Questions for implant veterans

[ditchman]

I've posted elsewhere on my situation, but brief update: after 10 years of ED due to venous leakage and congenital penile curviture / peyronies, I am scheduled for implant surgery on March 5, 2013 with Dr. Montague at the Cleveland Clinic, AMS CX. I am nervous and anxious, as expected, but looking forward to correction of an ongoing problem that has remained unsolved with all other options (I've done them all and still slowly deteriorating with worse and worse experiences). My wife is in full support.

Questions for you guys who have longer experience with the implant device:

URINATION

-How soon after the implant operation will I be able to urinate "normally"?

-Can you urinate with the device pumped up, or is it like natural where you cannot urinate unless your penis is flaccid?

KIDNEY STONES

-I have never had kidney stones, but my family has some genetic predispoition to them. If I have a kidney stone in the future with the device implanted, what complications may arise, if any? Does having the implant device make passing the stone more or less difficult? Does it cause other problems with treatment of the kidney stone?

INFLATION OF THE DEVICE

-I have read where some of you have very good success with inflating the device post-implant, and others where it is difficult or painful or cumbersome to get the device to inflate? In general, what can I expect here? How long does it take to inflate, is it painful to do so?

DEFLATION OF THE DEVICE

-How do you deflate the device? Do you just flip a switch and then squeeze your penis until the fluid is pushed back up into the resorvoir? Does that hurt, and does it cause movement or dislocation of the tubes in the penis? Again, in general, what can I expect, here?

Thank you. Great site, and so helpul on all my other queestions.

Ditch

[Dave92014]

-How soon after the implant operation will I be able to urinate "normally"?

-Can you urinate with the device pumped up, or is it like natural where you cannot urinate unless your penis is flaccid?

You will most likely have a catheter for about 20 hours after surgery so no problem with urinating in that. For the 3 days after my catheter was removed I had some difficulty urinating due to the urethra being constricted and the penis pointing only above the horizon. I could get it done but the stream direction was erratic and sometimes dribbled near the finish. I peed into the shower where I would not create any damage and then washed that down with water. Then I made myself a "director" by taking the bottom off a one quart drinking water bottle and used that to direct the urine into the toliet. By day five things had improved so I could pee into the toliet without the director. That may have just been time healing me but I also switched to Ibuprofen for pain, which has some anti-infllammatory characteristics, so that might have helped relieve the pressure on the urethra. The whole thing was a nuisance but not catastrophic.

KIDNEY STONES

-I have never had kidney stones, but my family has some genetic predispoition to them. If I have a kidney stone in the future with the device implanted, what complications may arise, if any? Does having the implant device make passing the stone more or less difficult? Does it cause other problems with treatment of the kidney stone?

I have no experience with kidney stones. My pee stream got back to normal about one week after surgery so that might indicate the stone passing would be no worse than before surgery.

INFLATION OF THE DEVICE

-I have read where some of you have very good success with inflating the device post-implant, and others where it is difficult or painful or cumbersome to get the device to inflate? In general, what can I expect here? How long does it take to inflate, is it painful to do so?

I did not inflate the device myself until 7 weeks after surgery. My doc did inflate it at my office visits 1 week, 3 weeks and 4 weeks after surgery. That was painful due to the fact that my scrotum was very sensitive to pain. There was no pain in the penis. I have the AMS CX so it does not grow much in length. If you have the LGX that does grow in length you might have a different situation. The pain when the doc pumped was pretty bad but it only took him a couple of minutes to do it. After he stopped pumping there was no pain. That pain was one reason I did not try pumping until 7 weeks post-op. But that is when the doc taught me how to pump so I did not press for pumping early. I know that others that have the LGX have pumped early to break in the penis to the pumping process. For me waiting 7 weeks worked fine but if you have the LGX you might have a different situation than I did.

DEFLATION OF THE DEVICE

-How do you deflate the device? Do you just flip a switch and then squeeze your penis until the fluid is pushed back up into the resorvoir? Does that hurt, and does it cause movement or dislocation of the tubes in the penis? Again, in general, what can I expect, here?

You are right. There is no pain unless your scrotum is still sensitive as you must push the button by pushing on the scrotum. Seven weeks post op I could move the pump to where the scrotum was not senstive so there was little or no pain.

[Dave92014]

I have one other thing about my problem urinating post-op. When I left the hospital I had a bandage that my doc had wrapped tightly around my penis. When I was having difficulty with the urine stream, two days post-op I called my doc's office, told his assistant my problem and asked if I could remove the bandage, as I thought that was adding to the constriction of the urethra. She went to ask the doc and came back to the phone and he said "if it falls off, that is okay." It was not likely to fall off, as it was wrapped tightly around the penis, but I wanted to get rid of it to see if that helped the stream problem and I figured his answer meant that nothing really bad would happen if I took it off so I did. I don't know how much that helped the stream problem as it was gradually improving, but I left the bandage off after that.

[ditchman]

Thanks, so much Dave, for taking the time to provide a very in-depth reply. Very helpful. Because I have penile curvature, I am not a candidate for the LGX, according to my doc, so will have the CX similar to you, and perhaps similar experiences. So, again, thank you.

[Dave92014]

My urologist said he does not ever use the LGX. He said he thinks if the doc does the measurement carefully and correctly that the CX will do as good as the LGX and the CX has one less moving part to eventually wear out. Obviously other docs feel differently as they are using the LGX but my doc has put in 1000 implants so he is very experienced. So don't feel that you are getting a second class device because you are getting the CX.

[radiodec]

One man's experience here. You can urinate when inflated; aim can be a bit of a problem and at max inflation it isn't as easy as deflated, but it can be done.

WIth the implants, I think that there are two sets of factors to be considered; what the surgeon is comfortable with using and what the capabilities of the patients body are. I have the LGX model and since I am a prostate cancer survivor and a long way from that surgery, the LGX length expansion feature is helping me to regain what I lost over the years of underuse and lack of rehab. It also gives me a little more near normal operations than would a maxmimum sized CX.

Before surgery I was no more than 3 inches flacid, with tons of manual stimulation and a little stretching could get to nearly 7 inches. With LGX I am now at 5 inches flacid, and at maximum pumping at 9 weeks post surgery I am a little over 6 and a half inches and that is slowly growing as I continue to use the implant. Working length is right at 6 1/2 inches; never do sex at maximum pumping, it isn't very comfortable. If I had to have gone with a CX the best fit would have left at 6 1/2 inches flacid; this would have been more of an adjustment than from 3 to 5.

If any of the devices, two manufacturers and three total main models, were clearly inferior it would have dropped from the market. As it is, the surgeon, and the patients anatomy make different choices for different patients.

Dave