Frustrated By Doc’s Implant Sizing Information

[Niculus9]

Hi all.

I have to have a prostatectomy due to prostate cancer very soon.

I’ve had two meetings with 2 different penile implant surgeons.

I told them my concern:

My flaccid penis is only 2.5” long, but 7.5” when erect.

Many docs will simply stretch your flaccid penis, the choose that size for the implant size.

However, my stretched flaccid is only 5 inches!!!

I asked them both, can you use Trimix to give me an artificial erection, and use THAT length as the basis for implant size, and they both said “No one does that.” That’s simply not true.

I said, my penis clearly CAN stretch more with some blood flow, I don’t want to lose 2.5 inches!!

I understand that you do NOT want the tip of the penile implant to push into the glans and cause erosion.

I’m just horrified of losing 2.5 inches, and I don’t understand how these surgeons can just “poo-poo” away my comments, when I could provide them with both medical literature AND the names of various surgeons who DO use Trimix to size penile implants.

It sucks, because my insurance will only pay for the surgery in my state of Nebraska, where there aren't any extremely knowledgeable surgeons.

Has anyone here who is a “grower” vs a “shower” NOT lost significant length after an implant?

Did anyone here have their surgeon size their implant by using a chemically induced erection INSTEAD OF a stretched flaccid?

I’m really down about this…

[danny1553]

The way they measure the length is NOT against an erected or stretched penis. During the surgery they dilate the inner tubes then measure the length from within the dilated canals.
I used to be a grower too. My initial implant was done in Canada where I had to wait for about 2 years to get it done. During that time I was actively using a stretching device in the mornings and pumps in the evenings. This protocol allowed to reach the max length during op-time measurement. As a result, once I got an LGX, in a couple of months I was back to my full length, and maybe 1 or 2 mm more.

[GoodWood]

First things first: do you actually need an implant right now? Or have your surgeons told you that you will be impotent as a result of your prostatectomy — that your disease is such that they can't do a nerve-sparing procedure? There's a real risk of impotence after prostatectomy, but it's not guaranteed. Many men retain or recover their erections.

Don't worry about being a "grower" and that somehow throwing off your measurements during implant surgery — a good implant surgeon will size you correctly regardless. Start using a VED now, unless you're already having great erections with no size loss since you were younger. Focus on recovering from your prostatectomy first. Then take your time finding the best implant surgeon you can. A good surgeon will size you appropriately, and after you've healed for a while, you'll likely be at or near your pre-op size.

If traveling to a high-volume implant surgeon is an option, it's worth calling their office to ask about experience with your insurance. Even if you've been told your plan won't cover care out of state, sometimes they can get approval — it's worth the phone call.

Hang in there. One day at a time. One thing at a time.

[Rider1400]

Agree with others… there will be a waiting period after prostectomy before any Dr would implant or your surgeon would allow you to be implanted. Get thru it first then do your homework. Some insurances even though might not be a PPO that allows any Drvto do surgery might allow an exception for a more qualified surgeon. Check with the big names about this when the time comes. I’ve never ever heard of a Dr using a chemical compound for erection during surgery. They generally insert a needle and use a BIG syringe to push fluid usually an antibiotic fluid to enduce an erection just prior to starting surgery to stretch the tissues out. If you’re worried about not being properly sized then do whatever necessary to get to a better more qualified Dr. but you have time for this after prostectomy.

[LGXDownunder]

I'm sorry to hear that Niculus, but many of us have been through the same and been able to restore both size and sexual function eventually.

GoodWood and Danny are spot on with their advice. We can possibly provide more information if you can tell us more about yourself and the background that has gotten you to this point. But I'll try and do that using my own experience.

1. You may well regain erectile function naturally post prostatectomy. It is normal to lose at least some erectile function temporarily due to trauma from the surgery, even if it is 100% nerve sparing. But there are many variables affecting what may happen longer term. If you are relatively younger, fitter, healthier in general, you likely have a better chance of not suffering permanent ED. Unfortunately I was already 68 when I had my prostatectomy and the ED was sudden, total and permanent. After failure with all the conservative ED treatments my implant restored my original size, and I now have very rigid erections on demand for sex. After your prostate surgery definitely start VED therapy as soon as your doc says it's safe to do so. I lost size quickly from the procedure but was able to turn that around with daily VED use.

2. I agree, if you do ultimately need an implant, the only measurement that matters is when the surgeon dilates you in the OR to determine the correct size. In the lead up to my implant surgery I used a VED aggressively at least twice a day to optimize my length. That helped allow the largest cylinders that my anatomy could safely accommodate. Rather than lose length it's more likely that you will eventually get back your 7.5 inches or very close. You will also likely progress from being a "grower" to a "shower". Your current 2.5 inches soft may well turn into 5 or 6 inches. Pre ED I was 6.5 erect and about 3 flaccid. Now I'm slightly over 6.5 erect and just over 5 flaccid.

3. If you ultimately do need an implant find the best surgeon you can even if you have to travel. My knowledge of US insurance is extremely limited but I know that, through persistence, some guys on here have gotten approval for things that were nominally exclusions.

But wait and see what happens after your procedure. It will take time before you know how it's going to impact you, if at all.

[Bent Ben]

I never had a stretch test and my surgeon never examined my erect penis prior to the surgery. He saw the pics of my bent penis and felt around where he could feel the scar tissue. He explained that he would size me on the table during surgery and he was fine with stretch tests and induced erections if it made me happy. I told him that I was good with his decision, in 2 days I will be 3 years out. My penis is 1/8” shorter and 1/8 more narrow than prior to surgery, so basically where I was preop.
I think all the pre surgery measuring is for the patients piece of mind. Watch the surgeries on line, you will need a strong stomach but will see the measuring is done during the surgery. Pick a reputable surgeon and youll be as good as you can be.

[John Dday]

Relax have conversations with the implant team, chosen manufacture, and us of course. Send them pics to 'show' your point.

[Handyman]

I had a prostatectomy too. I wouldn't worry about anything ED related until you are through that surgery. Do your kegels, they will help with make sure you can control urine flow.
Post prostate surgery,You also no longer have ejaculation but will still be able to orgasm. That is strange at first too. I would think you are likely 2 years away from having an implant. They will likely want to make sure you have 2 , 0 PSA tests
To verify cancer gone.