Penile Length/Girth Maintenance 1 Year Following Coloplast

[PFracture]

Prospective Evaluation of Postoperative Penile Rehabilitation: Penile Length/Girth Maintenance 1 Year Following Coloplast Titan Inflatable Penile Prosthesis

Abstract
Introduction

The most prevalent long-term complaint after successful inflatable penile prosthesis (IPP) surgery is reduction of penile length. The purpose of this study was to evaluate penile measurements in patients whose implantation experience included the aggressive new length measurement technique (NLMT) coupled with postoperative IPP rehabilitation (daily inflation) of the implant for 1 year. Moreover, we aimed to document objective data concerning dimensional changes of the phallus over time. Postoperative IPP rehabilitation has been discussed and presented at meetings, but no multi-institutional prospective data have been published.
Aim

Our goal was to assess results using the Coloplast Titan IPP, with NLMT, and postoperative rehabilitation.
Methods

After IRB approval, we conducted a prospective, three-center study of 40 patients who underwent IPP placement, with NLMT for end organ failure erectile dysfunction with the Coloplast Titan IPP. The patient was instructed to inflate daily for 6 months and then inflate maximally for 1–2 hours daily for 6–12 months. Fifteen penile measurements were taken before and immediately after surgery and at follow-up visits.
Main Outcome Measure

Penile length measurements after implantation compared with 12 months postimplantation.
Results

Penile measurement changes were statistically significantly improved at 12 months as compared with immediately postoperative and at 6 months. A total of 64.5% of subjects were satisfied with their length at 1 year, and 74.2% had perceived penile length that was longer (29%) or the same (45.2%) as prior to the surgery; 61.3% and 16.1% of subjects had increased and unchanged satisfaction, respectively, with penile length as compared with prior to IPP surgery. All but two subjects (93.4%) were satisfied with the overall function and dimensions of their IPP.
Conclusion

This study suggests using the Coloplast Titan IPP with aggressive cylinder sizing, and a postoperative penile rehabilitation inflation protocol may help optimize patient satisfaction and erectile penile measurements. Henry GD, Carrion R, Jennermann C, and Wang R. Prospective evaluation of postoperative penile rehabilitation: Penile length/girth maintenance 1 year following coloplast titan inflatable penile prosthesis. J Sex Med 2015;12:1298–1304.

http://www.ncbi.nlm.nih.gov/pubmed/26853014

A very interesting read, shall i say. And i noticed the name of Dr. Rafael Carrion there, which gives it a bit more credibility? What do you guys have to say? i guess it adds more support to the idea of going to the proper doctor to be adequately sized...

[merrix]

Carrion has co-produced another similar article, to which I have posted links before. That study showed huge size gains from frequent cycling. The problem with that study was the base line. They compared the new larger size to immediately post op. The relevant comparison is to pre-op in my opinion.
Furthermore it lacked a control group. Would the size gains from immediately post op to 24 months post op have been achieved without the aggressive cycling protocol as well? If so, the two-times-per-day cycling is useless and only shortens implant's length of life.

I will read this article later and see if it addresses these method issues from the previous one.

[dg_moore]

I have had my Titan since 2008. My length and girth were unchanged after the surgery, and I have never followed any sort of maintenance regimen - I inflate mine for a few minutes every 4-6 weeks or so when it happens to occur to me. My length and girth still remain the same.

[oldgoat]

Daily cycling will wear it out 7 times as fast as weekly use. More $$$$ for the surgeon with repeat business.
I have never used needless cycling and am very happy with my Titan.

[strongagain]

Daily cycling will wear it out 7 times as fast as weekly use. More $$$$ for the surgeon with repeat business.
I have never used needless cycling and am very happy with my Titan.

My doc said daily cycling is completely harmless. Sex would stress an implant much more than cycling.

[KMeister]

This editorial response was added by a Dr. Allen F. Morey:

"The question here is whether inflatable penile prosthesis cylinders act as tissue expanders and, moreover, whether a device that does not expand in length, such as the Titan®, can, in fact, lengthen the penis. While a 1 cm length increase may not seem like much, it underscores our observation that reimplant cases almost always require a longer cylinder the second time around. At least we have more data that debunk the widespread teaching that the penis is somehow shorter as a result of the device."

Many implant recipients who complain about penile shortening may have been the victims of a physician who was too conservative with the sizing of the cylinders.

In my case, there is no doubt that my penis gained considerable length from proper sizing from the doctor and regular cycling for several months after the operation.

KMeister

[PFracture]

I find that very encouraging kmeister. Gives me hope, if I go down this route I can gain back the size I lost due to the fracture!

[merrix]

Even though I have myself experienced size increase, quite a lot from immediately post-op, and a tiny little bit from pre-op, I still don't really see how it is happening. Can someone explain to me where it comes from?

We know the Titan itself doesn't get any longer. It is the flesh, the tissue, that expands. Why would the tissue expand? I guess it must be because the implant pushes it. In length and girth.
The girth is quite understandable.
But the length?
For the implant to expand tissue length wise, it must mean the cylinders are long enough to crinkle even when inflated. If they don't crinkle, they cannot put much, or any, force on the tissue to expand lengthwise. If they did, and the tissue expanded without the cylinders following, we would see the penis 'outgrow' the cylinders and we would get the 'floppy head' issue (cylinders not going all the way up in the glans), and the length increase would be a negative thing.

So, the cylinders crinkle when inflated, and push the tissue lengthwise. This could be the explanation in theory. But - that should imply then that the cylinders push so hard in to the top of the glans, that the shaft itself expands and get longer - rather than the cylinder tips protruding through the glans.
Is this really possible? Maybe it is, or maybe there is another explanation for the length increase.

Looking forward to your ideas!

[alibaba]

Interesting you bring this up merrix. I was thinking about writing a thread about how the penis reacts for thought.
We all know our dick and balls retract from any stimuli they perceive to be a risk, real or perceived.
Your ball sack will pull up and your dick will get shorter. Protects it from cold, impact or injury.
I have thought from the beginning of the implant search adventure that may be the cause of people reporting lost length. I asked a couple doctors who said impossible.
Think about it. Someone stick a knife in your dick and ball sack and they would contract. As long as there is a perceived danger or pain they are going to stay that way to protect themselves from the risk of injury. This is a reflex you have no control over. Someone throws ice water on your balls no amount of "ordering them" to hang low is going to keep them from drawing up. I think this is part of the reason Eid prefers spinal to relax the muscles as he has stated.
The 2 doctors I asked said bullshit. I disagree.
I tried to tell doctors how my dick worked. They refused to listen. I have several marks on my vacuum cylinder. The first was flacid. 5 1/2 " Second was 1st stage pumped 6", after which I released the vacuum and pumped again. The 3rd line was what my full erect size pumped up to, 7.25.
I maintain the muscles relaxed to allow the final phase.
Same when I would do a "stretch test" like they claim the implant surgeons use.
On me, first pull you would get only 5 1/2 but if you held it a few minutes you would suddenly feel a release and get another inch. When I first time posted my dick works this way several people thanked me for posting stating that is exactly the way theirs worked. All were what I call "extreme growers" like me.
I suggest the trauma of surgery and foreign body device causes a sympathetic reaction in the body to try to defend it's reproductive parts and keep them contracted.
Does this make sense to anyone? No need for doctors to respond. If it is not in the textbook written in 1928 and reprinted in every one since then, it cannot be so. Think outside the box. Close the f**king book and think about it.

[cumstein]

Newbie here, FWIW I have found that when I use the VED I gain length and girth. If I use a larger diameter cylinder, I get even MORE length along with
a lot of edema causing the girth to get larger also. I Have never been able to figure that out, but I have done it for years and start with a smaller cylinder and work up to larger diameter ones. Maybe it just me. I mentioned in another post that after pumping I could really stretch the penis, but by the next morning It was normal size and did not stretch as far. I have no clue what is going on.