scarring from long term injections and its effect on implant

[cumstein]

HI guys, I am a newbie but I have searched this and I didn't find anything that directly answers my question.
I have had ED for 20 years treated successfully with injections of PGE1 until recently. The Viagra, Cialis and Levitra did not work. I also got PCa in 2009. I went with radiation and am doing fine. But recently my injections have failed and I have noticed over the last 6 months some lumps in the Penis.
I consulted via phone with a high volume Implanter URO in NYC. I have an appointment set up to see If I can even have an implant.
Apparently using the the injections for so long will really complicate the implant. ( a very good reason to limit the injection treatment to short term). I always Injected with just PGE1 but last year that stopped working so went to tri mix. It still works but i need to find just the right location adjacent to the lumps to get a good injection. Clearly the addition of papaverine probably caused more scarring. The DR. is worried that the scarring from injections will eliminate his ability to implant the correct width cylinder. Makes sense to me. I have an appointment with him to examine me and do an ultrasound to determine what the inside of the corpora look like. So until then, we really don't know.

I just wondered if anyone has encountered this and if they were lucky enough to still get an implant that would work.
DR. said on the phone one way to do it is implant malleable rods for 6 months to dilate the corpora and then replace that with an inflatable device.
He was NOT pushing that, it was just an alternative if I do not qualify because of scarring. After reading about the malleable rods, and the pain associated with that along with the risk of infection, it looks pretty grim to me. I guess I could try the Xiaflex treatment but based on this board plus other comments, not sure the expense and lack of a lot of positive outcomes is worth it. Also have heard vibrator will break up scar tissue for some, but I do not know the protocol. Also wonder about Shock wave technology like Renova or other machines but they are primarily for angiogenesis.

Has anyone had this problem ( not Peyrones) and were you able to get an inflatable ? Has anyone had the rods first and then received a successful inflatable implant? This is about my last option so looking for any advice or experience. I am 64 and not ready to give up !!

[RelievedofED1]

I know there are narrow inflatables that are used sometimes to expand the corpora and then reimplajt with regular size if needed. I would take the time to see or at least at least call Dr Kramer and Dr Eid to have them examine you and give you their opinion as to options. Best of luck

[cumstein]

thanks relievedofED!. I am planning to visit Dr. Eid next month.
If someone else has had this scarring problem and still got a good result, please let me know. I just want to know what to expect and what my options are. Walking around with malleable rod's which you can't push down for 4-6 weeks because of pain doesn't sound great. But, this all sucks anyway so It may be my only hope!

[ValPinto]

just to add to previous posts, seems like Dr. Kramer puts that scenario in many of his videos. I think these little videos and conversational explanations he gives helped me gets some answers, check it out or youtube it.

[David_R]

I've heard that having had long-term injections does not interfere with getting an implant.

[cumstein]

thanks for the comments. This board is excellent.

When I talked to Dr Eid he did not recommend the narrower implants due to lack of axial rigidity. ( floppy penis)
I need that like a hole in the head.

I watched a number of Kramer's videos and I noted that he said in one of them sometimes he encounters scar tissue when he opens the corpora. He didn't mention what he did to deal with it. I sure don't want to go into surgery and have them find scar tissue and then put in a narrower implant. I see Eid soon so I will post what he says about this issue for anyone else who encounters this.

I guess I should get a second opinion from Kramer in person. If will post his thoughts.

[Anonymous 3]

I've heard that having had long-term injections does not interfere with getting an implant.

I used injections for about 10 years, both alprostadil and Trimix. Maybe I was just lucky but my surgeon did not report any scarring or difficulty with placing the cylinders. Quite the opposite actually. The pump, well he had to shoehorn that into place, as he let the ward know when he came to visit the next morning. "Wow, do you have a small scrotum!" Thanks doc!

[wavygravy]

I had issues with scarring from injections as well.

I am a paraplegic, 40 years now, used Viagra and then injectables for a few years.

Fortunately, my doctor (Dr. Hunter Wessells UW Men's Health Center, Seattle) was able to successfully install my implant. It is now 2 years and all systems are go!

Good luck.

[cumstein]

I thought I would update this for anyone who has concerns about penile scarring from injections.
I saw Dr Eid last week. Seemed like a good guy, the office was organized and I got right in to see him.
He agreed I had scarring but not as bad as some of his patients. The ultra sound showed fibrosis but no plaques. He showed me the dialators he uses to open up the corpora. Its not uncommon to use them. He starts with a small one and works up to larger ones until he feels he can get the implant in.
Looks like he can do the 20CM Coloplast titan most likely with no RTE's. I don't know if i will get a second opinion or not, but my meeting with him went well and he showed me his series going back about 15 years on infection rates. They really went down after the coated implants came out and were reduced further with the NTT.
So, now I got the scarring issue addressed. Who has had the 20CM Coloplast and what has been your experience with length or any other issues? I will research this question more, but would appreciate any comments on this implant. Also, when Dr Eid pulled the penis and measured it, that was consistent with what I have measured HOWEVER, After injection I could actually pull it another 1CM which is also consistent with what i found when injecting. I used a constriction ring to keep this length when i was injecting and never had a problem but I know you have to be careful with priapism so do that at your own risk. I am not an expert and only mention this to see if anyone else has experience the same thing. Thanks for all responses.
Does that mean I could actually get a longer implant? I am going to call him about this, and see what he says. I expect its a balancing act to get the correct size.....