AverageBloke's Implant Journal

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AverageBloke

Hi All,

Over the past year, my Peyronie's has been progressively worsening and affecting my erectile function. My Peyronie's symptoms are curvature, girth loss, narrowing and pain. I have decided to get a penile implant in order to stop this downward cycle of atrophy.

I have my penile implant surgery scheduled for the 6th of April 2022 with Dr Clavell in Houston, Texas.

Dr Clavell is a high volume implant surgeon who also specialises in Peyronie's Disease. He performs the no touch technique using a vertical penoscrotal incision. He can also do relief incisions, modelling & the scratch technique for people who suffer from Peyronie's in order to straighten the penis and regain lost length/girth. Dr Clavell requires his patients stay semi-inflated for the first 4-6 weeks after surgery.

You can watch some of his videos on his YouTube channel: https://www.youtube.com/c/clavelluro

I will provide updates and share my experiences throughout this journal. I welcome everyone to contribute in order to teach myself and others about a penile implant.

Thanks,
AverageBloke
Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

Hawk

Good luck to you in your procedure, AverageBloke. You will, of course, have one of the most valuable journals on the internet for other young men. I hope you keep a thorough journal and keep us updated for years into the future. So many thousands of young men will thank you.

Do you live in the U.S., or are you traveling from overseas to get this 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

AverageBloke

Hey Hawk,

I will be travelling from Australia to get this surgery. A 20 hour flight back home with a semi-inflated penis is going to be tough. I will ask the doc on how to best manage it.
Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

Hawk

If you are flying to the US, have you considered Dr. Eid?  Probably no one on the planet has done as many implants will all success stories on this forum.
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

AverageBloke

Hawk,

I've spoken to Dr Eid, Dr Hakky & Dr Clavell. Ultimately, I decided to go with Dr Clavell.

The reason for this is because Dr Eid does not do any modelling, scratch technique or relief incisions. He told me he would only place an implant and is unable to fix my twist or get me straight as an arrow. He said I would end up with 10 degrees or less. Dr Hakky was booked out for a couple months in advance.

Dr Clavell specialises in Peyronie's and is a high volume implant surgeon. He told me he could get me straight as an arrow and do any extra work during my surgery to my plaques/scar tissue if needed.
Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

Hawk

Interesting because Dr. Eid has several videos on remodeling, and per conversation (I was awake during surgery) and surgical notes, he did make relief incisions on my left base of the shaft to get me totally straight both in tilt and remove all signs of a significant dent. The notes say on first inflation, I had about a 10-degree tilt he was unsatisfied with, so he made the relief incisions. He straightened men on this forum with greater than 45-degree bends and has a video straightening a man with greater than a 180-degree bend.

However, I am confident you did your due diligence, and I am sure you will be happy with your decision.

Be sure to keep us updated. I am happy for you.
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

GaussRifle

All the best AverageBloke, we are rooting and praying for you :)  
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.

RichardWilson99

Best of luck friend! My advice, try to get business class on your flight back (if you can afford it obviously).  Or see if you can somehow spend more time in the US before travelling back. Reasons being:

A) you probably will have some of the usual worries everyone seems to have after an implant
B) You'll give yourself more time to learn how to handle a long flight back.

You're going to come back to Australia a new man! Best of luck!
31/Single
Injury Nov 2019, bend 15deg, loss of erections, dent and hard-flaccid
VED, cialis 5mg on/off
EQ medium (with pills), no NTE.  Lost 1+ inches length, lots in girth. Some loss of sensation. Considering implant to restore full sexual function

Hawk

Quote from: RichardWilson99 on April 02, 2022, 02:50:26 AM

You're going to come back to Australia a new man! Best of luck!

8)  I think it is more accurate to say you will become a new man AFTER you return to Australia.   :)

I also think you should hang out in the U.S. for at least 10 days.  I would ask Your Dr if he would teach you to inflate and deflate so you can deflate for that flight.  I cycled 3 days after surgery.  A week from surgery you should be able to deflate and partially inflate for something as grueling as that flight.

Best wishes !!!
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

AverageBloke

Day 1 & 2 Update

I am officially a bionic male. I had my surgery done yesterday the HCA Medical Center in Houston, Texas. The hospital was world class along with the nurses and doctors. They are very welcoming, comforting and understanding. They helped me throughout the entire process. I was given three nurses, a pre-op, an op nurse and a post op nurse. My pre-op nurse took me to my room and prepared me for surgery. I was dressed in my hospital gown and then transported on a bed to the surgery waiting area. I met my op nurse, the anaesthesiologist and Dr Clavell. I had a conversation with all of them and was ready to go. The anaesthesiologist went through a screening process to ensure I could undergo anaesthesia. They then inserted some fluid into my IV bag and I was completely knocked out.

