Tony’s excision, grafting and implant for Peyronies diary

[Tsanchez12369]

Hi, I had no grafting of external skin. Just cut on circumcision scar to expose tunica for excision and grafting. Then external skin resutured at existing circumcision scar. Scar dies seem to be much more prominent...but hoping decreases w time.

Day 21:

Last two days edema worse above circumcision scar. Using heat and compression to lessen....

Also, noticing tube? On dorsal side of penis. Will ask doc next week about this.

[Tsanchez12369]

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Day 22:

Compression and heat helping w edema-looking much more normal.

Today pumped 55x’s over an hour. Not sure why was able to get so many pumps in-but felt was pushing the envelope w some discomfort for the first time.

[DougAnd]

That is your AMS pump locking up. After it does that you can pump forever with no results. The thing I hate the most about this pump. Just use micro pumps after it gets hard and it won't do that as often.

[Tsanchez12369]

Thanks Doug, good to know.

[Tsanchez12369]

Update: no pain in scrotal skin when pumping now-guess it toughened up!

[alibaba]

Very good improvement. Keep up the good news.

[Tsanchez12369]

Day 27:

Sensation is returning to glans, though more painful than pleasurable I take it as a good sign.

Also, I know it’s almost universally said the implant eventually feels normal—I am very aware of it in my penis and esp of the pump hardware in my scrotum. Guess this diminishes w time.

At this point I am very happy with my decision to go to Dr Karpman for this double surgery. Please see this post from another thread re doctors and implantees’ experiences:

Dr Karpman did my implant in Northern California.
Ultimately I would recommend him to a friend, but I do believe it’s important to know many facets of the doc’s techniques and procedures to best align them with your own needs and hopes.

I believe (and at least two medical articles support) that high volume implant docs have better outcomes (less infections, less need for removal and replacement, and larger implants done safely). Dr Karpman is the highest volume doc on the west coast so this is the main reason he aligned w my needs.

I had severe peyronies. Many docs will have an implant only address the curve. Or do implant with “release” of the plaque through incisions only. Dr Karpman recommended total excision and graftingvw implant. This is a lengthy procedure and I believe less profitable given the two hours vs. 30-60 mins of many docs IR tine. Some believe the less OR tine results in fewer infections but I believe it was worth the risk...as slong w the curve I had severe hourglassing which I believe can best be treated w excision and grafting. Additionally he reported only one infection in 13 years. Thus was a key factor in my decision.

He does infrapubic rather than scrotal surgical approach. I am not sure that this maximizes the length or minimizes tubing showing. However, he prefers it because one can go home 70% inflated and cycle after 10 days. I know there is at least one doc who cycles after 4 days w a scrotal approach but most seem to wait for weeks before going so. So, on balance I was in agreement.

Dr K almost exclusively installs AMS products. I had concerns about this as AMS products come in 3 cm increments while coloplast comes in 2 cm-therefore needing 2 to reach the next size vs 3. I consider this a consideration as it seems medical resaearch indicates the fewer the # of RTE’s the steeper the angle of erection. I was willing to sacrifice the angle if size was at least maximized.

He explained if after implant when the plaque was excised-if additional length could be obtained he would add RTE’s. Ultimately he installed 18cm + 3 RTE’s. I would have preferred being upsized to a 21cm e no RTE’s but realized there can’t be many docs willing to take the financial hit of having discarded an implant without reimbursement.

He also prefers general anesthesia. I would have preferred a spinal which Dr Eid believes increases blood flow allowing the maximum measurement for the implant. Given Dr K is a high volume doc, is on my insurance and local I didn’t believe the potential for perhaps 1 more cm would be worth my expense to travel and certainly not to lose my insurance coverage (100% for me).

Well, this is just my thought process. Ultimately the more we know about each doc’s experience and techniques-the better we can match them to our needs.

[Tsanchez12369]

Had four week follow up w Dr Karpman and was given clearance for masturbation and expect full clearance in two weeks. Pump is healed in place in a good location, scar site from degloving for excision and grafting is also well healed. What I thought may be some tubing at my shaft he explained is internal sutures which will dissolve as all tubing is buried inside the body and not with the outer penis. I’m very happy one month after surgery!

Day 30

Since cleared for masturbation Tuesday, attempted twice w no luck. The reduced sensitivity above the degloving scar line, the hard scar at that suture line and two hard knots of internal stitches just feels to weird to get off. Just gonna give it timebfor the internal sutures todissolve, the scarline to soften and the sensations to return I guess. Being hard on demand is amazing still! Beginning to experience occasional twinges of pain at the tips in the glans as sensation returns—not too worried about that.

[Tsanchez12369]

Well, one bonus to an implant is becoming a “shower” vs. “grower” (which I always was). Apparently a little less so w the AMS vs Titan. But even w the AMS this is fully deflated:

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[FreddyFree]

Well, one bonus to an implant

That's quite a boner.... Er. .. bonus!