Peyronies Society Forums

I've already introduced myself in the Introduction forum, and now posting here as I await my pre-surgical appointment with Dr. Lentz at Duke, August 19th, 2021.

I'm 64, married. I have BC/BS Anthem insurance. I've chosen Dr. Lentz as he is a four hour drive away from me. Due to my job in county government, I can't be very far away from my work, and will be using my vacation time for the surgery and will stay one week afterwards nearby Duke until follow-up appointment.

I'll be honest here and say my issue started as far back as my late teenage years when I noticed that during masturbation I wasn't getting that big. During my college days in Engineering and Law school, this affected my confidence with women.
I managed to marry my wonderful wife at 32 and experienced about ten years of good sex with adequate length for penetration but had premature ejaculation issues. We managed to have children during that time. After I hit my forties, Erectile Dysfunction/vascular leakage became a real issue and the premature ejaculation became worse. I noticed my girth and length getting smaller. I saw a few Urologists then who did nothing but recommend Viagra which helped a bit and I carried on that way through that decade with less sex and burgeoning confidence/performance issues.

In my early 50's, I could no longer have regular intercourse. My length and girth and Erectile Dysfunction/PE/vascular leakage issues were getting severe. I saw a new Urologist who diagnosed Peyronie's disease and did an ultrasound which showed substantial scar tissue. When given the injection to cause an erection during the ultrasound, I got no erection at all. The Doc was surprised by that. I have an upward curve bend to my penis. Unsure of degree. Will post that info when I see Dr. Lentz.

At the age of 57 I saw another Doc in Atlanta who started me on a vacuum pump, cock rings to use, daily Cialis, and a good amount of T, and various supplements I have stayed on and which did help up until a year ago. Even with these, I still never got enough length for good penetration-only minimal (an inch or two)- and couldn't hold an erection for long-maybe two or three minutes with a cock ring after using the pump.

I saw Dr. Lentz in my late fifties, and back then the only pump available was the kind, I believe, that you pumped up from the outside. My wife was really afraid of infection and refused to be a party to that type of risk. So we declined and while intimate in other ways, we could not have intercourse. My wife read a few months ago about the Titan implant and that now implants are much safer, and here we are. Right now, I use the pump daily just to keep blood flowing to my penis for a few minutes each day, scared not to do that.

This morning when I measured myself after using pump and erect before I lost it, I had 5 inches length and 5 inches of girth in the middle. I don't know how much more length an implant will give, hope to have information from Dr. Lentz on that as well at initial appointment.

This surgery is very important to me. I have never been able to be spontaneous in sex, never been able to just enjoy it without performance anxiety and worry. I've never known what it's like to have a good degree of confidence.

I do want to mention that my condition with Peyronie's is probably genetic. My father had Dupytren's in his hands, back, and feet and required surgery. We found letters to my Mom after his death while clearing his things away that spoke of not being able to have sex after the age of 40 because of Erectile Dysfunction/Vascular leakage. I don't believe that Peyronie's was even mentioned to him back that far-would have been in the 1960's. I believe my daughter has inherited it to some degree, she has Endometriosis and had a hysterectomy at the age of 26 because of scar tissue buildup. My wife has none of these issues genetically on her side of the family.

I'm looking forward to your advice and wisdom here-this is a big step for me. I'm hoping others can learn from my experience as well.

I'm sorry to hear that. But it seems like you have had a fulfilling life with a wife and kid. It seems like you have done ok psychologically all these years. Were you not depressed in your 20-30's?

At your age and condition it seems like you would do great with an implant and finally have confidence in your sex life and not have to worry about it constantly. Hope to be reading about your progress

Lee ;

   what kind of surgery you are going for? Do you know about the sliding technique?

I was somewhat depressed, but coped. Very busy in the early years of my legal career. I met my now wife and she was very understanding--her father had been involved in a mining accident and spent some years not being able to walk and when he could, well, nothing worked well waist down.

I've never heard of the sliding technique. I'm hoping for one of the Titan implants, based on research.

I was offered the implant once before years ago by Dr. Lentz, I don't foresee a problem now going forward unless my insurance throws me a curve ball.

Keep using the VED to maintain or even gain a little size.  The implant is depended on to add any size.  You might gain some size if you have a leading surgeon who aggressively sizes.

Best of luck to you, and keep us posted.

PS: I personally would not consider surgery other than a standard implant surgery unless more size is absolutely a must-have at all cost.  The recovery is much longer, the chance of infection higher, and the surgeon selection far fewer.  On top of that, we have no successful accounts of those surgeries.  If you get a properly installed implant, you will be in about the best sexual shape of your life, and you will soon forget about whether you could have possibly gained 3/4" of an inch with some other procedure.

We are here for you.  Be sure to keep us posted. 

Lee, thank you for sharing such an informative background history.
I as you will read took the plunge 2 years ago and received a Titan implant that restarted my sex life.
Because of the Peyronies Disease I went from over 8" to barely 6" and with the Titan now have a solid 7.
My spouse and myself were more about increasing my girth as that took a big hit because of the Peyronies Disease too.
My only regret is that I didn't do it sooner.
When in my youth, I had terrible skin issues and also developed osteoarthritis. Having been a biology major at the university, I understood genetics and decided early on, not to spread my defective gene pool by getting the tubes snipped.
My oldest brother and myself both decided not to have children, whereas my other siblings did.
Both brothers have had Peyronies, sisters both had breast cancer as did mother. Mother lived to 100, father not so fortunate.
I believe Peyronies is much more rampant than people believe, but most men just give up and do nothing. I in fact was told by 3 urologists in early 2000's, there was nothing I could do. That is outrageous. I have never been a quitter, so I struggled needlessly with less than satisfactory surgeries until I discovered this site and found Dr Lentz.
Dr Lentz did a great job for me.
I recently heard his support staff were a little less responsive, but I don't know if that was a one time thing or not.
Any issues I had were immediately addressed.
But I found this forum to be the most informative and generous. 
Please accept my gift of prayer that you shall receive what you need.
StepOne

Hawk--thanks for the advice. This morning with my wife's help I got better measurements after using the vacuum pump.
Length: 5 3/4".
Base Girth: 6.0
Middle Girth: 5.0
Head Girth: 4.0
Left curve to upright penis, I'd say about 3 O'clock.

I have been doing much reading in these forums, and found that Trazadone helps with nighttime erections, which I'm not aware of now. I was on that to help with sleep several years ago and going to call my doc, ask for a new script. Can't hurt. There won't be anything much more for me to post till that August appointment but I'll be reading in the forums here. Any advice on anything else I can do in the meantime is appreciated.

Stepone: Thanks for your post. I'll be prepared to deal with Dr. Lentz's staff. That is one reason after reading your implant post that I'll be staying nearby for the 7-10 days it takes to get that first post-surgical appt done, and in case there are any problems that arise. I had the same problem with Urologists telling me nothing could be done as well. Part of the issue I've waited so long is that I felt there wasn't much hope and put it out of my mind until I learned that the implants were safer now. At my age, and getting an implant, if it lasts at least ten years, I'll be 75 and will have been a happy man. As technology increases, who knows what is next for better implants down the road. Thank you for the prayer.

I highly recommend that you first focus on the HIGHLIGHTED Sticky topics at the top of the implant forum.  If you study those, you will go in better informed than 99% of his patients.