After surgery I woke up in my post-op room along with a post op nurse to help me. I was given some juice and crackers to eat. Dr Clavell came to see me and said the surgery went very well. The post op nurse waited with me till my anaesthesia wore off and I was able to pee. I walked around the post room for at least half an hour to gather myself and change back into some loose fitting clothes. I was then given a package by the nurse from the doctor. It was a Coloplast information package along with a sample pump. I also received some post op instructions. The post op nurse escorted me out of the hospital in a wheelchair to my Uber.

Once I got back to my apartment, Dr Clavell contacted me and we went through all the details. I measured 22cm and 21.5cm on each side. He inserted a 22cm Titan OTR with no RTE's. I was very happy with the result. He said the surgery went well and I should be able to deflate in 4-6 weeks. I'm going to try aim for three weeks. I've decided to stay in Houston until I'm able to deflate. I can not imagine flying back to Australia with 60-70% inflation.

Prior to the surgery, me and Dr Clavell had a lengthy discussion on how he was going to do the procedure. Since my case had curvature, narrowing and torsion. I wanted to know exactly how he was going to fix all of that. When I spoke to Dr Eid he said there was no way to fix the clockwise rotational torsion, he would only place an implant and lessen the curve. Dr Eid said that in his experience the torsion never goes away with an implant.

Dr Clavell suggested that we use a small plication at the left base to fix the torsion which would only shorten my penis by a quarter of an inch. I trusted his expert opinion because he deals with all complex Peyronie's cases which Dr Eid does not like to do extra work on.

What do you know? Dr Clavell fixed all my issues and the penis does not look smaller at all. If anything it is probably 1cm shorter due to the plication but this will come back with time through cycling.

Dr Clavell is truly a World Class Surgeon and I recommend him for anyone with complex Peyronie's cases. The surgery and hospital costed me 20k USD altogether. In comparison to Dr Eid who quoted me a much higher price and could not fix the torsion. I still respect Dr Eid as a world class surgeon but he does not like to do extra work, he only likes to place implants. So if you have Peyronie's I ultimately recommend you go see Dr Clavell. He is very understanding and goes through all the benefits and risks. He is capable of doing full penile reconstructions, relief incisions, grafting, modelling, scratch technique and plication.

I asked Dr Clavell to place my pump behind my balls and tubing deep in my scrotum. I also asked him to bury the reservoir as deep as possible and I'm very happy with the placement.

The pictures speak for themselves.

Before Surgery Picture #1: https://ibb.co/CwDJcHv

Before Surgery Picture #2: https://ibb.co/j87tSv2

After Surgery Picture #1: https://ibb.co/nmVWmXC

After Surgery Picture #2: https://ibb.co/my961S4

Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

Hawk

Congratulations on your implant.  I look forward to your updates.  

Did you have a catheter?

Did he elaborate on why he keeps you inflated instead of early 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

AverageBloke

Quote from: Hawk on April 07, 2022, 04:34:00 PM
Congratulations on your implant.  I look forward to your updates.  

Did you have a catheter?

Did he elaborate on why he keeps you inflated instead of early cycling?

No catheter, I could pee immediately after surgery. Dr Clavell does not use them. I have no burning sensation at all as a result. I actually feel very good.

Dr Clavell keeps all his patients inflated for 4-6 weeks after surgery. He said he has not had a problem with over 500 patients doing it this way. I told him about Dr Eid's early cycling method and he was well aware of it. He doesn't believe in Dr Eid's method of cycling from Day 3 because it will only cause pain and discomfort. I believe this because I really do not see myself cycling at Day 3.

Dr Clavell explained I will regain all of my size through cycling regardless. He also explained that the scar capsules take months to form and I should not be worried about this theory. I expressed concerns about auto-inflation and he said that the implant has a lock valve which prevents this.
Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

Hawk

The pump indeed has a lock valve, but it is also very true that auto inflation is a significant complaint because that lock valve does fail against significant back-pressure.  It is more effective for the typical pressure of gravity on a full reservoir.  The other reason for early cycling is, of course, so the penis gets a 100% pump starting at day three and to avoid the major annoyance (and expense) of a 4 - 6 week erection that limits travel and work.

I am sure, however, that the outcome in a year will be the same, just with different trade-offs.

