Implant Scheduled for Jan 24, 2023

The final frontier. Deciding when, if and how.
Lost Sheep
Posts: 6162
Joined: Mon Jul 04, 2016 11:16 pm

Re: Implant Scheduled for Jan 24, 2023

Postby Lost Sheep » Thu Jan 12, 2023 3:34 pm

sswinsfba wrote:(edited for focus)
As I recall, the doc said that it will NOT be inflated during recovery but I'm not sure about that. I have a pre-op appt w/him on 1/19 and still have a lot of questions (including this one) to ask him then.

Ask your surgeon about the so-called "Coffin Effect" which has been discussed a number of times in this support group (use the "Search" function).

Re: "Psuedo-Coffin Effect" of scar tissue forming a restrictive capsule around the implant that would restrict inflation of the implant.

Also, you don't want a Psuedo-Coffin of scar tissue forming such a capsule around the reservoir, either, retricting deflation of the implant.
Lost Sheep
AMS LGX 18+3 Nov 6, 2017
Prostate Cancer 2023
READ OLD THREADS-ask better questions -better understand answers
Be part of your medical team
Document pre-op size-photos and written records
Pre-op VED therapy helps. Post-op is another matter

tomas1
Posts: 2003
Joined: Tue Jul 23, 2013 5:12 pm
Location: Tempe, AZ

Re: Implant Scheduled for Jan 24, 2023

Postby tomas1 » Thu Jan 12, 2023 3:40 pm

I can see that prior hernia repairs complicate this surgery.
The surgery times of the 2 methods puzzles me although I don't know how long my surgery took.
86 years
Inject testosterone weekly.
Implant on 1/22/19 by Dr Avila.
Scrotal, hor. incision just over 1"
18cm AMS 700 CX, 3.5cm RTE 100cc res
Gleason 6 prostate cancer. Monitoring it for now.
Update: On my last biopsies the cancer wasn't found.

frank66665
Posts: 1463
Joined: Wed Mar 25, 2020 11:18 am

Re: Implant Scheduled for Jan 24, 2023

Postby frank66665 » Thu Jan 12, 2023 4:06 pm

sswinsfba wrote:
frank66665 wrote:sswinsfba good luck to all of us, on the 23rd I will have mine too, it will also be my infrapubic, I will open my diary on the 21st when I leave by plane when I land in rome, yes the pre-implantation days kill you with the preparations for the exams of the blood/chest x-ray/cardiological visit and everything you need to bring, with the fear of forgetting something, I'll bring a lot of medicines with me, my implantologist wants me to stay in Rome for a week without leaving the hotel, I'll stay inflated to 70 % for 7 days, on Monday the 30th he will deflate me and send me home, the rule is 6 weeks to use it but he says that in 3 weeks I will start using it, I would sign it in 5 weeks


My doc claims that the incision(s) should be be healed in 1 wk, that cycling can begin in wks 2-3, and that I can begin using it in wk 4 but I'm skeptical.

I'm in no rush and am willing to wait as long as need be to make sure everything is healed and working properly before I start actually trying to use it.

I have a new GF (a widow) who is hasn't had sex for a LONG time. She knows about the procedure (she's the one who's driving me to the hospital and picking me up) and is willing to wait as long as need be. So, there is no urgency to the matter for me.

My concern w/ED is relatively recent. I can still get nocturnal erections -- not to max stiffness but close -- but I cannot retain them. Sounds like a venous leak but I've never had an leak test or ultrasound. The reason just wasn't important to me nor to my docs who never ordered the tests. Just fixing the ED is important to me.

In the past few years, I was only having sex w/my long term GF at the time early the AM when I got a boner which lasted long enough to complete the job. Sex at other times then was hit and miss. However, now I can't keep an erection at all, nocturnal or not. Hence, my decision to go for the implant.

As I recall, the doc said that it will NOT be inflated during recovery but I'm not sure about that. I have a pre-op appt w/him on 1/19 and still have a lot of questions (including this one) to ask him then.

I'm not worried about losing length -- didn't have all that much to begin with at only 5 3/4" -- but I always had a sufficient girth at about the same 5 3/4" around. I'm actually hoping that the Titan will (as they say it will) will increase my girth even further which is what "they" say that women value more than length any way.