PS: There is just something about the term "Sticky" topics on a penis forum that does not appeal to me  :D

I had my second appointment with Dr. Lentz at Duke this past week.  I had pretty much decided to go forward with the penile implant surgery but was still apprehensive. When I had my first appointment with Dr. Lentz in 2017 he impressed me as a competent and knowledgeable physician.  But the doctor I saw this past week had those same qualities plus brimming confidence in what the surgery could do to help me solve my erectile dysfunction issues.  I guess that is what happens with a doctor who has now successfully performed hundreds of the surgical procedures per year that is literally transforming the lives of many men.  His confidence sealed the deal for me.  He explained the procedure thoroughly to me, even drawing a diagram of how the surgery is performed. I am going with the Titan Coloplast implant.  I am scheduled for the implant surgery on October 11, 2021.  In light of issues with COVID, he is now doing the surgery primarily on an outpatient basis with no over night stay at the hospital unless absolutely necessary.  He told me I had very little fibrotic plaque.  It was present but not very hard or rigid, and that he could tell I had been working with the pump as I still had good flexibility in the penis.  He generally performs the surgery using an incision at the bottom of the scrotum, the scrotal approach(I think that is what he said).  In that my job is primarily sedentary in nature, I could probably return to work in about 7 to 10 days after the surgery.  One issue I have not resolved is whether to go straight home after surgery (I am scheduled for his second procedure that morning) or to spend a night in the area. I live five hours away from Duke, so I will be staying overnight near Duke the day before the surgery.  Dr. Lentz explained that I would have a drain that would need to be removed three days after surgery.  If I cannot pee on my own in the recovery area I would have a catheter that would need to be removed the day after surgery.  He explained that I would have a "mummy wrap" with my penis somehow secured in an upright position against my abdomen area.  So I could really use some tips on how to pee in that predicament.  My wife has had nursing training and is working towards her RN degree and I have a daughter three hours away who is an RN.  So I am not worried about getting good care at home and was thinking I might be better off to try and get home as soon after the surgery as possible.  But I am definitely open to suggestions on this issue from other members of the Board.  I want to express my appreciation for all the information that this forum has provided to me in this very special journey to recover a very important part of my manhood.  Hawk your dedication to this Board is amazing.  Thank you for your help and guidance.  I realize that this will not be a piece a cake and that trying and painful days await me for some time following surgery but I am locked in --damn the torpedoes and full speed ahead.  I will do my best to keep a detailed journal that I hope may be beneficial to others in the future that come to this Board for information on options in dealing with Erectile Dysfunction and Peyronies disease.

P.S.-from Lee's wife: Hello Everyone! You might see me post a bit here in the early hours after Lee's surgery until he can do that for himself. We were very impressed with Dr. Lentz, but his nurse is very competent and knowledgeable herself, and came in to speak to us about pre/post op instructions. She did not mince words and explained Lee would be very swollen, very bruised, and in pain. Dr. Lentz told us he uses a pain cocktail mix of two different anti-inflammatories, a nerve medication, and an opoid. We discussed whether we should just get back home as quickly as possible before the anesthesia wore off too much, or if we should stay overnight following surgery. She thought with Covid as it is in the area, it might be best to get quickly back home-but we are open to suggestions based on previous experience.

A note to wives/girlfriends: I know you read here, because I found the forum and alerted my husband to it. Please, if it has been a year of more of no sexual intercourse, or you are in menopause, see your GYN. It is very important that you ready yourself for sexual intercourse once more-either by dilating devices and/or hormones. I am very lucky to have found a GYN that treats men now as well as women, is knowledgeable about penile implants, and is helping me through estrogen replacement and other possibilities. It's been ten years since the last time we had unaided sex, so lots of work to be done.

I also forgot to add that my first re-check will be in 3 weeks for stitches removal and a check-up on the healing process -that re-check is with his nurses. My job is to keep the pumping mechanism pulled down into the scrotum after each time I urinate. The nurse told me if I had any issues, that the nurse triage desk was available, and at night and weekends, the Urologist at Duke on call. I can also message Dr. Lentz at any time. At six weeks I have my final check-up and clearance to begin to try to have sex again.

Best of luck Lee1979! Also to your awesome wife who is at your side you are what we men need to keep us in our right mind!! You are going to make it through this don't despair!

Congratulations, Lee, not only on your decision to address your issues but on having a wife who considers this a couple's issue and not just your issue.  I encourage her to make an account since she would be a huge asset to other wives and husbands facing these issues.

I came straight home from surgery.  That is a 4 - 4 1/2 hour ride.  While it would have been far better to have lived 2 hours away, I think I could not have done it the next day. 

Keep in mind that I was awake and had a spinal block.  It was the first one I ever had, and it absolutely sold me on them.  I think they block pain longer post-op.  There is no groggy feeling, no nausea, etc.
The only downside is that you feel awesome and are ready to go, but your legs won't work, and they made me wait until I could walk out the door on my own.  I knew this would happen and that I was racing a clock, so I put a cane in the car and had my wife bring it to me.  I think that bought me about 15 to 30 minutes.  My block was wearing off as I got home and climbed a flight of stairs.

Another issue is because it TOTALLY eliminated the pain; I think I was not careful as I should have been.  I should have fully reclined on the way home and used more ice.

Hawk---Thank you for that very helpful information on the issue on whether to attempt to go straight home after surgery.  I will follow your advice and head straight home as soon as they release me post-op.  You are absolutely correct I am blessed with a very understanding and supportive wife who has really stuck it out with me through "for better or for worse".  Now we both have the solid prospect of moving back into the "for better" part of our marriage.  I will post again the day before surgery.  I failed to note earlier that Dr. Lentz told me he implants the Titan Coloplast approximately 55% of the time as opposed to the Boston Scientific AMS.     I really appreciate all the great information and support this Board provides.  Lee

Lee, congratulations on your decision to move forward.
We all heal at different rates and we all experience pain at different levels.
That being said, let your body guide you through this procedure and do as your body tells you.
You are so fortunate to have a great wife that just happens to be a great nurse too. You are blessed!
Sorry I missed your earlier posts. I don't understand why I don't get alerts of posts, so I manually have to check this website.
Stay in touch and prayers will be coming your way in October.

  As I approach my surgery date of October 11, 2021 with Dr. Lentz at Duke several questions are coming to mind.  I will proceed on my belief that there are no stupid questions, just unasked ones.  Does anyone have recommendations on a brand of athletic supporter and/or compression underwear to keep my cock pointing straight up against my body post surgery?  Also any tips on techniques for peeing post -op and during the healing process with what I understand is a partially erect cock pointing straight up would be greatly appreciated.  I plan to come straight home post-op.  Duke is now doing the implant surgeries on an outpatient basis due to the continuing issues with COVID.  So assuming no complications, I should be released several hours after surgery to come home.  Home is a five hour drive from Duke.  I understand it is very important to lie as flat as possible with head down and feet up for several days after surgery to prevent blood from pooling in the scrotum to prevent hematoma and infection.  Any suggestions on how I do that traveling home in a car? I feel I have two options. 1) recline the front passenger sit as far as possible but my feet would still be down. I could prop my feet on the dashboard but I would have a hard time maintaining that position for 5 hours.  2) Lie down in the back seat padded with blankets with my feet slightly elevated with pillows, with small flatter pillow for my head.  Any suggestions or comments?  Thanks in advance for advice and input.  Lee
   

Quote from: Stepone on August 26, 2021, 07:44:12 AM
Lee, congratulations on your decision to move forward.
We all heal at different rates and we all experience pain at different levels.
That being said, let your body guide you through this procedure and do as your body tells you.
You are so fortunate to have a great wife that just happens to be a great nurse too. You are blessed!
Sorry I missed your earlier posts. I don't understand why I don't get alerts of posts, so I manually have to check this website.
Stay in touch and prayers will be coming your way in October.