You are on your way to an amazing transformation

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

AverageBloke

Quote from: Hawk on April 07, 2022, 05:07:24 PM
The pump indeed has a lock valve, but it is also very true that auto inflation is a significant complaint because that lock valve does fail against significant back-pressure.  It is more effective for the typical pressure of gravity on a full reservoir.  The other reason for early cycling is, of course, so the penis gets a 100% pump starting at day three and to avoid the major annoyance (and expense) of a 4 - 6 week erection that limits travel and work.

I am sure, however, that the outcome in a year will be the same, just with different trade-offs.

You are on your way to an amazing transformation

Thanks Hawk.

I read from your journal and Merrix's that you guys also experienced auto inflation early on. Did this go away for you? Do you press the inflate button once to lock the valve after deflating?

I'm aiming to deflate at 3 weeks but might leave it until the fourth week. The only reason is because the doctor also performed plication sutures to fix my torsion and I want to let them heal.
Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

Hawk

Definitely follow his instructions.  

Yes, I do pump once after deflating. That is supposed to put an extra lock against backflow, and it takes care of that one extra-firm first pump. Although responses vary widely, I suspect you will find that even locking the pump open to deflate is a challenge in the beginning. The trademark term "One-Touch" is a joke. You will likely have to hold the pump deflate button with one hand while squeezing the penis with the other, at least in the beginning (and I have agile hands with far more than average grip. After months it started working about 50% of the time. Now it is easy since the pump is broken in. A few NEVER get it, and a few have a pump that works from the beginning. The majority are in the middle.

It is not a huge issue if it takes two hands. It just irked me. I even tried pressing on the pump button with solid objects to get it to lock. I considered pliers with padding but never went that far. :)
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

AverageBloke

Day 3 & 4 Update

Was given the all clear to take my bandages off after 48 hours and have a shower. I have some bruising near the bottom of my shaft but the doc said it all looks normal. I've been having pain which I'm managing with Tylenol. It really is uncomfortable having an erect penis all day but I'll have to just tough it out for four weeks. I can definitely feel the implant already stretching my penis.

At the moment I'm just relaxing in my hotel room doing some work on my laptop, watching tv and laying in bed. I do walk around the apartment and clean sometimes to get exercise.

I feel some discomfort around the reservoir in my abdomen/pelvic area especially when I sneeze. Yesterday I tried stifling my sneeze and it gave me even more reservoir discomfort. I read online stifling your sneeze causes the internal pressure to increase by 5-20x. Do you guys think I caused any damage to my implant or reservoir by stifling my sneeze? Or am I just being paranoid?

Also here is an updated photo with no bandages:

https://ibb.co/gjzHC5J
Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

Hawk

Quote from: AverageBloke on April 10, 2022, 12:43:08 PM
Day 3 & 4 Update
Do you guys think I caused any damage to my implant or reservoir by stifling my sneeze? Or am I just being paranoid?  

NO chance, especially with your reservoir mostly empty.  You know doubt caused some pain in the surgical zone but the actual reservoir can sustain a kick with no damage so there is not much to damage.
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

AverageBloke

Awesome thank you Hawk. I really appreciate you providing your implant knowledge and experience.

On another note, I was having a bowel movement on the toilet today and I couldn't help myself but start passing urine with my erect penis. I pissed all over the bathroom floor and then tightened my pelvic floor muscles to stop my urine flow. I don't know what the correct term for this is but I'm sure you would have done it at some point in your life. Pee and then rapidly stop peeing.

After this, I felt some pain in the reservoir/abdomen area. Could this have caused reservoir migration or anything harmful?

Thanks,
AverageBloke
Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

morphball

Glad your surgery went well mate! Looking forward to hearing more progress! Seeing your pics already makes me want to take the plunge for an implant. But multiple urologists have told me it's too early for one considering I'm only 32. But I've got 10 years on you! Did the doctor talk to you at all about the number of revisions you'd have to have in your lifetime?
Age: 33
Suspected injury July 2020. Initial downward curve, now significant girth and length loss.
800+ hours with RestoreX. Some VED.
Have tried all oral medications and supplements.
Booked for an implant and TEP 3rd October with Dr Christopher Love

Pfract

Quote
No catheter, I could pee immediately after surgery. Dr Clavell does not use them. I have no burning sensation at all as a result. I actually feel very good.

Dr Clavell keeps all his patients inflated for 4-6 weeks after surgery. He said he has not had a problem with over 500 patients doing it this way. I told him about Dr Eid's early cycling method and he was well aware of it. He doesn't believe in Dr Eid's method of cycling from Day 3 because it will only cause pain and discomfort. I believe this because I really do not see myself cycling at Day 3.

