Hakky or Clavell?
Re: Hakky or Clavell?
I've looked at Hakky's youtube page and most of his latest videos show infrapubic procedures. I thought he did PS using no-touch just like Eid and Clavell?
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Re: Hakky or Clavell?
Jage64 wrote:You're overthinking this. In my opinion the cycling regimen of sooner or later should make no difference.
PLENTY of men thrilled with early cycling.
PLENTY of men thrilled with later cycling.
If there was any sort of noticeable difference in outcome between the two theories there would be consensus among all the high volume implanters. There is not. I wouldn't base a decision on which surgeon on post operative care opinions.
Find a doctor you trust first, counsel with them about which implant is best for you, double check their reasoning and opinions with your own research. If you still have that trust in them, then trust that they know what's best for you based on their own expertise and experiences.
Then, get that bad boy installed and take your sex life back. You'll wonder why you waited so long.
I agree with you.
I was supposed to start cycling after 4 weeks. Dr. found that it was too early for me with swelling and pain when he tried to inflate. So, he gave it 2 more weeks. It is about when you are ready for it and everyone's body is different.
Finally Bionic
1969. RP Oct. 2017. Pills and Trimix didn't work. Inguinal hernia repair on both sides. AMS CX 21 cm+1 RTE, by Dr. Kai Li at Kaiser, VA, Jan. 2021. FT member since July 2020 as AST2123. See my previous 457 posts.
1969. RP Oct. 2017. Pills and Trimix didn't work. Inguinal hernia repair on both sides. AMS CX 21 cm+1 RTE, by Dr. Kai Li at Kaiser, VA, Jan. 2021. FT member since July 2020 as AST2123. See my previous 457 posts.
Re: Hakky or Clavell?
nuance wrote:I've looked at Hakky's youtube page and most of his latest videos show infrapubic procedures. I thought he did PS using no-touch just like Eid and Clavell?
According to Perito, infrapubic is a much faster surgery and results in the ability to see more patients per day than penoscrotal. In one of his videos, Perito touts the financial advantages of faster surgeries for the benefit of the surgeon. Maybe that has been attractive to Dr. Hakky.
My own research resulted in my purposely choosing the penoscrotal approach for the advantages it offered in terms of perfect pump placement, which was of most importance for me due to it being what I interacted with most.
2/22/23 AMS 700 CX 21cm + 1.5cm RTEs. was 58 yrs old, wife of 37 yrs. Penoscrotal. 100ml Conceal reservoir. Dr. Clavell. Pills failing and went right to implant. 2+ yrs post op: 7 3/4" x 5 7/8", now 60yrs old in 2025
Re: Hakky or Clavell?
Faster surgeries also have a benefit of lower odds of infection.
IJIR: Your Sexual Medicine Journal
Review Article
20 May 2020
The good, the bad, and the ugly about surgical approaches for inflatable penile prosthesis implantation
The good of InfraPubic approach
(1) Easier, safer reservoir placement under direct vision
(2) Diminished scrotal swelling resulting quicker pump activation
(3) Shorter operative time in skilled hands
(4) Incision is remote from patients with incontinence and allows abdominoplasty
The bad of the InfraPubic approach
(1) Limited visualization of distal corpora cavernosa
(2) Pump placement is not optimal with the risk of pump migration
(3) Severe obesity and fibrotic corpora are challenging
(4) Revision surgery after the IP approach, if required, is associated with increased difficulty and worse surgical outcomes
(5) Scar of IP incision is visible
The ugly of InfraPubic approach
(1) Risk of dorsal nerve injury, a complication from which there is no cure. While a paper in 2018 claimed that there were no reports of this complication in the literature, both Drs. Scott and Wilson sustained one in the 1980s. Wilson has also been an expert witness in six additional cases sustained with IP (all successful) that came to litigation in USA. Decreased penile sensation occurs most often following revision cases when the anatomy is not so clear
The good of the PenoScrotal approach
(1) Excellent exposure of both proximal and distal corpora cavernosa even for patients with obesity or corporal fibrosis
(2) Little risk of injury to dorsal neurovascular bundle
(3) Pump placement is facilitated
(4) The small scrotal incision leaves negligible scar
(5) One incision double implant of IPP and artificial urinary sphincter is possible
The bad of the PenoScrotal approach
(1) Blind placement of the reservoir into the space of Retzius
(2) Scrotal swelling can delay device activation
(3) Risk of injury of scrotal urethra; the urethra is easily seen and can be repaired
The ugly of PenoScrotal approach
(1) None. There is no irreversible complication with PS incision.
IJIR: Your Sexual Medicine Journal
Review Article
20 May 2020
The good, the bad, and the ugly about surgical approaches for inflatable penile prosthesis implantation
The good of InfraPubic approach
(1) Easier, safer reservoir placement under direct vision
(2) Diminished scrotal swelling resulting quicker pump activation
(3) Shorter operative time in skilled hands
(4) Incision is remote from patients with incontinence and allows abdominoplasty
The bad of the InfraPubic approach
(1) Limited visualization of distal corpora cavernosa
(2) Pump placement is not optimal with the risk of pump migration
(3) Severe obesity and fibrotic corpora are challenging
(4) Revision surgery after the IP approach, if required, is associated with increased difficulty and worse surgical outcomes
(5) Scar of IP incision is visible
The ugly of InfraPubic approach
(1) Risk of dorsal nerve injury, a complication from which there is no cure. While a paper in 2018 claimed that there were no reports of this complication in the literature, both Drs. Scott and Wilson sustained one in the 1980s. Wilson has also been an expert witness in six additional cases sustained with IP (all successful) that came to litigation in USA. Decreased penile sensation occurs most often following revision cases when the anatomy is not so clear
The good of the PenoScrotal approach
(1) Excellent exposure of both proximal and distal corpora cavernosa even for patients with obesity or corporal fibrosis
(2) Little risk of injury to dorsal neurovascular bundle
(3) Pump placement is facilitated
(4) The small scrotal incision leaves negligible scar
(5) One incision double implant of IPP and artificial urinary sphincter is possible
The bad of the PenoScrotal approach
(1) Blind placement of the reservoir into the space of Retzius
(2) Scrotal swelling can delay device activation
(3) Risk of injury of scrotal urethra; the urethra is easily seen and can be repaired
The ugly of PenoScrotal approach
(1) None. There is no irreversible complication with PS incision.
Last edited by LastHope on Tue Dec 03, 2024 10:15 pm, edited 2 times in total.
40, Coloplast Genesis, 1/2025, Dr. Christine, UCAL
Re: Hakky or Clavell?
has resevior placement with PS approach been a problem with top doctors where a revision was needed? Is the biggest concern impact on prostate and kidneys? Is prostatitis possible cause of the implant?
Re: Hakky or Clavell?
This one was a particular consideration for me:
Risk of dorsal nerve injury, a complication from which there is no cure.
Every other risk mentioned can be treated or corrected.
Risk of dorsal nerve injury, a complication from which there is no cure.
Every other risk mentioned can be treated or corrected.
2/22/23 AMS 700 CX 21cm + 1.5cm RTEs. was 58 yrs old, wife of 37 yrs. Penoscrotal. 100ml Conceal reservoir. Dr. Clavell. Pills failing and went right to implant. 2+ yrs post op: 7 3/4" x 5 7/8", now 60yrs old in 2025
Re: Hakky or Clavell?
Jage64 wrote:This one was a particular consideration for me:
Risk of dorsal nerve injury, a complication from which there is no cure.
Every other risk mentioned can be treated or corrected.
Good point, Jage64. My bad, I combined the bad and ugly parts as bad, out of laziness to type. The ugly has to be highlighted, as it's a "no cure" complication. I have added the ugly sections above.
40, Coloplast Genesis, 1/2025, Dr. Christine, UCAL
Re: Hakky or Clavell?
what does dorsal nerve injury lead to?
Re: Hakky or Clavell?
nuance wrote:what does dorsal nerve injury lead to?
-Reduced/Loss of sensation in shaft/glans
-Orgasm/ejaculation issues
-Neuropathic pains
40, Coloplast Genesis, 1/2025, Dr. Christine, UCAL
Re: Hakky or Clavell?
nuance wrote:what does dorsal nerve injury lead to?
Even with an implant making your dick hard, you won't feel a thing and won't ejaculate.
All of the most important nerves run along the top of your penis to the glans. An infrapubic installation of the implant requires the surgeon to navigate around this bundle of nerves where they enter your torso.
2/22/23 AMS 700 CX 21cm + 1.5cm RTEs. was 58 yrs old, wife of 37 yrs. Penoscrotal. 100ml Conceal reservoir. Dr. Clavell. Pills failing and went right to implant. 2+ yrs post op: 7 3/4" x 5 7/8", now 60yrs old in 2025
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