Stepone --Thank you so much for your words of support and prayers.  As I proceed on this journey may I pm you? Lee

Lee,  anytime you improvise, you have to think things through in great detail.  If your body is somewhat inclined in the seat and you elevate your legs, you make your buttocks and scrotum the very lowest part of your body.  Blood from both halves of the body would drain to the lowest part.  You are much better off to keep your legs down and ICE.  In any position, it is counter-productive to elevate your feet.  Ideally, laying flat with a pillow under your butt makes your scrotum and penis the most elevated part of the body.

Five hours is a long ride.  I went four hours with the residual of a spinal block.  I felt I got home just when I was starting to feel the discomfort.  By the time I got in the house and walked a flight of stairs to the bedroom, I knew I was pushing the envelope some.

Make sure you get an ice bag something like this -> https://www.ebay.com/itm/384287563502?chn=ps&_trkparms=ispr%3D1&amdata=enc%3A1mfrJLLbOTsacdUWIZg65eQ88&norover=1&mkevt=1&mkrid=711-213727-13078-0&mkcid=2&itemid=384287563502&targetid=4580702890871448&device=c&mktype=&googleloc=&poi=&campaignid=418640321&mkgroupid=1233652283797640&rlsatarget=pla-4580702890871448&abcId=9300602&merchantid=51291&msclkid=18e52165b74617f5b87b4035488e309c

If you need more ice, pull into a fast-food drive-thru and get a cup of ice to refill the bag.  I would also get a "V" shaped pillow or "U" shaped pillow with a wide opening on the open end. It lifts your legs and butt and takes the pressure off of your scrotum.  That does not help with the swelling, but it is the only solution for sitting if you start feeling pain.  A soft pillow is the WORST.  When you sit, the center will thrust up against your scrotum.

Hawk--Thank you for the good advice and information--Lee

Well, my insurance BC/BS Anthem of Va (PPO 300) denied the pre-authorization for the surgery.  So no surgery tomorrow.  The denial letter indicated the denial was based on an exclusion in the Plan Policy.  I am going to ask that I be sent a copy of the policy exclusion.  My coverage is with a Group that is partially self-insured and uses Anthem as the third party administrator.  Anthem also provides the stop loss coverage and prescription drug card.  I turn 65 in February of 2022 so maybe medicare may be an option eventually.  I will need to work for at least another two years and will stay on my coverage through my employment since the employer pays 95% of the premium for family coverage.  So now my journey starts up a new road.  Lee

Medicare covers implant surgery with few questions.  If you get a supplemental policy, it will likely pick up everything Medicare does not cover, so you will pay nothing.

I would still appeal the insurance decision.  It will be interesting to see the wording of the exclusion.

I wanted to provide a brief update on my journal.  As noted earlier, my health insurance denied pre-authorization for the penile implant surgery due to an exclusion in the policy for implant surgery for sexual dysfunction.  I did appeal the denial of coverage.  The denial of coverage was upheld on appeal.  However, I have turned 65 years old and now have medicare parts A and B.  I am currently in the process of obtaining pre-authorization through medicare for the penile implant surgery with Dr. Aaron Lentz.  My surgery date is currently set for August 8, 2022.
One continuing problem I am having is a lack of a sex drive.  It has gotten to the point that I have almost given up being sexually intimate with my wife of 32 years.  I think it is a result of depression and frustration of not being able to perform as a man for a very long time.  This has created a real problem between me and my wife  We have used sex toys and oral sex over the last several years, but in the last year I have just about given up.  I realize this has not been fair to my wife.  I was wondering if anyone else has gone through this issue and how they dealt with it.  I am on TRT and generally my total T and free T have been in a good range.  My pregnenolone levels have been very low as in not even registering on labs. I am taking 2.5 miligrams of prenenolone 5 days per week to gradually bump up the level.  I am wondering if having such a low pregnenolone level could be contributing to my low sex drive.  Any guidance on these issues would be appreciated. 

Congratulations on the schedule of the surgery.
I spent the night at Duke, they took great care of me.
How far away from Duke are you?
The ride home was painful, even with a donut pillow.
If you could get the mrs to get your prescriptions filled the day of surgery, you can take one before your drive home. We did not, big mistake.
I think you could be suffering from depression. As I think back, we did not have sex for several months prior because we physically couldn't.
I am on TRT too, I did find the gel was not giving me the sex drive I was used to and started getting 1ml every 2 weeks. I did watch some porn, but it can be addictive, so I had to be careful.
Depression is a sneaky thing, as it sort of sneaks up and invades our lives. Sometimes anti-depressants are needed, but be sure to make sure that the particular medication you take does not harm libido.
I did increase my time at gym to make me feel more attractive and lose a few pounds.
I also found that I was anemic which didn't help, and once I got that resolved , I did get some of my mojo back.
Sex can he complicated and people can fall out of intimacy. I hate to say this, but sometimes you have to fake it, before you can make it.
I love oral sex and I did perform more oral sex on my wife. I just dove in and went to town on her. Her moaning was a turn on for me and even though I didn't cum, her satisfaction was working for me. Once I got the implant and the wait of 35 days, sex gradually improved. We now have better sex then we did over the last ten years.
But I have a friend that started TRT and their sex was wild! But after a few months, it fell apart. The wife and husband both put on a good amount of weight and they haven't had sex for over a year. I am closer with the wife and she told me that he wanted to F~@< her doggy style and she stupidly refused and she pissed him off. They have some big communication problems and I convinced them to get some marriage counseling. I'll let you know how that turns out.
In other words, you are not alone. Sex can be very complicated and frustrating as you know.
Sorry for my rambling.
August will get here, try to stay strong.
StepOne

I would call it everything but rambling. Sound advice Stepone!

Quote removed by the administrator.  Quoting an entire post is a violation of forum rule 7 which reads - 7. Limited Use of the Quote Button - Normally we should use the REPLY button to reply to a post.  We can use the quote button over a members post only when we want to quote a small portion of another post.  We can also use it when responding to anything that was previously posted BUT NOT when we are responding to the post immediately before our own post in the same topic.  When we do use the quote button we should trim the quote down so entire posts are not repeated. That way the reader can more easily follow the conversation.

Stepone---Thank you very much for the encouraging words.  I am back to using the pump to give myself the best possible result with the surgery.  I was not that well endowed to begin with and am somewhat conerned about losing some length from the surgery.  But with the vascular leakage issue I can not use what I have so for me this surgery is a no brainer.  I think I am making some progress with getting medicare pre-authorization for the surgery.  It is somewhat complicated as I am still working full time and my health insurance through my employer is considered primary while the medicare is secondary. But since my health insurance through employment has denied coverage based on a policy exclusion the medicare should kick in.  I just want that resolved in advance. As to the drive from Duke back home it is about six hours. My procedure is scheduled as an out patient procedure and is scheduled for very early in the morning. So I will probably be discharged by noon at the latest.  I have gotten some advice that the best thing is to lay flat for the first two days following the surgery to keep swelling down.  Also I am concerned about having the drainage tube and possibly the catheter to remove post surgery and may want to stay close to Dr.  Lentz's office to handle those issues as opposed to having to rely on health care providers back home for those issues.  I do want to get home as quickly as possible but am weighing what will be the best course of action considering all the circumstances.  We are thinking about staying over in Raleigh for two nights following the surgery.  Do you have any recommendations as to whether I should stay over for a couple of nights or try to go straight home.  I think Hawk thought it would have much more painful to wait to travel home, if I am remembering correctly. Thank you so much for all the encouragement as I move forward with this huge life changing event so late in life. 
Lee

If you are going to wait to travel I think you have to wait at least 4 days.  Obviously, the discomfort increases after surgery for at least a few days as the anesthesia wears off and soreness sets in, then the discomfort slowly begins to reverse.

