my left hand down my pants and cupped the left side of my scrotum and balls when I needed to move in bed - the stabbing pain either didn’t happen at all or if it did it was considerably less. I think as I did this and felt the reservoir tubing and moved everything to the right and held it there as I moved, I am somehow stabilizing everything in the movement. Really doesn’t matter, I just know it works, so try it if you are having issues moving to a new position in bed to sleep. The other thing I noticed is that I was pulling my cycling shorts too high over my boxer briefs putting way too much pressure on my scrotum, balls, and really the pump. As a cyclist I am used to upping my cycling chamois high for support and pulling my scrotum high to ride. The problem is I can’t handle this kind of pressure right now in that area. Also, keep in mind I am on HRT/Testosterone Therapy. Before IPP surgery, my testicles were very small and my scrotum naturally shriveled up due to my testes not working any more since my body was getting testosterone exogenous now. So I looked like I had small balls which I didn’t care about since it was actually nice because it protected my balls from getting hit or rubbing the wrong way on my large cyclist thighs or rubbing on a bicycle seat. Now of course with the swelling and the Tenacio pump that has all changed and will evolve as I heal. So, not pulling my cyclist chamois shorts so high really has helped with that pressing nausea feeling deep in my scrotum.

I would be curious to know from any FT members who are bionic and on testosterone what your experience is like in your scrotum size and shape?

I suspect that once I am healed the testes will shrivel up again tight but the pump obviously won’t thereby producing a look and feel of a single large testicul in the middle hanging so to speak. No big deal - just something I will need to adjust to.

Anyway, I did fall back asleep after cupping the left side of my scrotum tubing and adjusting my cycling chamois shorts in bed. I got up a couple hours later and pain and discomfort without Acetaminophen actually wasn’t too bad! I was optimistic that God was answering my prayer for grace and that I hadn’t damaged the healing process. Took care of business on the toilet (man it is hard to poop right now with the left side discomfort and pain no matter how much meds I have), got my coffee, pain meds and ice and been on the couch all morning taking it slow having a great quiet time journaling with God and then moving to my journal here.

Right now I feel as good or better than I did yesterday when I started to do too much. I’m hoping to go to church tomorrow with my family so I am making sure to really take it slow and not over do it today.

So I have a few more observations I would like to share in this process so far. For me, the pain and discomfort in the scrotum and penis has been very minor and uneventful so far. It’s almost like when I had a vasectomy years ago. I feel some pressure here and there that is different but nothing with much pain at all! I do feel that there is something in my penis but it is not weird or uncomfortable. It looks like that will be easy to get used to. I do have a little sensitivity in my penis shaft when I need to push to empty my bladder. It’s not bad and I assume this will get better as I heal. I’m guessing that having a vertical penoscrotal incision has helped in the discomfort and pain. I can’t imagine pulling on that area from a horizontal incision. My overall bruising has started to fade and swelling is not bad.

Something I have noticed that I hope a FT member can shed some light on as I am trying to not let it bother me. I noticed yesterday that my penis shaft swelling is coming way down which I think is making my cylinders feel like they are less pumped up than a couple days ago when I squeezed them with my fingers. My mind is playing tricks on me again that I have a faulty unit and the cylinders have lost saline. So my chubby doesn’t look as chubby anymore…

PLEASE TELL ME THIS FEELING IS NORMAL!?!?

I have pressed on my glans and I can feel the tips about a quarter of an inch back. Hopefully that sounds about right when it comes to avoiding floppy glan! Also, this is interesting but when I run my fingers over the little snake bike holes on my glans from the needle, I can feel the edge of the thread in my glans similar to a splinter without pain or discomfort. I keep running my fingers over that area to help ease my mind that the tips are far enough in the glans! Whatever works right?

A QUESTION I HAVE FOR FT MEMBERS WITH THE AMS CX:
When your CX was in the chubby state after surgery, did you notice a good amount of skin on your penis that was not stretched when it came to length? I guess what I am trying to say is I think my AMS CX is a little shriveled in the current chubby state since I clearly have a lot more skin to stretch for length - like I am guessing at least another inch. I don’t want to try and stretch my penis for fear of pulling the cylinder tips out of the glans. I know the LGX grows in length so this would be expected behavior. However my FT reading impression of the CX and Titan has been you pretty much have all your length at all times flaccid or erect hence becoming a shower and not a grower. So with the CX is the girth the only thing that changes from a flaccid to erect state? Or is there some length change as well for the CX between flaccid and erect? ANY HELP OR IDEAS HERE WOULD BE APPRECIATED!

