Deciding to get an implant

[Pdxguy]

Hey guys! I've yet to make an introduction here, but have been reading and benefiting from all the great information here. I can relate to so many of you and really appreciate all the time put into making this a great resource for those of us who suffer from ED.
I've personally, suffered for almost 20 years from ED, but it was manageable with Cialis and Viagra until around 3 years ago and I began working with a natural path doctor who specializes in men's health. I began TRT due to low T, which definitely helped with my libido, but I still suffered from ED. I also was given multiple P Shots (PRP) and Gainswave therapy along with VED, which would help each time for around a month then I would go back to my normal state of ED. After a year of this treatment I then began using Trimix, which limits you to using no more than 3x per week. I thought I found my solution with Trimix, but 3x a week was simply not enough for me and my wife. My wife is absolutely beautiful and has a high sex drive, like me, so not meeting both of our needs makes me feel like a complete failure. In fact, it made the times we tried without Trimix even more frustrating for us both and has impacted the intimacy in our marriage greatly. I began to notice an even worse decline in my ED around November 2022 and while the Trimix would make me hard from the base up, I was super wobbly which led to a less than satisfied wife. I noticed scar tissue beginning to form from the Trimix injections, which I found out can make ED even worse! Over the past year, I needed cock rings even when using Trimix to stay erect and I now lose my erection when laying on my back for some reason, which is my wife's favorite position. My wife talked to me and said this is likely going to only get worse and we still have so much life to live. In her most loving and supportive way, she encouraged me to consider an implant.
Sorry for the long explanation, but I wanted to give a background to my history and what has led to my decision for an implant. I was super reluctant to get an implant, first because I felt like it was admitting failure and second because there is no going back from getting an implant and what if it doesn't work. I found this forum and really began to feel like I was not alone in how depressed and helpless ED can make you feel as a man. I began my search for a surgeon and landed on Dr. Karpman in the SF Bay area because he's on my insurance plan and he is a high volume implant doctor on the west coast. I had my first appointment this past week and felt very comfortable with his level of expertise and relatability. I decided to move forward with the surgery and currently in the waiting phase of pre-authorization.
I feel both excited and nervous at this point, but I figure these mixed emotions are normal at this stage. I'm tentatively scheduled for surgery on 3/12 and I will share my journey as I begin this walk.

Thank you for making this a place where men can find support and guidance to live a better life.
 

[Hawk]

Welcome to the forum PDXGuy.  I am glad you found us

you said:

I was super reluctant to get an implant, first because I felt like it was admitting failure and second because there is no going back from getting an implant and what if it doesn't work.

How would it not work?  There is no doubt that an implant will work.

Do you have a diagnosis as to the cause of your ED?

Do you ever get nocturnal erections?
 

[Pdxguy]

Thanks Hawk.
I've only been told I have peyronies but not sure if that's the main cause. Since using Trimix, things have gotten significantly worse, so the doctor said that could have caused even further peyronies/scar tissue. Regarding nocturnal erections, over the past few years I've only had them for around a month after having a P-shot. I wake up with a chubby if anything these days.
 

[Hawk]

Do NOT take another TriMix injection.

I would frequently use a VED with moderate vacuum suction to maintain or increase length prior to your implant. Even better would be VED and traction if you have a traction device but I likely would not buy one without a constriction buy one if I did not have one.

BTW, the only reason I asked you about the cause of your ED was out of concern because ED can reflect serious health issues like diabetes, heart issues, etc.  It has ZERO bearing on whether an implant will work.  Like everyone else with a great surgeon, 6 weeks after you have you have surgery you will wonder why you ever waited this long.  

[Pdxguy]

I really appreciate your concern for other health issues. I have had several different tests including a heart scan, multiple bloodwork and a recent MRI of my prostate and everything has checked out good except for BPH was found. I've been living on the false hope that PRP or gainswave or VED would somehow miraculously bring me back but unfortunately it has not. I have started using VED daily but I don't have a traction device. I have a feeling that I will look back on all of this and wish I would have done it sooner.  

[Pdxguy]

Do NOT take another TriMix injection.

I would frequently use a VED with moderate vacuum suction to maintain or increase length prior to your implant.  

Hawk - would you mind defining moderate vacuum suction? I'm sure that's somewhat subjective, but wanted your input.
 

[Hawk]

I am sure there are those here more versed than I am but my rule of thumb is ZERO pain.  Some slight discomfort that gets you to the size of a natural erect or SLIGHTLY above is fine.

If you are using it for ED in order to have sex, that is an entirely different protocol than using a VED for therapy.  To read protocols and posts about VED therapy
go here --> https://www.peyroniesforum.net/index.php/board,38.0.html

There are protocols at the top of that board

[Pdxguy]

Hey guys,

Posting an update. I'm pre-approved and scheduled for surgery on 3/12. I know this will be a journey, but happy to see light at the end of the tunnel.

