Implant replacement surgery in November

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tshug

I visited with Dr Kramer today to get his opinion on my penile implant which was put in last year. I had visited Dr Eid earlier this year to get his opinion also. Dr Kramer agreed with Dr Eid that my implant cylinders were greatly undersized and that a replacement would be necessary to fix the problem where the head droops when inflated.

Dr Eid's thought was to replace the CX with a Titan. Dr Kramer would prefer to go with the AMS CX or LGX. Dr Kramer feels that since I already have a AMS AUS for incontinence that staying with the AMS product would be safer given that the AMS implants also have InhibiZone Antibiotic Surface Treatment. He also feels that the dog ears when relaxed are larger on the Titan than either AMS implant and could potentially cause irritation to the cuff used on the AUS.

With either Dr Eid or Kramer I know I would be in good hands given the amount of implant surgeries both have done. Since Dr Kramer now practices near where I live I will be scheduling surgery with him for sometime in November this year.  
71 Yrs old
Radical prostatectomy in 2017.
That surgery left me incontinent
2018  implanted AUS 800 artificial Urinary Sphincter
ED & Peyronies
AMS CX Penile Implant Surgery 12/16/2020
Revision- CX replaced with a Titan 20cm + 1 rte 10/26/21 Dr Eid

Hawk

Then between the two I would push for the LGX since it will give you a more natural flaccid and potentially some length gain over time.

I have to say that Inhibizone is hype.  Titan has a hydrophilic coating on all surfaces that bonds to the antibiotic coating of the surgeons choice.  There is NO difference in the infection rate between the two implants.

I would have also thought the smaller pump of the Titan would be more compatible since you have one scrotal pump.

At any rate, I'm sure you will be very happy with the outcome.
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

pichou

tshug,

I found your posting interesting. As you know, I'm having implant surgery with Dr. Kramer on 7/19 and he recommended that I have the Titan. I also have Peyronies and he said because of my length and girth he would go with the Titan. I think it shows that he recommends what he thinks is the best implant for the individual person. Which is a great thing.

20 years Peyronies Disease, tried VED, pills, Trimix & more
ED 15 years.
Hour Glass at base 30 bend left at glans
Penile Implant 7/19/21 Dr. Andrew Kramer
Penoscrotal approach
AMS CX 18cm 2CM RTE

tshug

After going back and forth on which doctor I will have do my replacement I've decided to go with Dr Eid. I've met with both doctors but feel more comfortable with Dr Eid. Both doctors are highly regarded, but Dr Kramer is now pretty much exclusively using the AMS CX and LGX implants and would be replacing mine with another CX. Dr Eid will be using a Titan for my replacement. My surgery will be on 10/26/21.

I would have preferred the Titan for my original implant, but my surgeon used the CX and sized the cylinder length wrong as well. With all the surgeries I've had I've lost a lot of size and with the CX I lost a little more. I think I'll be happier with the Titan since it's cylinders are larger than the CX. Already having a AUS artificial sphincter pump in my scrotum I also would prefer the smaller pump that the Titan has so it's not as crowded down there!

I'll be happy when this is all behind me  
71 Yrs old
Radical prostatectomy in 2017.
That surgery left me incontinent
2018  implanted AUS 800 artificial Urinary Sphincter
ED & Peyronies
AMS CX Penile Implant Surgery 12/16/2020
Revision- CX replaced with a Titan 20cm + 1 rte 10/26/21 Dr Eid

Pfract

Hey Tshug.

It is nice to know that you are on track to have your revision surgery after what happened to you. Curious about what you said regarding Dr. Kramer and he "almost exclusively only using AMS". I remember reading propublica website on Dr. contributions and he in fact used a lot of AMS products but had Coloplast implants here and there as he showed on his videos. I wonder what changed?

also in regards to your size loss, have you considered using the vacuum pump to regain some size? There is a protocol that you can follow which is very well known, when it comes to an upcoming IPP surgery and it may be of interest to you. Let me know if you want me to drop the link.

tshug

Pfract, my comments on Dr Kramer using AMS were based on my talks with him. He would not even discuss using a Titan only that they have had some recalls. Another contributor on this forum also recently had a CX implanted when he thought that going into the surgery he would be getting a Titan. He told him after the surgery that he is now using AMS most often. Dr Kramer is now practicing out of a medical group here in Massachusetts, I'm not sure if that's part of the reason behind the change.

