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Author Topic: Strongly considering a 3 piece penile implant  (Read 3251 times)

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lessor

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Re: Strongly considering a 3 piece penile implant
« Reply #100 on: September 13, 2018, 06:08:49 PM »

And what if he tells you more with BPEFL than with the measurement after giving you an injection? What is the measure that takes into account at the time of surgery? Because thats what happens to me, i was to an implant surgeon and he took measure with stretching flaccid test and it was one centimeter more than í get with injection because the injection only give me a semi hard erection.  Also when i get erections by myself it is bigger than with injection

Patients of Dr. Eid have told me that he doesnt give much importance to the stretching test, he gives much more importance to the erection after injecting and it is the measurement that he writes down. So I would lose one or more centimeters? I would be one centimeter shorter with the implant because he stop one centimer before of my maximum lenght when installing the cylinders? Or does he measure to the maximum in surgery even if he passes his measurements taken with the injection?

Why he can not give you a saline injection ( like in a cavernosometry) and inflate your corpus cavernosums? That would be the the most accurate way to measure and i know that that would give me my authentic length, not what i get with an injection that hardly worked. Why doesntt he do this?
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Hawk

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Re: Strongly considering a 3 piece penile implant
« Reply #101 on: September 13, 2018, 06:56:34 PM »

Lessor, I will try to make this clear. 
1. Dr. Eid will stuff as much implant in your dick as it can hold. 
2. No one on earth can get more length out of your penis with an implant
3. He will evaluate your penis through multiple methods and promise you your minimum post-surgery size


If you are disappointed with the promised post-surgical size you can.
1. See if another surgeon will promise you more (They won't)
2. If you think you are better off leaving your penis like it is you can do that
3. IIf you cannot get erections or use your penis and wait a few years before you go with Dr. Eid, you might find that the size he promises becomes somewhat smaller because of years of plaque and atrophy.

The bottom line is that it does not matter how he evaluates your penis, even if he does it with a magic wand.  What matters is whether he delivers what he promises AND it matters that you are happier with the promised penis than with the current condition of your penis.  I have never heard anyone say Dr. Eid does not deliver what he promises.  I cannot tell you what he would promise you.  Only Dr. Eid can do that.  If you dont like what he promises AND your penis does not work you will have to decide
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skunkworks

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Re: Strongly considering a 3 piece penile implant
« Reply #102 on: September 13, 2018, 08:33:59 PM »

Just want to say it really has been an amazing post.

It really is. Hands down the most educational thread on the actual experience of the procedure, recovery and use that I've ever read.

I'm lucky enough to have sorted my Peyronie's for the most part and have no ED, but now I'd really consider getting one 20-30 years down the track just for age related ED or earlier if I get long term ED again.

Sadguy

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Re: Strongly considering a 3 piece penile implant
« Reply #103 on: September 14, 2018, 06:32:45 AM »

Thank you Hawk, can you tell me how much it costs to have a consultation in the office with Dr.Eid?
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Frank55

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Re: Strongly considering a 3 piece penile implant
« Reply #104 on: September 14, 2018, 09:18:57 AM »

Thanks once again Hawk. In the same spirit of your very honest posts, I've posted my meeting notes with Dr. Levine below to provide further insight on my situation and to potentially help other men on the forum. I now have ED, curvature and penile pain. Not a pleasant situation.

The meeting notes vary from first person/second person narrative. Please ignore that.

I had incision/grafting surgery from Franklin Kuehhas in June 2016 which has gone completely sideways (pun intended.) I now have chronic penile pain (from nerve tethering from additional plaque accumulation.)

As you can see, Dr. Levine says he has done over 3000 implants, but he did not place a timeline on that. Coincidentally, I have a follow up phone meeting with him next week. I'll be asking the questions you listed - thanks.

One asset Dr. Levine does bring to the table is his experience with both implants and peyronies grafting/excision procedures. That two-sided experience would be helpful in my case. Do you think Dr. Eid would be equally effective in that respect?

Based on your sensible input, I did schedule a teleconference with Dr. Eid next week ($285 for the meeting for those asking about price.) I think it only makes sense to get a second opinion when one is considering a serious medical procedure like this one.

Also not sure how far out Dr. Eid is booking, but I'm thinking to get this done sooner rather than later (very tired of living with this pain.) I'll be asking him about that on Thursday.

