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Author Topic: Tex123's Implant Journal  (Read 237 times)

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Tex123

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Tex123's Implant Journal
« on: September 20, 2022, 01:18:47 AM »

Hi all,

I've been a member of this forum since the summer of 2019, but have never posted until tonight. This forum has provided me with a wealth of information in the last 3 years, and I wanted to thank all of the moderators and members who contribute to it. I had penile implant surgery last week, and thought it was finally time for me to contribute back to the forum.

I'm going to break this down into multiple posts over the next few days, covering the following topics in my journey to receiving a penile implant:
  • Backround & Diagnosis of Peyronies Disease
  • Treatments and Deciding on an Implant
  • Choosing a Surgeon
  • Pre-Testing & Surgery
  • 1st Week of Recovery

Hopefully, some of this information will help others who are dealing with this miserable condition.
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Age: 55
Congenital 40 degree ventral curve
90 degree ventral curve following injury in 7/2019
Coloplast Titan (22cm, 1 RTE) implanted by Dr Jonathan Clavell (Houston) on 9/13/2022

Tex123

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Re: Tex123's Implant Journal
« Reply #1 on: September 20, 2022, 01:22:48 AM »

Background & Diagnosis of Peyronie's Disease

Unfortunately, I was born with a congenital curvature of my penis. I had a ventral (downward) curvature of about 40 degrees, along with a slight bend to the left for the majority of my life.

As a teenager, this caused lots of anxiety. I never saw doctors as a child, and wouldn't have had the nerve anyway to ask about the issue. This was of course before the internet, so there was really no easy way to find out the cause of the curvature.

A 40 degree curvature is significant, but I learned to deal with it over time. Certain sexual positions weren't possible with my curvature, and other positions were uncomfortable to my partner due to the angle of my penis. It really didn't bother me much, and over time I learned from my partners that curved penises were more common than I expected. I would have been completely happy continuing to live my life with a 40 degree curvature, but unfortunately the curvature worsened in 2019.

I really don't know for sure how it happened. During this time, I had started taking Propecia (Finasteride) for hair loss, and my erections were not as firm as before. I believe I simply bent my penis during sex, causing the plaque to form that worsened my curvature. Some doctors have told me since that Peyronie's is simply more common for men with congenital curvature since there is already a bend which is being repeatedly stressed during sex. Whatever the cause, I now had a ventral curvature of 90 degrees, along with an additional 30 degree bend to the left.

The change in curvature happened fast, but there was never any pain. My penis was always curved, so I didn't even notice the change at first. It was only when I attempted penetration and failed that I realized that something was wrong.

To visualize this degree of curvature, consider yourself standing straight with an erection. In my case, the head of my penis would be pointing directly at my left foot. I was still able to get erections, but traditional sex is really not feasible with that degree of curvature.

In the next post tomorrow, I'll discuss the treatment options I considered and those that I tried before making the decision to get a penile implant.
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Age: 55
Congenital 40 degree ventral curve
90 degree ventral curve following injury in 7/2019
Coloplast Titan (22cm, 1 RTE) implanted by Dr Jonathan Clavell (Houston) on 9/13/2022

Hawk

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Re: Tex123's Implant Journal
« Reply #2 on: September 20, 2022, 09:55:42 PM »

Text, I thank you on behalf of all the members, including many who, like you, never post.  Add to that the thousands who view the forum as guests.

I look forward to your posts.

Thanks again,
 Hawk
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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

Tex123

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Re: Tex123's Implant Journal
« Reply #3 on: September 21, 2022, 12:36:39 AM »

Treatment Options
After being diagnosed with Peyronie's disease, I initially followed the survival guide and quickly ordered the recommended supplements. I'll be honest... I only stuck with the supplements for about 2 months before giving up on them.

I moved on to traction next, and purchased a RestoreX device. I consistently used the RestoreX for several months, and then intermittently for the next year or so. My curvature did not improve any using RestoreX, but neither did it get any worse. There were some minor benefits since RestoreX seemed to improve my erections and the flaccid length of my penis. I would have used it more consistently, but it was difficult to find the "private" time needed to use it.

