Pseudo-coffin #2

[Lost Sheep]

So, if you leave the reservoir or erectile chambers uninflated for a significant period of time you will have scar tissue develop around the empty vessels, and this will restrict their filling. The idea therefore is to keep cycling between both to prevent this from happening.

This is my understanding, so correct me if I am wrong.

The issue is that you can't have both full at the same time due to limited fluid. So you must cycle. You can't cycle too much at the start because....things are healing and cycling would jeopardise the healing process? Is that right?


If that is the case, would it not be a possible to fully fill the entire hydraulic system so that both the reservoir and the erectile tubes are both inflated, leave it like that until scar tissue formation and recovery is complete, and they remove the required volume of fluid from the system?

Presumably one could do this by reponing the incision in the scrotum and draining it through the pump system.

Or something....I don't know it's just occurred to me and presumably it doesn't work or they would do it already.

Am I overlooking something really obvious here and being stupid? I'm not a medic or an engineer so i have no idea of these things. It just seems like an obvious solution to me.

My thoughts exactly. I posed that question to Dr. Eid in trhe summer of 2017 and he did not think it necessary, as it would entail another (albeit minor) surgical procedure to drain the excess fluid.

Still, the excess fluid could be drained in a number of different ways, and not necessarily even from the closed system, but rather an auxiliary "spacer" reservoir. And the draining would not have to be at the scrotum (which Dr. Eid suggested would entail too much risk of infection) but at the reservoir. There are any number of ways this could be accomplished, even without opening the skin (the excess fluid, being sterile saline, is easily absorbed into the body).

But, I suppose the extra work and design is not justified by the marginal benefit.

The Italian study you mention did cite that pain at early activation to prevent the "Coffin Effect" was a factor in a high dropout rate, so perhaps some time in the future Coloplast or AMS might re-think the possibilities.

[Larry10625]

So, if you leave the reservoir or erectile chambers uninflated for a significant period of time you will have scar tissue develop around the empty vessels, and this will restrict their filling. The idea therefore is to keep cycling between both to prevent this from happening.

This is my understanding, so correct me if I am wrong.

The issue is that you can't have both full at the same time due to limited fluid. So you must cycle. You can't cycle too much at the start because....things are healing and cycling would jeopardise the healing process? Is that right?


If that is the case, would it not be a possible to fully fill the entire hydraulic system so that both the reservoir and the erectile tubes are both inflated, leave it like that until scar tissue formation and recovery is complete, and they remove the required volume of fluid from the system?

Presumably one could do this by reponing the incision in the scrotum and draining it through the pump system.

Or something....I don't know it's just occurred to me and presumably it doesn't work or they would do it already.

Am I overlooking something really obvious here and being stupid? I'm not a medic or an engineer so i have no idea of these things. It just seems like an obvious solution to me.

My thoughts exactly. I posed that question to Dr. Eid in trhe summer of 2017 and he did not think it necessary, as it would entail another (albeit minor) surgical procedure to drain the excess fluid.

Still, the excess fluid could be drained in a number of different ways, and not necessarily even from the closed system, but rather an auxiliary "spacer" reservoir. And the draining would not have to be at the scrotum (which Dr. Eid suggested would entail too much risk of infection) but at the reservoir. There are any number of ways this could be accomplished, even without opening the skin (the excess fluid, being sterile saline, is easily absorbed into the body).

But, I suppose the extra work and design is not justified by the marginal benefit.

The Italian study you mention did cite that pain at early activation to prevent the "Coffin Effect" was a factor in a high dropout rate, so perhaps some time in the future Coloplast or AMS might re-think the possibilities.

So... every time the skin is open at all, there is a risk of infection. Infection anywhere in the body can find it's way to the newly implanted device and that area is already compromised... Unfortunately, once infection finds the implant at all, it cannot be stopped and the only way to prevent septic shock is to remove the implant and then you will have to wait at least 6 months to be implanted providing there isn't so much scar tissue that it makes re-implanting impossible. There is a lot of medical terms that explains this but it becomes too hard to explain then.

Larry

[wallyworld]

I just removed my post. I realized I was missing some data and want to more thoroughly read before I repost on this topic.

[Lost Sheep]

[

So... every time the skin is open at all, there is a risk of infection. Infection anywhere in the body can find it's way to the newly implanted device and that area is already compromised... Unfortunately, once infection finds the implant at all, it cannot be stopped and the only way to prevent septic shock is to remove the implant and then you will have to wait at least 6 months to be implanted providing there isn't so much scar tissue that it makes re-implanting impossible. There is a lot of medical terms that explains this but it becomes too hard to explain then.

Larry

If the excess fluid was drained from near the reservoir, the opening in the skin would be up near the waistline, a new opening (even perhaps just a needle punch), easier to monitor than the scrotum, and a lot easier to keep clean.

Also, I believe there would be one way where no surgical procedure at all would be necessary, that the excess fluid would drain itself after a couple of weeks and be absorbed into the body.

[Opie52]

I finally got 8 pumps and then the pump got rock hard, yep my dick hurts like hell but I suppose it’s stretching, no pain no gain.

[wallyworld]

Found this 2014 interview with Dr. Eid on Yahoo Finance of all places:

https://finance.yahoo.com/news/size-mat ... 35263.html

"To ensure appropriate healing and prevent penile shortening, post-operative care is critical. If the implant cylinders are not inflated within the first two months, the retracted size becomes the permanent size of the erect penis. Dr. Eid routinely brings patients back to the office to cycle the device within the first four to eight weeks after surgery. Inexperienced doctors allow the patient to heal after a penile implant without having them inflate and deflate the device, which causes the penis to heal over deflated and retracted cylinders, causing decreased inflated length"

This seems to clearly state that the dreaded "coffin" effect happens at the 8th week without cycling. Taken together with the AMS Operating Room manual recommending cycling start 3-6 weeks after implantation would seem to indicate immediate cycling is not necessary.

I plan on discussing this topic with Jamie at AMS this week. I'll post the results of that discussion.

Mark

[Larry10625]

[

So... every time the skin is open at all, there is a risk of infection. Infection anywhere in the body can find it's way to the newly implanted device and that area is already compromised... Unfortunately, once infection finds the implant at all, it cannot be stopped and the only way to prevent septic shock is to remove the implant and then you will have to wait at least 6 months to be implanted providing there isn't so much scar tissue that it makes re-implanting impossible. There is a lot of medical terms that explains this but it becomes too hard to explain then.

Larry

If the excess fluid was drained from near the reservoir, the opening in the skin would be up near the waistline, a new opening (even perhaps just a needle punch), easier to monitor than the scrotum, and a lot easier to keep clean.

Also, I believe there would be one way where no surgical procedure at all would be necessary, that the excess fluid would drain itself after a couple of weeks and be absorbed into the body.

Actually Sheep... one thing I learned in school was that puncture wounds are at greater risk of infection. I think it's because whatever caused the puncture pushes bacteria into the tissue and because it's so small, there is almost no way to debride it where a laceration can be irrigated a little easier. When I had my triple bypass surgery I had 2 small lacerations in the lower chest... one was to flush in sterile saline solution to clean and the other was a drain off. That might work for what you are suggesting.

Larry

[warrenw]

"...Dr. Eid routinely brings patients back to the office to cycle the device within the first four to eight weeks after surgery..."

This seems to clearly state that the dreaded "coffin" effect happens at the 8th week without cycling. Taken together with the AMS Operating Room manual recommending cycling start 3-6 weeks after implantation would seem to indicate immediate cycling is not necessary.

The written post-op instructions I received from Dr Eid say:

"Similarly, scar tissue will also form inside the shaft of the penis and surround or trap the deflated cylinders. The penis will retract causing the cylinders to bend and form folds. To avoid foreshortening of the erect penis, it is very important to begin early cycling (post- op day 3 to 14) of the device by fully inflating the cylinders until they are fully deployed and straight. "

[Dave52]

Found this 2014 interview with Dr. Eid on Yahoo Finance of all places:

https://finance.yahoo.com/news/size-mat ... 35263.html

"To ensure appropriate healing and prevent penile shortening, post-operative care is critical. If the implant cylinders are not inflated within the first two months, the retracted size becomes the permanent size of the erect penis. Dr. Eid routinely brings patients back to the office to cycle the device within the first four to eight weeks after surgery. Inexperienced doctors allow the patient to heal after a penile implant without having them inflate and deflate the device, which causes the penis to heal over deflated and retracted cylinders, causing decreased inflated length"

This seems to clearly state that the dreaded "coffin" effect happens at the 8th week without cycling. Taken together with the AMS Operating Room manual recommending cycling start 3-6 weeks after implantation would seem to indicate immediate cycling is not necessary.

I plan on discussing this topic with Jamie at AMS this week. I'll post the results of that discussion.

Mark

Mark
Old article from four years ago. Dr. Eid has since changed his policy for cycling. He now suggests that cycling start on the third full day after not counting the day of surgery. As for me my surgery was on Friday October 26 7;00am on Monday morning I was activated I started cycling on Tuesday and I follow the routine he recommends sit in a hot bath for 15 minutes then pump to max you can stand leave it for 15 minutes twice daily for 4 weeks. If tolerable sex can begin after three weeks.
Its now been 9 days since I was implanted and six that I've been cycling/ Every day I get in more pumps in for example yesterday morning 30 pumps last night 33 pumps this morning 36 pumps. I probably could have squeezed in another but I was afraid I would slip and send the pump flying into its buddy next door. So far they have been sharing the space with no complaints. No need for any conflict in that area.
I believe that from the time you get the implant installed till the time that the tissue heals is not really relevant to when you start cycling. However the sooner that you start the routine the less chance there is for the formation of the pseudo capsule forming in an unfavorable way. This is also what Dr. Eid told me when I asked him why he changed his protocol.
Despite what trauma the insertion of the implant causes to the corpora there is a limited time to form the pseudo capsule before the healing process is in full swing the idea of formation while healing is very likely the least painful as there is only staking out territory and no tearing of scar tissue that has already formed.
One of the things that Dr. Eid prides himself in is no loss of length. From early cycling I believe that has a lot to do with the end result. Could be wrong but I don't hear of his patients complaining of loss of length.
I will go out on a limb here and say that AMS manual states that because they are covering a wide verity of surgeons from guys like DR. Eid to the local urologist that does less in a year the the High volume Doctors do in a week investigate you surgeon make sure he or she can answer any question you can think of when you make your decision to go with Dr, A,B or C stick with the plan if you don't like the plan then you don't want that Dr.
Dave

[LeRoastBeef]

Would it be possible for someone to make a poll for this; the time before you inflated after surgery and your erect length gain or loss.

This could then be plotted on a graph or even a correlation taken to see if there is a relationship there.

Lots of intervening variables there too so we would take it with a grain of salt, but it would be interesting to see.