Dr Clavell explained I will regain all of my size through cycling regardless. He also explained that the scar capsules take months to form and I should not be worried about this theory. I expressed concerns about auto-inflation and he said that the implant has a lock valve which prevents this.

Hey AverageBloke! Thank you so much for sharing this! I was shocked at the dramatic results you had after surgery, especially given the points you had to solve....  Thank you also for sharing your Dr's points on Dr. Eid's modus operandi. I was always curious about what MD's had to say.

Best of luck on the results and i can't wait to see further pictures. Fingers crossed for ya!

JustAGuy2020

Hi AverageBloke - like you - my Dr (Levine) kept me about 50% inflated for the first 4 weeks after surgery.  I found that using a plastic urinal (the hospital gave me one or I'm sure you could get one at any drugstore) was by far the best way to deal with peeing while inflated.  Much easier than bending the penis down toward the bowl, etc.  My surgery was last September but I find that my urination is a little different than pre-implant, I feel done but then have to go again within a few seconds.  Good luck with your recovery.
55 y/o, Peyronies Disease onset 2018, diag 2/19.
Pentox failed, Ref to U-Michigan, doppler showed 45D right curve and 80D dorsal w hinge effect.
Incision/grafting/plication at U-M 9/20 failed.
Implant / graft repair with Dr Levine (Chicago) 9/21, successful so far

AverageBloke

Quote from: JustAGuy2020 on April 12, 2022, 06:30:15 AM
Hi AverageBloke - like you - my Dr (Levine) kept me about 50% inflated for the first 4 weeks after surgery.  I found that using a plastic urinal (the hospital gave me one or I'm sure you could get one at any drugstore) was by far the best way to deal with peeing while inflated.  Much easier than bending the penis down toward the bowl, etc.  My surgery was last September but I find that my urination is a little different than pre-implant, I feel done but then have to go again within a few seconds.  Good luck with your recovery.

That is a good idea but I'm gonna just stick to peeing in the bath tub for the moment. How did you deal with the erection for 4 weeks? I'm trying to be really careful in everything I do. Did you still do regular activites around the house like crouch down to pick things up etc? Anything you couldn't do?
Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

JustAGuy2020

I was able to work from home during that time and just wore sweat pants around the house.  After the first week it got a lot better in terms of mobility, etc.  I had a full circumcision incision so I wrapped the incision area with gauze secured with tape, which helped a lot with friction on my stitches.  
55 y/o, Peyronies Disease onset 2018, diag 2/19.
Pentox failed, Ref to U-Michigan, doppler showed 45D right curve and 80D dorsal w hinge effect.
Incision/grafting/plication at U-M 9/20 failed.
Implant / graft repair with Dr Levine (Chicago) 9/21, successful so far

AverageBloke

Day 5, 6 & 7 Update

Not much has changed. Just recovering in my hotel room watching shows & movies.

My penis is slowly healing and looks better by the day. I've spoken to the doc through text and I explained to him that my flight home is 18 hours and I won't be leaving Houston till I can deflate. He said its fine to deflate at 3 weeks if my pain is controlled, swelling is minimal and I'm able to cycle.

So I'm at a crossroads, not sure if I should I deflate at 3 weeks or wait the full recommended 4 weeks? Pros vs cons?

Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

Hawk

What could be the possible cons when many doctors send patients home deflated?  The only "con" is that you need to start cycling at that point (not necessarily that day).  The deflation/cycling will give you a fully inflated reservoir and a FULLY inflated penis, both of which can only be positive.  It also gives you a penis you can take out in public.

I guess the con is the discomfort of cycling, but if guys in their 60's - 80's can endure cycling at days 3 or 4 days, I am sure you endure it a day 21.
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

AverageBloke

Day 7 - 11 Update

Hey guys,

I have been making progress with my recovery and a lot of my pain has reduced. My swelling and bruising is pretty much gone. I've spoken to my doctor recently, he agrees that I've been healing well and I may begin cycling in one week. However, I expressed to him that I have some concerns with palpable tubing in my scrotum and it feels as if my pump is stuck the bottom of my scrotum. My doctor has advised me to start pulling down on the pump in the shower to combat this. Not sure what's going on? Is this normal? I am pretty lean but it feels like the pump tubing is really prominent.

I've attached some photos and circled the tubing in red... Can you please provide your thoughts?

https://ibb.co/YhrcwLq
https://ibb.co/SJLTT48
Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

Hawk

Your progress sounds good AverageBloke.