Finishing up for the day by replying to questions and comments:

Rider1400 wrote:The first few days I had some very sharp pains where my reservoir was placed, especially when trying to sit up from the bed or a chair. I had double hernia with mesh about 25 years ago and this pain is very similar to the pain I had from the orthoscopic hernia surgery. I also had little to no pain in my shaft and had very little to no swelling in my scrotum although I did have mine done infrapubic. Sounds like you’re on the perfect road to recovery!! Just wait! It just gets better with time. Keep your present attitude and all will go well!

Thank you Rider for your response to my question about left side stabbing pain along left groin/pubic area of reservoir and tubing! Your answer makes a lot of sense and is reassuring that I am not having issues and this is normal recovery for me. I am not sure I have read anywhere about most of the pain coming in like a hernia operation recovery for some guys. Good to know and encouraging. I have to keep in mind that the extra incision is larger than usual from Dr. Morey for the reservoir placement since he had to move the reservoir to a better location for my anatomy after it was initially inserted. The incision is about 1.5 inches - so no wonder I am having more pain here! Again, thanks for replying and encouragement!

frank66665 wrote:thank you TruthEdge for your diary, congratulations for telling your story, have you asked your doctor about the differences between the tenacio pump and the ams ms pump?

Hi Frank and thanks for replying/questions: So I am trying to distinguish between what I have researched on the Tenacio pump and what Dr. Morey said. Dr. Morey stated that the Tenacio pump addresses every single issue or complaint of the original MS pump when it comes to reliability and function. He said the MS pump was overdue for an upgrade or replacement. He had mentioned that when he saw any of the AMS systems fail it was in the MS Pump where the single valve system would quit working in some fashion. The Tenacio has a double valve design with much better and more reliable valves. From my research, it looks like the Tenacio will be far more reliable long term because it is splitting the load of pumping over two valves instead of only one. The two valves allow you to pump fast for bigger pumps and slower for smaller pumps allowing consistency, speed, and fine tuning the erection. Dr. Morey mentioned I would be able to go fully pumped in about 7 full pumps! From what I understand this is a great change compared to the number of pumps needed on the MS pump or even the Coloplast pump. From my research on Tenacio I have found that the redesign with ridges and a longer neck between the release valve and inflate valve make the pump much easier and more intuitive to learn and use. I can attest to this myself as it is really easy to feel both the release button and the inflate pump right now with the swelling I have. My fingers naturally find the ridges and I can see how the ridges will prevent my fingers from slipping. Hope that answers your questions and I will try to add first hand experience as I heal and begin using it.

Witheringhog wrote:Great journal, please keep us posted, i like your writing and descriptions. The first time uses were very special, hope you let us know.

Thank you WH! I really appreciate it! I enjoy sharing as God has shown me for many years now that being vulnerable and sharing has a big impact on others. My wife and I have a great God story when it comes to him redeeming our marriage and we now counsel couples and lead a marriage group at church. We actually are working out the details on how we can share our penile implant story with other couples to help strengthen their marriage when it comes to intimacy. We are firm believers that God created the gift of sex for us to enjoy and share in our marriage and there is nothing wrong with getting help in the bedroom when either spouse is having any issues in intimacy. Anyway, thanks for the compliment on my writing style.

Did you remove your catheter yourself?

TruthEdge I must compliment you for your detailed and clear descriptions to everyone, I will answer your question about testosterone, the scrotum and testicles, I have been doing testosterone since January 2021, 2 years before the implant, the scrotum seems to have shrunk slightly, almost I have to tell you that it keeps my pump and testicles in position well, the testicles have actually shrunk considerably, in the early days I did gonasis (chorionic gonadotropin) to revitalize the testicles and increase ejaculate, now I don't do it anymore, I continue only very small doses of testosterone, around 55 mg of enanthate, this small dose allows me to have testosterone at the maximum or slightly less, this also allowed me to lower the red blood cells/hematocrit/psa/hemoglobin limits, first I did 125 then 100 then 83 mg and the testosterone was off the high scale, without resolving the ED, now with the implant I have reduced the testosterone and everything has returned to normal for 5 months, after the implant I continued to take tadalafil 5 mg a day and 10 /15/20 mg if necessary, or 50 mg of sildenafil, to engorge the glans, I realized that tadalafil only broke my bones and sildenafil did little or nothing, now I no longer use anything except testosterone 55 mg a week, the glans when I'm excited swells like when I took tadalafil and sildenafil, I have other types of problems that I will solve in September with a review with ams cx if my doctor keeps his word, keep updating, I'm very interested in the tenacio pump , heal soon, take it very easy, don't make any effort and try to stay still as long as possible, the more you stay still, the better you heal, I was still for 1 month or more and I didn't have any kind of problem with healing