Length is great for show but no woman wants a man pounding on her cervix and IMO most men (not just me) would prefer to be able to insert his full length in and touch (& pound when the mood demands) pubes with his mate during sex.

My length has almost always been ideal to enable full entry and pounding just short of the cervix. So, I never had any complaints about this from my playmates. ;)

A potential problem that I'm worried about is that my new GF's vaginal cavity is REALLY tight. It grabs my finger like a Chinese Finger Trap and I was already concerned that I might hurt her w/my normal girth. We'll just have to see what if any problem this causes after I'm sufficiently healed to begin having sex again.

As for length, in order to maintain it prior to surgery, I am actually using a vaccum erection device (VED) for 10 mins 2s/day at 5 hg (which is a very low level of use) with a 1.75" ID tube (which is the smallest that I have) and plan to continue to do this until the day before surgery when I'll be checking into a motel nearby for the early morning surgery and when my dick should fully return to normal size.

I have always been a grower (nothing to show off). Using the VED makes it a show-er but does not significantly increase it's length or girth under pressure. I just wanted to keep it expanded prior to the surgery to faciliate the process but, in the back of my mind, I was also thinking that (if the length was between implant sizes) this would enable the doc to choose the larger rather than smaller size, as he said he would in that situation, but it's never going to be porno length whichever size he uses.

I'll just be happy if just remains the same size as it was before.

We'll see . . . LOL! 8-)

many things are the same between us, the wound heals immediately, even if to look little or nothing with a little hair it will take 2/3 months, my doctor says 4/6 weeks but he bet 3 weeks to start using it, not I'm in no hurry and even 8 weeks is fine for me, I'll do whatever my doctor tells me I don't want any scruples about having done something I shouldn't have, my wife will accompany me, I have nocturnal erections, the drugs are much higher than allowed they work well for 15/20 minutes, sometimes they work just a little, he let me choose the implant, I chose titan for its greater circumference, he says that with each device I will have what I have now, I will lose nothing and add nothing , with the titan it will only be fuller, I will ask him as soon as I see him what he meant, I measured I don't know if I was precise, I think I have 6" or 6" and 1/4", and 5"/ 1/4" or 5 .5" fits me perfectly 6" x 5" 1/4 otherwise I would have gone ams cx, I sacrificed the flaccid comfort d i ams for the girth titan, my wife is also tight and suffers from the onset of penetration, we should add more gel before we go in, i don't think you needed the vacuum pump as you still had erections and still fuck with pills, though lose erection at the climax, never told me to use a see my doctor, i wish i was more girth than now or 5.5" thick and hard all the time so see the expression they feel it all the time
56, ED since 2010, pills work but not always and well, trt in progress improved but not so much, myocardial infarction january 2016, new stent september 2016, hypertension, venous on 1/23/23 titan one touch 22, no rte dottor Gabriele Antonini Italia

sswinsfba
Posts: 572
Joined: Sat Jan 07, 2023 3:08 pm

Re: Implant Scheduled for Jan 24, 2023

Postby sswinsfba » Thu Jan 12, 2023 4:18 pm

Lost Sheep wrote:Ask your surgeon about the so-called "Coffin Effect" which has been discussed a number of times in this support group (use the "Search" function).

Re: "Psuedo-Coffin Effect" of scar tissue forming a restrictive capsule around the implant that would restrict inflation of the implant.

Also, you don't want a Psuedo-Coffin of scar tissue forming such a capsule around the reservoir, either, retricting deflation of the implant.


Thanks for the warning but I don't think that should be an issue since my doc is instructing me to start "pulling" on the pump tubes (to avoid the pump bulb from rising) after only 3 days and, as I recall, wants me to starty cycling in wk 2.

I may be wrong about when the cycing is supposed to start but I'm pretty sure that it's no later than wk 3.