Is there any possibility that any portion of that is swelling?  I have nothing like that.  My implant is such a part of me that sometimes, I have to do a thorough check and analysis when members post questions.  I did that for this question.  It is difficult for me to tell that there is any tubing attached to my pump.  It free floats, suspended below my right testicle.  If I follow the top of the pump and push my finger way up in my scrotum, behind where the base of my penis meets my body, then I can feel a short length of tubing about 1" long.  Also, if I press into my body on the left side of my penis, I can feel a little bit of the tube, but nothing has ever been visible or easily palpable, even when I am at my very lowest body fat (5'8" 148lb and fit).  While the pump could be easily discoverable during foreplay that involved the scrotum, no one could ever find my tubing unless they went way beyond foreplay and advanced to a full-fledged exam.  Dr. Eid, however, makes a point in several of his videos about skill and technique in hiding the tubing.

The answer to "Is this normal" is tricky.  What is typical with one surgeon varies from what is typical with another.  Being able to easily feel tubing or being able to see it is not ideal.  I think during a follow-up exam with your surgeon, you need to ask, "Is this typical and something you expect when you do this surgery?"  He can only give one of a couple of answers. So be prepared with your comeback to both a "yes" and a "no."  

One last point.  I hear conflicting info all the time about pumps adhering to the scrotum and tugging down on pumps.  I can only share my experience with you.  I specifically asked Dr. Eid if I should pull down on my pump because I had read from others that you need to get it low in the scrotum and keep it from attaching to the scrotum.  It is the ONLY time I ever heard Dr. Eid speak forcefully or use profanity.  

He said, " No! That is complete BS.  That pump area is already healing and scaring in, and it will be in the proper position.  The pump can only adhere to the scrotum if there is an infection.  The pump is the bellwether of the whole system.  If the details of the pump can no longer be felt or if it adheres to the scrotum, it indicates an infection with only one solution..."

He was not rude, but he delivered the answer in absolute terms, and I never felt the need to bring it up again.  I did, however, obsess over whether I could use my thumbnail and feel the ridges on my pump bulb for a few months after that conversation.  I have always been able to slide the scrotum skin back and forth over the bulb.  In fact, when you first start cycling and the scrotum gets sore, that is one way to move the pressure to another spot on the scrotum.

PS: What kind of clothing can you wear with that much of an erection?  Can you leave the room?  It looks like it would be extremely challenging to deal with.
PS: I also added your journal to the index at the top of the Implant board, so it will always be easily accessible.  Thanks for the great contribution to others on this journey.

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

AverageBloke

Hey Hawk,

I've told the doctor and he thinks its normal, only a cosmetic issue. He told me to keep pulling on the pump and we will start warm baths soon. The weird thing is when I'm standing you cannot see or feel any tubing at all. You can only see the tubing when I lie down on the bed. Maybe this is because the pump is lodged to the bottom of my sac on an awkward angle? I've attached some photos of myself standing.

https://ibb.co/FKrLvCR
https://ibb.co/PYqbkSm

Also, I found two Dr Eid patients and a Dr Clavell patient on the "other forums" with the same problem. Dr Eid told his patients it was only a cosmetic issue and he can fix it if needed. Dr Clavell told his patient the same thing. So it might just be patient specific and happen sometimes.

Overall, I'm not really bothered by it and I'm just focused on unlodging my pump from the bottom of my sack. If it does begin to bother me I'll get the doctor to revise it.

I think Dr Eid doesn't tell patients to tug on their pump because by Day 3 they are already in a hot bath and manipulating the pump which would achieve the same result.
Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

Stepone

Everything takes time.
My pump was very tight too, but as the months went by, the pump loosened up.
I have very small balls, so my pump is as more prominent. But again, as months went past, my scrotum stretched and now it looks like I have decent size balls, which was a plus.
Give it time my friend and I think it will drop.
StepOne  
Nesbit surgery 2015, 66 years young, Titan Implant 4/25/19, 22cm, Dr. Lentz, Duke University NC

AverageBloke

Day 11 - 13 Update

Its been 13 days since surgery.

I'm worried about the protruding tubing in the scrotum, it really looks like it can affect penetration. My pump is on its side and stuck to the front & bottom of my scrotum. I'm going to see the doctor sometime this week to discuss options... I really don't know why its ended up like this I asked the doc to use minimal tubing and bury it as deep as possible.

I will let you know guys what he says and the course of action.
Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

Hawk

Can you easily push it deeper against the body with some moderate pressure?  If so, I would ask him if that is advised to "train it to lay deeper.  The one concern is that where cylinders and maybe the pump are the weak link with AMS/BS implants, the tubing is the weak link with Titan implants.  You do not want to fatigue the tubing so I would get some guidance from your doctor and a Coloplast Rep.