On the subject of insurance.  I am not certain about medicare.  Stabler probably knows since she works with insurance claims.  Often when you have any primary insurance and a secondary, the secondary pays a portion or all of what the primary did not fully pay.  HOWEVER, often the secondary does not kick in IF the primary denies the claim.

So much going on.
Six hours is a long drive without surgery.
You are definitely going to need pain pills to get you home.
Remember to take your medications even if the pain isn't bad. Once you are experiencing pain...and then you take the medication, the medication takes time to have an impact and the intensity of pain will increase before it decreases.
I did spend the night, perhaps it's because I suffered from several small strokes.
Unfortunately I don't recall a drain. They might have removed it prior to me leaving the next day.
I would call his administrator and ask
1. Will I leave with a drain? If I do, when will it need to be removed?
2. Can you give my spouse prescriptions once I go into surgery, so they can get it filled ahead of time?
3. Is there a chance you will keep me overnight?
4. (I was told to come back in 5 days and they showed me how to pump and deflate). Will they do that with you? (This was extremely painful, I should have brought pain pills and a driver)(My 2 hour ride home was dreadful).
5. Do they have a "after surgery" document with instructions and care? (This seems to be lacking for all surgeries.
Hope this helps.
By the way, I live in SC, it was about 2.5 hours for my drive to Duke.
StepOne

Quote from: Stepone on May 27, 2022, 07:55:48 AM

By the way, I live in SC, it was about 2.5 hours for my drive to Duke.
StepOne

StepOne---Well, I am now less than 48 hours away from the surgery with Dr. Lentz this coming Monday morning.  We plan to stay over in Raleigh through Wednesday night. That will permit me to stay flat on my back the first 72 hours post-op, as recommended. We will leave Thursday morning for home five hours away.  My wife will post to this thread after my surgery to begin what I plan to be a detailed description of my post-op experience.  I want to again thank everyone who has offered advice and encouragement through this process, particularly Hawk and StepOne. 

Very exciting.
I will definitely pray for the surgeon and you for tomorrow.
If you have surgery remorse over the next weeks, just keep in mind, this is a marathon process, not a sprint. It will take time and the more time the better. But over time, you will learn to love your new penis, despite its differences. I personally love my new penis more than my penis when I was in my fifties. It's hard as a rock, and thicker than ever.
I hope and pray for an even better outcome than myself.
Be patient and follow your recovery instructions.
You are so fortunate to have such a supportive wife. Emotional support is so support.
StepOne

StepOne—Thank you so much for your support and prayers—I may need your guidance over the next several weeks—Lee

Good luck with your procedure Lee. Fingers crossed for you!

Good Morning, guys. Lee's wife here.
We arrived yesterday (Sunday) to the Hampton Inn-Midtown in Raleigh. The hotel is 0.5 miles from Duke Raleigh Hospital where Dr. Lentz is performing the surgery. If you mention you are a Duke patient, you receive a special room rate of $99 a night plus tax. We are staying on the first floor, next to an exit/entry door and ice machines.
Warning: In room refrigerators are pre-set to a higher temp, impossible for ice packs, if you were to bring those. We had a special refrigerator brought in room to keep those packs very cold after some complaining to management was done. Otherwise, wonderful room and very clean.

We received pre-op/post-op instructions at Lee's last visit with Dr. Lentz. Lee is now in surgery. He is Dr. Lentz's first patient of the day. Lee is receiving both Gentamyacin and Ancef for infection control via IV. He was given 3 Tylenol via mouth in pre-op to control fever afterwards per Dr. Lentz's orders. He was shaved, Gentlemen. We will be able to pick up discharge meds/pain pills here in the patient pharmacy in hospital at discharge.

The approach will be Scrotal/Penile.

Lee signed permission for a three-piece Coloplast Titan to be implanted.

As soon as I get him back to the hotel and comfy, I'll update with more information.

Lee's wife here.

Lee was sized aggressively with 22cm cylinders and 2 cm rear tip extenders.

He will be very happy with that when he wakes up, he is still sleeping peacefully back in post-op. Dr. Lentz called me personally after the procedure, and said Lee did very well. The Peyronie's scarring was mild. So, venous leakage was his most troublesome problem. He's been given so many post-op meds, no doubt he will be sleeping the rest of today.

He was prescribed:

Oxycodone 5 mg. every 4 hours as needed for 5 days
Neurontin 300 mg. at bedtime for 14 days
Meloxicam 15 mg. once a day for 10 days
Bactrim antibiotic for 5 days
Tylenol 500 mg. three times a day for 10 days
Geri-Kot once a day.

Will update again on Day 2.

These are great news! Surprising to see the medication he has been given, but for sure the doctor has to know what he is doing. The implant size he got will leave him happy, most certainly.

This Dr sounds like he knows his business and also the correct pain killing regimen!! Now is the time to heal and things will be awesome I'm sure!

This is excellent news. I woke up last night and did a short prayer again. This is so exciting as it is a the start of a new beginning. Don't be alarmed if his penis looks good and then starts to turn black and blue after a day or two. I had no fever or infection and other than a few misguided steps on my part and miscommunications with one of his assistants, the follow up was fine. Your husband is so lucky to have you and thanks for taking the time to write. Big hugs and prayers
StepOne

Day 2:

Good Morning, Guys. Lee's wife here. Thank you for all the positive comments, and it's my pleasure to document Lee's journey with his surgery. He's kind of a quiet guy and doesn't say too much oftentimes, so he has given me permission to document here for him and the benefit of others until he can make coherent sentences again, LOL.

StepOne, thank you very much for the prayers. Lee wanted me to pass that along, that he is touched that you would do that for him.

We had a late day yesterday. Lee did not leave the hospital until 4 p.m., because he could not urinate. He must have gone into surgery slightly dehydrated, despite the fluids given via IV. He drank a liter of fluid yesterday before he could urinate. The burning and stinging each time he would try was extremely painful. The nurse brought him a dose of Pyridium (sp? The stuff that turns your pee orange and for bladder/urethra pain). Two hours later, and a walk down to the bathroom with privacy, and he was able to go enough to be discharged. No worries, he started really urinating about 6 p.m. and continued every few hours through the night (some sarcasm inserted there).

So Guys, if you are considering this surgery, please hydrate well the day before surgery. Ask for Pyridium if you experience pain urinating so you can get out of the hospital sooner, if need be.

Lee's pain level is at a 1. I've kept on top of the pain meds and have been alternating the Oxycodone and Tylenol. The Meloxicam and Neurontin he gets at bedtime. I've alternated the cold packs throughout the night, every 30 minutes, off and on. Resulting in this morning being just sore in the lower abdominal area. We have found that the squishy cold packs you buy in the drug store in varying sizes has worked the best. They mold and fit into areas we would otherwise have an issue with concerning big ice chunks. The only setback is you have to change frequently and need several.

Lee is still kinda out of it, alternating between being awake and sleeping. He's walking well to the bathroom and is increasing activity for today. His back hurts a little because he has his butt/scrotum elevated on a pillow, but we've taken the pressure off a bit by putting a pillow under his knees.

Tomorrow, we will start tapering the Oxycodone to every 6 hours to see how he does, and perhaps skip a dose at night. If pain increases, we will go back to original schedule. Bandages and drain will be removed tomorrow morning. We will then get good look at the bruising. The head of his penis IS black over about half of it. We weren't shocked because of warnings here on the forum and by StepOne about that.

The wound is draining well, and swelling looks down from yesterday evening. We managed to get a sink bath done and T-shirt changed. He is having some urinary incontinence upon standing and sitting down, but I think that could be expected from the trauma to the area.

