[Journey] Getting a erectile prosthesis.

[Someguy90]

Intro
As the title of this topic states, i am getting a penile protheses in The Netherlands where overall compared to the USA is a surgical low penile implant volume country.

I'm 32, and I have been hiding my start of impotence since the age of 20-21.

On New Year's Eve 2012/2013 I almost got into a ketoacidosis coma (The day we discovered diabetes 1) and they rushed me to the hospital. I can still remember saying to my family after sitting down on the kitchen floor; My mind wants to continue, but my body gave up. --Roughly translated from Dutch.

Lost weight from 91 kilos (200 Pounds), to 47 kilos (103 Pounds) before it got discovered.

Apparently, I had been walking around with diabetes type 1 for 1,5 year. Even tough going to the doctor more than 7 times in that period, it was undetected.
You can imagine this disease dissolved my wannabe athlete body and caused tremendous irreversible damage.

My mother got diagnosed with Diabetes Type 2, 3 days later due to the discovery that I have diabetes. She also had been walking around with diabetes for a shorter period undetected, by the same doctor.

At the age of 19-20 my size was (from pressing on the bone) erected 8.54" (21.7 Cm) - This is without pump or anything 100% natural.
Currently, I have a maximum of 6.6 (17 Cm) written on the pump when pumped, but I'm unable to measure it correctly from the bone due to the pump.
I'm a short man tough; 1,62m in length, around 58 Kilos (127 Pounds).

The thought of getting the implant has been on my mind for 7 years, but I kept refusing (denial) and I have used all other options. Androskat injection have never worked (2ml) let along all the other things...

This thread of our fellow bionic friend pushed me over the edge to do it, also the reason why I am creating this thread; viewtopic.php?f=6&t=20761

Doctor & Hospital
In the Netherlands, 7 hospitals do penile protheses (Here we call it erectile prosthesis), to give an idea how many a year get "installed".


Source: https://mijn.bsl.nl/vijf-jaar-regionali ... -/20139876

My doctor does 10+ implants a year (All the implants in hospital Antonius). Compared to what i read on this forum, other doctors do 4+ implants a day.
Source: https://www.antoniusziekenhuis.nl/behan ... ieprothese

Hospital: St Antonius Ziekenhuis
Doctor: Dr. J.J.H. (Jack) Beck, PhD - https://www.antoniusziekenhuis.nl/speci ... k-beck-phd
Years of Experience: Unknown - Hospital website states; Dr. Beck has a lot of experience with this treatment and has been performing it for years. This operation is performed more than 10 times a year by the specialized urologist dr. J.J. H Beck.
Update 1: After asking, he stated he does around 25-50 erectileprotheses a year, and he is experienced with diabetic patients.
Doctor assisted by: J.P. Verkerk-Geelhoed, MSc, nursing specialist. - https://www.antoniusziekenhuis.nl/speci ... elhoed-msc
Years of Experience: Unknown - Hospital website states; This operation is performed more than 10 times a year by the specialized urologist dr. J.J. H Beck. He is supported for treatment and guidance by Mrs. J.P. Verkerk-Geelhoed, MSc, nurse specialist.
Source: https://www.antoniusziekenhuis.nl/behan ... ieprothese

Youtube Video provided by the hospital, in the video you can see/hear the doctor and his assisted that are treating me.
https://www.youtube.com/watch?v=XgK449On0Ew
Around 00:26 the doctor clearly states; I think that we have a lot of experience in treating these conditions such as erection problems.

Financial: 100% Covered by standard (default) Insurance (erectile prosthesis cover added in September 2016. Health insurance is required by law).
Start Date: 4th of August, first appointment.

Please know that i might not add images or update this topic due to various reasons, I'm having a hard time doing this.

Start of getting an erectile prosthesis
4th of August 2023: Coming up (writing this 2nd of August) is the first meeting with dr. J.J. H Beck.
My trusted friend, and ex-girlfriend (From when I was 19), are going with me to drag my ass through this.