Whereas the cylinders get much softer with time, the tubing does not seem to do so.
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

JustAGuy2020

Hey AverageBloke, I hope you get your issues worked out.  I have a TItan and my Dr (Levine) never mentioned having to pull on or adjust the pump (and I never did).  Once I was healed, the pump was at the bottom of my scrotum (but not attached to the skin) and the pump mechanism was in a good location for me.  The tubing running from the pump back to the cylinders can be felt but is not prominent or a nuisance.  
55 y/o, Peyronies Disease onset 2018, diag 2/19.
Pentox failed, Ref to U-Michigan, doppler showed 45D right curve and 80D dorsal w hinge effect.
Incision/grafting/plication at U-M 9/20 failed.
Implant / graft repair with Dr Levine (Chicago) 9/21, successful so far

Hawk

If you read my journal, you will see that I was a little concerned that my pump was in an awkward position.  It just resolved after a few months and ended up in an ideal position with no corrective action needed.  While I could never casually feel tubing, there is at least some chance your pump will reposition which might reposition the tubing.  Just a thought.

Also, as you said earlier, it is cosmetic.  Surely, during deep penetration, the tubing has enough give to push out of the way.  If you are dissatisfied after 6 - 12 months then consider corrective surgery.  It will be no harder to fix then than now and you might dismiss the entire issue after a few months.
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

AverageBloke

Quote from: Hawk on April 20, 2022, 09:02:52 AM
Can you easily push it deeper against the body with some moderate pressure?  If so, I would ask him if that is advised to "train it to lay deeper.  The one concern is that where cylinders and maybe the pump are the weak link with AMS/BS implants, the tubing is the weak link with Titan implants.  You do not want to fatigue the tubing so I would get some guidance from your doctor and a Coloplast Rep.

Whereas the cylinders get much softer with time, the tubing does not seem to do so.

I can push it in but it is a little painful. It does seem to go in deeper when I pull my pump down but only temporary. I'll speak to the surgeon and see what the options are. Another odd thing, the pump is stuck to my scrotum horizontally on the bottom.

I've attached a photo with a demonstration pump so you can see what I mean...
https://ibb.co/T24LbGR

Do you think this is what causing the protruding tubing? Or could it be excessive tubing? I did get a 22cm Titan with no RTE's and my penis was 17.8cm before surgery.
Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

AverageBloke

Day 16 Update

Hey guys, just had a check up with Dr Clavell and got some really good news!

Dr Clavell relieved all my concerns and I feel a lot better. He told me the tubing in the scrotum isn't an issue and should drop further when the pump settles. I should have no issues with deep penetration or rough sex. The pump should also become unstuck from the scrotum as soon as I start taking hot baths. He showed me how to inflate to 100% max and deflate.

I also emailed Dr Eid to get a second opinion on the tubing and he doesn't think its an issue. He said its a cosmetic thing and won't affect deep penetration or the life span of implant.

Overall, I'm very happy with the result and Dr Clavell's work. He was able to fix my twisted penis with plication and give me an implant in the same surgery.

I've been cleared to start cycling daily but I have to wait 6 weeks for sexual intercourse due to the plication.

Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

GaussRifle

I am very very happy for you. I don't understand how you got the guts to do an implant surgery at just 22. I'm only 26 and have missed out on sexual intercourse all my life so far. It's coming to a point where my hormones and raging and I want to F~@< so bad... I just can't due to mental block dating and all and don't know of my penis will hold up during sex if I get that far.

But hats off to your bravery and tackling this problem like a champ. Overall, I wish I am able to put this behind me as well , one way or the other and have sex. xxxx xxxx I deserve it.

Language prohibited by forum rules was deleted from this post
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.

Stepone

Averagebloke,

Glad you shared your good news with all of us.
The hot bathtub soaks really do work.
It's wild how some men will do anything but a hot soak.
So glad they are working and you had a good informative surgery visit.
Keep up the good work.
StepOne  
Nesbit surgery 2015, 66 years young, Titan Implant 4/25/19, 22cm, Dr. Lentz, Duke University NC

Hawk

A god report AverageBloke.  You will have to change your name to ExceptionalBloke after this unit is fully working   :D

I have to tell you that I find it amazing that Dr. Eid took the time not only to respond to your email but to reassure you of another surgeon's work.  That is the sign of an exceptional human being.  There are many on here who cannot get their own surgeons to respond to them much less a surgeon they rejected for someone else.
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

AverageBloke

Day 20 Update

Thanks for the support guys!

To provide an update,

I've been practicing on how to deflate and inflate in the shower & tub. I can pump up easily but deflating is very tricky. It is still hard to find the deflate tabs at times and I can't determine if I'm fully deflated or not. I end up with a 4pm semi.

