The Implant Wars - PRO Vs Con :) moved from the Wake Forest Topic

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Pfract

@werther: thanks for posting the links. I was reading through them, and found them very interesting. I still maintain my opinion on the implant though. But i am biased. I broke my penis, and for all the treatments and their success rate, the implant is the one with best chances of solving it the majority, if not all problems. Is it the same as my old erection? for sure it won't be. I will have to adapt, and pray the surgery outcome is good. But.... all things considered... I don't know for how much longer i can deal with not having a hard erection on demand and be back having sex.... 4 years... and counting... god, do i miss some proper intimacy. (sorry for the venting off. i got carried away. :/      )

@werther / @hawk:

https://www.researchgate.net/publication/261950539_What_are_the_reasons_for_satisfaction_and_dissatisfaction_with_penile_prosthesis_implant_A_qualitative_study_of_53_implants

Was reading through this link, and was impressive to find that it was written by Portuguese doctors. Not from my home city, but on the capital .Still, i will  try to find a contact and talk to them. Curious if i will get a reply back, and if i do, what he will say when i tell my story?




Frank55

Werther has a valid point regarding age and implant perception/usage. Considering and/or having such an implant when one is older is definitely a different situation compared to a person in their 20s/30s. It would be a more difficult decision, though I don't think it is an easy decision at any age.

Dr. Andrew Kramer sometimes mentions/insinuates patient age in the titles of his surgery YouTube videos. It includes younger patients. Wish he would post a video about younger patients and their post-surgery impressions of life with an implant. That would be smart from a marketing standpoint.
Single and 58 yrs. old - first peyronies symptoms Fall 2015
Had grafting surgery by Franklin Kuehhas in June 2016 - complete failure
Borderline ED possible but not taking drugs, shots or using VED
Now evaluating options for next step

Hawk

Frank,

No two individuals are the same.  Some are old, some young, some are healthy, some have many health challenges, some married, some into seeing how much casual sex they can have, some very highly sexed, some with little sex drive.  There are MANY more factors and every one I mentioned are found in every age group.  what I do know and what drives me crazy is this.  IF an 18-year-old is trying to have sex and cannot because of ed then I do know how he will feel about an implant.  He will be thankful he has one and that he can outdo every 18-year-old friend he has.  He will be thankful he does not have to obsess over how much size is withering away.  Every aspect of it will become second nature.  I have talked to guys that have casual sex with at least one new partner every week with an implant.  

Now, if they cannot find or afford a decent surgeon, if their body cannot heal from surgery or such, if they have a decent ability to have sex, then that is different.  If however, they cannot have intercourse and they want to wait ten or twelve years so they might have one less revision I view that as crazy.  They could be dead in 8 years or in 1 year.  They could have had a relationship and a marriage while they could still find an available pool of people to choose from.  By the time the next implant comes along, it might be remote controlled and last 25 years.  Maybe some people sit around without having sex worrying about how many revisions might be in their life but I am not one of them.  If I have to have an out-patient revision every year to have sex, sign me 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

diehardpatriot

I want to add to the "too young for an implant" debate. On reddit, I read the story of a man who as a 16 year old boy on first FIRST time having sex a drunk fat girl came down on his dick fracturing it terribly. After his surgery for 6 months he had zero spontaneous erections and became depressed. He was implanted at 17. When he wrote the post he was 20 or 18 I think and he said he has a great sex life, his girlfriend LOVES it and calls it the "iPenis"  personally I don't think there such thing as too young. For me, going sexless for many years is way more psychology damaging than having to pump my dick before sex.  
Penis injury in late 2017. A lump formed at injury site that caused no deformity, just pain and a palpable lump. Pain is improving through proper rest and use, diet, and mindfulness. I am always learning and looking to share things that have helped.

Hawk

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

Frank55

Good points Hawk. Regardless of one's age, the single most important variable is the level of ED. If someone has a basically hopeless ED case then the implant decision should be easy. It certainly beats a sexless existence - particularly since the implant technology (and procedure) is so much better now.

In my case, I'm on the fence because my ED is borderline and I'm not convinced it is as bad as my September duplex test indicated. I can get a full erection using a porn site without any issue (albeit curved from peyronies, but an erection nonetheless.) One trimix (or bimix - whatever they use) test does not necessarily an ED case make. So I'm still considering a graft revision along with plaque excision instead of an implant. Seeing Dr. Levine later this month about that.
Single and 58 yrs. old - first peyronies symptoms Fall 2015
Had grafting surgery by Franklin Kuehhas in June 2016 - complete failure
Borderline ED possible but not taking drugs, shots or using VED
Now evaluating options for next step

Hawk

Frank, I am not sure if you are married and I don't know about your level of ED or what you do to compensate for ED (pills, shots, VED).  None of that is in your signature and all of it makes a difference.  

One thing is fairly consistent, however.  I have never know ed that was established over a year to get better.  Whatever it takes to produce an erection always increases.  If you can pop a Viagra and be assured of 30 minutes of sex and are happy with that fine.  What I would not want to do is to have excision surgery with borderline ED and then have to have implant surgery a year later when I could have resolved it with one implant surgery.  Of the two, the implant surgery is an easier surgery and either of them would obviously be better than both of them.  

As an example, if one 100mg Viagra gives you a usable erection but not an optimally hard erection (it takes a lot of lubricants, some slight bending) I say in a year without surgery it will be worse.  In a year with grafting surgery, it will definitely be worse.  I don't recall anyone curing ED with grafting surgery.
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

Frank55

Funny you should ask about the pills Hawk. Dr. Eid asked the same question at our consultation. I'll add that info to my sig.

The answer is I'm not taking anything at the moment. I did take both Pentox and Cialis for a long time (over a year) in an attempt to get rid of the penile pain, under the assumption the pain was inflammatory peyronies. When I realized the pain was not changing despite the continued pills I made the appointment with Dr. Levine. That is where I learned the pain was (probably) caused by tethered nerves from the returned plaque. You may recall that from the lengthy post I made a while back with the notes from that appointment. I'm also not doing shots or VED.

I went cold turkey on the pills after that appointment (9/9 of this year.) I don't like taking them anyway, but was willing to do so if it helped with the pain. So whatever option I choose next, part of the procedure must be to either incise or excise the returned plaque to cut the tethered nerves loose. Even if I do get an implant the nerves will need to be addressed - I can't have this pain permanently. Really casts a shadow.

So whatever erection I'm able to generate now, I'm doing it without any drug assistance. Which is encouraging but still not proof that I'd be able to do so after another grafting surgery. Levine said a second procedure of that type could worsen ED.

Also I'm single. I'll also add that to the sig as well. No easy decisions here, unfortunately.  
Single and 58 yrs. old - first peyronies symptoms Fall 2015
Had grafting surgery by Franklin Kuehhas in June 2016 - complete failure
Borderline ED possible but not taking drugs, shots or using VED
Now evaluating options for next step

Hawk

Well, you apparently have to have excision or something other than an implant.  If you have a shot at having intercourse now with no help, I would hope you would come through surgery needing only some minimal help.  maybe even only L-Arginine (you should try that now).  You really don't say what your erectile ability is.  Could you have intercourse?  Do you get less than totally erect or do you get totally erect but lose it quickly?

If you have a good chance of coming through surgery with a decent chance of intercourse with a minimal dose of an ED drug then I would probably roll those dice. If you later declined you could up the dose unless you are unsatisfied taking ED drugs.  If Drugs, or VED are not acceptable and you are borderline now, then I think you have to consider an implant.
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

Frank55

Thanks Hawk. I value your input. I honestly don't know if I could have intercourse now or not, at least not from a "hold the erection" perspective. I'm running a 70 degree curve to the left so attempting intercourse would be awkward, to put it mildly.

I've not pursued a relationship since this disease began. I intended to if the initial procedure had been successful. Been in a "holding pattern" since then.

You bring up an interesting question that I'll try to address in the near future - the ability to not only generate an erection but hold it. I think I probably could hold it but have not really tried. I've been generating erections in order to take photos to see if the curvature is changing (I want to make damn sure I am out of the acute phase before I schedule any further grafting surgery - rushing into the first one was in all likelihood what caused this bad situation.)

Once the photo is done, I've not attempted to retain the erection. I'll give that a shot - would be valuable to know. I do feel like the erections I can get are total. Holding them is another matter.

Funny thing also - I never took Cialis due to ED. I took it for it's supposed healing aid properties for the inflammatory stage of peyronies pain. It wasn't until the Levine appointment that I even considered the possibility of having ED - I went to him to diagnose the ongoing pain, not because of ED symptoms. I'll add that Dr. Levine seemed somewhat eager to make an ED diagnosis despite his judgment being based on only one duplex test. Again, you have to consider the sales angle some of these Doctors bring to their diagnosis. I'd guess that implant surgeries are quite lucrative.

I'd be OK with taking Cialis and/or L-Arginine if it helped the erection situation after the surgery (assuming I choose the grafting.) I did not experience any negative side effects from Cialis even after a long stint of taking it.

Another decision factor is that I'm in excellent health - non-smoker, good diet, exercise, etc.