That implies that I have an appointment in 2 days.
I'm bouncing around by the thought of doing this. What if it gets infected because I'm diabetic, and they need to remove it? I will be left with nothing. Things like that are bouncing around in my head.

#Update 1:
I've met my surgeon for the first time, and honestly, he gave me a lot of comfort.

Good thing I had my 2 buddies with me to be my ears because they remembered details I missed/forgot.
I'm a good candidate for the protheses, he said, BUT my A1C is a few points too high to be covered by insurance (did blood work before the appointment)!

It's currently 66 and the insurance requires 58 or lower.
I believe the typical diabetes type 1 "Somogyi effect" had increased my A1C between blood works. So I need to work on that immediately.... blood work end of August!
--I hope quitting smoking 1 week before will help decrease it. Smoking was the absolute last thing I had left of enjoyment...

Meanwhile, I will be meeting with a sexologist as it is also required before surgery.
He did a quick size measurement, and wrote down 14.5 CM flassed. I missed if he included the glans or not. Need to ask him about it next time, because my own measurement was higher, like with all men that measure themselves

Most noticeably is that he was surprised/excited that I read the research papers and conclusion that has been publicized last year (The screenshot in this thread was from that publication). It brought me a lot of comfort that the quality and result in numbers have increased, including the yearly amount of surgery performed by his team (From 10+ to 25 - 50 a year).

It was also a big + that I've been pumping to regain my losses before making the appointment. And that my wish was an AMS 700 LGX to keep working on it, he agreed and noted it down. He also preferred the AMS 700 series and explained the active 2 weeks of antibiotics that he soaks it in before placement.

1 Noticeable thing was; I'm pretty thin, so he noted that he might place the reservoir elsewhere and that he might need to make a small incision above the penis to avoid me having a noticeable "bulp" (the rest Penoscrotal). That is a good thing! He cares about a lot of things Quality, regain of size, shape, look and feel.

My main issue is infection due to my diabetes, I need to lower my A1C to < 58. To have the same infection rate as healthy people and not an increased risk.
##


I'll do my best to edit this post and add more info. So if you want to follow this, just keep an eye on the (this) first post.

[Bigdave]

Welcome to FT.
It sounds like you've done your homework, and have chosen the best option you have access to.

I didn't find FT until a couple weeks after my implant.
It's been a huge help through the recovery process, but I wish I had found it sooner.
My doctor is also fairly low volume, I think he said he does about 25 to 50 a year.
My recovery was moderately painful and I had a lot of swelling at the beginning, but overall my results have been positive.

Good luck, and keep us updated.

[Luther]

My goal is not to confuse you now that you have your first pre-op appointment this week, but did you consider consulting prof. dr. Koen van Renterghem in Hasselt, Belgium?

He performs prothesis surgery more frequently than any of the dutch doctors and dutch insurance will cover for surgery in Belgium as well (actually it's in their benefit as the costs are considerably lower in Belgium).

I will have surgery after the summer holidays performed by dr van Renterghem. If you have any questions feel free to ask, or send me a PM.

viewtopic.php?f=6&t=22236&p=208955#p207363
https://orcid.org/0000-0001-5367-6651
https://www.jessazh.be/web/internationa ... renterghem

[Someguy90]

My goal is not to confuse you now that you have your first pre-op appointment this week, but did you consider consulting prof. dr. Koen van Renterghem in Hasselt, Belgium?

He performs prothesis surgery more frequently than any of the dutch doctors and dutch insurance will cover for surgery in Belgium as well (actually it's in their benefit as the costs are considerably lower in Belgium).

I will have surgery after the summer holidays performed by dr van Renterghem. If you have any questions feel free to ask, or send me a PM.

viewtopic.php?f=6&t=22236&p=208955#p207363
https://orcid.org/0000-0001-5367-6651
https://www.jessazh.be/web/internationa ... renterghem

He does around 125+ operations a year. Compared to mine with 10+.
I don't know, I have absolutely no clue what I am doing.

I will talk about Prof. dr. Koenraad van Renterghem with my surgeon Friday i guess.

Only thing I know is, this is my only option to increase my quality of life.

[Someguy90]

Welcome to FT.
It sounds like you've done your homework, and have chosen the best option you have access to.

I didn't find FT until a couple weeks after my implant.
It's been a huge help through the recovery process, but I wish I had found it sooner.
My doctor is also fairly low volume, I think he said he does about 25 to 50 a year.
My recovery was moderately painful and I had a lot of swelling at the beginning, but overall my results have been positive.

Good luck, and keep us updated.

It does me well to read that your doctor is also low volume and that the result are positive.

[biomedex3090]

Intro
As the title of this topic states, i am getting a penile protheses in The Netherlands where overall compared to the USA is a surgical low penile implant volume country.

I'm 32, and I have been hiding my start of impotence since the age of 20-21.

On New Year's Eve 2012/2013 I almost got into a ketoacidosis coma (The day we discovered diabetes 1) and they rushed me to the hospital. I can still remember saying to my family after sitting down on the kitchen floor; My mind wants to continue, but my body gave up. --Roughly translated from Dutch.

Lost weight from 91 kilos (200 Pounds), to 47 kilos (103 Pounds) before it got discovered.

Apparently, I had been walking around with diabetes type 1 for 1,5 year. Even tough going to the doctor more than 7 times in that period, it was undetected.
You can imagine this disease dissolved my wannabe athlete body and caused tremendous irreversible damage.

My mother got diagnosed with Diabetes Type 2, 3 days later due to the discovery that I have diabetes. She also had been walking around with diabetes for a shorter period undetected, by the same doctor.

At the age of 19-20 my size was (from pressing on the bone) erected 8.54" (21.7 Cm) - This is without pump or anything 100% natural.
Currently, I have a maximum of 6.6 (17 Cm) written on the pump when pumped, but I'm unable to measure it correctly from the bone due to the pump.
I'm a short man tough; 1,62m in length, around 58 Kilos (127 Pounds).

The thought of getting the implant has been on my mind for 7 years, but I kept refusing (denial) and I have used all other options. Androskat injection have never worked (2ml) let along all the other things...

This thread of our fellow bionic friend pushed me over the edge to do it, also the reason why I am creating this thread; viewtopic.php?f=6&t=20761

Doctor & Hospital
In the Netherlands, 7 hospitals do penile protheses (Here we call it erectile prosthesis), to give an idea how many a year get "installed".


Source: https://mijn.bsl.nl/vijf-jaar-regionali ... -/20139876

My doctor does 10+ implants a year (All the implants in hospital Antonius). Compared to what i read on this forum, other doctors do 4+ implants a day.
Source: https://www.antoniusziekenhuis.nl/behan ... ieprothese

Hospital: St Antonius Ziekenhuis
Doctor: Dr. J.J.H. (Jack) Beck, PhD - https://www.antoniusziekenhuis.nl/speci ... k-beck-phd
Years of Experience: Unknown - Hospital website states; Dr. Beck has a lot of experience with this treatment and has been performing it for years. This operation is performed more than 10 times a year by the specialized urologist dr. J.J. H Beck.
Doctor assisted by: J.P. Verkerk-Geelhoed, MSc, nursing specialist. - https://www.antoniusziekenhuis.nl/speci ... elhoed-msc
Years of Experience: Unknown - Hospital website states; This operation is performed more than 10 times a year by the specialized urologist dr. J.J. H Beck. He is supported for treatment and guidance by Mrs. J.P. Verkerk-Geelhoed, MSc, nurse specialist.
Source: https://www.antoniusziekenhuis.nl/behan ... ieprothese

Youtube Video provided by the hospital, in the video you can see/hear the doctor and his assisted that are treating me.
https://www.youtube.com/watch?v=XgK449On0Ew
Around 00:26 the doctor clearly states; I think that we have a lot of experience in treating these conditions such as erection problems.

Financial: 100% Covered by standard (default) Insurance (erectile prosthesis cover added in September 2016. Health insurance is required by law).
Start Date: 4th of August, first appointment.

