18 +3 vs 21 without RTE?

The final frontier. Deciding when, if and how.
Lost Sheep
Posts: 6163
Joined: Mon Jul 04, 2016 11:16 pm

18 +3 vs 21 without RTE?

Postby Lost Sheep » Thu Nov 09, 2017 6:46 pm

I plan to ask my surgeon next week when I have a follow-up appointment but wonder if there is any reason why a surgeon would use an 18 cm implant with three cm rear tip instead of a 21 cm implant?

AMS LGX length 18CM X diameter12MM plus 3 cm rear tip according to the card in my information packet.

Also, does anyone know what the 12 mm diameter figure means. I thought the diameter of the rear of the implant was 9 mm.

Thanks
Lost Sheep
AMS LGX 18+3 Nov 6, 2017
Prostate Cancer 2023
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medhatg
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Re: 18 +3 vs 21 without RTE?

Postby medhatg » Thu Nov 09, 2017 6:54 pm

Wishing you a speedy recovery.

For AMS, there is an inflatable part of the cylinders and there is non-inflatable. The diameter of the inflatable part is 12mm (1/2") and the non-inflatable part is 9mm. Not sure how long would be the non-inflatable part for an 18cm implant. For the 21cm, it is about 5 cm (2").

Not sure why would the surgeon use 18+3 vs 21. A wild guess would be for pump positioning and the location of the tubes going into the cylinders. If he would have used 21, then the tubes would have entered the cylinders way to the back and the pump would have been quite high.

Anonymous3
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Joined: Thu Aug 03, 2017 9:43 pm

Re: 18 +3 vs 21 without RTE?

Postby Anonymous3 » Thu Nov 09, 2017 7:02 pm

I think it has something to do with angle. With the rte you can get the hinge effect

Larry10625

Re: 18 +3 vs 21 without RTE?

Postby Larry10625 » Thu Nov 09, 2017 7:09 pm

hturner12 wrote:I think it has something to do with angle. With the rte you can get the hinge effect



Yup, I think you are right. :)

Larry

Robocock444
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Joined: Tue Oct 17, 2017 8:45 am

Re: 18 +3 vs 21 without RTE?

Postby Robocock444 » Thu Nov 09, 2017 7:25 pm

Some guys have rather short cavernousa inside pelvis while others have a significant portion. The positioning of the inflatable cylinders should be consistently placed in each patient Although most surgeons are implanting with as few rte as possible, there are those of us that just can't be implanted with 2 or fewer rtes. My AMS rep was in the OR during my first surgery and commented that I was a rare patient. It just could be that simple.
1 LGX blowout.Cx revision. 3 AMS pump failures.1 Titan OTR pump failure. Huge swelling ea time. Last revision w Dr Eid. Cycling 4th day. Sex in 14 days. Now consulting patients of several Dr's pre and post surgery. Can I help you too?

Lost Sheep
Posts: 6163
Joined: Mon Jul 04, 2016 11:16 pm

Re: 18 +3 vs 21 without RTE?

Postby Lost Sheep » Thu Nov 09, 2017 7:46 pm

hturner12 wrote:I think it has something to do with angle. With the rte you can get the hinge effect

Which is why fewer rear tip extenders are better, usually

I forgot about the need to use tip extenders for pump positioning purposes and did not even consider the dimensions of the cavernosum into the crus. Thanks robocock444.
Lost Sheep
AMS LGX 18+3 Nov 6, 2017
Prostate Cancer 2023
READ OLD THREADS-ask better questions -better understand answers
Be part of your medical team
Document pre-op size-photos and written records
Pre-op VED therapy helps. Post-op is another matter

radioradio
Posts: 1012
Joined: Tue Aug 09, 2016 2:44 pm
Location: Philly Burbs

Re: 18 +3 vs 21 without RTE?

Postby radioradio » Thu Nov 09, 2017 8:16 pm

medhatg wrote:Not sure why would the surgeon use 18+3 vs 21. A wild guess would be for pump positioning and the location of the tubes going into the cylinders. If he would have used 21, then the tubes would have entered the cylinders way to the back and the pump would have been quite high.


