My tips for pre-op, during and post-op for penile implant

[London lad]

Hey brothers,

I've been meaning to jot down several tips based on my own experience of the penile implant in November and since then.. hope you find these helpful.. feel free to add to or question me on any aspects.

I have tried categorised my advice into Pre-op, During Op, and Post Op:

PRE-OP:
- I would say the number one focus pre-op is in decision-making and being happy with your decisions. I guess by now you've already examined for yourself if you do want to go ahead with a penile implant, but it's always best to assess the question for yourself - because it's your decision and your decision alone. (I knew I definitely did want to go ahead because it had reached a point I was so tired of erectile dysfunction my entire life - I felt I had nothing to lose in giving it a try - if anything I would say I had been too hesitant and postponed it too long in my life).
- The other main decision for me was whether to go for Coloplast Titan or AMS. In the end, it became clear for me that Coloplast Titan was the answer for me - based on the fact that my surgeon reckoned for my size range the Titan was available in 1cm increments (whereas AMS was 2cm increments - meaning a RTE would've been less likely needed with a Titan)*. Also my particular surgeon is generally more a believer in Coloplast Titan anyway.
[* There is a study about these differences in size increments in Titan v AMS - if I can dig it out somewhere I will add it to this post]
- Stretching or "Traction" of the penis - I don't think/know if there's a huge amount of scientific-proving of this - but I figured why not just give it a try - whereby I spent any spare time in the weeks/days/hours leading up to the operation just physically-stretching the penis out (to improve its elasticity and thereby hopefully enhance your chances of a maximised cylinder-size being inserted). Again, I don't think there's much scientific-findings to back this up, but I figured I've nothing to lose in just giving it a big physical stretch out. (I believe there are people on this board however who have spent literally months before the op using a traction device - so they would probably be best positioned to advise on the effectiveness of these).

DURING THE OP PROCESS (i.e. Day 1 to Day 3):
- The number one focus during the procedure itself is Pain Management - for me it certainly was - it was the most physical pain I've ever been in (don't let this put you off though - not all patients seem to have such a torrid pain experience - I think I must have a low physical-pain threshold or something).
- If I had to do something differently straight after the op, I definitely would have refused Morphine. I was trying it for the first ever time, and Its side-effects were so horrendous for me (blacking out/nausea), with hindsight I would've just refused it altogether. But if you do find the pain absolutely unbearable, then it does do an effective job for pain-relief.
- Sleep. This is the number one strategy for pain-management in my opinion. The only thing is, it's not easy to fall asleep when in so much physical pain. But that's where I would've taken 10mg Ambien (which I take regularly anyway) - because the side-effects of this sleeping-pill are, in my opinion, much much more tolerable than Morphine - and the ability to Sleep itself will solve out a lot of pain itself.
- Icing. You'll hear this recommended a lot on this board - and for me it certainly was the most important thing for Pain Management behind only Sleep. Bag of peas or a frozen ice-pack will do.
- Keeping the feet up - at or above hip level - this seemed to reduce the feeling of pain.
- Standing in a Yoga "Forward Fold" position (Google it to see how it looks) - I find this a relief also when the pain was feeling unbearable in the weeks after.
- Entertainment. Just keeping the mind entertained/distracted is a good idea for Pain Management. Even just taking your laptop with you (have your Mobile Phone tethering switched on for mobile internet access) - so that you can watch a comedy/sitcom (something funny/light-hearted that can take your mind off the pain is recommended. Also having someone to talk to like a friend or family member is a good idea for taking your mind off the physical pain.
- This Franktalk board. I found this board such a Godsend for any quickfire questions I had before, during and after the process- not only for the support but also the informational gathering from getting a wide spectrum of opinions on things. So a BIG THANK YOU TO EVERYONE ON THIS BOARD AND LARRY FOR COORDINATING IT! AND A SPECIALISED SHOUT-OUT TO SPIKEPORK FOR SEEING ME THROUGH THE PROCESS AND ONLY EVER BEING A TEXT MESSAGE AWAY!!

POST-OP:
- Keep yourself reminded on the end-goal. Despite the pain/stress of it all, remember that the reassuring thing that the operation generally has 90% satisfaction rate or something - and for me personally, I have definitely felt a notch up in self-confidence compared to before the op (because it is effectively the first ever time in my life now that I can get hard sustained erections, be they artificial ones). But as I say in the Pre-op advice above, always ensure that any surgery is a decision you're happy with beforehand.
- Sleep, icing, entertainment and this FT board - all excellent for Pain Management - as explained above.
- When trying to learn to inflate for first times, I would recommend using kitchen-towels to make gripping of the device much easier to handle and thereby use. It's painful if it keeps slipping out of your fingers. I even used rubber-thimbles at times, just to get myself used to gripping onto the pump device.