I can answer two of your questions. Testosterone did shrink my testicals a lot! And yes the pump does tend to hang down in the middle which is actually perfect placement for pumping. On a hot day if I was exposed it would show but never presents any issues. On a cold day my sack shrinks up and holds everything and I can’t even see any difference when this occurs. Your second question, yes the cylinders will in fact stretch out as they break in. I had similar experiences with swelling going down and feeling slightly less pumped although I had not touched the pump early on. Try not to worry or get too concerned about sizing or mechanical issues at this point. Time heals when it comes to implants. There’s almost nothing a Dr can do for a long time after implant except verbally insure that things are ok unless there’s some odd very low percentage issue. Give it time… 4-6 even 8-10 weeks and things will start falling in place as it all heals and all swelling goes down and you start using this amazing new implant.

DAY 6:
So I was a good boy the rest of the day yesterday and didn’t do anything no matter how good I felt. After overdoing it a bit on DAY 4, I came to my senses and am focused on moving as little as possible for the first week like Dr. Morey originally told me. Right before surgery, he was funny and said that I would be hating him for a week and to just focus on laying around staying still and doing as little as possible for that week. At the one week mark he said I could do most things including some walking as I feel up to it, but of no exercise or sex of course. He was stern about this because in my pre-op appointment I had mentioned that I was a fast healer from the previous seven surgeries I have had, and I wanted to know realistically the soonest I could begin very light exercise on the stationary bicycle or rowing machine. His response in the pre-op appointment immediately was no lifting until the 6 week mark. It’s funny how when a guy says exercise people immediately think lifting weights! Nothing wrong with lifting but cardio/endurance exercise is my thing. Anyway, I pressed him a bit here stating I was asking about non-weight bearing low impact exercise like rowing and stationary bike. He finally relaxed a bit and said I could probably ease into either of those at the 4 week mark but to stop immediately at any pain or discomfort. He went on to explain that he had a patient start lifting light weights too soon and caused a herniated reservoir that had to be repaired. Just another reminder to me that this procedure is also healing from a hernia repair due to reservoir insertion. OK, I got a little off track there, but wanted to clarify what Dr. Morey had advised me and what I am doing now and in the future weeks.

So yesterday ended well with lots of sleep doing nothing on the couch. Last night was my best night yet sleeping in bed! The stabbing pain on the left side groin/pubic area was pretty much gone when moving in bed. Sleeping then went much better since I didn’t have outcries of stabbing pain when I went to reposition myself. I woke up about 4AM since I had slept so much last night on the couch before going to bed.

When waking up I had some new sensations I did not care for and was driving me nuts! First I was extremely itchy in my penis and scrotum. The kind of itching where it is deep inside and you can’t really scratch! Parts of my skin on the outside also itched which I began to scratch a lot like the palms of my hands which is really weird. What ultimately made me get up out of bed was the feeling of pressure like a balloon in my penis and scrotum. The swelling had not changed. In fact it had gone down once I got up and examined everything. This pressure I am talking about was too the point of pain in the left scrotum area and left cylinder. I really can't explain it. It kind of felt like when your body tries to contract the muscles in the groin area when you pee or ejaculate but in this case after surgery I was feeling pressure of restriction from the implant that was a little painful as the pressure built. Again, there was no added swelling because that was my first thought. The muscles kept contracting making it feel like my body was trying to make my penis erect but it couldn’t because it was banging into the ceiling of the implants current chubby state. It was a very weird uncomfortable feeling. That eventually passed about 45 minutes after I got up. The itching didn't stop until I had iced everything for about 30 minutes, which I wasn’t able to start until I finished going to the restroom and getting my coffee so I could sit on the couch.

