Desision Time

[warrenw]

If I stay local I have this dread that I will be left with a useful but problematic results that I will be stuck with for maybe the rest of my life or even be left with something that does not work and can not be fixed. So Thursday is crunch time as far as making the decision. My local guy has no horrific results or any results at all that I can find. So at the office visit Thursday with my Uro I will decide to either roll the dice with him and hope for a good out come or go have the checks cut and send them East. If I were a betting man my money would be on going East. Part of this I am sure is just nerves about pulling the pin and getting this scheduled.

Have you read any of Merrix's posts? I'm quoting one below that influenced me when I was deciding whether to stay local or go east:

20 MONTHS UPDATE

WHICH DOC DO YOU LET CUT UP YOUR DICK AND PUT A PROSTHESIS IN IT?

As my signature says, I think this is the most important decision to get right if a perfect result is the goal. There are studies, linked to by myself further up this thread if I remember right, which shows a clearly higher failure rate when going with low-volume (i.e. less experienced) surgeons than with high-volume (i.e. more experienced) surgeons. That doesn’t of course mean you are doomed to a crap result with your local low-volume surgeon. An absolute majority of implants are done by low-volume surgeons, and satisfaction rates are above 90% in total. That could never be achieved if low-volume docs didn’t succeed (as in create patient satisfaction) in an absolute majority of cases. But for me, I would want to maximise my chances.
Furthermore, what is a good outcome? Guys who have their surgery with their local low-volume surgeon might answer ”yes” to the question ”are you satisfied with your penile implant surgery” and even say ”I couldn’t be happier” on FT. Bullshit. How do they know that? They don’t have a clue whether they could be happier. Maybe they would be a lot happier with another brand of implant inserted by a more skilful surgeon. They don’t know that. Period. Just because something works doesn’t mean it couldn't be even better. It’s like a guy buying a new Renault car and never having driven a Mercedes. And he says ”I love my car, I couldn’t be happier”. Bullshit. Let him try the Benz and he will take that statement right back. He will realise he could be a lot happier with a Benz in his garage.

Looking now in hindsight, Merrix was absolutely correct. There are a lot of little aches, pains, uncertainties, doubts that go along with this surgery. Using a surgeon of unproven expertise just adds to the question of did I get the best possible outcome. We can't control the outcome of the surgery or know in advance how the new normal is going to feel; but researching and then choosing who you feel is the most skillful and experienced surgeon goes a long way towards being happy and satisfied with the result.

[Lost Sheep]

Warrenw is right. As satisfied as I am with my imllant, I have questions about pump placement and positioning, a slight bulge on the side of the penis at extreme inflation and use of RTEs. .

Despit those, the function, rigidity, size and the gentle upward curve of my natural erection (which I, thankfully, still have) are all optimal. The best I could hope for.

Recovery was not as pain-free as Dr Eid's patients comonly report, and activation wat at almost two weeks as I recall, but I am happy as a clam with my result.

The mian event is the MAIN EVENT. Lesser details are just peripheral.

[newbie443]

I had my best appointment so far with my Uro this morning. I found out a lot from him. He did the most through external exam so far. The dialog was relaxed and forthcoming on his part. It did not change my decision but did rather reinforced it. This is the information I received.

How many implants have you performed in total? Maybe 20 or so.
How many implant surgeries do you perform per month? He and other Uro's in the group do aprox. 3 a year each.
What implant do you prefer, AMS or Coloplast, and why? He does mostly AMS but can do Coloplast if I want. He dose mostly AMS and prefers them as that is what he has the most experience using.
When will you make the decision on which implant to use for me, during surgery? I will tell him what I want ahead of time
Will you have both brands and a size range available to choose from during my surgery? No. What I chose a head of time is what he will use. He will contact the implant company and a rep from the company will be at the surgery with the different sizes.
Will I lose any length?? Yes. Approx. one inch.
Will an implant fix my peyronies? Is there extra surgery or modeling required for peyronies? During his more complete external exam he said he could not see any indication of damage and no other test have been or will be done.
Penoscrotal or infrapubic and why? {ADDED} He does use the scrotal surgery but he can do the pubic if I want. He said he had received some tranling with Petro in Florida.
Referrals to previous patients {ADDED} No.

