Finally posting

[honeyman1951]

Hi Guys!
Been on this site for almost 2 months, and what a great forum it is. Reading every day, I feel like I know a lot of you personally, and have learned an awful lot! Finally decided to post.
65 now, and have had ED since about 1998. Viagra fixed it for many years. It stopped working about 7-8 years ago.
My lovely wife and I started dating in November, 1968, our senior year of high school. Married in June, 1972. She is still the loveliest person I've ever met in my life!
She never complained about my ED, although she is extremely sensual and has a high sex drive, even now. She would just get on top (her favorite position), and ride my soft, flaccid dick until she orgasmed. Than she was happy to give me a BJ. However you can imagine my frustration in not being able to satisfy this beautiful woman.
Saw the local urologist about a year ago, and have been through vAcuum pump with restriction rings (which are a pain in the ass and hurt!) and injections (which didn't work). Finally decided implant was the way to go.
Thankfully found this forum, and you guys made me see the light! And the best surgeons to go to.
Finally decided on Dr. Kramer, and now have surgery set for June 21. Can't wait.
My local urologist recommended the AMS, which I was all set to go with. Now I'm not so sure. My lovely wife has always told me (and recently reiterated) girth is much better than length, and I'm doing this more for her than me! After pumping, I'm about 6" in length and 5.5" in girth. From reading on here it seems the Titan gives significantly more girth.
Although i will go with Dr Kramer's recommendation, Please, help me with my decision!

[stiffupperlip]

When I went to Dr. Kramer he let me decide. I choose the Titan for the same reason - girth. He showed me both types and went over the pros and cons of each but ultimately let me decide and I've been really happy with the result. Good luck!

[CTR5000]

I've had my AMS 700 LGX model for just two years now and LOVE IT! The LGX stands for (L)ength (G)irth e(X)pansion.... and it does what it promises! I gained roughly 3/4" in my "L" and not sure how much in my "G" (I never measured it pre-implant}... But it's DEFINITELY more "G" ... my husband even adds "Not a doubt about it! It's thicker!" So both my "L" and my "G" have 'X'd!!

[ccrider]

I've had my AMS 700 LGX model for just two years now and LOVE IT! The LGX stands for (L)ength (G)irth e(X)pansion.... and it does what it promises! I gained roughly 3/4" in my "L" and not sure how much in my "G" (I never measured it pre-implant}... But it's DEFINITELY more "G" ... my husband even adds "Not a doubt about it! It's thicker!" So both my "L" and my "G" have 'X'd!!

...my AMS 700 LGX has added about the same length from pre-op stretch measurement plus definite gain in girth...I also like the way it deflates down to a natural level...very happy with it...

[Bigred]

Post deleted

[Donnie1954]

It's so good when implanted brothers have a great experience. Unfortunately that is not always the case. Our prayers and support go to those who have had or are having complications. Praying that the Master Designer will give you peace through this trial. Alibaba, we are so happy for you and sorry for the hell you went through. Why these things happen we don't understand. I wish all surgeries could be as successful as mine.
Blessings
Donnie

[David_R]

I'm scheduled on the 21st also with Kramer. Maybe we will cross paths.

And I live in the Baltimore area and would be glad to meet sometime if it would help any of you guys.

[strongagain]

VERY INFORMATIVE:

"Patient’s need to be aware of key issues that determine the penile length, feel of the cylinders, quality of erection and cosmetic appearance of the penis after the penile implant procedure. First a penile implant has limitations and although satisfaction rates are extremely high, an inflatable penile implant will not function exactly like a “normal” penis. The
flaccid penis with an implant cannot retract like a “normal” penis. The flaccid penis therefore will always be longer than before the implant was inserted.

Second, when the cylinders are deflated, the flesh of the penis will no longer be under tension and will retract causing the deflated cylinders to bend and fold inside the
shaft of the penis like an accordion. The folds will be more prominent and palpable with the Coloplast Titan than with the AMS cylinders. In a beefy overweight patient with the
metabolic syndrome for example, this will not be an issue, but in a very thin frail elderly patient this may be uncomfortable and unsightly. In general the deflated AMS
cylinders are more comfortable and softer than the deflated Coloplast cylinders.