My VED usage was minimal. I did try it a few times after purchasing two cylinders and a pump on Amazon, but always had issues getting a good seal and maintaining pressure.

Overall, I wasn't very consistent with any of the non-invasive treatments. I'm not sure if I could have gotten better results, but I regret not trying harder. I think over time the depression from both having a disease that seems untreatable, along with all of the COVID turmoil just depressed me and made me give up.

As for the surgical options, the severity of my curvature seemed to rule out treatment options like plication surgery. I did consider Xiaflex, but I never found a urologist that I trusted enough to perform the procedures. None of them seemed to have a thorough understanding of Peyronie's, and it seemed like more of a cash grab than a reliable treatment. I also have never gotten a consistent answer on whether Xiaflex should be considered for a ventral curvature like mine due to the risk to the urethra.

A Penile implant always seemed to be the most promising treatment for my situation. I considered an implant from the very beginning, but wanted to try the other treatments first since you can't reverse an implant. Unfortunately by the time I made the decision to get an implant, COVID hit and I was stuck in limbo during the shutdowns and travel restrictions. It was only earlier this year that I felt comfortable proceeding with the surgery.
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Age: 55
Congenital 40 degree ventral curve
90 degree ventral curve following injury in 7/2019
Coloplast Titan (22cm, 1 RTE) implanted by Dr Jonathan Clavell (Houston) on 9/13/2022

Tex123

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Re: Tex123's Implant Journal
« Reply #4 on: September 21, 2022, 12:40:11 AM »

Choosing an Implant Surgeon
Once I made the decision, I started researching the various surgeons recommended on this forum. Dr Eid was always on my list given his sterling reputation, but I was also considering Dr Jonanthan Clavell who seemed to be an up-in-coming implant surgeon. I scheduled virtual consultations with both doctors in March of this year.

I was impressed with both doctors. A possible infection is the scariest thing about an implant, and Dr Eid's techniques to avoid them are really the gold standard. Dr Clavell is the highest volume implant surgeon in Texas, and I really liked how he uses his YouTube channel to educate people about implants and Peyronie's disease. Even if you don't use Dr. Clavell as a surgeon, I highly recommend that you still view some of his videos.

The decision for me really came down to two factors - how effective would the surgery resolve my curvature and the location of the surgeon. Dr Eid seemed a little reluctant to say that I would be "cured" by the surgery given my severe 90 degree curvature. I don't remember the exact words, but he just didn't seem confident that my curvature would be completely corrected by the surgery. Dr Clavell said that it would be a more difficult surgery given the severity of my curvature, but he showed me some before and after photos of another patient with a similar curvature and overall seemed more confident that he could fix me up without complications.

Being perfectly straight following the surgery wasn't a huge factor to me - I've already dealt with congenital curvature my whole life and could live with some curvature. Therefore the second factor of location was very important in my decision. I live in Dallas, Texas, and Dr Clavell's primary office is located a 4 hour drive south in Houston, Texas. Being that close to home and my support system was very comforting. While many people fly in to New York for Dr. Eid, I wasn't really eager to do that.

The main drawback of using Dr. Clavell is that he keeps his patients partially inflated for 4 to 6 weeks following surgery. Dealing with an erection for over a month is not easy for anyone, but I understand why he does it and thought I could handle it since I work remotely from home anyway.

In the end I selected Dr. Clavell for my surgery and scheduled my surgery for September 2022. 
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Age: 55
Congenital 40 degree ventral curve
90 degree ventral curve following injury in 7/2019
Coloplast Titan (22cm, 1 RTE) implanted by Dr Jonathan Clavell (Houston) on 9/13/2022

Stepone

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Re: Tex123's Implant Journal
« Reply #5 on: September 21, 2022, 09:19:42 AM »

Tex,
Keep on writing!!!!
I appreciate your openness, honesty, organization of your writings,  and explanations on how you reached your decisions.
Perfect!
Thanks for sharing.
StepOne
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Nesbit surgery 2015, 66 years young, Titan Implant 4/25/19, 22cm, Dr. Lentz, Duke University NC

Pfract

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Re: Tex123's Implant Journal
« Reply #6 on: September 21, 2022, 11:58:13 AM »

A very well written and detailed story about the way you approached your condition. Thank you for contributing and coming forth. I am hoping your recovery goes well and you are able to discover new-found joy and the pleasure That comes along with your new implant.