In any event, that's on my list of thing to ask at the pre-op appt but, from what I've read so far, "early" cycling at 3 wks should abate the "coffin effect."
Last edited by sswinsfba on Fri Jan 13, 2023 1:56 pm, edited 1 time in total.
Age 73. Started taking 5 mg Cialis daily in 2000. Minor ED started in 2021. Major ED problem started in 2022. Coloplast Titan (20 cm w/1cm RTE) implanted infrapublicly on 01/24/2023 by Dr. Edward Karpman (El Camino Urology Medical Group, Mt. View, CA).

ThailandBound
Posts: 966
Joined: Fri Dec 16, 2022 5:32 pm

Re: Implant Scheduled for Jan 24, 2023

Postby ThailandBound » Thu Jan 12, 2023 4:44 pm

sswinsfba wrote:
ThailandBound wrote:The new neighbor is the scrotum accounts for the soreness when sitting. I cannot feel it at all when walking or lying down on my back. (I sleep on my side often, and so at night i've learned to put a fluffy pillow between my legs. If i accidentally roll over onto my stomach, i'm aware of it almost immediately and roll back onto my side. No big deal). When sitting, it's more sore on a hard surface chair, understandably. However, I put my donut pillow down on all surfaces when sitting. It creates space between the chair and the scrotum and is MUCH more comfortable. Yes, i use it when driving.

I am not in the least alarmed by this soreness. Many here have related similar and almost without exception this discomfort disappears in short order and the owner is not even aware of it.


My ball sack is always REALLY tight and I am worried about it being too tight to accomodate the pump bulb

I was thinking asking for an orchietomy to remove one of the "boys" to make more room for the pump bulb. Has anyone ever done that?

I've read of orchietomies performed at the same time as an implant here but a fake testicle was usually implanted as well which wouldn't solve the space problem. Testosterone production could also be an issue.

I guess if it's a problem down the road, I could ask for that to be done later but this is one of the pre-op questions that I have for my doc.


My friend, I had the same concerns. As a youngster i had an inguinal hernia and a testicle that would disappear into my body cavity most of the time. That was apparent to nobody until i hit puberty, then it hurt and i had surgery at 14. Fast forward to 39, and that same testicle had started ascending. So much that it hurt when having sex with the girl on top. Her bouncing would hit my nut which had ascended oddly high. Surgeon then opened me up through the abdomen and found scar tissue which he cut, and was able to descend my testicle to its proper place. All the while, i always had a "tight nut sack". As a young guy in the Air Force, i once had a certain Asian lady-of-the-night ask me "where are your balls??". How flattering, right?

They didn't disappear though. When i was relaxed and comfortable...and especially, warm, they would descend to an acceptable lever where they could actually be seen, but mostly, in the cold air, they rode high and my scrotum was tight. I had the same concern as you, and since I was considering Dr. Perito at the time, i sent him my question about this, which he subsequently addressed in one of his youtube "Meet The Penis" episodes. Here it is:

https://www.youtube.com/watch?v=JzrFv_otx_A&t=23s

I did consult with him in person, and upon seeing my actual scrotum he assured me there was nothing to fear. In fact, he wondered why i'd made a fuss at all saying he had plenty of stretchy skin to work with and that it was a needless worry. Same with Dr. Clavell, who did my surgery. He did comment after the surgery that the only accomodation he had to make was shortening the tubing somewhat. The trauma of the last few days has mostly caused the boys to go into hiding. Still, i was able to reach down below and with a slight touch find the bulb in what i believe is the perfect position, slightly aft toward the perinium and not visible....but accessible by touch. I'm encouraged.

So, please have a look at the video. I hope it gives you some reason for optimism. Best wishes.
Active, athletic 63 years old. Sexually, still 33 in my mind and spirit. Pills and injections all worked, until they didn’t. Diagnosed with veinous leakage in 2022. Coloplast Titan. 22 CM. No RTE. Peno-scrotal. Implanted 1/4/23. Dr. Clavell.

sswinsfba
Posts: 572
Joined: Sat Jan 07, 2023 3:08 pm

Re: Implant Scheduled for Jan 24, 2023

Postby sswinsfba » Thu Jan 12, 2023 5:18 pm

ThailandBound wrote:My friend, I had the same concerns. As a youngster i had an inguinal hernia and a testicle that would disappear into my body cavity most of the time. That was apparent to nobody until i hit puberty, then it hurt and i had surgery at 14. Fast forward to 39, and that same testicle had started ascending. So much that it hurt when having sex with the girl on top. Her bouncing would hit my nut which had ascended oddly high. Surgeon then opened me up through the abdomen and found scar tissue which he cut, and was able to descend my testicle to its proper place. All the while, i always had a "tight nut sack". As a young guy in the Air Force, i once had a certain Asian lady-of-the-night ask me "where are your balls??". How flattering, right?

They didn't disappear though. When i was relaxed and comfortable...and especially, warm, they would descend to an acceptable lever where they could actually be seen, but mostly, in the cold air, they rode high and my scrotum was tight. I had the same concern as you, and since I was considering Dr. Perito at the time, i sent him my question about this, which he subsequently addressed in one of his youtube "Meet The Penis" episodes. Here it is:

https://www.youtube.com/watch?v=JzrFv_otx_A&t=23s

I did consult with him in person, and upon seeing my actual scrotum he assured me there was nothing to fear. In fact, he wondered why i'd made a fuss at all saying he had plenty of stretchy skin to work with and that it was a needless worry. Same with Dr. Clavell, who did my surgery. He did comment after the surgery that the only accomodation he had to make was shortening the tubing somewhat. The trauma of the last few days has mostly caused the boys to go into hiding. Still, i was able to reach down below and with a slight touch find the bulb in what i believe is the perfect position, slightly aft toward the perinium and not visible....but accessible by touch. I'm encouraged.

So, please have a look at the video. I hope it gives you some reason for optimism. Best wishes.


I've had the same assurances from both of the docs that I've consulted with.

My ball sac loosens up in hot weather and after a steam bath or a warm soak and I have seen the video before but, of course, that doesn't prevent one from worry.

I'll just take the word of the docs that it "should" not be a problem and address it later if they're wrong.

One thing that has been common in my life that I've sometimes heard/tell, from medical staff and others when I had a particular problem unique to me, is that they'd never "seen/heard of a problem like THAT before."

Here's hoping that doesn't happen again in any respect w/regard to my implant surgery. ;)
Age 73. Started taking 5 mg Cialis daily in 2000. Minor ED started in 2021. Major ED problem started in 2022. Coloplast Titan (20 cm w/1cm RTE) implanted infrapublicly on 01/24/2023 by Dr. Edward Karpman (El Camino Urology Medical Group, Mt. View, CA).

sswinsfba
Posts: 572
Joined: Sat Jan 07, 2023 3:08 pm

Re: Implant Scheduled for Jan 24, 2023

Postby sswinsfba » Thu Jan 12, 2023 5:58 pm

Here's another preop question that I'm going to ask my surgeon.

When I was looking into dick lengthening methods many years ago, I came across cutting the suspensory ligament (SI) as a way of making my dick "look" longer.

Of course, cutting the SI does NOT actually make your dick longer, it just allows more of the dick (that's inside your body) to be revealed while relaxed.

This never made sense as something for me to do as a "grower" but, since following the surgery, I'm due to become a show-er, I was wondering if it would help to cut the SI during the PI surgery to enhance that effect.

Yes, it's vain and unncessary but I've given it thought none the less.

The only downside to cutting the SI, as far as I know, is that you dick would not longer point up but, after PI surgery, most people report that it doesn't point up anyway; at best, "only" straight" out.

My dick never pointed up that much to begin with and would not be bothered if it only pointed "down" if the SI is cut (I've always had to direct my dick to the prize regardless of which way it was pointed) as long as it looks even bigger to me (and the casual observer) while relaxed.

I'll let you know what my doc has to say about it after I speak w/him next week.
Age 73. Started taking 5 mg Cialis daily in 2000. Minor ED started in 2021. Major ED problem started in 2022. Coloplast Titan (20 cm w/1cm RTE) implanted infrapublicly on 01/24/2023 by Dr. Edward Karpman (El Camino Urology Medical Group, Mt. View, CA).