If you are considering using Dr. Lentz for this surgery, you might want to make sure you have someone with you to help you the first 48 hours, because of the pain meds he has chosen to use to treat pain after surgery. I don't think Lee could have kept up with all the first day and night, into the second day. By tonight/tomorrow morning, I think he will be back to pretty much himself.

If you do have to do this alone, bring a portable table tray or two to sit up across from your bed to hold meds and water, and a separate one for anything else you may have, like your urinal and wipes. That way, if you would be a fall risk on Oxycodone, you minimize your risk of falling on your way to the bathroom, etc. the first day or so. We expect a call from Dr. Lentz' office later today to check in on him.

Lee is still shocked and extremely pleased that he was given a Titan 22 cm. He felt he was so small that he would get a 18 cm.

That's all I can think of at the moment. If you have any questions, please ask.

Sounds Great!!

My first comment is
LEE IS A BLESSED MAN TO HAVE YOU AS A WIFE!
Are you a nurse?
I hope that one of our administrators, if not already done... and go through everyone's helpful hints, as you have provided several.... And compile them into a "helpful hints" pre-op and post-op.
I am so happy to hear how he is progressing and yes great to hear about 22cm.
It's smart about tapering the drugs.
One thing you will find is that, even when he may be feeling fine sometimes, there are these sharp phantom pains that will come from nowhere.
Since I have small balls, I didn't have any problems with the pump, but some men with larger equipment have had pain in the scrotum.
Once Lee is cleared and is allowed to start cycling, I did mine in a clean jacuzzi along with a beer and something to
Listen to to take my mind off the pain.
Once again thanks for Lee's update and for you posting.
Big hugs to both and prayers for both of you.
God loves all of us equally.
StepOne

Thank you for the ideas, StepOne. Lee has mentioned already that he can't wait till day 7 and a bath. He is diabetic, so we have to wait till then instead of day 5.

I am in nursing school. But that aside, Lee and I have waited years to have this done. He has to do all the hard work-the surgery and then the healing. We wanted to make sure this was done right, and we had an action plan in place. Anyone in a support position could do the same for their loved one. We looked all over the internet at different forums and websites to gather ideas on care after the surgery. From travel/hotel room selection to communication with Dr. Lentz and his staff, all the way through.

A good doctor who has an understanding of a man's needs, is super confident, does hundreds of these surgeries a year, and knows how to get a good handle on the pain afterwards and to prevent infection is THE first step. You just don't know till you experience this whether or not you made the right decision on a doctor. This is not the time for a mistake, and men need to be positive they have picked the best one for them.

Dr. Lentz has exceeded expectations thus far.

I came back in to add that I think it is very important for men to know exactly what to expect, given that every man, and every experience varies-but knowing what happened to this one guy, and this other guy-that helps so you personally can plan for all contingencies.

I know that Lee was afraid of the surgery for many years, we tried just about everything to see if that/this would work instead, and we couldn't get our luxury health care plan we've had over a decade to pay for it. It wasn't till he reached Medicare age that it became possible. The path has been difficult and bumpy. But we never gave up.

He went through a horrid depression for years about this, as well. Right before the surgery, in this last year, he gave up being intimate at all. Very aloof. Lots of hurt, there.

But I've seen him smile, and his eyes light up, at the thought of what his life is going to be like now in the last 24 hours. That's been worth it all. He actually tried to catch his nurse at the door to the bathroom (me) and try to sneak a kiss this morning.

My contribution is for guys here to know what they might experience in the hours after, and for girlfriends/wives to know how to care for their loved one throughout the process. If one person reads this thread and is helped in some way, it's been worth it.

Lee will be back here tomorrow to give report. I'll pop back in occasionally to give an update, as well. Do you have a "Ladies Section" here on the forum?

Let me repeat.
Lee is blessed to have YOU!
You are not the norm, you are a definite 10+.
Yes, we have all suffered  in silence for too long.
I have a good supportive spouse, but you are perfection!
Big hugs to both.
StepOne

Quote from: Stepone on August 09, 2022, 11:37:43 AM
Let me repeat.
Lee is blessed to have YOU!
You are not the norm, you are a definite 10+.
Yes, we have all suffered  in silence for too long.
I have a good supportive spouse, but you are perfection!
Big hugs to both.
StepOne

     Well first let me say I agree with StepOne that I have been truly blessed with God bringing my wife into my life some 33+ years ago. She is and has been fantastic in her support and care for me throughout our marriage, but in the last 10 years when we have struggled to have sexual intimacy she has never given up on me or us.  She definitely is a 10+.
     Now on day three post op.  Dr. Lentz and his staff are absolutely the best!  The surgical team and staff at Duke Raleigh Hospital were terrific as well.  From the moment I was taken back for pre-op I felt I was in good hands. The nurses were top notch and know their stuff. The anesthesiologist and her nurse anesthesiologist explain how they would put me under, first with a medication through the IV to "take the edge off" then with a mask.  I remember being rolled into what I assume was the OR.  I remember they took both of my arms looking up at the lights then the next thing I remember is waking up in recovery.  I had to be at the hospital by 5:15 am with the surgery scheduled at 7:15 am.  I was Dr. Lentz's first surgery of the day (yay!).  He had six other surgeries scheduled on Monday.
     I got to recovery around 9 am or so according to my wife.  Was given some medication by the nurse.  My job then was to be able to pee so I could be discharged home.  Well that process took about until 4 pm that afternoon.  I drank alot of water and diet ginger ale to get to that point.  It was painful to pee initially, but that eased with time and the nurse gave me Pyridium (sp?) to make it easier to pee.  Now having my new bionic cock at attention at 3:00 o'clock certain makes peeing in a urinal easier.  They had put a jock strap on me when they bandaged me up and cut a hole in the jock strap for my cock to go through.  After successfully being able to pee (they will not discharge you until you can pee), I was moved to another area of post-op where we (mainly my wife) was given post-op instructions, particularly in regard to the drain which is coming out of my scrotum and draining blood into a small bulb. When the bulb is emptied the nurse showed us how to squeeze the air out of the bulb to create a vacuum to make the drain work more efficiently.
     I was still having a good bit of drainage yesterday (day two post-op) so we sent a message to Dr. Lentz on Duke MyChart as to what to do about removing the dressing and drain the next day (today--day 3 post-op).  A nurse from Dr. Lentz's office called us within 30 minutes and said for us to call her back today around 3PM to check the status of the drain.  The drainage seems to be slowing down this morning quite a bit, so I believe my wife will be able to remove the dressings and drain at 3:30 and I can try to start finding the pump in my scrotum and pulling it down.
I'm easing back on the pain medication (Oxycodone) today.
My pain level is a 1 in bed. When I get up to walk, it becomes a 6 out of 10 because of the reservoir on the left side groin/abdominal area.
Dr. Lentz' office staff has been great with communication. We can send a message on MyChart, and his office calls within 30 minutes during the workday.
More tomorrow, Day 4.
 