Tex123

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Re: Tex123's Implant Journal
« Reply #7 on: September 22, 2022, 10:49:28 PM »

Thanks for the kind words everyone! I'm continuing with two more posts today covering preparation for the surgery, and the surgery itself. I'll have one more post tomorrow to discuss how the recovery has been going so far (just 1 week).


Surgical Pre-Testing and Preparing for the Surgery
Once the deciding to move forward with the implant surgery, Dr. Clavell's office assigns you a surgical coordinator who is your primary point of contact up until the surgery. The surgical coordinator will schedule both a pre-testing appointment at the hospital and the surgery itself. The surgery coordinator will also complete any short term leave or FMLA (Family Medical Leave Act) forms required by your employer, but there is a small additional charge ($20 or so) for this service.

Most patients choose to schedule the pre-testing appointment the day before their surgery, but I scheduled mine about two weeks before the surgery. To be honest, the pre-testing appointment was the worst part of the entire experience. I arrived at 11:30 AM for my noon appointment, and I had to wait an hour before seeing someone to complete all of the paperwork. After that, you're sent to a different waiting room to wait for a nurse to perform the testing. I was stuck in this waiting room for another 2.5 hours, freezing to death in the cold room and dehydrated since all of the water fountains were still shut off due to COVID.

The pre-testing itself was pretty straight-forward, you're asked to provide a urine sample, your blood pressure is tested,  blood is drawn for lab testing, an EKG is performed, and finally the nurse discusses your medical history. You're also provided a bottle of anti-bacterial body wash that you are told to use the day before and the morning of your surgery. Pre-testing probably takes about 30 minutes normally, but took longer for me since I was dehydrated and the nurse had trouble drawing blood.

Around this time, Dr Clavell's office will also send you a link to a website called "vidscrip.com" which provides a timeline up until the day of the surgery, along with short video clips from Dr. Clavell on the related topics. For example on the date two weeks prior to your surgery, the website will display a list of 7 videos providing a "Preoperative Checklist" with topics like "Arranging Transportation for your Surgery", "Do I need to change or stop medications", and "What steps can I take to ensure a successful procedure?". You're given paperwork by Dr. Clavell's office with instructions for the procedure as well, but I found the website useful to refresh my memory and to make sure I didn't forget anything.

Overall, I was really happy with Dr. Clavell's office. They managed all of the insurance process and approval, and were very responsive to any questions I had, usually returning my calls within an hour. You can tell they do a lot of these surgeries, and they've got the process down.
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Age: 55
Congenital 40 degree ventral curve
90 degree ventral curve following injury in 7/2019
Coloplast Titan (22cm, 1 RTE) implanted by Dr Jonathan Clavell (Houston) on 9/13/2022

Tex123

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Re: Tex123's Implant Journal
« Reply #8 on: September 22, 2022, 11:03:39 PM »

Surgery
The last two weeks prior to the surgery was spent getting prepared, mostly by re-reading the implant journals of other forum members. I also found the wiki "Road to Becoming a Bionic Male" on patientpop.com to contain a lot of useful information.

I wasn't sure how my body would react following the surgery, and therefore wasn't sure how long I would have to wait before returning to Dallas. The surgical coordinator from Dr. Clavell's office suggested I stay a few days just in case there are any complications, so I ended up booking an Airbnb for 3 nights in the Houston Galleria area (about 15 minutes from hospital).

A few days before the surgery, I contacted the office to get the prescriptions I needed for the surgery and recovery. Dr. Clavell prescribed 4 medications for me: 2 antibiotics (one starting the day before the surgery, and one starting after the surgery), and 2 pain killers (one for minor pain and one for more severe pain). He recommends using Extra Strength Tylenol as the primary pain reliever, but you can use the other medications as needed if the pain is more severe.

