infrapubic v scrotal surgery for implant

The final frontier. Deciding when, if and how.
newbie443
Posts: 1931
Joined: Fri Dec 01, 2017 9:41 pm
Location: Sedgwick county, Kansas USA

Re: infrapubic v scrotal surgery for implant

Postby newbie443 » Tue Jul 19, 2022 1:37 am

The old rule of thumb was that infrapubic was better for reservoir placement and penoscrotal was better for pump placement. But with a really good doctor neither of those apply. So it depends on the doctor. The less skilled doctor the more issues that come into play. Scarring and tubbing visible and there is a nerve bundle that needs to be avoided with infrapubic.
Injections failed. Implanted 3-21-18 AMS 700 LGX 21 + 1 RTE 100 cc reservoir 6.5" L 5" G Dr. Kramer.

Proximal Perforation Sling Repair 4/13/21 Dr. Broghammer

66 years young.

Will show and tell and talk with others.

aussiePeyronies
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Joined: Thu May 05, 2022 9:44 am

Re: infrapubic v scrotal surgery for implant

Postby aussiePeyronies » Sun Jul 24, 2022 6:46 am

Thanks a lot guys, I am using Australia's best implant surgeon.. I do believe he uses infrapubic but I spoke to Dr Eid who said Scrotal preserves the most size (i have loss of size and hinging/dents due to peyronies)... I am just confused on whether I should go with it or think about switching to a different Dr.
34 Years Old...Peyronies for 4 years. 20 Degree left and upwards curvature, major dents and narrowing, ED.

Implant + Tunica Expansion Procedure, 7th Feb 2023, Titan 22cm + 1cm RTE

frwmw1
Posts: 436
Joined: Thu Oct 01, 2020 7:38 am

Re: infrapubic v scrotal surgery for implant

Postby frwmw1 » Sun Jul 24, 2022 9:28 am

aussiePeyronies wrote:Thanks a lot guys, I am using Australia's best implant surgeon.. I do believe he uses infrapubic but I spoke to Dr Eid who said Scrotal preserves the most size (i have loss of size and hinging/dents due to peyronies)... I am just confused on whether I should go with it or think about switching to a different Dr.


All the Australian surgeon's use the infrapubic method, as far as I'm aware. Love, Katz, Chung, Chee, and the rest, they all use infrapubic.

But the Australian surgeon you are speaking of, I've not heard of anyone losing size with him, albeit I've only read of 3-4 people here using him, yet none of them complained about a loss of size, one person has a complaint about the pump placement but otherwise has a very good result, particularly in regards to length.
45yo, venous leak. Pills increased tinnitus (very rare). Using bimix+atropine, 0.2 of:
Atropine Sulfate: 52MCG/ML, Phentolamine MES: 0.9MG/ML, Papaverine HCL: 26MG/ML

Flip_5
Posts: 48
Joined: Sat Apr 30, 2022 10:36 pm

Re: infrapubic v scrotal surgery for implant

Postby Flip_5 » Sun Jul 24, 2022 9:52 pm

What I'm about to say is not medical advice. It's my own opinion based of experience.

I think some of the answer to this is it depends on YOUR BODY. E.g., infrapubic may be good for some. What I've learned is that infrapubic may be more problematic if you have a small scrotum as it's harder to position the pump and possibly harder to position the tubing which (may?) resut in a need for glansplexy (happened to me). Advantage however would be if you're of slim build because infrapubic means easier resevoir positioning than penoscrotal. Slim build means harder to position resevoir. Less space to maneuver. Infrapubic provides more direct access.

aussiePeyronies
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Joined: Thu May 05, 2022 9:44 am

Re: infrapubic v scrotal surgery for implant

Postby aussiePeyronies » Mon Jul 25, 2022 4:53 am

Thanks guys, really appreciate the advice.

If all the Aussie docs use infra pubic - I guess that is my only option.

A lot of guys have only had IPP here for ED and not PD and ED, so I am also not always sure of the overall outcome of someone with PD and ED getting an implant with each surgeon.
34 Years Old...Peyronies for 4 years. 20 Degree left and upwards curvature, major dents and narrowing, ED.