[Hawk]

Great news.  It is always exciting to follow another journey and witness the transformation as it takes place.

Best Wishes!

[Pdxguy]

Sorry guys! I'm a few days late posting my journey since the surgery but I wanted to provide how each day has been so far.

2/12/24: day of surgery

Yesterday I had my pre-op appointment and had a sonogram performed. Dr. Karpman confirmed I have a venous leak on both sides of my dick. He said I have more than enough blood flowing in, but with the leak, he can see why I was struggling. Today, Dr. Karpman performed the surgery and told me he ended up giving me a Titan 22cm+1cm RTE. My pain levels coming out of the surgery were around a 6 out of 10 so they gave me a pain pill. The majority of my pain is located around the incision site which just below the public bone. I have a little pain in my scrotum and perineum but not much. Dr. Karpman said the surgery went perfectly and he feels I will have a positive result.
Since being in my hospital room, I've felt my pain sneak up on me rather quickly. I tried to go as long as possible before asking for more meds, but this got things out of control and they ended up giving me even more meds this afternoon. About 4 hours later, I hit a pain level of 6-7 again and took more meds.
Regarding the measurement the doc took pre-surgery I was 16cm in length and 15cm girth.
Before all this happened, I was closer to 18.4cm length and 13.5cm in girth. But the Trimix made me lose length and gain girth it seemed.
Emotions are all over the place, I'm excited for the end result then laying here thinking what the hell did I just do.
I hope things improve tomorrow.

Day 1 post op:
It was a very long night with little sleep in the hospital, counting the minutes until I could take more pain meds. The doctor visited and pulled out the catheter and my drain and said everything looked great. I was also able to pee soon after the  catheter removal.
I was released from the hospital around 11am, which was a good feeling.
Dr. Karpman left me inflated at 70% and said we will leave it there until my follow up appointment next Thursday.
My flight home wasn't until around 5pm, so my wife and I decided to go walk around a mall, just to see how I feel and to help with my pain. I could feel the pump in my scrotum and it was hurting at times in my left nut and on my left side where the reservoir is located.
My 70% filled dick wants to stick straight out in the 3 o'clock position, so when I'm out in public I had to position myself straight upright, which is annoying because there's constant pressure against my dick.
The flight home was very painful and I was super happy to get home.

Day 2 post op: 3/14
After a very rough night I woke up with a lot of pain probably because I slept past my next round of pain meds. I took my first shower then started working. I work from home, thankfully, but I probably wasn't quite ready to get back to work, just due to pain and still being foggy from the anesthesia.
By noon, I decided to try and switch my next round of pain medicine over to ibuprofen instead of narcotics, which actually worked and kept my pain manageable. I continued this regime until the evening and decided to take a narcotic to help pain through the night.

Day 3 post op 3/15
I woke up and felt much better! Slept well for the first time and started my day with a hot bath, per doctor recommendation. I started back on ibuprofen and continued this regimen all day.
Regarding swelling, I have quite a bit of swelling and bruising in my nutsack, and around my pubic area. Also, I have been keeping on my jockstrap and I have a pretty swollen area at the base of my dick on the bottom side. It almost looks like a turkey neck down there. I sent pictures to my doctor and he called and said everything looked fine and the swelling will begin to go down over the next few days.
At this point my pain is very limited as long as I keep ibuprofen rolling on a set schedule. My doctor told me that he injected a long-term anesthetic and that I would see an uptick in my pain on day three, for me that doesn't seem to be the case. I'm hoping the anesthetic wore off already and I don't see any uptick at this stage.

Day 4 post op 3/16/24
I woke up and took another bath. I stayed on ibuprofen through the night and slept very well. My pain is fairly under control and I am beginning to see some of the swelling subside. Mostly in my dick. I'm still pretty swollen in the pubic area and scrotum. I'm also able to stretch the time between taking ibuprofen beyond my normal six hour routine, hoping I'm on the other side of pain.

   

[Stepone]

Congratulations!
Thanks for sharing.
StepOne  

[LWillisjr]

Very surprised your surgeon recommended a hot bath so soon after surgery. They typically don't want the stitches to get wet for 10-12 days.  

[Pdxguy]

Very surprised your surgeon recommended a hot bath so soon after surgery. They typically don't want the stitches to get wet for 10-12 days.  

My doctor placed a wet seal/glue over the incision and advised me to begin taking a bath on day 3.  

[Pdxguy]

Day 6 post op 3/18/24
I've had a little pain in my left testicle. This morning in the bath, I was trying to pull down on my pump and it felt like there could be a little of the pump connected to tissue on the bottom scrotal wall. I attempted to detach the pump but had to stop due to a sharp pain. My doctor said to keep massaging it to move it away from the wall. Has anyone experienced this?
Another thing, my dick has always pointed out around 10 degrees to the left. I am still pointing left post surgery and wondering if this will change over time once I start cycling.