You're instructed not to shave your pubic area prior to the surgery. The concern is that you will accidentally cut yourself doing this, and increase your risk of infection. You are told that you will be shaved at the start of the surgical procedure.

I packed loose clothing, ice bags & ice packs, medications, jock straps, compression shorts, and my laptop and tablet for the trip to Houston (day before surgery). To be honest, I overpacked and didn't think about how I would carry all of this stuff back to my car after being told not to lift anything heavy after the surgery. Luckily my wife accompanied me, but I felt bad since I couldn't help out much after the surgery.

Dr. Clavell performs his surgeries in the mornings, and I was scheduled for the first surgery of the day at 7:30 AM and told to arrive at the hospital by 5:30 AM. On the day of the surgery, you're instructed to give yourself an enema that morning and to shower again using the antibiotic cleanser given to you during pre-testing at the hospital.

I arrived at the hospital (HCA Houston Medical Center) at 5:15 AM, and check-in went way more smoothly than my pre-testing appointment. Within 5 minutes, I was directed to a private room and asked to change into a hospital gown. The nurse checked my vitals, and started me on an IV containing antibiotics. I remained in this room for about an hour with my wife, and then was sent to a large staging room with other patients scheduled for surgery that morning. I was visited first by the anesthesiologist who reviewed with me my medical history, and then by Dr Clavell who asked if I had any questions before the surgery. I remained in this room for about an hour and a half, until the anesthesiologist returned and gave me the anesthesia as I was being wheeled into the surgery room.

When I woke up, I was back in the staging room with the post-op nurse asking me how I felt. In the moment of truth, I looked under my gown and found my erect penis surrounded by a large circular dressing that fully surrounds your penis and testicles. It looked straight, but it was hard to tell for sure since most of my penis was covered by the dressing. I did notice that the head of my penis was slightly curved to the left by a few degrees.

At this point you're pretty much done, but you must show that you can pee before you're allowed to leave the hospital. Normally that's not an issue for me, but I would stand at the toilet and nothing would happen. You're told not to eat or drink after midnight prior to the surgery, so I was dehydrated and given an IV to restore some fluids. I was also given several glasses of water and orange juice to help out. After two hours or so, I started to get stressed and wonder if something was wrong. The nurse mentioned that I would possibly require a catheter, but I finally felt the urge and was able to urinate successfully. It did hurt like hell, but I was told that was normal following surgery.

During this period of time, Dr Clavell did drop by to check on me and to let me know that everything went well. I mentioned the slight curvature in the head of my penis, but he reminded me that I was only partially inflated and that it would likely straighten out on full inflation and cycling. I'm not worried about it - I came into the surgery with basically a non-functional penis, and I'm not about to complain about a slight bend in the head of my penis. Dr Clavell gave me his personal cell number, and told me to contact him if I had any questions or concerns. He also asked me to text him a picture of my penis each day so that he could verify that I was healing well.

I was finally able to leave, and was wheeled out while trying to hide the bulge in my grey sweat pants. It reminded me of this old movie scene LOL: https://youtu.be/mSJVEb-qljA

It was a long day overall, and I didn't finally leave the hospital until 4:00 PM - just in time for rush hour traffic! Dr Clavell was extremely nice to both me and my wife, but I specifically wanted to call out the nurses at HCA Houston Medical Center - they were incredible! The pre-op nurse was a really nice guy, and kept me calm before the surgery. The post-op nurse was so sweet and funny, and made a stressful situation much easier to manage. 
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Age: 55
Congenital 40 degree ventral curve
90 degree ventral curve following injury in 7/2019
Coloplast Titan (22cm, 1 RTE) implanted by Dr Jonathan Clavell (Houston) on 9/13/2022

Stepone

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Re: Tex123's Implant Journal
« Reply #9 on: September 25, 2022, 07:46:57 AM »

Great detailed report. Thanks
Funny YouTube video
StepOne
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Nesbit surgery 2015, 66 years young, Titan Implant 4/25/19, 22cm, Dr. Lentz, Duke University NC
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