All great news!
Thanks for reporting.
All sounds great.
It's been so long ago for me, it's hard to remember, but I don't recall receding directions to slightly tug on bulb. I assume that was in the post op directions?
Did they verbally tell you or did you get written instructions?
It would be interesting to see your post op instructions, without any patient ID information.
Very happy for you.
They kept me overnight because I have a history of TIA's (mini-stroke) and it was later in day. They took my drain out the next day which was great. I think they gave me a blowup donut balloon for the drive, but don't recall where it came from. The ride home was rough, so glad I had the pain meds.
Are you home yet?
And of course like all of us are blessed. You are extra blessed, lol.
Hugs to both of you and stay safe.
StepOne

StepOne--I leave to go home tomorrow at 11 am. I was given written orders. My wife bought one of those boppy pillows for nursing mothers because it has a U-shaped design. I rode back to the hotel on it and it provided relief. I think I'll be as comfortable as I can be under the circumstances tomorrow going home with it.
On the drain issue we empty and then press down on the bulb to get all the air out, then place the plug back in. It creates a vacuum and more suction power. I have to empty it every 4 hours per Dr. Lentz.
Calling nurse back at 3 p.m. to report how many cc's collected since last night to get the go-ahead to take it out.
I'd be happy to take pics of the post-op discharge orders and post here when I get home.
Having my lunch and then plan to get the bandages off and drain out around 3 pm and take a good look--then I'll post back here.
Thanks for all the kind words and thoughts.

UPDATE:
Wednesday evening

Lee's wife here. Bandages are off, JP drain is out. There is absolutely no swelling in the scrotum or penile area.
No bruising anywhere except head of penis, which is black over about 50% of it.

Looks like having the butt/scrotal area up on a pillow for over 48 hours with ice was key.

Lee is now cleaning up and getting underwear on with a new jock strap. I had to cut the one he got in surgery gently away since there was no easy way to get his penis out of it since a hole had been cut in the middle. The nurses gave us an extra one in post-op to take home with us.

Hints:
*Ask for extra jock strap in Post-OP, they should give you one, just to have in case of.
*Take a dose of pain med 30 minutes before JP drain removal. I had to gently tug a bit for a moment and it was uncomfortable for Lee.

Day 4:

I'm getting ready to start the drive home today. I had minimal pain overnight except for Reservoir site. I did cause some bleeding from the incision site on my scrotum looking for the bulb of the pump to pull down. I think I popped a stitch--it stopped bleeding pretty fast so I'll have to be more careful--my balls are small so I had no problem finding it.
I really want to get home and get in my own bed. I'll update again on day 5.

Thanks for your reports.
By the way, did Dr Lentz tell you to pull on the pump?
I don't recall receding that I formation.
Yes I had some minor bleeding around my stitches when I picked at the scab on the scrotum. I shouldn't have done it, but I was ok.
Good luck on your ride home.
StepOne

StepOne-Dr. Lentz told me to start to pull down on the pump when the dressings and drain came out every time I had to go to the bathroom. His nurse in giving instructions at my last appointment, told me "that's your job". It seems to be holding pretty well in a good position.

Day 5:

Good Morning, Lee's wife here. Currently, he's on the couch with his first cup of coffee and in some pain.

He did really well on the drive home yesterday, we kept him iced up with ice packs packed into the U-shaped pillow area and around the reservoir area, and he slept well last night, but this morning his pain is up around the reservoir on the left side of his scrotum and right above that in the lower abdomen area-pain is about a 2-3. He's had Tylenol and is icing the area again, and sitting still.

He does have bruising this morning, and we are seeing it for the first time in other areas. There are two bruises to the right and left side of his penis on the pubis, both circular, about dime size.

He has some bruising on the penis itself starting midway down the shaft going to bottom.

Stitches look good and no swelling anywhere. All that black skin on the head of the penis looks as if it is drying up.

He says to tell you guys that the Boppy pillow has been a lifesaver. In the car, here at home--I think it was Hawk that mentioned a U-shaped pillow or plastic blow up one. It has really helped him quite a bit in not only elevating him, but getting ice underneath his scrotum.

He's already talking about going back to work next Tuesday and sitting in his office chair with his Boppy pillow and locking his office door and just taking calls and emails.

I am trying to talk him out of this.

Lee here--Post-op day five(this is in supplementation to my wife's very accurate and detailed post earlier this am)---Trip home went amazingly well yesterday.  One oxycodone just before we left and tylenol later on the road controlled the pain well. I also used an ice pack under the boppy pillow which worked perfectly.  So I am now home.  Another hurdle overcome in this journey to rediscover my manhood.  I have a distinct feeling that this will end up being a life changing experience.  The next challenge will be learning to use the pump.  Since I have a relatively small ball sack with small testicles, the bulb of the pump was easy to find.  I tried initially to gently pull down on the pump as instructed to do so and it would not budge.  The bulb of the pump seems to be at or very close to the bottom of my ball sack.  I found this video on youtube on tips on how to operate the pump mechanism for the coloplast titan.  I found this video helpful to visualize what is exactly now inside my body.  I hope posting this youtube video does not violate any of the board rules.  If posting this youtube video is a violation of Board rules I would ask one of the moderators to please remove the video. https://www.youtube.com/watch?v=o1t3YuJ_zz4

I think for now I will just keep a check on the pump bulb location in my scrotum.  As long as it remains near the bottom of my scrotum I am not going to pull on it.  I look forward to start taking warm baths on Post-Op day seven.  That should give me an opportunity to become more familiar with the pump mechanism, particularly where the deflate button is located.  I know from the video that the deflate button is located just above the pump bulb but have not yet been able to locate it in my scrotum.  If today and tomorrow are uneventful in the healing process, I will probably report back after taking that first warm bath on post-op day 7.  Thank you again for all the support from this board as I make this journey.  StepOne thank you so much for your prayers and encouragement.  Lee 

Thanks for update.
It is interesting how bruising takes time to appear.
I remember when cycling I caused a bruise too. It is a process.
I am retired, but when I went back to choir the following week, I took a special cushion with me too.
I sent an email to the choir director prior to my return that I had a "man urology surgery" and no one asked any questions.
Everyone was very caring and supportive, I assume they all thought it was my prostate, lol.
If anyone would have asked I would have told them I had some surgery on my penis. When I told my brothers and sisters, I had a penile implant, no one asked any questions, lol big time!
My family has always been shy when it comes to anything related to sex. Not me, I was ready to show and tell, lol again!
Stay safe
StepOne

Lee, I too have small balls and sack. Some guys had problems reporting that the pump fought with their testicles. I had no problem.
I am remembering more about the pump. So the top of the pump goes into the underside of your penis with all the tubes. Because of this the actual button area and release area are close to the underside of the penis.
I seem to remember having difficulty finding it at first, because initially it is right against the penis.
Overtime it will gradually loosen and drop down a little, I think that's why I was instructed to GENTLY pull on the pump.
Ask for a model if they haven't already given you one.
You have plenty of time to figure that out and you can do that when you take  warm baths and explore.
StepOne

Post-op day 6---Not much to report.  I have stopped taking the oxycodone and am controlling pain with the tylenol.  After not being able to have a bowel movement Monday through Thursday, I finally broke through yesterday and things are getting back to normal today.  So another hurdle overcome.  Still having mild discomfort in the scrotum at times and in the area of my lower abdomen where the reservoir has been placed.  But swelling is decreasing and my wife says I seem to be healing well.  I now understand that I have to wait until day 10 post-op before taking warm baths, 2-3 per day.  So that will be this coming Wednesday.  Well that is about all for now.  Lee

Thanks for your report.
We all have different pains at different places.
I never had any reservoir placement pain. Mine was mostly penis and ball sac.
If you could post a copy of your post op instructions minus your personal identification information, etc. that would be great.
I added you to my personal prayer list, so I am praying for a good recovery. I had a friend named Lee, so yours is easy to remember.
StepOne

Lee there is another video with helpful hints.
YouTube.com/watch?v=tcQgJB3kbO0
StepOne