Notes from Dr. Levine Appointment

Severely abnormal tissue at that narrow junction – particularly on left side. Feels abnormal. It is either graft alone and/or the graft plus residual peyronies scar tissue.

Within that there is probably tethering of the nerves that run along the surface of the penis which had to be lifted up to lay the graft in. They are laid back down, but if there is a contraction of tissue (which normally happens after surgery) but they have happened excessively with your response to the surgery and all of that is tethered in.

We see this with other types of surgery – for example, after a hernia repair some people have persistent pain. No fault of the doctor – there were no nerves that were directly injured but as the tissue heals it pulls that adjacent tissue into the area of scarring. That pulls nerves in and you get a chronic pain syndrome.

We see that in a variety of places. One way of addressing it would be stretching – stretch therapy. A second option would be intralesional verapamil. One of the things we’ve found with verapamil for men with pre-surgery peyronies pain is that with 2 – 4 injections they had resolution of their pain.

Will that happen here? I don’t know. You have post-operative pain. I think the Pentox you are taking is worthless at this point.

If you want to address the pain, deformity and get “back in the saddle” again and be sexually active there is only one approach that I’d recommend. That would be the placement of a penile prosthesis with associated straightening maneuvers, which in your case would be plaque partial excision (or incision) which likely will release some of the scarring there and likely release the tethering nerves in that area. Then possibly some patch grafting over that area so the prosthesis would not herniate into that area.

Prosthesis and implant are the same thing. Similar to replacing a knee or hip.

Would other surgical options work? Dr. Levine says he could go in there and potentially excise that scar tissue, lay a graft in and hope that this process does not reoccur. We would hope that this process may release the tethering nature of the scar tissue and maybe get rid of the pain.

However, he thinks there is a good chance that procedure will not improve my erections and will probably make them worse. Prosthesis would address both the straightening and the pain.

You have a different type of pain - this is not initial acute inflammatory peyronies pain you have now. This is a post operative pain syndrome from tethering of nerves. I work with chronic testicular pain and I see this a lot, like with patients who have had a vasectomy. This also happens with other scrotal operations. Perineural fibrosis around the nerve scar tissue. This pulls the tissue in and activates abnormal nerve firing.

By stretching, we may release that to some degree. If that were not to work, we would go in hope to disrupt and release the tethering nature of that scarring. You may end up with some sensory loss in that area as well. If your goal is just pain, then we go with verapamil and traction therapy.

If your goal is a straight and sexually functional penis, the only approach I see there is a surgical approach with a prosthesis because you have a severe degree of curvature. More importantly, you have severe indentation from the nasty scar you have there. That indentation may also be a contracted graft.

Is there a penile blood flow issue? Yes in the sense that your arterial inflow is fine but you have venous outflow. That is why we are not getting a good erection.

Your scar tissue is way too rigid for traction to be effective for straightening.

If we do this procedure in the hospital OR there is a high cost. For people who have different payment plans, we do it in the surgery center. Device is $10,000 roughly. Somewhere the better part of $20,000 if done in the surgery center.

What does an implant look like when it is flaccid? Appearance is very natural. Intercourse feels natural as well. Feels natural like wearing glasses. You’ll only really feel the pump – transferring fluid from the reservoir to the cylinders.

Pump is in the scrotal sack – plenty of room, like a third testicle. Cylinder is sized to fit the entire length of the penis. Dr. has done over 3000 of these. Does not activate any other medical conditions. Can be replaced if necessary. Does not cause any medical concerns if unused.

Dr. Levine recommends an implant/prosthesis if I’d like to have a sexually functional penis again. He could risk re-doing the grafting, but there is a risk of making your already bad erectile dysfunction even worse. At least a 50% chance of that.

What about straightening effect of a second grafting operation? I can’t guarantee what we would end up with structurally. Most of the scar tissue would be carved out.  Given that you’ve already had surgery there, there is a lot of tethering of the nerves over the surface of that. That would probably result in regional sensitivity issues. Like an absence of sensation.