Implant + Tunica Expansion Procedure, 7th Feb 2023, Titan 22cm + 1cm RTE

nuance
Posts: 303
Joined: Wed Feb 24, 2021 8:14 pm

Re: infrapubic v scrotal surgery for implant

Postby nuance » Mon Jul 25, 2022 8:48 pm

Is reservoir placement (and how well it's hidden) with penoscrotal a problem for skinny guys without fat pad?

Txagq8
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Location: Texas Hill Country

Re: infrapubic v scrotal surgery for implant

Postby Txagq8 » Mon Jul 25, 2022 9:57 pm

Flip_5 wrote:What I'm about to say is not medical advice. It's my own opinion based of experience.

I think some of the answer to this is it depends on YOUR BODY. E.g., infrapubic may be good for some. What I've learned is that infrapubic may be more problematic if you have a small scrotum as it's harder to position the pump and possibly harder to position the tubing which (may?) resut in a need for glansplexy (happened to me). Advantage however would be if you're of slim build because infrapubic means easier resevoir positioning than penoscrotal. Slim build means harder to position resevoir. Less space to maneuver. Infrapubic provides more direct access.


Bingo. Too bad this isn’t a TV game show. You could have hit the daily double.

Yes, sizing and placement of cylinders is key to a terrific outcome.

So is having a reservoir to pump fluid from without difficulty. I’m not sure where I read it but somewhere I’ve seen that early revisions were frequently due to pump and reservoir problems instead of anything to do with the cylinders.

In my case I was 63. I hit the gym 5x weekly, on average, and over 4 years had gone from a 38” waist to a 31” waist, only losing 10 lbs in the process. Right at 10% body fat.

Throw in scar tissue from 5 hernia surgeries-2 inguinal, 2 epigastric, 1 umbilical. I asked the doc beforehand if it was going to be trouble and he assured me he would make it all work. And he did. Truth be known, I don’t REALLY know for sure where reservoir is.

If you trust a doctor enough to let him slice and dice your junk, then you ought to be able to trust him enough to choose the best approach to result in a happy ending. Pun partially intended.
Age 68. Physically fit educated red neck in Texas. Very married. 23 cm (18+5) of LGX installed by Dr. Bryan Kansas 12/31/2019. I fought the ED and my wife & I won. I’m either full of shit or sound advice. You decide which.

Floridaspeedo
Posts: 305
Joined: Fri Jun 17, 2022 11:15 am

Re: infrapubic v scrotal surgery for implant

Postby Floridaspeedo » Tue Jul 26, 2022 9:51 am

@Nuance I am a thin guy waist 29 and have had no issues with the pump or resevoir. Pic of me before implant. Now my Speedo is a lot tighter.
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ED survivor 5 years. Tried pills, Gainswave, PRP, Bi-Mix/Tri Mix (worked 50% but very painful for 24 hours after injection.) 55 Gay - Single Titan Coloplast implanted June 1st, 2022, scrotal in Miami by Dr Billy Cordone..,very happy. Zero regrets

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Dr.Menshchikov
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Re: infrapubic v scrotal surgery for implant

Postby Dr.Menshchikov » Thu Jul 28, 2022 4:29 am

aussiePeyronies wrote:What are the ups n downs of each?

I've been told by Dr Eid that Scrotal approach helps conserve size ?


Penoscrotal access allows better placement of the Cylinders in the corpora cavernosa, in the scrotal pump. This allows the implant to last longer and break less often.
More than 1000 penile prosthetics operations. More than 130 operations per year. Most surgeries out of all doctors in Eastern Europe. Mentor Coloplast.

gjmjoe017
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Joined: Thu Apr 13, 2017 9:32 am
Location: NW Arkansas

Re: infrapubic v scrotal surgery for implant

Postby gjmjoe017 » Thu Jul 28, 2022 6:42 am

Dr.Menshchikov wrote:
aussiePeyronies wrote:What are the ups n downs of each?

I've been told by Dr Eid that Scrotal approach helps conserve size ?


Penoscrotal access allows better placement of the Cylinders in the corpora cavernosa, in the scrotal pump. This allows the implant to last longer and break less often.

Are there studies showing more failures with Infrapubic?
71 yrs.old married,ED for 7 yrs.Pills for 3 yrs,TriMix for 21/2 yrs.6 1/2 inches flacid,71/4 inches erect,6 inches girth.Coloplast Titan put in 11/13/20,Dr.Bozeman,Arkansas Urology,Little Rock.22cm + 2 RTE.


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