He asked if I was right handed and when I said yes he stated he would position the pump on the right side. I don't know if the surgery on my left testicle has anything to do with that or not. He stated that the surgery would be done at a surgery center. That I would stay the first night. The next day the catheter and compression bandage would be removed and I would be sent home. He said I would be activated at 6 weeks. He stated if there was infection with the implant it would need to be removed and I would have to wait at least 6 months for another attempt. I believe insurance would require waiting at least until a new deductible take effect. That a second attempt would most likely have caused scar tissue that would necessitate further reduction in size. He said the surgery could be done in 2 weeks.

With this information I do more than ever want to travel east. I hope to know if that is possible by this evening. If for some reason that does not happen then I will have him do the surgery and then work on securing a trip east in the future for a refit. Kind of like a post I read "would you rather have a 6" you can't use or a 4" you can". So he is waiting to receive word from me as is the surgeon east.

[radioradio]

I had my best appointment so far with my Uro this morning. I found out a lot from him. He did the most through external exam so far. The dialog was relaxed and forthcoming on his part. It did not change my decision but did rather reinforced it. This is the information I received.

How many implants have you performed in total? Maybe 20 or so.
How many implant surgeries do you perform per month? He and other Uro's in the group do aprox. 3 a year each.
What implant do you prefer, AMS or Coloplast, and why? He does mostly AMS but can do Coloplast if I want. He dose mostly AMS and prefers them as that is what he has the most experience using.
When will you make the decision on which implant to use for me, during surgery? I will tell him what I want ahead of time
Will you have both brands and a size range available to choose from during my surgery? No. What I chose a head of time is what he will use. He will contact the implant company and a rep from the company will be at the surgery with the different sizes.
Will I lose any length?? Yes. Approx. one inch.
Will an implant fix my peyronies? Is there extra surgery or modeling required for peyronies? During his more complete external exam he said he could not see any indication of damage and no other test have been or will be done.
Penoscrotal or infrapubic and why? {ADDED} He does use the scrotal surgery but he can do the pubic if I want. He said he had received some tranling with Petro in Florida.
Referrals to previous patients {ADDED} No.

He asked if I was right handed and when I said yes he stated he would position the pump on the right side. I don't know if the surgery on my left testicle has anything to do with that or not. He stated that the surgery would be done at a surgery center. That I would stay the first night. The next day the catheter and compression bandage would be removed and I would be sent home. He said I would be activated at 6 weeks. He stated if there was infection with the implant it would need to be removed and I would have to wait at least 6 months for another attempt. I believe insurance would require waiting at least until a new deductible take effect. That a second attempt would most likely have caused scar tissue that would necessitate further reduction in size. He said the surgery could be done in 2 weeks.

With this information I do more than ever want to travel east. I hope to know if that is possible by this evening. If for some reason that does not happen then I will have him do the surgery and then work on securing a trip east in the future for a refit. Kind of like a post I read "would you rather have a 6" you can't use or a 4" you can". So he is waiting to receive word from me as is the surgeon east.

His answers would give me pause.
Actually, for me, the answers would disqualify him.
Bob

[Larry10625]

If I stay local I have this dread that I will be left with a useful but problematic results that I will be stuck with for maybe the rest of my life or even be left with something that does not work and can not be fixed. So Thursday is crunch time as far as making the decision. My local guy has no horrific results or any results at all that I can find. So at the office visit Thursday with my Uro I will decide to either roll the dice with him and hope for a good out come or go have the checks cut and send them East. If I were a betting man my money would be on going East. Part of this I am sure is just nerves about pulling the pin and getting this scheduled.

