Pain After Implant

[Texas75008]

Skier123 - the doctor ordered the hydrocodone by accident from my mail order pharmacy for post surgical recovery. I would not have received it for 7-10 days! I never got it. He couldn’t order it again at the local pharmacy, which is why he prescribed the hydrocodeine directly after surgery. Thus, when it was time for refill he used the hydrocodone. Maybe this is one of the reasons I am struggling with pain.

[steven1]

Keep in mind it is now against the law to give us good pain meds like oxicotin ,oxicodone is just a souped up aspirin , hope you feel better soon it will work out for you in the end

[stephen54]

I just had my implant (AMS 700 LGX) a week ago today on November 11, 2019. While I have had worse pain from orthopedic surgeries, the pain and discomfort from this surgery seems to have lasted longer than prior surgeries, and I am wondering if there is an end in sight. The source of the pain is twofold: (1) from the implants inflated at roughly 60% in my penis which is uncomfortable (feels stretched), slightly bruised and tender; and (2) from the pump implanted within my scrottal sac. The pain is less if I lounge in bed, and worst when sitting. If I walk around, I feel increased pain from the pump area. Thus, I tend to lounge in bed quite a bit. I don’t see any swelling anywhere, and there have been zero discharges from the surgical site. The pain is not helped much, if at all, by the pain meds. I have been taking them to help with sleep, and they don’t seem to do much. I am using briefs vs boxers; the doctor suggested I keep a clean wash cloth in my underwear to keep the penis pointed to the belly button - I find the cloth irritating, and not necessary to achieve that objective. The only thing that seems to help is ice, and time.

I like my surgeon, and he does these regularly (2 or so a week). But, he didn’t do a great job of setting my expectations on the recovery process, and I am wondering how long this pain and discomfort will last. And I can’t imagine operating the pump without excruciating pain. I will see the doctor next week for surgical follow-up.

I am 65, have had bad ED for years, and progressed through all the typical treatments before settling on moving forward with the penile implant.

Please let me know what your recovery experiences have been, and any thoughts on how to cope with pain and discomfort.

Thanks!

Hi...I'm only on day #4 here, was implanted 11/18 by Dr. Levine here in Chicago, a very high volume implant surgeon, arguably one of the best reputations out there, and a perfectionist/pro who has apparently seen it all over 3000+ implants and 30 years. Also a guy who over the years must have learned to set those "what will it feel like" expectations pretty bluntly. His informed consent document I signed prior to surgery stated that post-implant pain will be, and I quote, "likely be very disturbing for 7-21 days".

"Disturbing".

Certainly caused me to pause briefly and reflect on what, exactly, that might mean. He was unambiguous. Which I appreciated. Expectations were clearly established ahead of time.

I get what multiple people seem to be saying, that there is pain but maybe more accurately described as a deep sore discomfort. I definitely have that. It's a bit unsettling, to be sure, but I would not describe this as frank pain in the way where I've broken bones, etc. Have absolutely had much more severe pain from any number of other (mostly orthopedic) injuries over the years. Having said that...my surgeon's protocol is not to inflate the cylinders right away, so that's a little different and I feel my discomfort fairly generally across my very low abdomen/groin. Not surprising if you watch, like I did, an uncensored complete video of what's involved. It's kind of crazy! Have not seen my scrotum yet. Today is my unwrapping of the mummy and first post-op shower, so that'll be interesting I'm sure. Scrotum feels swollen as hell and full - I don't feel in any particular hurry to touch it. In any context. Indefinitely.

I've taken a few hydrocodone/acetaminophen tablets day 1 and day 2 but I honestly don't find them necessary. I don't have a focal "pain" to act as an antagonist to the drug, so it's effectively pointless. Also for what it's worth, I spent most of my career in the pharmaceutical industry and I launched Oxycontin back in 1994. I saw someone comment that the base ingredient, oxycodone (the opioid) is a "souped up aspirin". Pain is subjective, to be sure. But that comment is comically uninformed and laughably false. If you're having frank pain, take the opioid and take them on a schedule, proactively, even when the pain wanes down a little. There is a principle to pain management where it's advisable to get ahead of the anticipated pain and stay ahead of it by taking the drug; waiting for the pain to worsen typically means you'll ultimately take more drug, for a longer period, and with a diminished benefit/relief. For what it's worth.

[Skier123]

Stephan54, thanks for the detailed notes from your procedure. Hope you are recovering quickly.

Which pain med did Dr. Levine order for you? How is it working?

[stephen54]

Stephan54, thanks for the detailed notes from your procedure. Hope you are recovering quickly.

Which pain med did Dr. Levine order for you? How is it working?

Hi...he gave me simple old trusty generic Norco (combination of hydrocodone 5mg / acetaminophen (Tylenol) 325mg. He gave me #30 tablets. Typically prescribed like he did as one tablet every 4 hours PRN/as needed for pain. I think I took 4 over the first 24-36 hours and then I just sort of realized...this isn't specifically "pain". Not through my own perception, anyway. Stopped taking them and the nature of the discomfort didn't appreciably change for the better nor for the worse. So Levine planned for about 5 days of these based on 30 tablet.