Give me a shout with any other questions. I might add more to this post as/when I remember more tips that were helpful to me.

P.S. The following two Youtube videos I also found very helpful for tips straight after the op:
https://www.youtube.com/watch?v=tcQgJB3kbO0
https://www.youtube.com/watch?v=28oz8ldQcso

[Lost Sheep]

- Stretching or "Traction" of the penis - I don't think/know if there's a huge amount of scientific-proving of this - but I figured why not just give it a try - whereby I spent any spare time in the weeks/days/hours leading up to the operation just physically-stretching the penis out (to improve its elasticity and thereby hopefully enhance your chances of a maximised cylinder-size being inserted). Again, I don't think there's much scientific-findings to back this up, but I figured I've nothing to lose in just giving it a big physical stretch out. (I believe there are people on this board however who have spent literally months before the op using a traction device - so they would probably be best positioned to advise on the effectiveness of these).

There is little I know of on the merits of traction, but there are several studies in the medical journals indicating the use of Vacuum Devices pre-operation has benefits.

It makes sense to me, as a vacuum expands the penis and fills the penis with blood a lot more like a natural erection than traction. More evenly distributed for one factor.

[London lad]

Oh yes - another thing to mention - in the weeks leading up to my op I did buy myself a vacuum pump and use it fairly regularly - not sure of the difference it made - but again, felt I'd nothing to lose in just giving it a try

[UK_Steve]

After my prostatectomy I was told that to prevent scarring and to maintain my penis size I MUST use a VED every day. This was to force blood into the penis and oxygenate the tissues. Over 12 months later I can confirm that I still had my original pre op size.

[George03]

My urologist that removed my prostate due to cancer (non nerve sparing) to use the pump. I used it for sex a couple of times before getting an implant.

[London lad]

THat would be another other thing to mention regard my scenario - I didn't have a prostatectomy before the implant (reason for my having the implant was simply a lifelong erectile dysfunction) - and so in this respect my starting position was perhaps different to others on this board who had a prostatectomy beforehand

[London lad]

Another tip (for POST-OP) whilst I remember - is Savlon antiseptic cream (not sure its equivalent brand name outside UK). If your stitch-wound area in the days after surgery is very sore like mine was, I found rubbing Savlon on it significantly helped it in terms of pain management. And think it's quite a gentle cream so shouldn't have any side-effects. Savlon I probably used for a month after the operation (around 2-3 times a day as/when needed). I especially used it before trying to pump as it significantly reduced soreness.

Another cream I found useful when I first started pumping is EMLA (which is a local anesthetic type cream). *But* be careful not to apply this to the stitch-area as it stings a lot on open wounds. Also use it very sparingly, as one of it's side-effects is stinging, which you don't particularly want to be feeling on the balls. (Don't try washing it off after use either, as water also makes it sting). Reason I found it useful though, is because I was finding grabbing the pump for the first time was so painful, that slightly numbing it with this EMLA cream significantly helped me able to pump. I probably used EMLA 2-3 weeks after first trying to pump.

The doctor/nurse didn't mind me using Savlon/EMLA either when I told them I was using it.

[Larry10625]

Hey brothers,

I've been meaning to jot down several tips based on my own experience of the penile implant in November and since then.. hope you find these helpful.. feel free to add to or question me on any aspects.

I have tried categorised my advice into Pre-op, During Op, and Post Op:

PRE-OP:
- I would say the number one focus pre-op is in decision-making and being happy with your decisions. I guess by now you've already examined for yourself if you do want to go ahead with a penile implant, but it's always best to assess the question for yourself - because it's your decision and your decision alone. (I knew I definitely did want to go ahead because it had reached a point I was so tired of erectile dysfunction my entire life - I felt I had nothing to lose in giving it a try - if anything I would say I had been too hesitant and postponed it too long in my life).
- The other main decision for me was whether to go for Coloplast Titan or AMS. In the end, it became clear for me that Coloplast Titan was the answer for me - based on the fact that my surgeon reckoned for my size range the Titan was available in 1cm increments (whereas AMS was 2cm increments - meaning a RTE would've been less likely needed with a Titan)*. Also my particular surgeon is generally more a believer in Coloplast Titan anyway.
[* There is a study about these differences in size increments in Titan v AMS - if I can dig it out somewhere I will add it to this post]
- Stretching or "Traction" of the penis - I don't think/know if there's a huge amount of scientific-proving of this - but I figured why not just give it a try - whereby I spent any spare time in the weeks/days/hours leading up to the operation just physically-stretching the penis out (to improve its elasticity and thereby hopefully enhance your chances of a maximised cylinder-size being inserted). Again, I don't think there's much scientific-findings to back this up, but I figured I've nothing to lose in just giving it a big physical stretch out. (I believe there are people on this board however who have spent literally months before the op using a traction device - so they would probably be best positioned to advise on the effectiveness of these).