How do you guys deflate your titan touch? Do you have to hold the tabs for a while?
Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

Hawk

A couple quotes from other topics

Quote from: Hawk on May 13, 2019, 12:47:14 PM
This has often been a point of confusion.  Here is the scoop.

Current Titan's have a "Titan Touch" pump.  If there has ever been a misnomer, this is it.  It takes far more than a touch to inflate and even more to deflate.

To deflate, the Titan Touch is designed to be pressed firmly for 2 seconds and then released.  You can then either let it very slowly drain on its own or squeeze the penis to drain the fluid quickly.  You can drain more fluid any time (even the next day) with just a squeeze of the penis UNTIL the point that you make the first extra firm pump on the bulb.  That first firm pump double locks the valve so fluid cannot flow in either direction.

The problem is that most men are not able to make this work in the beginning.  Some very few can.  It took me about 2 months as I recall (it is all in my journal).  What typically happens, in the beginning, is that you depress the deflate valve enough that fluid will drain from the penis as long as you keep your hand on the valve and squeeze your penis with the other hand.  This is because the patient does not press the deflate valve hard enough to lock the valve into the deflate position.  You will know if it failed to lock in the deflate position in two ways.
1. You will not be able to drain fluid from the penis if you let go of the pump deflate button.
2. When you begin to inflate Your first pump won't require an extra hard squeeze because the valve is not locked in the deflate position.

During this early stage, deflating is often a two-hand operation.

With time, the scrotum gets less sensitive and the pump loosens up, and your deflate squeeze becomes more efficient at isolating the deflate button.  At that point you press the deflate button for 2 seconds, let go, then squeeze your penis to drain the fluid.  You then give one firm squeeze to double-lock the valve.

It is very normal for your penis to be pain-free and your scrotum to be sore from the pumping.  You would have to read other patient journals to know how long it takes for that to go away.  As I recall it is about 8 weeks but it might be slightly sensitive until 12 weeks.  It does get better weekly beginning with the first week of cycling.

Quote from: Hawk on November 18, 2019, 09:13:12 AM
Interestingly enough I have had noticeable softening of my cylinders even between the 1-year mark and now (15 months).  I do NOT regularly cycle on a daily basis.

The pump button is definitely hard to press and I have a strong grip.  It does get easier even up to or beyond the 1-year mark.  If you get no more backflow without resetting the valve (with 1 small pump) than you do with resetting it, I would leave the valve open.  That way a few times during the day when you take a leak you can simply squeeze your penis to re-drain it without touching the valve.

I will also add that it is easier to TOTALLY drain the cylinders if instead of squeezing with one hand you press your penis flat between the heels of your two hands.  You can even roll the heels from tip to base on the shaft.  I find this TOTALLY flattens the cylinders.  If I do this, in time I will get a slight amount of backflow but not enough to care about.  In fact, I prefer it for a more natural hang.

I have also noticed I hang even better with a few pumps.  I think the weight of the fluid in the cylinders is just enough extra weight to weigh my penis into a deeper hang, but not enough to make it rigid in the least.

The last quote about leaving the valve without a pump to double lock it is completely a preference call.  I don't worry about it one way or the other.
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

Stepone

Hawk is definitely the expert here.
I have encountered "owner operator" problems several times with my pump. And as I have said it's always where I have not pressed hard enough.
As long as I take my time and use both hands it always works.
Some days I will totally deflate and other days I might leave a few pumps in there.
How many pumps does it take you to totally inflate? It seems I pump 24 to 30 pumps, depending on how tight I squeeze the ball pump.
StepOne  
Nesbit surgery 2015, 66 years young, Titan Implant 4/25/19, 22cm, Dr. Lentz, Duke University NC

Hawk

Quote from: AverageBloke on April 26, 2022, 12:11:51 PM
Day 20 Update
How do you guys deflate your titan touch? Do you have to hold the tabs for a while?

When you say "Tabs"  There is a single deflate button (tab)

PS: I am no more the expert on deflating a Titan than any other guy with a Titan.  I have expoermented and I have probably explained it more times but my opinion is no better than any other Titan owner.
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

AverageBloke

Thanks guys you have been very helpful :)

Also, I'm flying back home tomorrow and my flight is 18 hours. I'm not sure how to position my flaccid penis, should I point it up towards my stomach? And should I lift from nut sack up? Or just lift from the shaft up?
Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

Hawk

I cannot say much about penis position and comfort, but from the standpoint of the outcome angle of the inflated penis, I think that it should be pointing up.  Some say it does not matter, but I believe, as do some others, that downward pressure on the crus makes it scar in with less stability.  If you have to bend it down, hinge it on the shaft 1" from the body rather than at the body.