[Stepone]

Pdxguy,
Yes I had pump issues seeming to stuck to something, but gentle massaging in a hot bath seemed to ease things up.
Your doctor is giving you good instructions.
Time will change the position and "angle " it will point/hang.
I am sure you have read from others on this site about trying to keep your cock pointed up when you have clothing on.
In plain terms, you want the root of your cock to heal in an upward position, so when you pump it, your cock will point upward.
I personally have found, years have caused my penis angle to change. If I wear tightly briefs with my cock to the left, when I take my briefs off, it assumes that position.
When I have worn my cock to the right with briefs, when naked it hangs to the right.
In other words, I think your cock soft angle is easy to change its angle.
But for now, while the base is still healing and forming scar tissue, I would try to keep it pointed up.
As time went by, I found it easy to change its hang.
Hope this helps
StepOne  

[Pdxguy]

Thanks Stepone! Regarding my angle, that's what I was hoping to be the case.

I have another question, I'm still inflated at 70% and I can feel the top of the implant under my glans from the top of my cock. Does the implant push even further up into the glans as you inflate more?

[Stepone]

Pdxguy,

No, mine did not push any further into the head.
Time is the big healer!
I am in my 4th year and each year far exceeded the previous year.
StepOne  

[Hawk]

Dr. Eid is adamant that there is absolutely NO reason to tug on your pump.  He said a pump would NEVER attach to the scrotum unless there is an infection, and if there is an infection, there is only one solution.  In fact, the only time I ever heard him curse was when I suggested that some surgeons say to tug on the pump.  He said it is detrimental to the healing process.

[Pdxguy]

Hi Hawk,

I understand and it is very interesting how each doctor has a slightly different protocol. I respect what you are saying. The main reason I was told to pull down on the pump was to make sure it settles lower in my scrotum. My pump is not attached to the scrotum wall, I can move it around with ease. I just feel some tissue connected. Overall my pain has been pretty low, thankfully.  

[Pdxguy]

3/21/24 9 days post op
My follow up appointment was today.
Dr. Karpman said everything is healing great and the pump isn't connected to the scrotum wall. I'm very thankful and now moving to daily cycling.
I didn't realize how I would feel the reservoir when it's full. It makes sense since I've never had it filled up, just a new feeling.
 

[Stepone]

Pdxguy,
 Great news, no problems, yeah!
Glad you have a good surgeon.
StepOne  

[Pdxguy]

3/23/24 11 days post op
I'm starting to get used to cycling. I feel like my number of pumps varies quite a bit probably because sometimes I get a full pump and others more like half a pump. It seems like sitting in hot water definitely makes the pump softer, and I can push it further. Yesterday I was able to get 47 pumps but today I was only able to get 39 the first time then 30 the second time. I'm trying to keep track of my progress but with the inconsistency of the pump being full or half. Does anyone have the same experience?
 

[Stepone]

Pdxguy

Yes it seems like sometimes I pump 30+ times and other times, I may pump 24 times. It's really based on if you press the pump walls completely flat or 1/2 way pumps, etc.
There is nothing wrong, it's a process not to worry about.
I have gotten to the point where sometimes I don't even count.
StepOne  

[Pdxguy]

3/25 13 days post op
Today my scrotum swelling has increased quite a bit, which I'm fairly sure is from the pump slipping out of my hand and shooting around like a marble.  

3/27 15 days post op
My scrotum has continued to swell on one side. I spoke with my doctor last night and he told me to stop cycling for one week but keep taking hot baths and massaging the pump the best I can. The swelling feels puffy and squishy. I don't think it's an infection, my doc thinks it's inflammation from the pump slipping and causing trauma.
Has anyone else experienced this after having their pump slip a number of times?

[tomas1]

I didn't have much scrotal swelling, but I did feel like there was mush in there for some time after surgery.

Try to restrain the pump by holding where the tubing connects to the pump while pumping.

[Stepone]

Pumping can be precarious sometimes. I have done the "pump slip" many times which certainly gave me a shot of pain.
Sometimes I will use two hands. One hand acts as a support holding the other fingers in place.
Hawk wrote about the method.
StepOne  

[Hawk]

Your number of pumps will also vary if you fail to TOTALLY deflate each time.  This is critical since your reservoir is already starting to scar in and it is very important that you fill that reservoir.  Get every possible drop out of your cylinders in between cycling.  

[Pdxguy]

4/3/24 22 days post op
I had my 3 week follow up appointment yesterday and the doctor said things are healing nicely. I still have quite a bit of swelling in my scrotum but it's better than it was a week ago. Dr. Karpman cleared me for sex, which is amazing news!
I'm happy with this news, but I have mixed emotions because I want my healing to be further along. I think I just need to keep my focus on this being a marathon and not a sprint to full recovery.
Last night, I had sex with my wife and it was amazing, but I realized I still have a lot further to go before getting back to normal. The crazy good thing was I never lost my erection, even though I kept checking. The emotional healing is just as important as the physical and I know both will take time.