Dr Eid discussed both AMS and Titan with me and feels the Titan will be best for me. He is not aware of any recalls on the Titan and I haven't found anything online either. Dr Eid has also been working with AMS on a redesign of the cylinders for the AMS.

Thanks for the offer for information on the vacuum pump, but at this time I don't want to try anything new prior to my surgery.
71 Yrs old
Radical prostatectomy in 2017.
That surgery left me incontinent
2018  implanted AUS 800 artificial Urinary Sphincter
ED & Peyronies
AMS CX Penile Implant Surgery 12/16/2020
Revision- CX replaced with a Titan 20cm + 1 rte 10/26/21 Dr Eid

Hawk

If Dr. Eid is not aware of any recalls, then there simply could not be any recalls.  I was VERY suspicious of the recall statement even before reading your comment about Dr. Eid.

My guess is that either Dr. Kramer or the practice is getting a kickback from the manufacture (not uncommon).  Dr. Kramer had a video online making an extensive comparison to AMS and Coloplast implants, concluding it was a toss-up.  He started with mostly Coloplast and Titans. After that, he gravitated to AMS but still did Titan occasionally.  Since he changed practices, he suddenly seems hardcore AMS (which is really Boston Scientific now).  He is using arguments like an infection which he dismissed as "the same" in his comparison video. This is a total change after doing implants for decades. That video seems to now be missing. Now he is mentioning recall when the current Titan has been the same for a decade ???

If he were going to dismiss Titan, you would think he would use one of its known disadvantages, such as the pump taking a little more dexterity and/or strength or the tubing being the common first thing to fail.  AMS cylinders or pumps usually go first.  As it is, I am concerned that his comments are not totally forthcoming.  I could respect a doctor who said, "There are some academic differences, but these are equal products.  I implanted many of both but now use AMS exclusively because our cost is determined by the volume we use, and the cost difference is significant for an equal implant."

I am very busy at the moment with forums and personal issues but I intend to contact Dr. Kramer and attempt to have a frank conversation with him.
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

LightAtTheEndOfTheTunnel

Hey Hawk,

First of all thank you so much for all you do and creating this platform. I've been on this forum for over 4 years and not once did I click on the implant section. I could never even have wrapped my head around the possibility of getting an implant when this nightmare started. I was 29 when it first stared and I'm 33 now. Even if you asked me a couple weeks ago it wasn't even a thought in my head.

I've tried everything. Pills, Restore-X, VED, on and on. Nothing has worked. I can still get good erections but they don't last long. My penis is straight and I haven't lost much length if any but I have significant narrowing, hourglassing & dents. So I can have sex, but only in certain positions. Any position when the girl is in control is painful and scary. I'm petrified that my penis will fracture due to the instability caused by the narrowing. It's like.... even though I'm hard the areas with the scar tissue are still just soft and rubbery. And once I finish.... I'm finished. Absolutely no possibility of a round 2. My penis is a painful dented mess for hours and sometimes days after sex or masturbation. And the worst part of all the pain. 4 years of non-stop painful erections. I finally reached my breaking point a couple weeks ago. I was in bed for days, seriously depressed and suicidal. Not that I want to die, it's just that thought that constantly runs through my mind of "there is no hope" and "i'll never be able to really please a woman or have good sex again". The reviews on plication and grafting are mixed at best, I have no desire to waste anymore of my youth trying one of those surgeries with zero guarantee things will get better.

But a couple weeks back I was browsing the forum late at night as I've done constantly over the past 4 years searching for any sort of answer to my problems and the implant forum just happened to catch my eye. I clicked on it and ended up reading for hours. For the first time in what seems like a lifetime I genuinely felt a sense of hope and optimism. The way Hawk and so many others described their experience as life changing having finally gotten their sex life back made me so happy and hopeful for my own future. I then saw the glowing reviews about Dr. Kramer and dug a little deeper. I was thrilled to find out he was now working for a practice in Massachusetts because that's where I reside also. So I checked to see if he accepted my insurance and he does. I was beyond ecstatic and felt like at the very least I had an option to get my life back on track. Then I read this post and got extremely discouraged again. I just had a couple questions I was hoping you might be able to answer. If they are elsewhere on the forum already then I apologize.

