Revision scheduled 4/5/2023

[Daytripper]

After 10 years of reliable service my Titan failed and Im having a revision in 3 days with Dr. Clavell in Houston. Also just had an Aquablation prostate procedure 60 days ago, that recovery was tougher than expected due to catching Covid 5 days after surgery and then a UTI infection but I've been 2 wks symptoms free from UTI and my San Antonio doctors have given me the green light to proceed.

[ThailandBound]

Nobody looks forward to a revision, but that’s a pretty good decade of reliable service. Wishing you a good recovery and outcome!

[Daytripper]

Appreciate the well wishes. Thinking back I was really nervous for the first surgery, but for the revision I feel more relaxed and confident about the procedure. Has to do with being better informed and of course the experience of the first procedure. Still I have to admit about having my share of concerns but for me there is no other choice I would be happy with so im ready to have this done and move on with my life.

[Jage64]

I think you'll be very happy with Dr. Clavell, he implanted me on Feb. 22. I was cycling at 4 weeks, sex in less than 5 weeks, hardly any pain at any point.

Good luck!

[Old Guy]

Ten years of use is great. Best wishes for the revision to go well.

[Daytripper]

I had not planned on posting my revision log on Franktalk but had an experience while waiting in the surgery prep area I observed a fellow bionic brother being wheeled in for his surgery too and started to speak with him through the divider curtains frankly he very nervous and the nurse commented that he looked very anxious. I believe it stems from a lack of information of not being sure what to expect so these notes are to provide insight and help guide people who are having this procedure. Im not a doctor and am sharing my personal experience for reference because if I live long enough I will most likely need another revision and can look back at my notes to refresh my experience. Your experiences may vary.

Revision log: Surgery performed by Dr. Clavell
Tues, 4/4/2023 Arrived the day before to do check in paperwork and have prelabs done consisting of a urine test, blood test and ekg. Orignally my surgery time was 5:30am check in but received a call in the afternoon the had moved the time to 9:00am.

Wed, 4/5/2023 Surgery date was a smooth start when I arrived I was directed to go straight to the 5th floor for surgery prep. Once on the 5th floor they checked me in immediately I mean I didn’t even get a chance to sit down and take off my jacket Lol. It was very efficient and smooth. Pre op nurse ask me to dress into the surgery gown and later asked my history in particlular about medicines Im allergic to, she then placed a red band on my arm with the allergies written on them. Preps my arm with an Iv for medications.

Dr. Clavell arrives and reviews my chart and history we discussed my particulars I asked him to use the same space for the new reservoir as the old one which is in my right lower groin area because the left side is developing a hernia that flares up occassionally. He says he will do his best and expects everything to turn out well. Also says he has one surgery before me that will take about an hour and I will be next. Dr. Clavell has very good bed side manner. Nurse starts my antibiotics through my iv.

I then get wheeled into a staging area with a new set of nurses that do the final prep for your surgery and was placed in a large room where each patient was seperated by curtains. Nurse explains what to expect going into to surgery and also what to expect when I awake post surgery and discusses pain medications that will be used.
Later the anesthesiologist arrives who was a stunningly beautiful young woman from Phili, took my breath away. Anyways she explained the procedures one of which to my surprise was placing a breathing tube down my throat during surgery but she said not to worry that I would be knocked out by then. About 30 minutes later the surgery nurse ask me to pee and left the portable urinal but I was dry. Anesthesiologist arrives and tells me its time, gives me the feel good juice in my IV, we're having a conversation as she is wheeling me down the hallway things are starting to get fuzzy I remember being rolled into the surgery room and looking up at the lights in the ceiling and next thing I know I awake in the post op recovery area.

Upon awaking I was feeling no pain or discomfort but that quickly changed in about 2 to 3minutes as my body started to wake up from the surgery. The pain started at a 2 but was rising fairly quickly and over time peaked at 6 then with medication settled at about 2 Over the course of an hour and half the nurse administered 3 morphine shots and 2 pain medication pills. The nurse was gauging the effect of the pain medication and was increasing it as necessary and did a very good job managing my pain. Also the nurse informed me my time in surgery was one and half hours, this is probably because a revision requires more work for the surgeon.

