Going Public With My Implant Story

[OttoHS]

I have begun to tell close friends about my implant surgery in November and male sling surgery in January. I have lurked here for about a year and thought that I should go public here, too.

First, let me say that I owe a great debt of gratitude to all of you who have posted about your experiences over the past year. I am very happy with both of my surgeries and would have been much more reluctant to take the plunge, especially with respect to the implant, but for the many positive accounts that have been posted here.

Second, let me introduce myself. I am 57 years old. I was diagnosed with prostate cancer in early 2014 and had a radical prostatectomy on March 24, 2014. I never was able to achieve a useable erection notwithstanding my following various "penile rehabilitation" strategies -- PDE-5 inhibitors, including both daily Cialis and large doses of Viagra, and frequent VED pumping. I also had severe incontinence that eventually "improved" to moderate incontinence. But, I hit a plateau about six months after surgery and even on good days I was using three to five Depends Guards and on bad days I often had overflows that required a change of clothing at work.
Other than being diagnosed with prostate cancer and the side effects of the radical prostatectomy, I was and am in good health. I am an avid road cyclist and generally am an active person. I was divorced in 2012 and was just entering the dating scene when I was diagnosed with prostate cancer. Since then and until now, I have not been motivated to date. The few times that I have been out socially with women, I have spent more time focusing on whether the urine in my pants is going to leak out rather than on the person on the other side of the table. That is not a stragegy for romance success.

The world-famous medical institution where I had my radical prostatectomy takes the position that anyone who has nerve sparing surgery, which I had, is not a candidate for in implant until at least two years after surgery. I was clear to me after a year had passed that I never was going to have an erection again absent a miracle. By the Summer of 2015, I had decided that I had to be more proactive with respect to my recovery. I was not sure how implant surgery would impact my bike riding, so I decided to wait until the end of the Summer riding season to explore both the option of an implant and surgery to correct my incontinence. Based on the many positive reviews of Dr. Kramer that I had read here, I made an appointment to see Dr. Kramer in October 2015, We discussed both of my issues -- impotence and incontinence. Although Dr. Kramer said that it was possible to do a combined implant/sling surgery, he recommended that the procedures be done separately -- the implant first followed by the sling. I followed his advice and had the implant (AMS CX) on November 18, 2015, followed by the AdVance Male Sling on January 13, 2016. Here are links to the videos of my implant and sling surgeries. https://www.youtube.com/watch?v=akAzlBd ... PVhpqnQuvh https://www.youtube.com/watch?v=nNpHKyS ... PVhpqnQuvh

My implant surgery went well. The only thing that did not go according to schedule was that Dr. Kramer said that I should be able to return to work the Monday following my surgery. I did return to work that Monday, but sitting was very painful. If I had taken lots of painkillers, I probably could have continued to work at the office. But, I spent the rest of that week at home working on my laptop while laying on my back, the most comfortable position. On the Saturday ten days after surgery, I woke up and realized that the pain was gone. I had an appointment about four weeks after surgery for Dr. Kramer to do the initial inflation of my implant, but seventeen days after surgery I was exploring my scrotum in the shower and inflated myself. I then had to figure out how to deflate. The keychain pump model was very helpful. The next morning, a Sunday, I emailed Dr. Kramer, and received a response within an hour. He told me I could keep inflating and advanced my follow-up appointment. It was unseasonably warm in late December and I emailed Dr. Kramer and asked if I could try to ride my bike. He said that I could so long as I took it easy and did not do anything crazy. Less than six weeks after my surgery, I was back on the road. I did two 18-mile rides with some climbs before the weather turned cold and my next surgery was on the horizon.

The sling surgery initially was less painful than the implant surgery, but the residual pain/discomfort has been longer. It took about three weeks before I would say that I was totally pain free and I stil feel occasional twinges. Given the volume of my urine leakage, Dr. Kramer was not sure that the sling would give me a total cure, but he also felt that an AUS Artificial Urinary Sphincter was more than I needed and would add to the hardware in my already crowded scrotum. The sling has been largely successful. I am not bone dry, but I would say that I am 95% of the way there. Some days I have no leakage. On other days, I may need to change a Depends Shield once or twice. I usually drink tea and water throughout the day. On the days when I have restricted my fluid intake to drinks only with meals, I have not had any leakage. Last week Dr. Kramer said that I could resume normal activities, such as cycling. Given that it is 20 degrees outside today, I have not been on the bike yet. But, I plan to be out on the roads the first sunny weekend day that the temperatures are above freezing.