StepOne--Thank you for the video.  I am on post-op day 13.  I have my first post-op check with Dr. Lentz's PA this Wednesday, August 24.  Pain has been fairly manageable but worsened Friday and Saturday.  The pain is in the area of the left upper groin and lower abdomen where the reservoir has been placed.  The pain seems to be predominantly on the left side of the groin and scrotum.  This past Thursday (post-op day 10) I started taking warm baths twice a day for 20 minutes each.  Seems to be helping.  I am actually sitting on an ice pack now.  I guess I have two questions at this point.  How long can I expect the pain and discomfort to persist?  And how much discomfort am I looking to experience with the removal of stitches this coming Wednesday. I believe this also the appointment where the PA will inflate and deflate the Titan.  Any guidance or comments on the pain issues would be appreciated.  Lee

I don't remember pain from where the reservoir was placed.
My penis seemed to hurt.
I am on the thin side, so maybe there was not a lot of cutting with me in the abdomen.
Your doctor should be able to figure that out and let you know.
They did not remove my stitches as they were self dissolving.
My scrotum hurt really bad around the stitches.
So when I had to pump and deflate it was very painful.
I forgot my pain pills, so be sure to take one before and have another just in case. I forgot my pills and I was in a lot of pain deflating and driving home. Tylenol did nothing.
I would email them and say you are still having abdominal pain. See what they say, maybe there is a valid reason. I am sorry, but I don't recall abdominal pain at all.
But of course we all are built differently.
Let us know what happens. 
Big hugs
StepOne

StepOne---That is promising about the stitches dissolving.  I have pain around the stitches as well, particularly if I move too quickly.  Today has been a better day.  So will the PA inflate and deflate me and then I do it during the same appointment as well?  Really appreciate your input--Lee

Lee, my stitch area hurt too.
Sporadic shots of pain.
The PA inflated me and the pain was so bad, I told her to stop and let me do it.
Then she said let me show you how to deflate and I said NO.
I need a minute to breathe! Lol
I deflated, but it was painful.
It's so much better to do while sitting in a warm whirlpool with a cocktail, lol
Who knows how they do it now, it's been over 3 years.
Big hugs
StepOne

StepOne---Thanks for all the great information.  I think I will have a backup plan of staying in Raleigh overnight if I do not feel I can make the drive back home after the appointment on Wednesday.  I will let you know how it goes.  Lee

Sounds like a plan. If you take pain pills with you or take one when you get there you may be ok. But I had neither and I should have asked for something for the pain. I thought I could handle it, but I couldn't get home fast enough to get some of my meds and lie down.
StepOne

Post-op day 17---Yesterday (post-op day 16) I traveled the 5 1/2 hours to Raleigh for my first post-op visit at Dr. Lentz's office with PA Ian Hunter.  I was very apprehensive about the pain I might encounter with having the stitches removed.  However, that went very well with little pain experienced.  However, there was some blood.  (After I got home --again a 5 1/2 hour trip home--there was significant blood on my jock strap and underwear. I would have freaked out if not for my wife who is a nurse).  Anyway, the PA had asked if I was having any pain prior to getting started and I advised him I was having fairly consistent discomfort where the reservoir had been placed (lower left side of abdomen and groin area) with discomfort going down the left side of the groin. (The PA indicated that this is where the tubing from the reservoir to the pump was placed).  The PA after removing the stitches showed me what the Titan implant looked like that was now inside my body.  He showed me where the pump mechanism and where the deflate mechanism were located.  He also pumped me up just slightly beyond the approximate 20% inflation level I had been left at post surgery and then showed me how to deflate.  I was able to use the inflate bulb but could not locate the deflate mechanism in my small shrunk up ball sack.  It is much easier to locate everything during a warm bath
with the scrotum relaxed by the warm water.  So I have challenges ahead as the PA wants me to start cycling once a day between now and when I see Dr. Lentz for my second post-op appointment on September 21. I had watched a video some time ago so was fairly familiar with
what the Titan looked like and where everything was located.  When I started taking warm baths on post-op day 10 I was able to easily located the pump bulb which is at the bottom of the Titan implant. The deflate mechanism is right above the inflate bulb.  In any event I have some work to do but will try to remember StepOne's guidance that this is a marathon not a sprint.  Fortunately, my wife was able to come with me yesterday and did 80% of the driving.  I would be lost without her. Last night, I did have a lot of burning pain, again where the reservoir has been placed and down the left side of the groin where the tubing has been placed.  It is better sitting up this morning.
   I had more pain and discomfort this afternoon where the reservoir and tubing from the reservoir are located.  The pain is a burning type pain that seems much worse when standing.  The burning sensation subsides when I sit down and is more of an aching type pain.  Tonight I am going to work on trying to completely deflate the implant it is in approximately in the same state of inflation as immediately post surgery.  I will do this while taking a warm bath. I sent in a request to the nurse today for a refill on the Neurontin, but have't heard back yet.

Good report Lee.  I think you just have to outlast the pain.  We all have different experiences, and while your pain may not be just like mine, healing and pain reduction will take place.  You will NOT have daily improvement.  That bounces around, but you should have weekly improvement.

Yes excellent reporting.
Sorry about the continued pain.
Interesting you had stitches to remove, mine were self dissolving.
Could you update your signature with the month and date of your implant and the 22cm + 2?
I'll pray for you for speedy recovery, but sadly it takes a while.
Stay safe and say hi to the mrs.
A year from now, this will be a distant past.
Big hugs to both of you
StepOne

I also had stitches to remove at week two (I Think).  Dr. Eid told me I could get my local urology office to do it.  I set the appointment, and I only saw a beautiful nurse who was quite interested in the implant.  I had no bleeding or discomfort.  I would be concerned that bleeding might indicate I could introduce infection from sitting in a tub of water.

I am not sure you can tub-soak with dissolvable stitches.  I was tub-soaking at day three.

Thanks to both Hawk and StepOne for the encouraging words and guidance.  This Board is a blessing.  Post-op Day 18 AM--Took neurontin last night and slept fairly well.  Pain is tolerable lying down.  I have found I can sleep on my side to some extent with a pillow between my legs.  My major issue now, besides the pain is not feeling at all that comfortable using the deflate button.  Post-op Day 18 PM --Pain today has at times has been significant.  So I left a message on the nurse's line and then sent a message to Dr. Lentz on Duke My Chart this afternoon.  The nurse called Dr. Lentz and he directed her to call me back with some specific instructions.  He was concerned about the issue of bleeding from the removal of stitches and did not want me to take any more baths until the wound healed completely.  He also did not want me to cycle or tug on the pump ball for the time being.  The nurse spent quite a bit of time speaking to me.  She indicated that Dr. Lentz wanted me to report on my progress on Duke My Chart on Monday morning.  She also told me that Dr. Lentz told her to tell me that the pain I was experiencing on the left side of my groin was not unusual at this point and that I could use a hot pack on the affected area. 
I was very impressed with how quickly the nurse contacted Dr. Lentz and how quickly she relayed his instructions to me.  Wish I could say the same for PA Hunter who had still not responded to my message that I sent him yesterday.  But clearly, if you are one of Dr. Lentz's patients from surgery, his office has been instructed to keep a close eye on messages sent to his attention.  The nurse said that for now they would keep my appointment with Dr. Lentz as scheduled for September 21, but if my situation worsened they would get me in sooner.  I requested a refill on the neurontin prescription yesterday afternoon and it was in at my pharmacy first thing this morning.   Although in pain, I feel better tonight.  Hawk is right, I just have to out last the pain.  And as StepOne has repeatedly told me, it is a marathon not a sprint.  Heck, no where to go but forward. Lee 

Post-op Day 37

I regret I have not been more consistent in my reporting.  I will now try to catch up. 