Third, to date nothing exists in the world to make the erect penis longer (including vacuum devices, traction or surgery). And neither the Coloplast nor the AMS LGX will
increase the length of the erect penis. At best the length of the erect penis with the implant will be the same as the length of the erect penis measured before the implant
procedure in the standing position after a penile injection test.

Finally the health of the tunica albuginea (the thick layer that surrounds the erectile muscle) also will impact the size of the implanted penis, as does the postoperative
care, which I will discuss later. In a patient with vascular disease or diabetes the tunica may be thickened and loses its elasticity limiting its ability to stretch. This may decrease the overall length of the pre-implanted erect penis. So does Peyronie's disease, which in a patient with ED may not be revealed until the patient is in the OR.

Choice of implant cylinder

The AMS cylinders are tunical independent and will only expand to 18mm girth (a mesh prevents further expansion). This is more than adequate for many patients.
For patients requiring cylinder length of 20cm or more this lateral expansion may not be enough and better rigidity will occur with the wider Coloplast cylinders (the longer
cylinders expand to 21mm plus). The Coloplast cylinders are tunical dependent and if the tunica is not healthy or thin, the rigidity will not be as good as with the AMS
cylinders. The Coloplast cylinders expand fully against the tunica and overtime this can cause thinning and atrophy the tunica albuginea which will cause the penis to become very wide and less rigid. On the other hand, use of the AMS cylinders in the larger and wider penises will cause inadequate rigidity of the penis as well as a flat appearance of the shaft
of the erect penis. The urethra, which is usually at the bottom of the shaft, will instead nestle between the narrower AMS cylinders. It's important to have all types, makes and sizes of cylinders for every case, because often the surgeon may not have pre-operative knowledge of all the variables necessary to select the best cylinder option for that particular individual. For practical reasons, most urologists will use the same brand of penile implant for every patient.

The issue of rear tips extenders

The inflatable cylinder is made of a non-inflatable rear portion that measures 4.5cm (AMS) and 5 cm (Coloplast) and an inflatable anterior portion of variable length. So for
example a 20cm Coloplast cylinder will only have 15cm of inflatable distal portion. The fixed proximal portion also has a thinner diameter. For the AMS cylinders that diameter
is only 9mm. Often surgeons will increase the length of the proximal portion with rear tip extenders to adjust the size of the cylinders, rather than choosing a cylinder of the correct
length. For example if a patient measures 20cm and the doctor is committed in using an AMS device he will have to use an 18cm with 2cm rear tip extenders. Therefore only
13.5cm out of the total 20cm inflates; the rear, which now measures 6.5cm, is thin and non-inflatable. The unstable junction where the inflatable portion connects with the
fixed rear portion will now be located in a more distal position in the penile shaft and the erection will have a hinge effect, wobble and point downward when the cylinders are inflated. This may not affect the overall length of the penis but will decrease the quality of the erection. Instead a better choice would have been to use a 20cm
Coloplast (AMS does not make a 20cm). Most urologists, including yours truly, were trained believing that the crus of the penis does not play a significant role on the quality of
the erection and that placing a thin non-inflatable implant would not affect the outcome. Use of rear tip extenders decreases the quality of the erection.

Post-operative care

During the first three months after the surgery the cylinders must be kept fully deflated in order to maintain the reservoir fully inflated. This will allow scar tissue to form on a full reservoir and prevent auto-inflation later on. This means that the penis will heal over deflated cylinders and scar tissue will form over cylinder folds and curvatures.
A long wide penis with deflated cylinders may retract by as much as two inches. If the implant is not inflated early in the immediate two weeks after the surgery, it may heal in
this foreshortened dimension, causing permanent deformity and reduced inflated length. In order to be able to inflate early one must be able to feel all of the components of the
pump, inflating bulb and deflation footprint. The more experienced the surgeon and the more precise the surgical technique the less swelling and pain will occur after the
surgery. Incisions and dissection must be kept at a minimum and meticulous surgical hemostasis must be achieved so that the patient's postoperative risk of hematoma and swelling is reduced. This will enable the patient to feel the components of the pump early after the procedure and inflate and deflate as soon as possible. Think of it as rehab after an orthopedic procedure. If the shoulder is kept in a sling for several postoperative weeks, the shoulder will freeze in that position. Post-op bed rest for 48 hours with ice followed by daily hot baths will minimize swelling and accelerate healing. Unfortunately in most general urology practices post-operative care is often relegated to ancillary staff with little knowledge of these issues. It is vital, especially for the larger stretchy penises that inflation and deflation of the cylinders is started as soon as possible in order to prevent healing in a retracted foreshortened state. Maximizing length and quality of the erection as well as cosmetic appearance depends on many factors perhaps
the most important being the practice implant volume and surgeon's experience."