I was then wheeled onto recovery to put back into the care of my Pre-op nurse who said she would continue to monitor. my pain and that the goal now was to pee so I could be discharged. This is where my first complication occurred after drinking at least 32oz of water of the course of hour I was not able to pee, the sensation was there but I could not get the stream started. I've learned this can be a side effect of anesthesia for some patients but not normally and is the reason some doctors prefer to send patients home with a foley cathetor after IPP surgery. I wanted to avoid having to use a foley cathetor because it remains in you attached to a collection bag which has to be emptied every couple of hours, its very uncomfortable to have a foley and the doctor may leave it in a couple of days to a week until your follow up. At the 3 hour mark I was catherized (at my request) using an intermittent cathetor (drain and go) and was given a cathetor kit to take with me in case I couldn’t urinate later that night. I was ok with this arrangement since I could self catherize if needed, I was then discharged from the hospital.

Side note, I have history with using intermittent cathetors and have a supply of them used to treat my BPH symptoms prior to my Aquablation surgery 2 months ago so I was comfortable with this arrangement. This night I got very little sleep because I was drinking water and still trying to pee and had to catherize 3 more times (around every 2 hours). Finally around 5:00am there is a small trickle of urine coming out, with stops and starts. This continues several more times for the next 2 hours unit I progress to an intermittent urine stream that is splattering every where (like peeing into a strong wind lol!) This lasted for another hour and I finally progressed to a good but intermittent urine stream with complete voiding. Around 9:00 am I have had two consecutive steady urination sessions with complete voiding and am ready to driving back home to San Antonio. Fortunately the nerve blocker Dr. Clavells applys was still working so I experience very little pain during this process.

The attention and performance by the HCA Houston Healthcare Hospital has been excellent, professional and caring at the same time and the staff here treats Dr. Clavell and his patients like VIP's. Likewise Dr. Clavell has been great, excellent communicator, follow up with patients has been outstanding and has shown to be a top IPP surgeon. Highly recommend Dr. Clavell.

Day 0, 4/5/2023 Revision surgery is completed, reservoir was placed in right lower abdomen.
Pain is a about 2 but can go up with certain movements.

Day 1, 4/6/2023 7:30am received a call from Dr. Clavell as he was driving into his office, says surgery went fine. I was implanted with a 24cm Titan One Touch and 1CM RTE's. Btw 24cm is what I had before but it was made of 20cm with a 4cm RTE's. He was able to reuse the same space for the new reservoir. He also said the old reservoir was pretty easy to get to. Also he says to expect the penis to be as rigid as I want it to be and says he thinks I will be pleased. Feeling no pain and only slight discomfort with certain movements. Nerve block is still blocking pain. Urination is good, easy start and strong stream with some stinging from surgery.

Side note: The bulb and pump sit perfectly centered and to the back of my scrotum which is an ideal placement i believe the doctor was able to achieve this because he cuts the tubing to his measurements and then attaches it to the pump my understanding is this is a more advanced technique on the surgeons part.

Day 2. 4/7/2023 Removed mummy wrap and took first shower. Looked at the incision for the first time it’s approx 4 inch line that runs vertically in the back of my shaft. A 2x5 bandage covers it nicely. There is a small ball of swelling on one right side of testacles. Also there is swelling in the right groin area where the reservoir is placed I can feel it to the touch, it feels like a large wad of cotton is there but its not painful. Penis is swollen making girth look larger than before. Changed bandage. Felt some pain in the morning and took 1/2 of a Tramadol, then alternated between Tylenol and Advil. Spent most of the day in bed resting. Its uncomfortable to sit down for very long. Urinating fine, some stinging from surgery. Icing 10 minutes 2, 3 times.

Side note: my incision is approx. 4 inches vertically, using Carbou Silicon Foam Dressing 2x5 size. Also doctor issued Bacitracin Zinc Ointment USP for the incision and am applying with each bandage change, I'm using 3M Micropore Surgical Tape along the edges of the dressing to keep bandage in place. To change dressing using alcohol applied with cotton balls to apply to surgical tape to make removing tape pretty easy. Also I use latex gloves when working around the wound changing bandages to help prevent infection, in particular I only use the pinky to apply medication on incision and don’t let it touch the ointment container or surgical tape dispenser. Yes its an abundance of caution but the stakes are high.

Day 3, 4/8/2023 Took a shower today and gently washed the incision with soapy water. Changed bandages.
Noticed swelling is going down on the penis. Saw for first time bruising on both sides. Spent most of the day resting. Incision is looking good in that there is no swelling at the stiches or discharge. Also had my first bowel movement since surgery, felt great no problems once urge set it. Urinating 100% normal with no discomfort or stinging. Took 2 tylenol and 2 Advil today. Continuing icing treatment.

Side note: Bowel movement on third day after surgery. I purchased a 25oz bag of almonds and started eating a fist full on the first day of surgery, with each day I was eating several fist fulls per day along with drinking lots of water this made having a bowel very easy and naturally. Btw I routinely eat almonds because they have a high fiber content and I believe this is what help this be a smooth operation its very effective just remember to drink lots of water too.

Day 4, 4/9/2023 Swelling continues to improve and today only took 1 Tylenol, penis is uncomfortable with angled up and trying to wear pants. Things are looking better. Also reservoir is less pronounced than before and feel it less. Sitting is still a challenge but getting better. Took 1 tylenol today. Icing treatment.

Day 5, 4/10/2023 Starting to be able to feel the bulb portion of the pump now pretty well it is sitting low and to the back of my scrotum. Swelling in scrotum is improving but still too much swelling to actually feel the pump housing or to locate the release valve. As the swelling is going down and the pump is now able to move a little bit I believe this is also causing some the pain I've been experiencing today as the bulb comes into contact with a chair when sitting. Pain presents after 30 to 45 minute periods of sitting down. Took 1 tylenol and 1 Advil today. Pain is concentrated to scrotum. Icing treatment.

Side note: I've been using the Jockey Life Microfiber Stretch long leg boxer briefs, these work great to keep my member in place pointing north with just the right amount of compression. I had tried a jock strap, cycling pants and Separate underwear but the Jockeys had the best balance of compression and comfort. Also wearing cargo pants instead of jeans much more comfortable with more room in the front. First time wearing cargo pants for me, they're very comfortable.

Day 6, 4/11/2023 Am able to feel full outline of bulb now and bottom portion of pump as swelling continues to decline. Had errands today that required I be on my feet for over an hour and after 30 minutes I started to feel pain on the penis, since it's positioned to point north it has bend that creates dog ears and this is where the pain is coming from. Normally I would just pump up little bit more to smooth these out but since this is a new revision I don’t have that option until 6 weeks. Took 2 tylenol to help with the pain. Btw if I laydown the dog ears are not as pronounced and that also helps manage any discomfort. Also I'm able to sit for longer periods of time now 30 to 45 minutes at a time with no discomfort, before it was uncomfortable to painful. No pain in scrotum today, only the dog ears presented a problem. Icing treatment.

Side note: The most comfortable position is laying down in bed commando style, the penis is at a 30% angle and this provides relief from the dog ears that occur when wearing underwear. Commando style is how im sleeping at night with no issues.

Day 7, 4/12/2023 Took a shower and changed bandages incision looks good, dry and no inflamation. The bruising on the sides of the penis is fading now and looking much better. I also detect things loosening up in the scrotum and am able to start feeling the edges of the pump housing but have not located the deflate button yet. Went for a 20 minute walk for the first time since surgery, things felt a little tight along the groin area but felt better once I warmed up. Sitting straight up is still challenging for anything longer than 30 minutes. Took 2 tylenol. Continuing with ice treatment.

[Tokyo_123]

I enjoyed reading this. Thank you. I read on this forum that revision is usually easier than going the 1st time.

My only suggestion is that you have doctors monitor the incision for possible infection. I did that, and the doctors here (at St. Luke's) would watch it, and give me additional antibiotics (in both pills and ointments) as needed for the 1st month. Granted, I felt that they were a bit overaggressive, have no problems with that.

[cbinspok]

Good write up Daytripper, when that day comes, I will be knocking on dr Clevell’s door

[cautiouslyoptimistic]

Awesome man. How does it feel in terms of tubing? Any palpable tubing on or around the shaft?

[Daytripper]

How does it feel in terms of tubing? Any palpable tubing on or around the shaft?

Tubing is not detectable anywhere at this time but granted swelling is still present so it's too soon to tell. But so far so good.