Medhatg,

I think you are exactly right with your wild guess. I'm pretty sure that's why my pump is on the high side. My corpora may be 21 cm, but more than an average amount is internal (judging by the relatively short length of my external penis). So a fair amount of the tubing is not available for the pump to hang down far. I'm debating whether or not to go through with a revision that would add tubing and enable a lower positioning of the pump.
I believe my doctor used the 21 cm vs the 18cm + RTEs to give me the best chance to regain some of the length I lost from the prostatectomy. With regular cycling, I am seeing some gains, and I've only been cycling for 9 weeks.

Lost Sheep,

Wishing you the best for a speedy recovery (although sometimes it may seem like it is taking forever) and hard times ahead! :D

Bob
2.3
Born '52. Married '79. RALP 3/1/17. ED 50+% prior to surgery even w/ meds. VED, Injections, ineffective. Considering implant even before PCa diagnosis. Dr. Kramer 8/2/17. LGX 21cm+0.5 RTE. Kramer replaced/repositioned pump 12/13/17. Willing to Show/Tell.

Greg1956
Posts: 1736
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Location: Atlanta, GA USA

Re: 18 +3 vs 21 without RTE?

Postby Greg1956 » Thu Nov 09, 2017 9:27 pm

I also have an AMS LGX that's 18cm with 3cm RTE. I asked my surgeon why he did that versus a 21cm. His answer was a portion of the penis is outside and a portion inside and that is one factor and the other is the relationship of the back end of the implant to the location of the pump. I did not ask for clarification, but assumed that meant a guy with lowhanging balls versus my tighter sac would maybe require something different.
I am 64 and had ED from a VL. Implanted by Dr. Ronald Anglade in Atlanta on 9/18/17. I have an AMS700LGX 21 cm via a Penoscrotal incision. Very happy with results. 6" soft and 6 3/4” x 5 5/8” hard.

Lost Sheep
Posts: 6163
Joined: Mon Jul 04, 2016 11:16 pm

Re: 18 +3 vs 21 without RTE?

Postby Lost Sheep » Thu Nov 09, 2017 10:41 pm

Greg1956 wrote:I also have an AMS LGX that's 18cm with 3cm RTE. I asked my surgeon why he did that versus a 21cm. His answer was a portion of the penis is outside and a portion inside and that is one factor and the other is the relationship of the back end of the implant to the location of the pump. I did not ask for clarification, but assumed that meant a guy with lowhanging balls versus my tighter sac would maybe require something different.

Yes, indeed. The Northwestern AMS representative was kind enough to respond to my text and reiterated what I heard here. I am reassured, and did not have to bother my surgeon.

Good customer service from AMS.
Lost Sheep
AMS LGX 18+3 Nov 6, 2017
Prostate Cancer 2023
READ OLD THREADS-ask better questions -better understand answers
Be part of your medical team
Document pre-op size-photos and written records
Pre-op VED therapy helps. Post-op is another matter

Larry10625

Re: 18 +3 vs 21 without RTE?

Postby Larry10625 » Fri Nov 10, 2017 6:50 am

Lost Sheep wrote:
Greg1956 wrote:I also have an AMS LGX that's 18cm with 3cm RTE. I asked my surgeon why he did that versus a 21cm. His answer was a portion of the penis is outside and a portion inside and that is one factor and the other is the relationship of the back end of the implant to the location of the pump. I did not ask for clarification, but assumed that meant a guy with lowhanging balls versus my tighter sac would maybe require something different.

Yes, indeed. The Northwestern AMS representative was kind enough to respond to my text and reiterated what I heard here. I am reassured, and did not have to bother my surgeon.

Good customer service from AMS.


When I first got my implant, I had a lot of questions... rather that bugging my very busy surgeon, I called the AMS rep for our area and he was FANTASTIC. He answered ALL of my questions with great detailed answers. I could not have hoped for more. A truly great company and customer service. :)

Larry


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