The purpose of Rear Tip Extenders (RTE's)

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Hawk

The question was asked,
QuoteWould you please explain the purposes or rear tip extenders and why surgeons use them?

I'm implanted with titan 16+3 rte.
I asked my surgeon why did he choose this option and not 18+1 or 20+0?
Unfortunately, I didn't get a clear answer
.

Most if not all high volume surgeons make it a point to do all they can to either eliminate or reduce the number of RTE's used. At times they will even go to a larger implant and trim down the uninflatable rear portion to avoid RTE's. One reason they are successful at avoiding or minimizing RTE's is that they maintain a large inventory of expensive implants and take several into the OR with them with every surgery.

There are at least 2 reasons, they do what they can to avoid RTE's.

#1 RTE's obviously do not inflate. They are fixed. scar tissue encapsulates the portion of the implant within the body (the crus). the inflated penis is supported much like a small porch flag with a flagpole in a holder, or a fence post in the ground. The penis is supported by the portion of the penis that is internal. In time the scar tissue around the internal base is stretched just slightly. This allows the fixed part to wobble or become less stable. Again, it is much like a fence post in a hole that is just slightly too big. Even a slight enlargement of a post hole causes considerable wobble and movement of the far end of the post. The longer the pole or post the more movement of the far end. ----- If there are no RTE's then this process is greatly minimized. The scar tissue is far less likely to stretch because the inflated part of the implant goes well into the body. When it deflates it takes pressure off of the scar capsule. Next, even if the capsule did slightly enlarge, when you inflate the internal part of the implant it will still fit snugly within the capsule preventing wobble. IE: If the internal part of the implant is inflatable it will snuggly fill the internal scar capsule. If the internal part of the implant is fixed RTE's it will more loosely fill the scar capsule.

#2 The tubes from the reservoir enter the implant at a junction near the rear of the implant. The more RTE's you put on the end of the implant the further forward you move that junction and the tubes that connect to it. This can make hiding the tubes more difficult. In worst case scenarios the tubes can be both visible and palpable in the scrotum or the shaft and can even sometimes be felt by your partner during sex.

Here is an excellent video that shows the contrast of the same man with and without RTE's
https://youtu.be/oGBMccEQERw

RTE's are just one of the factors that determine whether you have an optimal implant. The best surgeons do use them on occasion. They just avoid them and minimize them when they can. Instability or wobble does not prevent intercourse if you are firmly inflated. It can be a functional issue but is largely cosmetic with your erection pointing down rather than up.

Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Bfubar

Good afternoon Hawk, I asked Dr. Eid about this very thing. I am now almost three months into my implant and have a little bit of a wobble. I am not sure if they used RTE's but I do know mu proximal plaque was so bad my surgeon had difficulty getting my Titan placed. I had a very bad case. Every thing else works great but I wondered if there were any exercises or something I can do to make it more stable. Pelvic floor exercises maybe? I May have to live with it until revision time.
I need your expertise!!!!

Thanks for all you do and thanks for this site!!!
47 years old. 90 degree lateral curve.VED, Restorex, Pentox, Tadalifil, 4 cycles of Xiaflex. Partial Excision and Grafting.
Failed all treatments. 22 cm Coloplast Titan installed,11-14-23, Dr. Richard J. Fantus. KU MED.

Hawk

First, you should have no doubt about what is implanted in your body.  It is the most basic piece of information you are entitled to from your surgeon.  If they were not responsive enough to give you this information without asking, then DEMAND IT! Send them a written request for a copy of your "surgical notes."

Ex[lain exactly what you are calling "wobble."

I do not believe there are any exercises that can correct wobble or a low-pointing inflated penis caused by a loose scar capsule at the base of the implant or the fact that RTEs at the base of your implant do not inflate.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums