Tonys IPP revision surgery diary.

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TonySa

I thought I'd start a new thread for my revision surgery now scheduled for 2/11/20.

See my prior threads for original implant:
https://www.peyroniesforum.net/index.php/topic,10616.msg100640.html#msg100640
And:
https://www.peyroniesforum.net/index.php/topic,10764.50.html

1/13/20
-Met w Dr Karpman re implant deflating during intercourse and requiring additional pumps every 4-5 minutes.  We settled on a full revision rather than just the pump because everything I've read said if replacing any component, replace all.  He absolutely listens to his patients.
-He agreed w switching to the Titan.  One reason is I always thought the AMS should be stiffer, more rigid, for intercourse.  I am also happy that it's girthier and has a smaller (not squared off) pump.
-So I finally found out why he has the manufacture rep in the O.R.  It's because they have all sizes, models and components on hand (different operating dates for coloplast vs AMS).  I like this as I suspect not having the correct length is why some guys end up with 4 or more RTE's as the surgeon did not have the longer implant on hand.
-I'm now 18 cm + 3 RTE for a total of 21.  He expects I'll go up to 22 or higher.  Since Coloplast has 2cm increments in their sizes-it could maybe be 24cm.  I forgot to ask if he'll trim the base of the cylinders like Dr Eid does to eliminate RTE's.
-Will keep you the thread updated as I go along.

PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

melting

Maybe a stupid question but considering the impressive size, is this implant route a thing that people would do just for that without having a prior peyronies issue?
Daily Transdermals and Traction/VED solved my Peyronies Disease https://www.peyroniesforum.net/index.php/topic,12587.0.html (DMSO+X)

TonySa

Yes, if someone has ED, they qualify for an implant without peyronies. I had both so it was a clear choice.  
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

TonySa

Forgot to add, for about 3 weeks now I've been doing VED for an hour a day (being careful not to overpump) to stretch as much as possible before sizing during revision surgery.  Traction is recommended before implant surgery but don't think that can be comfortably done wnan implant in place, so going w VED.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Hawk

Quote from: melting on January 13, 2020, 06:03:29 PM
Maybe a stupid question but considering the impressive size, is this implant route a thing that people would do just for that without having a prior peyronies issue?

Do you mean would a fully functional male opt for an implant because of size??  If so the answer is no.  The implant is matched to the optimal size of your penis,  You might regain some size.  If it is for ED and you never lost size you might even gain 1/4 inch over your natural size although Dr. Eid dismisses that (some of his patients swear it is true.)  No one would ever implant a functional penis for enlargement.
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

Hawk

Tony, I am almost certain the Titan 24 cm steps up in girth but the Titan 20 cm is already more girthy than the AMS.

Depending on your girth that might be a plus.  If you have a 5' - 5.5" I am not sure it makes any difference.  My guess is that he will not trim the base, however.  
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

TonySa

Yea, I read the girth is maximized w the Titan 22cm.  My original girth was more than I have the AMS, so I'm looking forward to the Titan (also because I still have some hourglassing at the site of the graft).
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Hawk

Tony, look at the Titan size chart again.  I am almost sure I recall the 24 CM Titan has a girth increase over the 22 CM titan.  I could be wrong
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

TonySa

PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Hawk

I hope your implant is bigger than that graphic.  It was microscopic :)  Too small to see ANYTHING
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

TonySa

Ha!  Changed link w pic of good size.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

SW01

Good luck. Looks like I am just starting down this road. Will see over the next weeks ahead after urology appt.

I also will start back with ved to keep my gains if it looks like they need to do a total redo. Right now I hope it could be reservoir migration ssue related to messed up stomache issues from long ago surgery. I am shooting for 20 cm posiible If i need new cylinders, keeping my titan. I like it and the pump.

Like I always said. If it messes up getting this thing fixed asap.

Such a pain.  
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.

TonySa

Surgery is tomorrow.  General anasthesia always makes me nervous...  I'll update after surgery.  
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

curved

51 yrs old; diagnosed 3.5 yrs ago; 90 degree upward bend
But I had no ED
tried all pills, VED, traction, Xiaflex PRP, ESWT, H-100 & stem cells; IF diet. implant surgery with Dr. Eid 3/28/19
to correct deformity - 20 CM Titan 2cm RTE / 1 cm RTE

Larry

Quote from: melting on January 13, 2020, 06:03:29 PM
Maybe a stupid question but considering the impressive size, is this implant route a thing that people would do just for that without having a prior peyronies issue?

There was a porn star on FT a while back and he wanted a IPP because he would be like energizer bunny... Basically he was told that it was for Peyronies or ED and no credible physician would implant a perfectly healthy penis.  So you might find a surgeon willing to do it for a price but don't be surprised if when you get a cold your dick gets post nasal drip. :) :D :)
54, 3 Botched Circumcisions, 3 botched Reconstructive Surgeries. 2021, my heroes - Dr's Brock, Richards and Gan... all highly respected international professors. AMS LGX 18 cm implant & Tummy Tuck March 2021.

TonySa

I wanted a baseline, so This morning before surgery bone pressed inflated was 6.75".
Surgery was late am.  Dr Karpman removed 15 cm # 3-1cm Rte AMS CX.  He installed 22 cm + 1cm Rte Titan.
I thought this surgery recovery would be a breeze compared to my original excision, grafting and implant.  However the pain (left pumped up) was way much worse.  He thinks the wider girth Titan is stretching the previous capsule and the price to pay for increasing girth and strength.
It's just crazy how the pain can be different for everyone, or different for the same person 17mos later w a slightly diff procedure.
Tons of pain meds today (overnight in hosp) but still can't sleep.
I'm sure like last time, I'll eventually be quite happy with it.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Pfract

Wow Tony! Such a nice increase on the implant size! So curious to see what you think of the differences between the two devices...  Hang in there pain wise. You got this! 😎

TonySa

Day 2: Bandages off, catheter and drain pulled. Doc said begin cycling as soon and as long as possible.  
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

TonySa

Day 3.  Back home.  Deflated last night and reinflated this morning.  Girth improves but may be inflammation post surgery.  Initial length less than pre-op so will keep cycling.  Pain is completely manageable.  Pump bulb vibrates after squeeze in prep for next squeeze.  Is this common w Titans?
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Pfract

Can't help you with that tony. Hoping master Hawk chimes in anytime soon!

Stepone

Tony, I get a vibration sometimes when inflating. I can never figure it out, why sometimes and not others. But I do think its where I position my fingers on the pump.
Nesbit surgery 2015, 66 years young, Titan Implant 4/25/19, 22cm, Dr. Lentz, Duke University NC

TonySa

Thxs, mine vibrates after each squeeze.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Stepone

I found this on FT.......

https://www.FT/phpBB3/viewtopic.php?t=6871

By the way, sometimes my squeaks too.

But I don't care. LOL
Nesbit surgery 2015, 66 years young, Titan Implant 4/25/19, 22cm, Dr. Lentz, Duke University NC

Roddy

Wow Tony - just catching up with this now. Can totally empathise with your pain. Best advice is to keep ahead of the pain with strong painkillers so it doesn't become an issue for you. Glad it's loosened off a bit. Interesting to read your updates as you go with the differences between the implants. Keep us posted and best of luck.  
Aged 51 congenital curvature and then Peyronies onset, excision and grafting not successful,
Coloplast Titan implant on June 3rd, 2019 (aged 47) to correct a 90 degree bend
Dr. Mike Fraser - Glasgow, Scotland.

TonySa

Day 4 and no pain pills needed since yesterday am.  Tylenol and ibuprofen is sufficient.  Don't mind if the pump vibrates just want to be sure it's not defective.  
First difference I've noticed is when deflated the cylinders feel more obvious and crinkle when squeezed w the Titan unlike the AMS.  I think this is because their larger around (girth).  Not a problem, just an observation.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Stepone

Tony, right on with the obvious feelings of the cylinders. Hawk says they soften slightly over time. Mine have softened some and I am 10 months in. But the rigidity of the Titan is great, and I am sure you can agree to that. Are you pumping to max? Also have you noticed an increased girth? I had an indentation from a previous surgery and when pumped, it is completely gone.
I am amazed at the low pain. I guess it's true "revision" surgery is easier on the patient.
Best wishes.
Nesbit surgery 2015, 66 years young, Titan Implant 4/25/19, 22cm, Dr. Lentz, Duke University NC

TonySa

Certainly increased girth, but still swollen from surgery.  Yes, I'm pumping to max as well.  
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Pfract

Hey Tony! Thanks for sharing the picture with us. I presume you still have old ones lying around from your first implant a month or two after surgery? It would be so cool to put the two pictures side by side for a comparison with a text description.... But I am patient... I can wait! :D

Are there any changes to your erect angle, now that you have more inflatable part of the implant and less RTE's or barely none?  

TonySa

I think it's a slightly somewhat higher angle now.  Lots of other pics in my other diary.  
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Hawk

Tony, you did a preop bone pressed measurement and mentioned length.  Did you measure girth at that time?
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

TonySa

No, meant to do it but couldn't find the cloth tape.  I think I might have an earlier measurement I can look up.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Larry

Quote from: pfract on February 14, 2020, 11:43:22 PM
I presume you still have old ones lying around from your first implant a month or two after surgery? It would be so cool to put the two pictures side by side for a comparison with a text description

Or even pictures before ANY, then after 1st surgery and finally now.

Larry
54, 3 Botched Circumcisions, 3 botched Reconstructive Surgeries. 2021, my heroes - Dr's Brock, Richards and Gan... all highly respected international professors. AMS LGX 18 cm implant & Tummy Tuck March 2021.

TonySa

Tomorrow is day 9 and I'm feeling good to go back to work.  Except for the first 24 hours this recovery was much easier than the first excision, graft and implant.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Stepone

Thanks for the update. It's nice to know that if we need a revision, it's not as bad as first one. Thanks for sharing and I can't wait to hear how you compare the new model to the old.  
Nesbit surgery 2015, 66 years young, Titan Implant 4/25/19, 22cm, Dr. Lentz, Duke University NC

TonySa

Back to work yesterday after one week.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Roddy

Tony, after the length of my recovery from my implant last year, I cannot believe you are back at work within 9 days!! That is unbelievable. Are you generally super-human? Incredible recovery ...
Aged 51 congenital curvature and then Peyronies onset, excision and grafting not successful,
Coloplast Titan implant on June 3rd, 2019 (aged 47) to correct a 90 degree bend
Dr. Mike Fraser - Glasgow, Scotland.

TonySa

LOL, actually overdid it ... by this afternoon had shooting pains in penis, so just stayed sitting at desk rather than walking around and it let up.  Hubby says I'm looking pale...may take the rest of the week off 🙃
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

TonySa

Seems like for revision the incision is twice as long...ordered something gel scar strips as it's quite a raised scar.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Larry

Quote from: TonySa on February 19, 2020, 11:26:17 PMmay take the rest of the week off 🙃

OK, Tony (and everybody) Just out of curiosity, what did you tell work you were taking surgery time off for?

Larry
54, 3 Botched Circumcisions, 3 botched Reconstructive Surgeries. 2021, my heroes - Dr's Brock, Richards and Gan... all highly respected international professors. AMS LGX 18 cm implant & Tummy Tuck March 2021.

TonySa

"Old man Urology concerns". Those who inquired for more info for my first surgery I explained I had peyronies.  This  time I Said it was a f/u re-do.  With 3 close friends (2guys, 1 gal) I went into all the details including implants.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

samsung

You're a brave man. If any of my friends knew I would have to bury them immediately;)
45 y.o. Single. Onset of symptoms (pain-stinging like a wasp) @ 6/2018. No sudden injury. Curve developed slowly. 40 deg. dorsal. Hourglassing. Torsion to left flaccid. 4 rounds xiaflex. Restorex, DMSO+, heat, arginine, cialis, lipoic acid, vit. K2

TonySa

Lol, just recounted...st least 4 guys and 2 gals know about implant.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Stepone

Thanks Tony
Since we are confessing on who we have told.
I have told 4 women and 6 guys.
And when my church asked me why I was going to be out, as I have responsibilities in the church, I told them it was one of those "guy urological surgeries". I sometimes received a follow up question if it was cancer. I would respond no, and I guess the all thought prostate, because no more questions.
When I used the same line with my male and female friends, they all asked what kind of surgery and when I told them, they hadn't heard of implants for the penis, so they had lots of questions.

Nesbit surgery 2015, 66 years young, Titan Implant 4/25/19, 22cm, Dr. Lentz, Duke University NC

TonySa

Is the Titan truly one touch (squeeze) or do guys find multiple squeezes is best?
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Stepone

Since we are all different, let me share my experience.

When I deflate, I have to hold the deflate button, and apply pressure to completely deflate the penis. Sometimes I will think I have deflated all the way and when I give the bulb a squeeze, its too easy to squeeze and I know I have not fully deflated. If I don't fully deflate, my penis will gradually refill to a small chubby.

When I know I am fully deflated, the bulb will be tight. I then have to give a small squeeze to the bulb. If I don't, the fluid gradually inflates my penis to a small chubby. It never fully inflates, but it will inflate somewhat.

This is confusing for sure, it's really about feeling your penis and the cylinders. Some days, I am more successful than not. I know not everyone has this issue, but it is a small price to pay for 100% guaranteed sex every time.

I joke sometimes to myself, if this implant was a car, I would take it to the shop and have it looked at, but my physician doesn't seem to be concerned when I emailed him, so I am good.

StepOne
Nesbit surgery 2015, 66 years young, Titan Implant 4/25/19, 22cm, Dr. Lentz, Duke University NC

TonySa

Thxs, I see my doc today for first f/u, so he can show me.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

TonySa

Saw doc for 2 week f/u.  Cleared for sex next Tuesday 😎.  I'm very happy w the implant and feel the Titans a better fit for me.  Will take some pics soon.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Stepone

Tony, gosh, this was a fast recovery.

So the theory seems to be correct and that revisions are quicker to heal from.
Good luck with your new "toy".

Thanks for sharing, it makes us all hopeful that if we need a revision, we don't have to freak out.

StepOne
Nesbit surgery 2015, 66 years young, Titan Implant 4/25/19, 22cm, Dr. Lentz, Duke University NC

Hawk

Quote from: Stepone on February 24, 2020, 04:32:07 PM
Tony, gosh, this was a fast recovery.

That's 3 weeks which is the standard recovery time for Dr. Eid
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

Hawk

On the one-touch.  I think Stepone was using the term "totally deflated" incorrectly.  I think he meant sometimes he thinks his deflate valve is locked open and it isn't.  

You can tell if you got the deflate valve totally locked open either of two ways.
1. Turn loose of the valve and squeeze your penis.  If it deflates with your hand off of the valve then it is locked open.
2. Give the bulb a squeeze like you are going to start pumping fluid into the cylinders.  If it was locked open that first squeeze is hard because it has to flip the valve.  If you can give a little pump with only normal effort then it was not locked open.

If you read my journal and others you will find that MANY men cannot lock that valve open in the beginning.  They have to depress it and since it is not pushed far enough to lock open they have to hold the valve while squeezing the penis.  It was months before I ever got it to lock.  Some guys never get it and some get in in the first few weeks of cycling.  
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