new menber thinking about implant

[knotreel]

I heard about this group from my participation in the Healing Well prostate cancer board. I am 10 months post op from robotic radical prostatectomy. I am totally impotent as well as incontinent. I have been more concerned with the incontinence than the impotence but it looks like I am heading for a date with the artificial urinary sphincter and hopfully then my remaining issue of impotence will be up next. I had bad ED before the op and as I expected the op killed off what little there was. I started off with errection rings and finally vacuum pumps and finally before the op I was probably less than 50% sucessful when attemping intercourse. Needless to say I had lost confidence and lovemaking with my wife was not working very well. Doctors have told me while dicussing the RP that my ED sounds like leakage. Before the op I could get a usable errection, vacuum assisted, but it usually didn't last long enought for penetration and often would go limp during intercourse.
Since the op, all I get is a slight plumping naturally and with the pump full errection but it very quickly deflates, less than a minute.
Now, since I am going later this month for testing to see if there is any chance of recovering continence and if he says i need the sphincter installed I am going the ask if he can do the penile implant as well. The thing is, I haven't gone for any formal testing for ED or tryed injections. I am hoping the Medicare will cover some (80%?) of the cost but I wonder if I will be required to try some of the other things first. Oh, I have been on Viagra for 10 months now and when I have taken a full tab, nothing. So what do others think, can I just go forward and getthe implant or will I need further diagonosis? I don't know what additional risks are involved with doing both implants the same timeor even if my the doc I am seeing will do it but I to me one op soundes so much better than two. I am squirming in my seat as I think about it.

[jackpTenn]

To answer your question about Medicare. It covered 80% of my cost and my supplement covered the other 20%. I had meet most of my deductable so my out of pocket at Vanderbilt was $8.34 plus travel.

A very good doctor may be able to do the artificial urinary sphincter and an implant at the same time. Be sure to check out the qualifactions of the doctor. You want a Male Sexual Function Specialist, not a general prictice urologist, that does at least 100 a year. These doctors are rare and not in all major metro areas. Several of us on this forum choose to travel to Nashville TN to Dr. Douglas Milam at Vandebilt.

I have several things on the implant I can forward to you if you would like. Send me an email to jwp104@att.net and I will be happy to share my research with you.

Unlike a lot of guys on this forum I did not have PCa but peyronies. The results of both in the ED department are about the same. I had my implant almost 2 years ago and my results are better than my wildest dreams.

Good Luck, any way I can help just let me know.

Jack

[knotreel]

Things are moving now as I met with the incontinence specialist and I will need the artificial urinary sphincter implant if i want any improvement of continence. The Dr. I have choosen for that, can work "tag team" style with another Dr. and both implants can be done in one op. My next step is to at least try some injections before making the decision for the penile implant. However, i am doubtful that injections will work for my leakage levels but I need to try. The AUS implant will be done by Dr. Boone in Houston and he works with Dr. Larry Lipshultz, whom I haven't met yet, for the penile implant. Both Drs. seem to be very qualified in their areas.

[knotreel]

I now have a surgery date, Jan 11, to receive the two implants, AUS and IPP.THe surgery will be done at Methodist in Houston with Dr. Timothy Boone doing the AUS and Dr. Larry Lipshultz Doing the IPP. I am going to begin daily pumping with my VED as I was told. My main worry right now is how I will control my incontinence just after the surgery after the foley catheter is removed. I assume my penis will be taped to my abdomen and I have seen an online video showing how a patient was sort of "ace" bandaged up after. Is the wrapping the penis and scrotum the usual way to leave the hospital? How long will the penis be taped up to my abdomen? I plan on asking for a foley catheter to be put in before I leave to deal with my severe (total) incontinence. I think the IPP doctor is ok with that so i hope the Dr. Boone will ok that too. I see a bad car ride home and urine dribbling over my incisions unless i have a foley. Has anybody had a foley for a week or two after the surgery? I think I would like to heal up a bit and after the penis is pointing down I could wear the condom catheter that a now wear everyday.

[franglais]

x

[jackpTenn]

K

A better mentod of holding your penis up pointing at your navel. Try Jockey Pouch Briefs. They have what Jockey calls the H cut. The material is a little thicker and goes across instead of at an angle. Also an extra jock strap would be advisable for the first week to 10 days, it helps support your testicles with the pump. A lot of us have done this and it works well for most of us, beats tape .
After my first implant attempt was aborted, by a local doctor, I had to ware a foley for 10 days. With the tubing coming up over the band in the briefs it also helped support it also. I bought mine at Macy's and Kohl's. They are also available online. I would suggest getting a couple of pair and try them out before surgery. By the way it is eassier to keep it pointed up after surgery.
Good Luck
Jack

[knotreel]

Thanks Jack, I will check out the briefs, that sounds good to me. Being prepared with the right post op clothing was helpful when I had the RRP and I would like to ready this time too. What about the "ace bandage" type wrap job? I saw that on Utube where an IPP Doctor in Shreveport did that post op. Will I likely be sent home wrapped up like that? Any advise on the jock strap? tight or loose?