Have you read any of Merrix's posts? I'm quoting one below that influenced me when I was deciding whether to stay local or go east:

20 MONTHS UPDATE

WHICH DOC DO YOU LET CUT UP YOUR DICK AND PUT A PROSTHESIS IN IT?

As my signature says, I think this is the most important decision to get right if a perfect result is the goal. There are studies, linked to by myself further up this thread if I remember right, which shows a clearly higher failure rate when going with low-volume (i.e. less experienced) surgeons than with high-volume (i.e. more experienced) surgeons. That doesn’t of course mean you are doomed to a crap result with your local low-volume surgeon. An absolute majority of implants are done by low-volume surgeons, and satisfaction rates are above 90% in total. That could never be achieved if low-volume docs didn’t succeed (as in create patient satisfaction) in an absolute majority of cases. But for me, I would want to maximise my chances.
Furthermore, what is a good outcome? Guys who have their surgery with their local low-volume surgeon might answer ”yes” to the question ”are you satisfied with your penile implant surgery” and even say ”I couldn’t be happier” on FT. Bullshit. How do they know that? They don’t have a clue whether they could be happier. Maybe they would be a lot happier with another brand of implant inserted by a more skilful surgeon. They don’t know that. Period. Just because something works doesn’t mean it couldn't be even better. It’s like a guy buying a new Renault car and never having driven a Mercedes. And he says ”I love my car, I couldn’t be happier”. Bullshit. Let him try the Benz and he will take that statement right back. He will realise he could be a lot happier with a Benz in his garage.

Looking now in hindsight, Merrix was absolutely correct. There are a lot of little aches, pains, uncertainties, doubts that go along with this surgery. Using a surgeon of unproven expertise just adds to the question of did I get the best possible outcome. We can't control the outcome of the surgery or know in advance how the new normal is going to feel; but researching and then choosing who you feel is the most skillful and experienced surgeon goes a long way towards being happy and satisfied with the result.

Yeah, so while you are under the knife is notices something else... he has to finish what he's doing, wake you up and explain the new problem. Then you go under again with a different doctor to do the new procedure, if there is a specialist available that fast.. Whatever... I did not have the dream ego team and mine is just perfect.

Larry

[newbie443]

We have had a couple of nasty bugs making folks sick around this area. One is the flu the other is something else and lots of folks are off work and they have even closed school for it to try and stop the spread. So with folks off work all this week I am not able to get this written in stone yet. Each points of view have merits. But each of us are different and must make our own choices.

[MikeAN]

Newbie,
There are a number of reason for choosing an experienced surgeon for your implant. One that I think is very important is how quickly they can perform the procedure, which improves greatly with experience. I believe there is a strong correlation between the amount of time it takes to do the surgery and risk of infection. Of course other things come into play but the longer your open on the surgery table the greater the risk for infection.
Mike

[newbie443]

It would be nice if everyone had an experienced great surgeon near them for this. All the world class surgeons had to start somewhere so maybe my guy is on his way to being one. Some of us are not able travel and have to do the best with what we have. I really like my local Uro after talking to him yesterday and I do think he will do the best he can for me. I believe he is a good surgeon. But I do feel I would have better results with a more experienced surgeon with a proven record. I do agree that I will be flying over some really great surgeons if I am able to go east for this. But if I am able to travel to a more experienced surgeon with a proven record I don't think that really means a lot. I would still have to travel and pay out of pocket. Even though my insurance will pay some of the cost to stay local I will still pay a good portion out of pocket. So for me the cost to travel is just the difference between what I would pay local. A very tough decision that has me revisiting even having the surgery. The delay's have just given me more time to second guess myself. Most of it as I have written is just nerves and I suspect will even get worse as I get closer to having this done.

Thank you all for taking the time to read my posts and for the replies. With your help I am getting through this. With out it I don't think I could have.