Like you said, it will be a roll of the dice. I do not dread the idea of an implant the way I used to after your reading the implant stories on this forum. But at the same time, if a reasonable chance of getting usable erections after an additional grafting surgery exists, I may take that chance. I'll be making that call within the next 3 - 6 months.
Single and 58 yrs. old - first peyronies symptoms Fall 2015
Had grafting surgery by Franklin Kuehhas in June 2016 - complete failure
Borderline ED possible but not taking drugs, shots or using VED
Now evaluating options for next step

Hawk

I am with you frank.  If you are getting erections without a partner with no assistance from any drug or even L-arginine AND if you have no aversion to taking those drugs, I would get the excision/ grafting by a great surgeon.  I have not followed and retained enough information on those procedures to be certain, but my impression is that they typically are not erection killers. After surgery, if you need some help with erections you have that entire spectrum of solutions still at your disposal from L- Arginine to full-dose PDE5 inhibitors or even the combination.  If you need a daily low-dose Cialis for spontaneous sex so be it.  You can even throw in a cool high-quality cock-ring if needed and have great sex.  If you have all of that untapped and un-needed up until now, I would forget the implant.  You know its there if you need it 5 or 10 years down the road.  Maybe never.
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

SW01

I have to admit dealing with ed and peyronies is hard at 56. I cannot imagine it in my 20s. I just went to see my 4th urologist surgeon. I was hoping by some miracle of medical science that my ed was being caused by something that could be fixed as a result of my fall. I went to several drs because I did not feel comfortable with the prior ones. I wanted information and all I got was rushing around and limited help. If my ed was caused by something fixable I would have entertained excision and grafting surgery after they took care of the ed.

Well today I found out I have great blood flow going in, but it is going out almost as fast. So ed and peyronies. My curve has gone from about  50 degrees to 35 over the past few months. The only thing I can attribute to it is either the pentox and or the traction. At about a 3/4 woody from trimix it was  about 5.5 inches. Here is where the fun starts. From the start of my issues over 2 years ago I had a about 7 inches. So I am down 1.5 so far.

As far as what dr. Told me. These are my options and only mine to deal with.

1. Do nothing except what I am doing now. Which pretty much means no sex. I have been active since i was 14 and am 56 now. Not an option for me. I would compare it to driving a Ferrari for years and now they hand you not a horse even but I get a mule. You can ride a mule but it is rough. They have a total mind of their own and sometimes will go and do what you want but odds are not so much. I had one spend all day in a horse trailer and would not come out. No matter what I did he would not budge. You wonder what to do to get that sucker to move. Same way I feel about my penis. What can I do to get it to move. Whatever I need to do.

So I take oral meds and maybe get a half erection not good enough for sex.

2. Take trimix. Hurts like crazy. Still only get about half hard. Not an option for me. Also I think it does cause peyronies. When I said that to the dr. Just looked down at his notes and said nothing.

3. Get the excision and grafting surgery. Again will not really help me with the ed so why put my penis through it if not necessary. Will still need ed meds and they do not work so good now and surgery will not help that.

4. Get an implant. I asked about both ams ams titan. Due to my curve the titan has stronger cylinders for correcting. They are stiffer, which can also be a negative but you deal with the best options you can.

5 .Next is finding the best dr. You can. Different post.

Being sexless is not my best option. Been that way for over 2 years. To long for me. My hats are off to anyone who can exercise that one. My life would have been a lot less complex if I could have done without sex. Tried at times cannot do it. Weak I guess. Wish everyone the best. Sorry for the long post but just got this news today and it really is not a decision I take lightly. Even with the insurance I figure my copay part is going to be around 5000. Not as much as some paid but a good chunk when you are retired. Best to all.

Will definitely be getting an implant around March. Not sure which dr. I will use. I like the new localer one but figure if I can work it out eid or Kramer would be my go to ones even with travel.





Dealt with ED, Peyronies, & venous leak for 3 yrs.
implant on March 7, 2019 w/ a Titan 18 cm plus 1cm RTE
Revision after hernia surgery. Dr. Andrew Todd, Richmond KY
Removed Titan and put in LGX 18 cm plus 2 RTE's, 20 cm total.

Frank55

Thanks for the honest post SW01. I think you are wise to avoid Trimix, and also think it is smart to keep shopping around for a competent urologist. If your ED diagnosis is definitive then you are making the right choice. Drs. Eid and Kramer both have excellent reputations - let us know who you decide upon.

By the way, agreed about the age impact of this disease. Not easy at any age but really tough for the younger men.  
Single and 58 yrs. old - first peyronies symptoms Fall 2015
Had grafting surgery by Franklin Kuehhas in June 2016 - complete failure
Borderline ED possible but not taking drugs, shots or using VED
Now evaluating options for next step

james1947

SW01

Your assessment fit many forum members, me also, so thank you for the post.

Regarding mules you are right also, but not in all the cases. When I was a kid we had a mule exactly as you are detailing, except with my mother that he never refused when she told him something. But it was because she was treating him like a human, same as she was treating our dog and cats :)

James  
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum