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Quick one guys, I was at a consultation with a urologist here in Ireland, he seems to be the best implanter here, whatever that means for a small country, my original implant was done penoscrotally and he said he doesn't do penoscrotal he does infrapubic... but he said he would have to do penoscrotal as you have to do the same as original!!
He said 3 things that didn't fill me with confidence,
That was one
The second is when I asked how does he size the implant, he replied very quickly with "I will put in the same size as you originally got!!!"
And third, he said there will be 2 incisions, first is penoscrotal incision, and the second is for the reservoir...
How does this all sound to you??

irishguy wrote:Quick one guys, I was at a consultation with a urologist here in Ireland, he seems to be the best implanter here, whatever that means for a small country, my original implant was done penoscrotally and he said he doesn't do penoscrotal he does infrapubic... but he said he would have to do penoscrotal as you have to do the same as original!!
He said 3 things that didn't fill me with confidence,
That was one
The second is when I asked how does he size the implant, he replied very quickly with "I will put in the same size as you originally got!!!"
And third, he said there will be 2 incisions, first is penoscrotal incision, and the second is for the reservoir...
How does this all sound to you??

- 2 incisions should not be necessary (if it was not necessary the first time, why would it be necessary the second time?). You can ask him why you need 2 incisions?

- The implant size, unless you have complaints about your size and ask him to make it bigger, it is possible he will just want to play it safe and keep the same size as the previous one. Why would he do a different size if you are happy with your current one?

- Most people want to have the same incision as the first one, so if you had penoscrotal before, you would probably not want to have a second infrapubic scar. But if you ask him for that second separate incision, i am guessing he would do it. But why do you need a different scar than the original one?

irishguy wrote:And third, he said there will be 2 incisions, first is penoscrotal incision, and the second is for the reservoir...
How does this all sound to you??

My surgeon did two incisions because he couldn't "optimally" place the reservoir from the penoscrotal incision. I don't know how common that is (mostly people here are penoscrotal or infrapubic).

Had my revision last June, pentascrotal both times, 1 incision, I have read that surgeons doing revisions like to leave the reservoirs in because they become attached internally and can become difficult to remove. I spoke to 2 surgeons about this and they both said the same. I chose my surgeon and I asked him to look at my reservoir and to remove it if he could. He did remove mine and placed the new one in the same place. Also you have had your implant for 8 yrs, he should be going in to measure because you more than likely can take a larger one now. Mine was the same but he used a AMS LGX and told me that it has some expansion built in for both length and girth and that is what he used.

wilsonmill wrote:Had my revision last June, pentascrotal both times, 1 incision, I have read that surgeons doing revisions like to leave the reservoirs in because they become attached internally and can become difficult to remove. I spoke to 2 surgeons about this and they both said the same. I chose my surgeon and I asked him to look at my reservoir and to remove it if he could. He did remove mine and placed the new one in the same place. Also you have had your implant for 8 yrs, he should be going in to measure because you more than likely can take a larger one now. Mine was the same but he used a AMS LGX and told me that it has some expansion built in for both length and girth and that is what he used.

Why was your reservoir changed? i mean if it was working properly why change it?

Discover
I meant my fear is he only does infrapubic and there's no way here in Ireland that he is a high volume implanter so I'm thinking low volume implanter plus now he has to do the penoscrotal approach which he doesn't do...

Also on the size I fully understand where you are coming from,but if there's space for a slightly bigger implant safety then why not... everything just shouts that he's not experienced enough for a good level revision implant but I could be wrong

wilsonmill wrote:Had my revision last June, pentascrotal both times, 1 incision, I have read that surgeons doing revisions like to leave the reservoirs in because they become attached internally and can become difficult to remove. I spoke to 2 surgeons about this and they both said the same. I chose my surgeon and I asked him to look at my reservoir and to remove it if he could. He did remove mine and placed the new one in the same place. Also you have had your implant for 8 yrs, he should be going in to measure because you more than likely can take a larger one now. Mine was the same but he used a AMS LGX and told me that it has some expansion built in for both length and girth and that is what he used.

Thanks for reply, why do he give you so many rte's??

Both surgeons had recommended the LGX, for length and girth , and here is what comes off the AMS site

"Longer LGX device considerations
Longer LGX devices, such as the 21 cm device, can be prone to instability, aneurysm, or s-shaped deformity
Some recommend using 18 cm LGX with rear tip extenders to prevent these device complications"

Discovernew wrote:

wilsonmill wrote:Had my revision last June, pentascrotal both times, 1 incision, I have read that surgeons doing revisions like to leave the reservoirs in because they become attached internally and can become difficult to remove. I spoke to 2 surgeons about this and they both said the same. I chose my surgeon and I asked him to look at my reservoir and to remove it if he could. He did remove mine and placed the new one in the same place. Also you have had your implant for 8 yrs, he should be going in to measure because you more than likely can take a larger one now. Mine was the same but he used a AMS LGX and told me that it has some expansion built in for both length and girth and that is what he used.

Why was your reservoir changed? i mean if it was working properly why change it?

I had the Titan originally, They installed a AMS LGX for the revision, so different a different mfg for one thing but the biggest thing was is that they would have to make new connections in your body, connections are weak points, I think most surgeons prefer a completely pre- assembled device. I guess if you went back with your same device they could connect the tubing without any issues as the tubing should matchup.

Most cases I’ve read about and videos from Eid and Perito say after a few years you generally will go up by 2cm. This is Susie to the rear tips seating in over time and making a little more space. Either way he definitely should remeasure. Also sounds like he would probably do a small scrotal incision to remove old IPP and then an infrapubic to install new one.