After all the itching and pressure passed I had the thought that the stabbing pain was actually easier to deal with than the constant itching and pressure for the hour after I woke up! The stabbing pain was so short of time it seemed easier to deal with than itching and pressure that lasted a consistent time. Anyway, I am feeling great overall now after icing everything. The stabbing left side groin pain is still there every once and in while but it is seldom and not near as sharp/stabbing. So another good mark of healing!

I did choose to stay home from church today. As I said earlier, I am focused on doing as little as possible until the week is up. If I had gone to church, I would have been tempted to push too far in serving like I normally would. Plus I won’t have to deal with questions on why I am slow moving today. Still working out the details with my wife on what we say and don’t say. We are good with me going into the details when I am talking to men only, but in mixed environments with ladies around we haven’t come up with a good response yet. The problem is when you try to be vague with people after they ask point blank what surgery you had, then they jump to conclusions like cancer or something. So, we are working on a positive response when ladies are around that says enough for them to let it go without jumping to conclusions of something bad. I know the general consensus on FT is just say you had a hernia repaired and that is actually partly true after that reservoir placement. I think my wife said she would just play dumb today at church and say it was a surgery in the groin area that is a good positive thing and to talk to me if they want to know more. Ladies won’t ask for more but men might and it opens up conversation for me to share in case they have had similar issues. I know most will read this and think - it’s none of their business and why say anything or why not just lie. It’s just not how we roll. My wife and I are both leaders in our church and people are attracted to us because we are so open and vulnerable. We have just learned over the years to use our trials and victories in conversation to encourage others around us and we have no intention of stopping now because of the sensitive topic of a penile implant. It’s all good and we look forward to what God will do in us and through on this journey.

OBSERVATION: Answering my own question yesterday about my chubby changing or if the cylinders have lost any pressure - I believe now that the cylinder pressure has not changed from what Dr. Morey setup in surgery. What is changing is the amount of swelling around the cylinders that makes me think the cylinder pressure is fluctuating or reducing. Day 2 it felt the most pressure because I had the most swelling. When the swelling went down a little it made the cylinders feel softer. I can only verify this by the fact that my chubby felt harder this morning when I woke up due to the engorgement or swelling I experienced in pressure here. Anyway, I am just going to believe that nothing is wrong here and I can’t do anything about it anyway. I will say there is no way I can believe that Dr. Morey pumped this up to 60%! I am sure all doctors are different on how much they pump you up at the end of surgery. Right now based upon what I see, Dr. Morey must be more on the lower side of how much erection you are left with after surgery. I am also assuming after reading on FT a little more yesterday that the AMS CX is probably a little crinkled in length due to not enough pressure in the cylinders yet. There is a ton of skin that can be stretched at this point for length so I am just going to relax and trust the process of healing and then cycling.

OBSERVATION: Not really tied to the Tenacio specifically, but I did notice that the pump was slightly turned to the left when feeling around with my left hand holding the deflate block and my right fingers grasping the inflate bulb. Not a big deal and in fact probably makes it a little easier since I am right handed and probably would pump this way anyway. Thought crossed my mind that this might be an issue if I was left handed. I thought about straightening it out but wasn’t sure how much pressure I can put on this right now. I don’t want to rip open my scrotum incision trying to twist the pump into place. I honestly don’t think pain would have been the issue. Anyway, just sharing here and there my experience with Tenacio pump as I heal.

CLOSING OUT RESPONDING TO COMMENTS/QUESTIONS:

kbb1957 wrote:Did you remove your catheter yourself?

Hey KBB! Sorry I missed going into more details here on my DAY 2. So, Dr. Morey placed a Folley catheter in me and sent me home on a several hour drive home. For the first 24 hours after the surgery the catheter was by far the worst thing to deal with! It was such a relief to pull it out myself the next morning after surgery. It was extremely easy to take out. The Folley catheter has a valve connected to a saline solution balloon in your bladder that is filled to prevent the catheter from falling out. All I had to do was sit on the pot and take the syringe and connect to that valve and then withdraw the saline solution. I did it twice to make sure I had all the saline out. Then the body just pushes the catheter out naturally. It felt weird of course and can be described like the feeling of poop going out your anus only its a tube going out your penis! LOL! My wife was there to help and was ready with a trash can so we could prevent a mess. It felt so good to get that thing out of me! I immediately was able to dribble pee a little and then a fairly normal string later in about an hour. Let me know if you have any other questions and thanks for asking!

frank66665 wrote:TruthEdge I must compliment you for your detailed and clear descriptions to everyone, I will answer your question about testosterone, the scrotum and testicles, I have been doing testosterone since January 2021, 2 years before the implant, the scrotum seems to have shrunk slightly, almost I have to tell you that it keeps my pump and testicles in position well, the testicles have actually shrunk considerably, in the early days I did gonasis (chorionic gonadotropin) to revitalize the testicles and increase ejaculate, now I don't do it anymore, I continue only very small doses of testosterone, around 55 mg of enanthate, this small dose allows me to have testosterone at the maximum or slightly less, this also allowed me to lower the red blood cells/hematocrit/psa/hemoglobin limits, first I did 125 then 100 then 83 mg and the testosterone was off the high scale, without resolving the ED, now with the implant I have reduced the testosterone and everything has returned to normal for 5 months, after the implant I continued to take tadalafil 5 mg a day and 10 /15/20 mg if necessary, or 50 mg of sildenafil, to engorge the glans, I realized that tadalafil only broke my bones and sildenafil did little or nothing, now I no longer use anything except testosterone 55 mg a week, the glans when I'm excited swells like when I took tadalafil and sildenafil, I have other types of problems that I will solve in September with a review with ams cx if my doctor keeps his word, keep updating, I'm very interested in the tenacio pump , heal soon, take it very easy, don't make any effort and try to stay still as long as possible, the more you stay still, the better you heal, I was still for 1 month or more and I didn't have any kind of problem with healing

Thanks for the compliment - it has been fun to share. Thanks for answering my questions on testosterone and testicle/scrotum size effect on the implant life. You have confirmed my thoughts that the shrinkage will actually lock my pump in place so to speak. Funny - I was on HCG too in the beginning of my HRT journey to help with erections and prevent my testicles from shrinking. I never saw a benefit to erections and the HCG would cause swings in testosterone and estrogen so I quit it. I will admit that my ED problem most likely was not only due to venous leak but also due to having a hormonal imbalance when it came to testosterone and estrogen both. The reason I say this is based upon passing through the sweet spot of my testosterone levels and my estrogen levels. In the sweet spot, I could actually have a decent erection but not the best due to the venous leakage. It is almost impossible to keep testosterone and estrogen balanced perfectly by manual means. You only kind of get in the vicinity so to speak and try your best to stay there. It’s just part of the process when the body is unable to regulate the balances. Good to hear that you were able to find a better balance after your implant! Yeah I intend to keep taking my 5mg a day of Tadalafil/Cialis. It helps keep my prostate from swelling and now I expect it to help with blood flow to my glans with the implant. I haven’t heard about Tadalafil breaking bones and I have had Deja scans proving my bone density. I will definitely keep an eye out though. I will do my best to keep updating on the Tenacio pump any other questions that come up. Thank you for the encouragement on healing and staying still. I wish you well and pray that everything is resolved and or you have some answers by September which is not far away!

Rider1400 wrote:I can answer two of your questions. Testosterone did shrink my testicals a lot! And yes the pump does tend to hang down in the middle which is actually perfect placement for pumping. On a hot day if I was exposed it would show but never presents any issues. On a cold day my sack shrinks up and holds everything and I can’t even see any difference when this occurs. Your second question, yes the cylinders will in fact stretch out as they break in. I had similar experiences with swelling going down and feeling slightly less pumped although I had not touched the pump early on. Try not to worry or get too concerned about sizing or mechanical issues at this point. Time heals when it comes to implants. There’s almost nothing a Dr can do for a long time after implant except verbally insure that things are ok unless there’s some odd very low percentage issue. Give it time… 4-6 even 8-10 weeks and things will start falling in place as it all heals and all swelling goes down and you start using this amazing new implant.

Hey Rider! Thanks for chiming in! Good to hear and more confirmation on exogenous testosterone testicular shrinkage is not a bad thing for the pump and actually might make it easier! Thank you for reassuring me on the cylinders stretching over time and your own personal experience when the swelling went down around your chubby after surgery making it feel less pumped up! I will heed your advice to just relax and heal over these next 4-6-8-10 weeks. Thanks brother!