I would wear it up or up at an angle in the crease of the body.

I am not sure how healed the scrotum is, but Rolling a bath towel and then shaping it into a "V" with the point at the back of your seat is a valuable tip.  Then place the hamstring of each leg on each leg of the "V." This prevents upward pressure on the scrotum.  Sitting on a soft pillow does the opposite.  That causes the soft pillow to puff um at the scrotum when you sit and is like a punch to a sore scrotum.

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

AverageBloke

3 Week Update

After 24 hours of travelling from the United States I have finally made it back home to Australia. It feels good to be back home.

The flights were pretty gruelling but I pretty much made sure I deflated as much as possible, my penis would end up around 4pm - 4:30pm angle and was still sort of semi erect because of body fluids/swelling. I wore baggy pants and a baggy shirt to hide my bulge. I made sure not to put much pressure on my flaccid penis but there was discomfort at times walking through airport customs, gates, terminals etc...

Overall very happy with my decision to travel to the US to see Dr Clavell. I highly recommend everyone to go and see Dr Clavell if you have Peyronie's Disease or Erectile Dysfunction. He was very understanding of my concerns and made sure to address them before surgery and after surgery. He also provided me with his WhatsApp number after surgery and allowed me to contact him whenever. The surgery cost for a penile implant with Dr Clavell is 20k USD and there may be additional costs if he needs to do additional work such as plication, grafting or penile reconstruction.

Looking forward to the road ahead.
Peyronie's Disease
Titan Touch 22cm - Dr Clavell 06/04/22

RichardWilson99

(NotSo)AverageBloke,

;D You sound happy! Love to hear it.  Thanks for checking in and giving an update.  Happy you made it back home!

Try to journal every day or other day ( on your own ), so that when you give us periodic monthly, semi-annual, annual, etc. updates, you can go through your personal journal and remember some details.    Also, I believe having a journal will help in life in general.

Best of luck amigo!
31/Single
Injury Nov 2019, bend 15deg, loss of erections, dent and hard-flaccid
VED, cialis 5mg on/off
EQ medium (with pills), no NTE.  Lost 1+ inches length, lots in girth. Some loss of sensation. Considering implant to restore full sexual function

jj21

Thanks for sharing this, please keep us updated.

I also have a clockwise twist, I did not know that some surgeons are unable to fix this during implant surgery.

If you don't mind, I just had a few questions:

1. You stated the device is 22cm? Does that mean it will erect to 22cm?
2. Was this your size pre peyronies and have you gained this back?
3. What is the likelihood of regaining lost size?
4. did you gain girth?
5. Does it fix narrowing and dents?
6. Is the clockwise twist fixed?

Thanks ,
J
34 Years Old...Peyronies for 4 years. 20 Degree left and upwards curvature, major dents and narrowing, ED.

Implant + Tunica Expansion Procedure, 7th Feb 2023, Titan 22cm +1cm RTE, Partial revision 27th June 23 (fix pump, remove 10ml reservoir).

Hawk

JJ21, I am asking this to seriously try to understand where we are going wrong getting out information.  How can a man be on this forum for four years, rank 22nd out of twenty thousand members in posting, and still ask if the length of the cylinders is the same as the length of the penis?

Have you read one implant journal?  if so, which one?  Have you read any of the sticky posts at the top of the implant board?  Do you take this seriously or is posting just an obsession.  Please help me understand.
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

jj21

Hawk,

Apologies if my questions are frustrating. I'm currently working and studying at the same time, I haven't had the time to read journals just yet.

Asking specific questions and reading responses just seeemd less time consuming than researching on this forum atm.

J
34 Years Old...Peyronies for 4 years. 20 Degree left and upwards curvature, major dents and narrowing, ED.

Implant + Tunica Expansion Procedure, 7th Feb 2023, Titan 22cm +1cm RTE, Partial revision 27th June 23 (fix pump, remove 10ml reservoir).

Stepone

Averagebloke,
Thanks for all your detailed posts.
Good old fashioned detailed sharing can help others learn, thank you for your time.
JJ21, all of our time is valuable. It is no less time consumable for one of us to answer unnecessary questions than it is for you to read.
Averagebloke, if you have not done so, could you please add to your signature date of implant, who did the surgery, etc. I don't recall seeing it.
Once again thanks for all your posts.
StepOne  
Nesbit surgery 2015, 66 years young, Titan Implant 4/25/19, 22cm, Dr. Lentz, Duke University NC