Would you still recommend Dr. Kramer knowing that he is using exclusively the AMS? I was really hoping to get the Titan after all the positive things I've read. I know Dr. Kramer is a top notch surgeon, I'm not questioning that.... but my main issue and concern is my girth. I was very thin before peyronies hit and now I'm even thinner, like somewhere in the 4inch range. I read that the Titan is the best in terms of adding girth and I need that desperately. And it's more rigid which I also need badly due to the instability of my erection. I also saw several members say the pump is smaller and more rounded on the Titan and that most prefer it over the AMS. I already have large saggy nutsack due to a vericocele so the last thing I want is a larger more unnatural looking/feeling pump. I could care less what my flaccid looks like honestly. I really want to add girth and have a pump that isn't so obvious so that I can have the confident to start having great sex again.

Just wanted to get your thoughts. Obviously if the choices are stay how I am now or get the AMS i would choose the AMS. I know beggars can't be choosers but I just wanted to voice my hangups and concerns after reading he's only using AMS exclusively. Getting the opinion of men who've had this procedure done already is invaluable. And as much as I'd love to go with Dr. Eid paying out of pocket just isn't an option for me unfortunately. Much appreciate any and all feedback, thanks!!

tomas1

Obviously, I'm no expert, but I'm not sure a Titan will give you the girth you seem to want.
Since your penis is straight, the AMS CX may not be all that bad for you.
It should also attempt to increase your girth issue.

There's nothing I can say about the blocky pump, but having a roomy sack similar to what I have hasn't presented a problem.
I know that a partner who explores there will notice either pump.
I've heard, but don't know for sure, that AMS pumps may be more durable long term.

Good luck with all this, and I believe you're on the right path to overcome this problem.
85 years old.
Implanted 01/22/19 by Dr Avila.
18cm AMS 700 CX, 3.5cm RTE 100cc reservoir
Diagnosed with Gleason  6 prostate cancer.
Monitoring it for now.

GaussRifle

Ih8peyronies,

We understand your point. But this is not the right place to ask about yourself, it is considered as topic stealing to ask about yourself on someone else's topic. If you'd like your questions answered, please start a new topic in the implant board, give your background and repeat what you stated here. You can use that topic for us to address throughout your journey from beginning to end and we'll be more than happy to answer.
26 year old
45-50 degree downward curve with an indentation on one side when erect.
Using RestoreX and Xiaflex injections
Taking coq10 with daily Cialis 5mg.

tshug

Ih8peyronies,

I understand your concerns about which implant is best for you. I to was thrilled to see that Dr Kramer is now practicing in MA. I met with him and was going to schedule my replacement with him based the meeting with him and the positive reviews I've seen on this site and the short commute to  where he is practicing now. After much thought and another virtual meeting with Dr Eid my wife and I decided that even though both doctors are highly rated we felt more comfortable talking with Dr Eid and feel I'll get better results this time with Dr Eid and a Titan.

I'm fortunate that my insurance covers both doctors and I could make a choice. I think you would be in good hands if you decide to go with Dr Kramer and have an AMS implant. For me having an Artificial Sphincter pump already I'm hoping that the smaller pump on the Titan will help make for more room and comfort in my sack. One thing for sure is I know Dr Eid will size the cylinders right this time not like the surgeon who put in the AMS CX I have now. If not for the wrong sizing I would not be going through another operation so soon and would have been ok with the CX.
71 Yrs old
Radical prostatectomy in 2017.
That surgery left me incontinent
2018  implanted AUS 800 artificial Urinary Sphincter
ED & Peyronies
AMS CX Penile Implant Surgery 12/16/2020
Revision- CX replaced with a Titan 20cm + 1 rte 10/26/21 Dr Eid

Hawk

Tshug, you will be in excellent hands with a surgeon so accessible it is astounding.  

When he goes it will be a huge loss.

Be sure to keep up well updated on your progress.
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

tshug

Thanks Hawk. It will be a huge loss when Dr Eid retires. I have my pre-op appt at Dr Eid's office this Thursday and the surgery will be on 10/26. I'll post the results of the surgery and recovery as I go through the recovery process.
71 Yrs old
Radical prostatectomy in 2017.
That surgery left me incontinent
2018  implanted AUS 800 artificial Urinary Sphincter
ED & Peyronies
AMS CX Penile Implant Surgery 12/16/2020
Revision- CX replaced with a Titan 20cm + 1 rte 10/26/21 Dr Eid

Hawk

Please do.  we want to know all is well with you and it will be a vital piece of experience and information for other members and lurkers.
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