by Dr. Francois Eid

[sliphill]

VERY INFORMATIVE:

"Patient’s need to be aware of key issues that determine the penile length, feel of the cylinders, quality of erection and cosmetic appearance of the penis after the penile implant procedure. First a penile implant has limitations and although satisfaction rates are extremely high, an inflatable penile implant will not function exactly like a “normal” penis. The
flaccid penis with an implant cannot retract like a “normal” penis. The flaccid penis therefore will always be longer than before the implant was inserted.

Second, when the cylinders are deflated, the flesh of the penis will no longer be under tension and will retract causing the deflated cylinders to bend and fold inside the
shaft of the penis like an accordion. The folds will be more prominent and palpable with the Coloplast Titan than with the AMS cylinders. In a beefy overweight patient with the
metabolic syndrome for example, this will not be an issue, but in a very thin frail elderly patient this may be uncomfortable and unsightly. In general the deflated AMS
cylinders are more comfortable and softer than the deflated Coloplast cylinders.

Third, to date nothing exists in the world to make the erect penis longer (including vacuum devices, traction or surgery). And neither the Coloplast nor the AMS LGX will
increase the length of the erect penis. At best the length of the erect penis with the implant will be the same as the length of the erect penis measured before the implant
procedure in the standing position after a penile injection test.

Finally the health of the tunica albuginea (the thick layer that surrounds the erectile muscle) also will impact the size of the implanted penis, as does the postoperative
care, which I will discuss later. In a patient with vascular disease or diabetes the tunica may be thickened and loses its elasticity limiting its ability to stretch. This may decrease the overall length of the pre-implanted erect penis. So does Peyronie's disease, which in a patient with ED may not be revealed until the patient is in the OR.

Choice of implant cylinder

The AMS cylinders are tunical independent and will only expand to 18mm girth (a mesh prevents further expansion). This is more than adequate for many patients.
For patients requiring cylinder length of 20cm or more this lateral expansion may not be enough and better rigidity will occur with the wider Coloplast cylinders (the longer
cylinders expand to 21mm plus). The Coloplast cylinders are tunical dependent and if the tunica is not healthy or thin, the rigidity will not be as good as with the AMS
cylinders. The Coloplast cylinders expand fully against the tunica and overtime this can cause thinning and atrophy the tunica albuginea which will cause the penis to become very wide and less rigid. On the other hand, use of the AMS cylinders in the larger and wider penises will cause inadequate rigidity of the penis as well as a flat appearance of the shaft
of the erect penis. The urethra, which is usually at the bottom of the shaft, will instead nestle between the narrower AMS cylinders. It's important to have all types, makes and sizes of cylinders for every case, because often the surgeon may not have pre-operative knowledge of all the variables necessary to select the best cylinder option for that particular individual. For practical reasons, most urologists will use the same brand of penile implant for every patient.

The issue of rear tips extenders

The inflatable cylinder is made of a non-inflatable rear portion that measures 4.5cm (AMS) and 5 cm (Coloplast) and an inflatable anterior portion of variable length. So for
example a 20cm Coloplast cylinder will only have 15cm of inflatable distal portion. The fixed proximal portion also has a thinner diameter. For the AMS cylinders that diameter
is only 9mm. Often surgeons will increase the length of the proximal portion with rear tip extenders to adjust the size of the cylinders, rather than choosing a cylinder of the correct
length. For example if a patient measures 20cm and the doctor is committed in using an AMS device he will have to use an 18cm with 2cm rear tip extenders. Therefore only
13.5cm out of the total 20cm inflates; the rear, which now measures 6.5cm, is thin and non-inflatable. The unstable junction where the inflatable portion connects with the
fixed rear portion will now be located in a more distal position in the penile shaft and the erection will have a hinge effect, wobble and point downward when the cylinders are inflated. This may not affect the overall length of the penis but will decrease the quality of the erection. Instead a better choice would have been to use a 20cm
Coloplast (AMS does not make a 20cm). Most urologists, including yours truly, were trained believing that the crus of the penis does not play a significant role on the quality of
the erection and that placing a thin non-inflatable implant would not affect the outcome. Use of rear tip extenders decreases the quality of the erection.

Post-operative care

During the first three months after the surgery the cylinders must be kept fully deflated in order to maintain the reservoir fully inflated. This will allow scar tissue to form on a full reservoir and prevent auto-inflation later on. This means that the penis will heal over deflated cylinders and scar tissue will form over cylinder folds and curvatures.
A long wide penis with deflated cylinders may retract by as much as two inches. If the implant is not inflated early in the immediate two weeks after the surgery, it may heal in
this foreshortened dimension, causing permanent deformity and reduced inflated length. In order to be able to inflate early one must be able to feel all of the components of the
pump, inflating bulb and deflation footprint. The more experienced the surgeon and the more precise the surgical technique the less swelling and pain will occur after the
surgery. Incisions and dissection must be kept at a minimum and meticulous surgical hemostasis must be achieved so that the patient's postoperative risk of hematoma and swelling is reduced. This will enable the patient to feel the components of the pump early after the procedure and inflate and deflate as soon as possible. Think of it as rehab after an orthopedic procedure. If the shoulder is kept in a sling for several postoperative weeks, the shoulder will freeze in that position. Post-op bed rest for 48 hours with ice followed by daily hot baths will minimize swelling and accelerate healing. Unfortunately in most general urology practices post-operative care is often relegated to ancillary staff with little knowledge of these issues. It is vital, especially for the larger stretchy penises that inflation and deflation of the cylinders is started as soon as possible in order to prevent healing in a retracted foreshortened state. Maximizing length and quality of the erection as well as cosmetic appearance depends on many factors perhaps
the most important being the practice implant volume and surgeon's experience."

by Dr. Francois Eid

Thanks, that was extremely informative. From injecting, my urologist said I have some minor scarring. So you are saying that one could have Peyronie's Disease and not even know it. I thought that Peyronie's Disease caused curviture of the penis. I hope I don't have it, as I'm scheduled for an implant on 6/9.

[Tybeeman]

VERY INFORMATIVE:

"Patient’s need to be aware of key issues that determine the penile length, feel of the cylinders, quality of erection and cosmetic appearance of the penis after the penile implant procedure. First a penile implant has limitations and although satisfaction rates are extremely high, an inflatable penile implant will not function exactly like a “normal” penis. The
flaccid penis with an implant cannot retract like a “normal” penis. The flaccid penis therefore will always be longer than before the implant was inserted.

Second, when the cylinders are deflated, the flesh of the penis will no longer be under tension and will retract causing the deflated cylinders to bend and fold inside the
shaft of the penis like an accordion. The folds will be more prominent and palpable with the Coloplast Titan than with the AMS cylinders. In a beefy overweight patient with the
metabolic syndrome for example, this will not be an issue, but in a very thin frail elderly patient this may be uncomfortable and unsightly. In general the deflated AMS
cylinders are more comfortable and softer than the deflated Coloplast cylinders.

Third, to date nothing exists in the world to make the erect penis longer (including vacuum devices, traction or surgery). And neither the Coloplast nor the AMS LGX will
increase the length of the erect penis. At best the length of the erect penis with the implant will be the same as the length of the erect penis measured before the implant
procedure in the standing position after a penile injection test.

Finally the health of the tunica albuginea (the thick layer that surrounds the erectile muscle) also will impact the size of the implanted penis, as does the postoperative
care, which I will discuss later. In a patient with vascular disease or diabetes the tunica may be thickened and loses its elasticity limiting its ability to stretch. This may decrease the overall length of the pre-implanted erect penis. So does Peyronie's disease, which in a patient with ED may not be revealed until the patient is in the OR.

Choice of implant cylinder

The AMS cylinders are tunical independent and will only expand to 18mm girth (a mesh prevents further expansion). This is more than adequate for many patients.
For patients requiring cylinder length of 20cm or more this lateral expansion may not be enough and better rigidity will occur with the wider Coloplast cylinders (the longer
cylinders expand to 21mm plus). The Coloplast cylinders are tunical dependent and if the tunica is not healthy or thin, the rigidity will not be as good as with the AMS
cylinders. The Coloplast cylinders expand fully against the tunica and overtime this can cause thinning and atrophy the tunica albuginea which will cause the penis to become very wide and less rigid. On the other hand, use of the AMS cylinders in the larger and wider penises will cause inadequate rigidity of the penis as well as a flat appearance of the shaft
of the erect penis. The urethra, which is usually at the bottom of the shaft, will instead nestle between the narrower AMS cylinders. It's important to have all types, makes and sizes of cylinders for every case, because often the surgeon may not have pre-operative knowledge of all the variables necessary to select the best cylinder option for that particular individual. For practical reasons, most urologists will use the same brand of penile implant for every patient.

The issue of rear tips extenders

The inflatable cylinder is made of a non-inflatable rear portion that measures 4.5cm (AMS) and 5 cm (Coloplast) and an inflatable anterior portion of variable length. So for
example a 20cm Coloplast cylinder will only have 15cm of inflatable distal portion. The fixed proximal portion also has a thinner diameter. For the AMS cylinders that diameter
is only 9mm. Often surgeons will increase the length of the proximal portion with rear tip extenders to adjust the size of the cylinders, rather than choosing a cylinder of the correct
length. For example if a patient measures 20cm and the doctor is committed in using an AMS device he will have to use an 18cm with 2cm rear tip extenders. Therefore only
13.5cm out of the total 20cm inflates; the rear, which now measures 6.5cm, is thin and non-inflatable. The unstable junction where the inflatable portion connects with the
fixed rear portion will now be located in a more distal position in the penile shaft and the erection will have a hinge effect, wobble and point downward when the cylinders are inflated. This may not affect the overall length of the penis but will decrease the quality of the erection. Instead a better choice would have been to use a 20cm
Coloplast (AMS does not make a 20cm). Most urologists, including yours truly, were trained believing that the crus of the penis does not play a significant role on the quality of
the erection and that placing a thin non-inflatable implant would not affect the outcome. Use of rear tip extenders decreases the quality of the erection.

Post-operative care

During the first three months after the surgery the cylinders must be kept fully deflated in order to maintain the reservoir fully inflated. This will allow scar tissue to form on a full reservoir and prevent auto-inflation later on. This means that the penis will heal over deflated cylinders and scar tissue will form over cylinder folds and curvatures.
A long wide penis with deflated cylinders may retract by as much as two inches. If the implant is not inflated early in the immediate two weeks after the surgery, it may heal in
this foreshortened dimension, causing permanent deformity and reduced inflated length. In order to be able to inflate early one must be able to feel all of the components of the
pump, inflating bulb and deflation footprint. The more experienced the surgeon and the more precise the surgical technique the less swelling and pain will occur after the
surgery. Incisions and dissection must be kept at a minimum and meticulous surgical hemostasis must be achieved so that the patient's postoperative risk of hematoma and swelling is reduced. This will enable the patient to feel the components of the pump early after the procedure and inflate and deflate as soon as possible. Think of it as rehab after an orthopedic procedure. If the shoulder is kept in a sling for several postoperative weeks, the shoulder will freeze in that position. Post-op bed rest for 48 hours with ice followed by daily hot baths will minimize swelling and accelerate healing. Unfortunately in most general urology practices post-operative care is often relegated to ancillary staff with little knowledge of these issues. It is vital, especially for the larger stretchy penises that inflation and deflation of the cylinders is started as soon as possible in order to prevent healing in a retracted foreshortened state. Maximizing length and quality of the erection as well as cosmetic appearance depends on many factors perhaps
the most important being the practice implant volume and surgeon's experience."

by Dr. Francois Eid

So really the length of the penis is not an issue in deciding which implant. But if a man has a large Garth he should go with a Coloplast?