Now the question that I know that everyone has: Did I lose any length or girth after the implant? I really cannot answer the question. Prior to my radical prostatectomy, I was longer and wider than I am now fully inflated. But, I never had a natural erection after the prostatectomy. With the VED I could get up to 7.25 inches in length. But, VED length supposedly is longer than that what you can get otherwise. I never really did an exact measurement of my penis prior to my prostatectomy, but I am sure that it was north of seven inches. Right now my penis fully pumped is somewhere between 6.25 and 6.5 inches. I have been cycling twice per day and have seen some slight lengthening and substantial girth increase over the past eight weeks. To the extent that my penis is smaller than it was back in the day, I attribute that to the prostate surgery rather than the implant.

Finally, let me say a few words about Dr. Kramer, his staff and the University of Maryland Medical Center. I cannot say enough good things about Dr. Kramer. Both of my surgeries were very successful and much more pain free than those about which I have read in other reports. Dr. Kramer has been incredibly accessible when I have had questions. I have dealt with many physicians over the past decade and generally have been a satisfied patient. But not one of my other physicians has come close to Dr. Kramer in terms of responsiveness and communication. He not only is a skilled surgeon, but he cares deeply about his patients. I recommend him highly to anyone who is considering implant or other urological surgery. I also was impressed with Dr. Kramer's staff. On the morning of my implant surgery, several of the men and women who would be assisting in the surgery came in to see me. I was impressed not only that they wanted to make sure that I was comfortable but that many of them had been working Dr. Kramer for years. Dr. Kramer's office staff also was very helpful to me. I had some insurance pre-approval delays and they made sure to keep things moving so that my initial surgery date was not delayed. For the past 15 years, all of my medical care has been at the University of Maryland's cross-town rival institution. I had not been inside the University of Maryland Medical Center since my father had been a patient there in the early 1980s. I was very impressed by the warmth and helpfulness of everyone I encountered during the course of both surgeries.

Now that I no longer am lurking, I will post in other threads when I have something to add. But, I wanted to introduce myself before I jump into the fray.

Otto

[dirtman1993]

Thank you for the info on Dr. Kramer as I leave the 29th for Baltimore and surgery on March 2nd. I too am having Dr. Kramer record the surgery and told him to place on web if he wished. I have told Franktalk I will speak with others and show if requested to help. I wish someone close to me had offered the same and maybe I would have done the implant a year ago.

Thanks again.

[OttoHS]

I can understand one's being hesitant to pull the trigger. But if I have any message other than praising Dr. Kramer is that once you realize that your ED is not getting better, go for the implant. I really did not question my decision before or after surgery with one exception. On the morning of my surgery as I was sitting in the waiting room at the surgery clinic at the University of Maryland, for a fleeting moment, I had the urge to flee. But, I am not the kind of guy that runs and I stayed in my seat until I was called for surgery. I am very happy that I did.

[RelievedofED1]

Congrats and welcome to the club. I read your post and smiled. I sometimes worry I will come across as a paid advertisement (along with others here) for Dr Kramer. A lot of Kramer and Eid patients do. No surgeon is right for everyone and none can guarantee success but have to agree with you re my experience regarding rapid recovery and a doctor like Dr Kramer and his team that was and continues to be (when I have a worry or question) caring and responsive. I am sure there are other doc's out there that just don't have the volume or web presence to be as well known that are also very good but I can't imagine any of them being better than Dr. Kramer. This is not a paid announcement! We hear that a lot up here during the primaries but in this case it's true. Congrats again for not leaving your seat and going through with the surgery. I still remember the waiting room and that same thought.

[strongagain]

Congrats again for not leaving your seat and going through with the surgery. I still remember the waiting room and that same thought.

Same happened to me too! The evening before the operation Dr. Leiber came to my hospital room. I told him that I'm ready to run away. He laughed and said that he is feeling with me but I shouldn't worry, everything will be fine. He was right of course. Silly me, why didn't I get an implant years earlier? I remember to have visited him in 2009 already. He mentioned the implant and I thought, wow, that's what I need, with that I can screw for ever. I left him with a flyer in my hand. At home I studied the flyer in detail and thought to myself, never ever would I agree to such a procedure. I was such a chicken then...

[OttoHS]

Congrats again for not leaving your seat and going through with the surgery. I still remember the waiting room and that same thought.