DURING THE OP PROCESS (i.e. Day 1 to Day 3):
- The number one focus during the procedure itself is Pain Management - for me it certainly was - it was the most physical pain I've ever been in (don't let this put you off though - not all patients seem to have such a torrid pain experience - I think I must have a low physical-pain threshold or something).
- If I had to do something differently straight after the op, I definitely would have refused Morphine. I was trying it for the first ever time, and Its side-effects were so horrendous for me (blacking out/nausea), with hindsight I would've just refused it altogether. But if you do find the pain absolutely unbearable, then it does do an effective job for pain-relief.
- Sleep. This is the number one strategy for pain-management in my opinion. The only thing is, it's not easy to fall asleep when in so much physical pain. But that's where I would've taken 10mg Ambien (which I take regularly anyway) - because the side-effects of this sleeping-pill are, in my opinion, much much more tolerable than Morphine - and the ability to Sleep itself will solve out a lot of pain itself.
- Icing. You'll hear this recommended a lot on this board - and for me it certainly was the most important thing for Pain Management behind only Sleep. Bag of peas or a frozen ice-pack will do.
- Keeping the feet up - at or above hip level - this seemed to reduce the feeling of pain.
- Standing in a Yoga "Forward Fold" position (Google it to see how it looks) - I find this a relief also when the pain was feeling unbearable in the weeks after.
- Entertainment. Just keeping the mind entertained/distracted is a good idea for Pain Management. Even just taking your laptop with you (have your Mobile Phone tethering switched on for mobile internet access) - so that you can watch a comedy/sitcom (something funny/light-hearted that can take your mind off the pain is recommended. Also having someone to talk to like a friend or family member is a good idea for taking your mind off the physical pain.
- This Franktalk board. I found this board such a Godsend for any quickfire questions I had before, during and after the process- not only for the support but also the informational gathering from getting a wide spectrum of opinions on things. So a BIG THANK YOU TO EVERYONE ON THIS BOARD AND LARRY FOR COORDINATING IT! AND A SPECIALISED SHOUT-OUT TO SPIKEPORK FOR SEEING ME THROUGH THE PROCESS AND ONLY EVER BEING A TEXT MESSAGE AWAY!!

POST-OP:
- Keep yourself reminded on the end-goal. Despite the pain/stress of it all, remember that the reassuring thing that the operation generally has 90% satisfaction rate or something - and for me personally, I have definitely felt a notch up in self-confidence compared to before the op (because it is effectively the first ever time in my life now that I can get hard sustained erections, be they artificial ones). But as I say in the Pre-op advice above, always ensure that any surgery is a decision you're happy with beforehand.
- Sleep, icing, entertainment and this FT board - all excellent for Pain Management - as explained above.
- When trying to learn to inflate for first times, I would recommend using kitchen-towels to make gripping of the device much easier to handle and thereby use. It's painful if it keeps slipping out of your fingers. I even used rubber-thimbles at times, just to get myself used to gripping onto the pump device.

Give me a shout with any other questions. I might add more to this post as/when I remember more tips that were helpful to me.

P.S. The following two Youtube videos I also found very helpful for tips straight after the op:
https://www.youtube.com/watch?v=tcQgJB3kbO0
https://www.youtube.com/watch?v=28oz8ldQcso

You are most welcome. I hope everything is going great for you.

Larry

[Larry10625]

Another tip (for POST-OP) whilst I remember - is Savlon antiseptic cream (not sure its equivalent brand name outside UK). If your stitch-wound area in the days after surgery is very sore like mine was, I found rubbing Savlon on it significantly helped it in terms of pain management. And think it's quite a gentle cream so shouldn't have any side-effects. Savlon I probably used for a month after the operation (around 2-3 times a day as/when needed). I especially used it before trying to pump as it significantly reduced soreness.

Another cream I found useful when I first started pumping is EMLA (which is a local anesthetic type cream). *But* be careful not to apply this to the stitch-area as it stings a lot on open wounds. Also use it very sparingly, as one of it's side-effects is stinging, which you don't particularly want to be feeling on the balls. (Don't try washing it off after use either, as water also makes it sting). Reason I found it useful though, is because I was finding grabbing the pump for the first time was so painful, that slightly numbing it with this EMLA cream significantly helped me able to pump. I probably used EMLA 2-3 weeks after first trying to pump.

The doctor/nurse didn't mind me using Savlon/EMLA either when I told them I was using it.

The medicinal ingredient in Emla is Lidociane, which is a very powerful analgesic. If it stings when applied, just hang on a sec because it won't sting for very long. I had absolutely no problems with it. Tattoo parlours here in Ontario use it a lot, especially for people who are getting large tattoos.

Larry