Choices

[principles]

Hello everyone!

I have a decision to make regarding which implant to have installed. Before I continue, it's important that I tell you that my stretched flaccid is 19cm and my insurance does not cover IPP's, only malleables.

Not being in the US, and due to my country's health and import bureaucracy, I have the following options available to me:

1)Coloplast Titan (max size available is 22cm + 7.5cm of RTE's).
Due to my stretched flacid being 19cm+, and using the heuristic of having approximately 1/3 of my penis proximal, it is fair to say that I could have atleast 8cm inside of me. Therefore, it is possible that I require an implant of 19-1+8 = 26cm or even more (-1 due to the fact that the cilinder will hopefully reach just 1cm short of the tip of my glans). Suppose 26cm is the size of the prosthesis I require, using a 22cm Titan, that would make the inflatable portion 17cm, and that would also make the inflatable portion start 1cm outside of me, which could produce the dreaded 'hinge effect'. The rigidity factor of this particular case would be 17/26 = 65%. Compare this to a 26cm Titan with no RTE's and it's rigidty factor of 81% and atleast 3cm of inflatable implant proximal.
So, I do have the Titan as an option, but with the limitations mentioned above. Also, for the Titan being an inflatable, that would mean I would have to pay for the prosthesis with my own money. Approximately $10k.

2)Coloplast Genesis 13mm Malleable
All the pros and cons of the malleable are known, so I'll just skip it. For this prosthesis, my insurance would cover it's cost.

3)AMS 700CX
Unaware of the sizes available, but likely wouldn't be available in the 24cm size. Also, approximately 20% more expensive than the Titan and doesn't over the girth nor the axial rigidity that the Titan does. Therefore, I'm not interested as of now.

4)Getting implanted in the US
Not even a current possibility due to recent covid related travel restrictions. Also, it would increase total cost by more than 60%.

Bare in mind that Rigicon, Tactra and most other offerings are not presently available in my country. Also, my insurance covers hospital costs and malleable prosthesis. It does not cover the cost of the medical team and the inflatable penile prosthesis. The surgeon I'm in contact with does work with both types of implants and he's a medium volume surgeon. There are no high volume surgeons where I live as far as I know. Not within my budget atleast.

In short, I'm down to options 1 and 2. Either a potentially 'hingeable', expensive and self-paid Titan or an insurance paid Genesis semirigid.

Every single input would be appreciated. Thank you all in advance!

[wolfpacker]

I don't think most people on this site would consider a malleable over an IPP unless you are unable to use the pump on an IPP for some reason, for example bad arthritis in your hands.

[jcooley]

Where do you live? I thought you are in US

[Old Guy]

I love my Titan. Being it keeps me semi-erect there is no way I could go with a malleable implant that kept me almost rigid all the time. I find it tough enough getting my semi hard on stuffed into my underwear in a comfortable way.

[principles]

I understand the argument for the Titan, but it's hard to justify the out of pocket expense for a potentially sub-optimal result as explained above.
Jcooley, pm sent.

[Hrc714]

The amx is available in 24 cm but is special order. That is what I have implanted. Length is great but a bit thinner than i was. You are right on that concern.

[Old Guy]

You do have a tough choice. 10 grand is a big hunk of change.
Bottom line, what do you prefer? Each has advantage over the other. One thing is make sure the figures you have are correct, I've seen one of docs videos demonstrating the Titan and the guy was huge.

[principles]

Went to the doctor today. I got a light trimix injection, did a doppler test and we found out that I do have venous leakage.
I was also told that I have a short proximal penis and probably a loose suspensory ligament. When my penis is completely erect, it hangs at 0400.
He estimated that I would accomodate a 22cm Titan and 2 to 3 centimeters of extenders. This made me even more concerned with the lack of XL sizes for my procedure. Also got myself concerned with the thought that he would undersize me in order to use less RTE's.
He also said that because of my short proximal penis and loose suspensory ligament, that the Coloplast Genesis semirigid would make this even worse, and that it would probably not give me satisfying result.
Because of my anatomy, he said I shouldn't use VED pre-op, as it would bring more of the proximal penis distally, making this naturally ocurring hinge even worse.
Now, I did communicate with him before this appointment of my concern with the lack of bigger implant sizes and use of RTEs. I do not think it's the case but I worry if he's making the remarks about my anatomy to justify a poor outcome of this procedure as it relates to angle and hinge effect.

On a site note, my penis aches unconfortably from the injection, and the dosage was not high. I would definitely not want this long term, which solidifies the decision to move forward with the implant even though the details of it all have yet to be determined. I still bought a vial of trimix to experiment with and hopefully have good sex with my girlfriend before this upcoming surgery.

I'm trying to digest it all.Your thoughts and concerns would be highly appreciated.

[Larryb8x8]

I would do the Titan I have the Titan with 3 RTE and I'm a pretty good-sized man. Girth is a bit too much

[oldbeek]

I still say the hinge effect when using RTEs is BS. See my signature. I can hang a hand towel on it straight out at 3:00