A second grafting procedure also carries risks of ED, possibly recurring curvature or incomplete straightening, sensory issues and further shortening of the penis. I think the chance of your having good erections after this procedure would be low.
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Hawk

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Re: Strongly considering a 3 piece penile implant
« Reply #105 on: September 14, 2018, 10:18:50 AM »

Thank you Hawk, can you tell me how much it costs to have a consultation in the office with Dr.Eid?
  Insurence covers it if you go to his office.  If you do a video conference it is $300 for 30 minutes.  It is easy to set up right on his website.  His staffare all very helpful if you have issues or general questions.
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Tsanchez12369

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Re: Strongly considering a 3 piece penile implant
« Reply #106 on: September 14, 2018, 10:38:32 AM »

Frank55, quite a detailed post.  It warrants a thread of its own as well.  Maybe side effects or bad outcomes of surgery.  I added implant to my excision and grafting.  I think the implant part is easier than the excision and grafting.  Please keep us posted.
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Hawk

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Re: Strongly considering a 3 piece penile implant
« Reply #107 on: September 14, 2018, 10:46:28 AM »

Frank55, quite a detailed post.  It warrants a thread of its own as well.  Maybe side effects or bad outcomes of surgery. ...  Please keep us posted.

Frank, I agree with Tsanchez.  You have an involved case, are good at listing details, and will have a very educational journey ahead (and hopefully successful one as well).  Why not copy your post to a new thread.  Do not worry about the one that is here.  The administrator will overlook the double post ;) 
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Hawk

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Re: Strongly considering a 3 piece penile implant
« Reply #108 on: September 14, 2018, 11:25:27 AM »

Day 37 Thursday 9/13/2018

I was active all day yesterday in long pants.  I wore my Duluth Trading Firehose flex pants in a snug size (at times I have worn a larger size when healing).  They have good give but are a medium-heavy weight material.  I was active on a gun firing range and other activities.  Every now and then it occurred to me that my implant was not an issue.  It was not just an absence of any pain.  I felt comfortable.

Sex continues to improve.  A personal issue is that I seldom initiate sex even though I have a high sex drive.  I far prefer to know my wife is genuinely in the mood.  Before our last encounter, I sensed she was and pumped up a few pumps just so my penis was not totally drained which makes it feel abnormal, especially at this stage when the cylinders are new and less flexible.  She snuggled and placed her hand on me.  During foreplay, I pumped up more but probably a few pumps short of maximum.  We had intercourse for about 20 minutes but only in one (man on top) position.  At no point was I aware of my implant.  There was no brief moment of discomfort.

Afterward, She said, " you were hard when I first touched you".  I told her sometimes it is more comfortable with a few pumps in it just to straighten out the folds.  I did not go into this but the Titan (at least at this stage) does always feel at least like the beginning of an erection especially in the glans end of the shaft since my folds when deflated are in the base half of the shaft.  She said did you pump it up more before intercourse"?  I told her I did during foreplay.  She then said, " I think you are getting some natural erection on your own even without pumping."

The significance that makes me openly share this is: Even with my wife of 50 years knowing me as well as I know myself, and knowing that I have an implant, and with me only using only the least amount of subtlety or discretion, she was not aware of me inflating my implant.  I will concede that if you are on a beach during the daytime at spring break and a random girl jerks your swim trunks down to perform oral sex you will have a different experience.  On the other hand, those girls are usually so drunk you could probably use a VED and they would not notice or care.

Just for context, our room is subtly lit with night lights and outside lights and we are NOT ones that ever have sex under the covers.  To me sex uses all the senses including sight.
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Hawk

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Re: Strongly considering a 3 piece penile implant
« Reply #109 on: September 14, 2018, 11:40:00 AM »

Thank you Hawk, can you tell me how much it costs to have a consultation in the office with Dr.Eid?


Sadguy, I called his office just to ask your question.  It is $450.00.  Insurance covers that for those that have insurance.  A 30-minute video conference is $300.00 and insurance does not cover that.

Also of interest, Dr. Eid runs about 6 to 8 weeks out on his surgery schedule.

New York is a high cost of living city so lodging and restraints can be somewhat expensive.
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Sadguy

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Re: Strongly considering a 3 piece penile implant
« Reply #110 on: September 14, 2018, 01:06:08 PM »



Sadguy, I called his office just to ask your question.  It is $450.00.  Insurance covers that for those that have insurance.  A 30-minute video conference is $300.00 and insurance does not cover that.

Also of interest, Dr. Eid runs about 6 to 8 weeks out on his surgery schedule.