I was thinking, you know, that while pain is certainly wildly subjective there's the other variables with implants of the different surgical approaches, tools, techniques varying by surgeon's experience, preferences, patient's specific anatomy. So we're all having an entirely unique recovery / pain experience and physicians need to have open dialogues with patients proactively. Most patients are ill-prepared to challenge a physician. They don't have the information and they don't know what or how to ask and they don't want the anticipated conflict.

I spent a lot of time working with palliative care/opioid drugs in pharma, mostly in late stage oncology, and one thing for sure is that patients need to be vocal and assertive and blunt with their physician. It's unacceptable for the surgeon to hide behind their feelings about a publicized opioid crisis, etc. There's a responsibility to proactively and thoughtfully address patient pain. And then, these guys are understandably freaked out by litigation and liability around the single agent opioids (like Oxycontin, which is pure, extended release oxycodone only - no acetaminophen). The addition of acetaminophen and aspirin in some cases to drugs like Norco, Vicodin, Percocet, etc, was in no small part done to try and establish a quantifiable daily cap on how much drug gets into the patient in a given 24 hour period. It varies, but for example acetaminophen is managed in such a way that depending on which hospital/physician/pharmacist you ask, it's believe that somewhere between 3000-4000 mg per day is the upper limit not to be exceeded. This is directly tied to what your liver can tolerate through its metabolic pathways. Oxycodone smartly navigated around that daily limit by removing the acetaminophen and very precisely controlling the release timing of the opioid. A truly awesome drug. But of course, crushing it and snorting it was unfortunately inevitable and now you have entirely legitimate, often desperate patients who would benefit, paired up with scared shitless physicians and health systems.

My opioid rant, for what it's worth!

[notaes]

Stephen54

I wish you the best. Sounds like you are doing ok. I am scheduled for January 2020. Watching your posts carefully. best of luck. I know it will be worth it. Hang in there man we are all rooting for you!

[cobylinks]

Hi
Had surgery Oct.04,2019 by Dr. Brady in Orlando, Fl
all went well and was released the same day(Friday)
Returned on Monday to be unwrapped and deflated as well as have the cath. removed.
Unwrapping and cath. removal went off without a hitch. As for the deflating part.

OMG & holly hell it hurt!

The Dr. assistant took hold of my swollen and stitched scrotum
and squeezed the release bar firmly while squeezing my penis with her other hand.
I would have run away but for the fact that I couldn't let go from my death grip
on the bed rails.
Although it was over in about 30 seconds I will remember the pain for a very long time.
I am now in my 7 post surgery recovery week and I have to say that the pain is gone.
I can still feel a little sore at times but no pain.
I have found that wearing under ware like "Separatec" shorts or similar style makes
all the difference. it keeps your penis from rubbing against your scrotum.
Some guys use a baby sock on the penis but these shorts are the way to go.
I don't regret getting the surgery and would do it again even knowing the pain I would be in.
Take the drugs they give you and ask for something stronger on the deflation date.
Good luck.

[Toronto67]

Welcome to the club!!!

Ohh the pain... I my case pain was bad but after the second day I was able to move from heavy pain killers to Tylenol and lots of ice, lots... I was very fortunate as I was able to stay at home for more than two weeks, in my bed and naked most of the times.

I am now 4 1/2 months after my surgery and pain is ZERO but at the beginning everything was painful or at least caused some discomfourt, Having sex was painful, deflating the implant 100% caused discomfort when wearing pants so I have to pump it one or twice before getting dress.

Time and patience is key here, take it easy, keep the wound clean and do not try to rush the healing process, remember, the best it heals the most of enjoyment and least amount of problems you will have.

[Texas75008]

Hi
Had surgery Oct.04,2019 by Dr. Brady in Orlando, Fl
all went well and was released the same day(Friday)
Returned on Monday to be unwrapped and deflated as well as have the cath. removed.
Unwrapping and cath. removal went off without a hitch. As for the deflating part.

OMG & holly hell it hurt!

The Dr. assistant took hold of my swollen and stitched scrotum
and squeezed the release bar firmly while squeezing my penis with her other hand.
I would have run away but for the fact that I couldn't let go from my death grip
on the bed rails.
Although it was over in about 30 seconds I will remember the pain for a very long time.
I am now in my 7 post surgery recovery week and I have to say that the pain is gone.
I can still feel a little sore at times but no pain.
I have found that wearing under ware like "Separatec" shorts or similar style makes
all the difference. it keeps your penis from rubbing against your scrotum.
Some guys use a baby sock on the penis but these shorts are the way to go.
I don't regret getting the surgery and would do it again even knowing the pain I would be in.
Take the drugs they give you and ask for something stronger on the deflation date.
Good luck.

Two follow- up questions:
1. After the 30 seconds of intense pain, did you have any residual pain? If so, how much?
2. At what point were you deflated (weeks past surgery)?

Thanks!

[stephen54]

Stephen54

I wish you the best. Sounds like you are doing ok. I am scheduled for January 2020. Watching your posts carefully. best of luck. I know it will be worth it. Hang in there man we are all rooting for you!

Hey thank you so much. I unwrapped this thing last night and showered. I'm not super comfortable on day 5 here but I'm still also not terribly uncomfortable and I can still honestly say - I don't characterize anything in my current experience as "pain". Still a consistent heaviness and a deep soreness...but nothing sharp or acutely painful, specifically. I posted some pics also, for anyone who wants to see some of the reality of day 5 post-op.

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