Please know that i might not add images or update this topic due to various reasons, I'm having a hard time doing this.

Start of getting an erectile prosthesis
4th of August 2023: Coming up (writing this 2nd of August) is the first meeting with dr. J.J. H Beck.
My trusted friend, and ex-girlfriend (From when I was 19), are going with me to drag my ass through this.

That implies that I have an appointment in 2 days.
I'm bouncing around by the thought of doing this. What if it gets infected because I'm diabetic, and they need to remove it? I will be left with nothing. Things like that are bouncing around in my head.

I'll do my best to edit this post and add more info. So if you want to follow this, just keep an eye on the (this) first post.

thank you for this informative post

[wolfpacker]

What if it gets infected because I'm diabetic, and they need to remove it? I will be left with nothing. Things like that are bouncing around in my head.

Regarding what happens if you get an infection, this would be a great question for your doctor when you meet with him at your appointment. Ask what the procedure is in case of infection. Usually what I've seen on here is that they will remove the inflatable implant, wash the inside of the penis out with antibiotics, then install a malleable penile implant for several months to allow the infection to subside. The malleable implant will ensure you don't lose too much size during that time. Then they can re-attempt the inflatable implant surgery a few months later after infection has subsided.

[Gt1956]

At least in the USA. How well your diabetes is controlled is very important. We use a test called the A1C. This is a blood test that has the ability to measure your average glucose level for the last 3 months. Any test at 7 or lower is considered controlled. I had been around 6.5 to 6.8. A talk with my dr convinced me that I was taking my insulin at the wrong time. Best to judge how many carbs you will eat & take enough insulin for that amount.
Next test I was 6.3. Two months later just before surgery I was 6.2.
If your A1C shows that your glucose is well controlled then your infection risk is the same as a non diabetic patient.

[Someguy90]

What if it gets infected because I'm diabetic, and they need to remove it? I will be left with nothing. Things like that are bouncing around in my head.

Regarding what happens if you get an infection, this would be a great question for your doctor when you meet with him at your appointment. Ask what the procedure is in case of infection. Usually what I've seen on here is that they will remove the inflatable implant, wash the inside of the penis out with antibiotics, then install a malleable penile implant for several months to allow the infection to subside. The malleable implant will ensure you don't lose too much size during that time. Then they can re-attempt the inflatable implant surgery a few months later after infection has subsided.

The surgeon said "We have 1 go to do this correctly, no second changes also due to insurances."

At least in the USA. How well your diabetes is controlled is very important. We use a test called the A1C. This is a blood test that has the ability to measure your average glucose level for the last 3 months. Any test at 7 or lower is considered controlled. I had been around 6.5 to 6.8. A talk with my dr convinced me that I was taking my insulin at the wrong time. Best to judge how many carbs you will eat & take enough insulin for that amount.
Next test I was 6.3. Two months later just before surgery I was 6.2.
If your A1C shows that your glucose is well controlled then your infection risk is the same as a non diabetic patient.

*Added "Update 1" to the first post.

Both of you are correct, my A1C has increased between blood works It seems the "Somogyi effect" is at play in my case.
In this case, I'm lucky since I need to talk with a sexologist. I hope it decreases in time and not delay this whole process.

[Lost Sheep]

The Somogyi effect is usually associated with people who take insulin. Do you? Getting your daily blood glucose (and your A1C) lowered appears to be vital to your ability to get an implant. Consulting your endocrinologist to gain tight control over you glucose levels might be worth whatever sacrifices you would need to make.

I will note (as you probably already know) that A1C is not quickly responsive to glucose control, as it is measure of the red blood cells' history of exposure to blood glucose and red blood cells have about a 90 day lifespan. Thus A1C indicates your 3 month history of glucose levels. If you get your glucose levels well controlled for only the week or two before surgery, your A1C will not be a good indicator of that improvement of control.

Good for you to stop smoking. Drugs in tobacco cause restrictions in your blood vessels. Restricted capillaries are a high risk factor for slow healing and reduced ability to control infections.