Lost Sheep
Posts: 6162
Joined: Mon Jul 04, 2016 11:16 pm

Re: Implant Scheduled for Jan 24, 2023

Postby Lost Sheep » Thu Jan 12, 2023 10:24 pm

sswinsfba wrote:
Lost Sheep wrote:Ask your surgeon about the so-called "Coffin Effect" which has been discussed a number of times in this support group (use the "Search" function).

Re: "Psuedo-Coffin Effect" of scar tissue forming a restrictive capsule around the implant that would restrict inflation of the implant.

Also, you don't want a Psuedo-Coffin of scar tissue forming such a capsule around the reservoir, either, retricting deflation of the implant.


Thanks for the warning but I dDon't think that should be an issue since my doc is instructing me to start "pulling" on the pump tubes (to avoid the pump bulb from rising) after only 3 days and, as I recall, wants me to starty cycling in wk 2.

I may be wrong about when the cycing is supposed to start but I'm pretty sure that it's no later than wk 3.

In any event, that's on my list of thing to ask at the pre-op appt but, from what I've read so far, "early" cycling at 3 wks should abate the "coffin effect."

There as one study (Caraceni et al) that had patients cycling after only a few days. Those patients' experiences are instructive.

(Clipped from another thread)

This article refers to the differences that early activation (EA) vs no early activation (NEA) of the inflatable prosthesis
Title" Pseudo-capsule “coffin” effect: How to prevent penile retraction after implant of three-piece inflatable prosthesis
Authors: Enrico Caraceni, Lilia Utizi, Giovanni Angelozzi; Department of Urology, Civitanova Marche Hospital, Italy.
Short Summary: http://www.ncbi.nlm.nih.gov/pubmed/25017596
Longer summary: http://www.ncbi.nlm.nih.gov/pubmed/25017596
with this sentence: "The result is a penis bigger in flaccid state but smaller in erect phase, when early activation is not performed"
Full article: https://www.researchgate.net/publicatio ... prosthesis

This article was obviously translated from the original Italian, so there may be some grammar issues to overlook.

And this thread might be of interest: "Over what timespan does Scar Tissue form post-op? (And can it be reversed)?"
viewtopic.php?f=6&t=11379&p=97430


See also

viewtopic.php?f=6&t=17903&p=162931
viewtopic.php?f=6&t=16509&p=148632


As always, I defer to your surgeon's judgemennt. He/She has actually examined your body and assessed your situation in all its details, so is in a MUCH better position to advise than any of us here.
Lost Sheep
AMS LGX 18+3 Nov 6, 2017
Prostate Cancer 2023
READ OLD THREADS-ask better questions -better understand answers
Be part of your medical team
Document pre-op size-photos and written records
Pre-op VED therapy helps. Post-op is another matter

sswinsfba
Posts: 572
Joined: Sat Jan 07, 2023 3:08 pm

Re: Implant Scheduled for Jan 24, 2023

Postby sswinsfba » Fri Jan 13, 2023 2:04 pm

Lost Sheep wrote:As always, I defer to your surgeon's judgemennt. He/She has actually examined your body and assessed your situation in all its details, so is in a MUCH better position to advise than any of us here.


That's the plan. I'll definitely ask about the "coffin effect" in the context of when he recommends to start cycling.
Age 73. Started taking 5 mg Cialis daily in 2000. Minor ED started in 2021. Major ED problem started in 2022. Coloplast Titan (20 cm w/1cm RTE) implanted infrapublicly on 01/24/2023 by Dr. Edward Karpman (El Camino Urology Medical Group, Mt. View, CA).

Old Guy
Posts: 2700
Joined: Tue Mar 31, 2020 4:31 pm
Location: Ohio

Re: Implant Scheduled for Jan 24, 2023

Postby Old Guy » Fri Jan 13, 2023 3:10 pm

If you're getting a Titan any additional means to make it more of a show-er won't be needed, believe me. Took me a long time to come to terms with how my package looks now. I was one of those guys that in the cold my dick would shrivel up almost inside itself but grow to 6". Now there's a bulge in my pants that never goes away.
Good luck on your upcoming surgery.
Nov. 8, 2019
4+ years, Coloplast Titan OTR
Married 36 years to my beautiful young bride
Always here to answer questions if you PM me


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