New York is a high cost of living city so lodging and restraints can be somewhat expensive.
So $450 without insurance. Ok thank you very much
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Sadguy

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Re: Strongly considering a 3 piece penile implant
« Reply #111 on: September 14, 2018, 01:26:59 PM »

one more thing hawk sorry, if you can tell me or you know, in the $ 450 is included the doppler with injection that the usually does or that is not included?
If it is not included, do you know how much it would cost? Because if I were there I would like to have that done too  :-\
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Frank55

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Re: Strongly considering a 3 piece penile implant
« Reply #112 on: September 14, 2018, 03:27:59 PM »

Hawk - I will start a new thread with that post. It is a lot to take in, I know.

Still interested in your take on my one question though. Given the facts of my case (where the surgical procedure would be both excision/grafting and also implant), do you think Dr. Eid would be equally capable for that procedure? Or do you regard him as better for the implant procedure only?
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Hawk

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Re: Strongly considering a 3 piece penile implant
« Reply #113 on: September 14, 2018, 07:47:35 PM »

I just want to alert those that find value in this topic, that I just posted an implant journal by a gentleman named Merrix.  Because of its vastness, it is posted as a PDF attachment.  It is a comprehensive 80,000-word, 2-year journal on his research and journey with an implant.  It is brutally honest, comprehensive, and makes every other journal on the internet pale in comparison.  I am more than thankful to Merrix for his contribution to men everywhere suffering from ED with or without Peyronies Disease.  I also want to thank Pfract for alerting me to Merrix and this great journal.  I still refer to it often.

The Definitive Journal on Penile Implant Surgery - by Merrix - Peyronies Society Forums
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lessor

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Re: Strongly considering a 3 piece penile implant
« Reply #114 on: September 16, 2018, 05:54:38 PM »

im also interested in how much a visit would cost with doppler injection and taking measuress
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pfract

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Re: Strongly considering a 3 piece penile implant
« Reply #115 on: September 16, 2018, 11:59:52 PM »

Thank you for the  shout out Hawk. I appreciate things like this a lot, and i am so glad it is helping you so much, because right now it is the time where you need it the most. I've been following his posts since he did the sclerotherapy in 2014, which did not worked out and then proceeded to do the implant. Brought tears to my eyes many times reading it. It was a breath of fresh air, to see such an approach in a place like franktalk, from somebody not much older than me, also active at the gym.

As for your diary, i also enjoy following. It would be nice to read updates from time to time, even if monthly.

https://www.franktalk.org/phpBB3/viewtopic.php?f=6&t=10990&sid=4aa72d11ff6df5b79a8b44ae3f6345e9

Reading through this alibaba post, it is one of my biggest concerns... the longevity of the implant. I wonder how many revisions i will need, and if the infection rate increases with each revision... or if it stays the same, and the outcome is more dependant on the doctor itself?
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Hawk

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Re: Strongly considering a 3 piece penile implant
« Reply #116 on: Yesterday at 12:28:30 PM »

Sex, the entire point of the implant, continues to get better.  By better, I mean:

it is easier to pump up.  It is a one-handed operation with no pain and only slight discomfort as the skin is pressed between the bulb and the thumb.  I cradle the bulb by cupping my 3 fingers and letting the bulb rest in those cupped fingers while I press with my thumb. This prevents the bulb from slipping out of my grip under the significant pressure it takes to pump.  If that happens it can slip out with a lot of force and speed and hit a testicle which is not devastating but also not pleasant.

The last time my guess would be that we had intercourse for 20 minutes in 3 different positions and it was superb for both of us.  Again it was a totally spontaneous situation where my wife actually woke me up a 2 am just by snuggling in a way that set off enough signals that I woke up.  She was still asleep but after years of marriage, I knew what was coming.   I took15 seconds to partially pump up just to be ready because I was super deflated and did not want her grabbing my semi-flat penis with conspicuous folds in the new stiff cylinders.   If she had, it would have been no more than a blip but I could avoid that blip so I did.  I wanted to have some solid mas because I knew if she subconsciously put her hand on me in her sleep she would be awake within a minute.  I was right ;)           

While there was no pain or discomfort during sex, we are still reasonably careful.  For instance, I can go full force with straight intercourse but I would NEVER consider changing positions such as rolling onto our side or her on top while I was inserted.  That would be a killer at this point.  Although there was no pain during sex, I was slightly aware of some mild pain or burning in the glans a few moments during the night.  Today all is well.                                 

My deflated angle is SLOWLY getting better.  It is at almost 5 o'clock but I still would not walk in a public shower at this stage,   It is very easy to accomidate in clothing during the day however (either up or down).                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
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