Same happened to me too! The evening before the operation Dr. Leiber came to my hospital room. I told him that I'm ready to run away. He laughed and said that he is feeling with me but I shouldn't worry, everything will be fine. He was right of course. Silly me, why didn't I get an implant years earlier? I remember to have visited him in 2009 already. He mentioned the implant and I thought, wow, that's what I need, with that I can screw for ever. I left him with a flyer in my hand. At home I studied the flyer in detail and thought to myself, never ever would I agree to such a procedure. I was such a chicken then...

The first friend I told about my implant had no idea what I was talking about. I sent him a link to the video of my surgery. His response was: "Dude, I cannot believe that you let some guy do that to your dick." My reply was: "Before I lived with a totally limp dick for over a year with no prospect of its getting better, I felt the same way." When I awoke from my surgery, my first thought was: "Did I really do this?" Well, I did and do not regret it. But, I fully understand the desire to flee.

[David_R]

"To the extent that my penis is smaller than it was back in the day, I attribute that to the prostate surgery rather than the implant." I totally agree with you. It has not been a year yet for you as your continue regular pumping up. It takes time and patience, sorry to say. I hope you'll be as happy with your implant as I am with mine.

[stringerbell]

kramer is a tremendously skiled surgeon- i agree, watch his hands in those videos, pretty incredible to see.

[OttoHS]

Otto,
I did my surgery with Andrew Kramer also about 1 year ago or so, I'm a surgeon and he put mine on-line. I thought his personality was fine/OK, but honestly I didn't care one way or the other. He came in wearing scrubs, unshaven, a big life-preserver type vest with a big clip on the pocket since the zipper broke- sort of a quirky/"I-don't-care 'cause I'm the best" sort of look. Operatively or technically he's amazing, watch his hands during the videos. No wasted motion, he ties knots better and faster than I've ever in any surgeon in my entire career. He's slick. I'm sort of disappointed I think he had a resident suture me up on one side, his took 15 seconds, the other side took 5 minutes. I have a 100% perfect result- I still support saying he's the best (or top 2) in the world. But in retrospect I might ask any academic guy if they are doing the surgery, or having trainees do part of it. I think he stands on the right in my surgery and the guy/girl on the left does some stuff. Hey- he put it on-line. So I'd go back to him in a heartbeat, unbelievable technician. Called me back within 10 minutes every time I had a question. I just want to give loyal readers every piece of information, good or bad (hate to say bad.... just made me think). MS

Given your professional expertise as a surgeon, your comments about Dr. Kramer's skill is very interesting. However, I take exception to your comment that he is slick. I am a lawyer who has litigated business cases for over 30 years. You and I might have different definitions of "slick." But, to me, a "slick" person is someone who overpromises and underperforms or tries to sell you something that you do not need. Using my definition, Dr. Kramer is not slick. I will admit that that he is very confident of his abilities and does not hide his light under a bushel. But, when it comes to having someone slice and dice my penis, I want someone who is confident rather than Caspar Milquetoast. It was my experience that he was scrupulously honest about what he thought that he could do for me and ultimately did better than he predicted. I presented with both ED and incontinence. I cannot recall Dr. Kramer's exact words and figures, but he essentially said something along the following lines: "I have done over 3,000 penile implants and I am confident that you will have a good result with respect to erectile function. I do not have the same amount of experience with the sling procedure and I cannot guarantee the same result with respect to incontinence, but I think that you will have an improvement." Dr. Kramer's distinction between the two procedures illustrates what I am trying to say. When he knows that he can achieve something, he will say it without false modesty. But, if he is not 100% sure, he will not overstate what he thinks he can do.

Insofar as whether the surgeon is doing the whole operation or having people assist him, Dr. Kramer's videos clearly indicate and show that he has assistance. In you listen to the video of my implant procedure, Dr. Kramer says that his assistant is working synchronously with him to cut the operating time in half. I did not have a problem with that. He was there for the whole operation and I assume that if his assistant ran into a problem, he would have taken over the whole procedure. Cutting the operation time in half clearly is a benefit to the patient. But, you do make a good point about inquiring who actually will be doing the operation and what the level of supervision will be. When I had my prostatectomy, my well-regarded surgeon came out to see my sister who was in the waiting room about midway through my surgery and told her that I was doing fine and that "they are wrapping up the operation in there now." I was in the operating for substantial time after that and my sister had the impression that after she saw the surgeon, he was not going back to my operation but elsewhere. Given that Dr. Kramer videotapes his surgeries, there is total transparency as to who did what during the operation.

[treifsnyder]

I'd have to agree with OttoHS, I found after watching his videos that his hands are superb, I've read other doctors on this site and others comment on it. I also agree with others who say these top couple of guys are all great decisions, splitting hairs to pick.