I continued to have significant pain in the left side of my groin. It has now resolved. It was a burning pain that at times would be extreme. The only relief for this pain was to sit down.  When I would sit down the pain reduced by at least 90%. I found that being on my feet for almost any period of time brought on the pain.  So I reported back on Monday, August 29, 2022  the information on DukeMyChart and Dr. Lentz's office scheduled me to come in to see him on Thursday, September 1.  By September 1, the pain in the left groin area was starting to diminish but I attempted to keep the appointment, a five and half hour trip to Raleigh from Southwest Virginia.  I ran into car problems about 45 minutes into the trip and had to turn around and come back home and reschedule the appointment for the next week on Thursday, September 8.  By the time I made the trip to Raleigh on September 8, the pain on the left side of my groin had almost completely resolved, but I still felt I needed to see Dr. Lentz to let him check and make sure everything was OK. I needed to get his clearance to begin cycling with the pump.  As to the pain in the left side of the groin, I estimate it lasted about 10 to 12 days with a gradual lessening of pain over the last five to seven days.  I still get a twinge of pain there from time to time but nothing like when it first started.  I used Aleve and Tylenol on an alternating basis to deal with the pain and also got a  refill on the Neurontin medication. 

Back to my appointment with Dr. Lentz on September 8.  He inflated me and deflated me. I asked if would inflate me again so I tried  to deflate myself.  I was very apprehensive about making sure I could deflate the implant.  This was one of the main reasons I felt I needed to keep the September 8 appointment even though the pain in the left groin area had pretty much resolved.
I was able to partially deflate--Dr. Lentz came back in to see how I was doing and helped me finish the process of deflation.  I had been unsure as to whether I had to continue to press on the deflate button while squeezing my penis.  Dr. Lentz explained that was not necessary as the Coloplast Titan release was a one touch system. 

Flash forward to present.  I have been cycling with the pump for about a week now while taking a hot bath each day for about 30 minutes, spending 15 minutes inflated. Just getting 15 minutes in is extremely painful. I had a real problem initially depressing the pump bulb and am still trying to getting the hang of it.  I am using the two handed method --one hand to steady the bulb and the the thumb on the other hand to press down on the bulb.  The pump bulb is not easy to depress and takes quite a bit of force.  Maybe it will get easier with time.  I am having a lot of pain in the penis when it is inflated.  It has not been easy to go the full 15 minutes of inflation with the pain but I am doing it.  My wife, the sweet and nice nurse of a couple weeks ago has changed into drill sergeant mode.  Geez!   

With deflation, I am going through the push the deflate button and squeeze the penis three times as per the instructions, but finding I am doing it a couple more times after getting out of the bath to be sure I am fully deflated.  I have lost about a half inch in length, with length at four and half inches with the implant inflated.  With the the VED, I had 5 inches in length and 5 inches in girth.  I do have about 5 inches in girth with the implant inflated.  Hopefully with a 22 cm +2 Coloplast Titan I will be a grower with time and effort.
This is all I have to report for now. I will try to report on at least a weekly basis going forward. Lee

Seems like you are taking small steps forward towards getting better. Based on other guys journals your pain while inflated will definitely go away with time and you probably will regain that lost size for sure.

Keep on pumpin as they say..  ;)

Thanks for your detailed report.
So my 22cm implant gave me 7" with 6 to 5.5" girth solid.
My penis grew over 18 months.
So I am thinking with your 24cm, you should do well, but you need to feel the pain and stretch your penis.
Yes pain was frequent and diminished with time, but no pain, no gain.
I used to get up early in the morning, pump my penis up and walk around naked drinking my coffee and reading emails. I tried to do an hour every day. Sometimes the hour seemed to be like hours, but I managed through it.
There is a pop song called "pump it up" that I find amusing.
Stay in touch
StepOne

Thanks Sonic and StepOne for the replies. I will shoot for thirty minutes inflated.  I was never very well endowed to begin with so I was somewhat surprised on ending up with a 22 cm +2 titan.  I know Dr. Lentz will not oversize so I will keep working on it.  I must be making some progress because it hurts like hell.

Lee,
The pain will gradually decrease.
I sometimes had a beer in afternoons when I inflated to full the pain.
Of course Tylenol would help sometimes too.
I remember as do others on here have commented, when the pain goes away, you are no longer stretching, so that means no more gains. So several of us said we missed the pain.
StepOne
Keep on pumping...

Hello Lee

I just finished reading your story and sounds a lot like mine. I just had my revision July 19,2022. I too have a 10+ wife that has been my nurse (which was a nurse before we met). I also suffered with PE most of my life.
You will read up here different sizes (mine a 24cm titan). If you read on your operative note or on paperwork you received about your titan it should say how much of your titan was placed inside and how much was outside, which changes with each person. For example: mine was 24 and I had 12cm inside and 12cm outside but that was how my body was. In my prime I was 6.5 inches in length and a good girth. Now 8 wks out with great hard on I am 5 1/4 length and girth and straight. The titan stretches in both length and girth so there is light at the end of the tunnel!

Glad you hung in there with insurance and deciding to get titan ipp!  Glad yal stayed couple night post surgery. My 1st one was 4 hours away and they messed me up and we came home couple hours post surgery. Took 9 hours to get home with my wife stressed out!

We will keep you in our prayers and pray for your drill sergeant! Trust me they are the best support

waveboy out

to also add to my note Lee. I am a positive person even through my botched surgery. Now 8-9 weeks out of revision a great thought to keep in your head as I do in mine. I talked in note about measurements. If you measure your length now you will NEVER be any shorter!!!!!!! It just gets bigger and better!
As far as the PE yes it was a downer in the past. remember that( in the past)! Now even if you loose that round early you will look down and it still be rock hard! You decide when it goes down not your PE!
You have control!

we be praying together!

waveboy out!

Hello Guys, Lee's wife here, to give an update with Lee's permission. He's been covered up with work at his job.

All is going very well. Completely healed and doing good with his morning exercise in a warm bath. He is up to about 25 minutes now inflated and is measuring 5 1/4th inches length, and 5 inches girth.

He still has moments of a twinge of pain out of the blue, but told me that he had been warned about that here. It was unusual that he had so much pain on one side after the surgery, but that eventually went away. We found one other man who was on another forum and had written about his experience about this pain as well. It eventually went away for him, too.

We've had one attempt at sexual intercourse, about a week ago. That went well and was a success but painful for both of us.
He is still having some pain fully inflated, and I am still working on the estrogen replacement and over time, I think the pain will go away for both of us. Lee also had some labs come back that showed he was low on DHEA and Pregnenolone, so he is taking supps of those now and they have just started to increase his sex drive and give him a bit more energy. He does take Testosterone replacement and those levels are good.

Dr. Lentz has been wonderful to work with throughout. He kept telling Lee to call or make an appointment to come in (always within just a few days) if he had a concern. Telephone calls were always promptly returned within a few hours or even less. Dr. Lentz was always very compassionate to Lee's concerns and issues.

Lee will be back in here as soon as his work lets up a bit!

A big "Thank-you" to all of you who offered advice, concern, prayers, and friendship. It's meant so much to him.

It's all good news as this has been a long haul for both of you! Continued success. I have also been on full TRT replacement for 18 years now and I could not survive without it. He may like the pregnenolone cream if he can get a provider to prescribe it.

Warms my heart to see a man with a supporting wife to go through this ordeal. Wishing you both a renewed and fulfilling sex life for years to come.

Glad to know that things are going will with lee!

Post Op Day 67.  I have been remiss in posting this past month.  Generally, I have been making steady progress.  I cycle every morning in a warm to hot bath and there is still pain when fully inflated but it is more manageable now.  I want to thank everyone for all the support and encouragement over the past two plus months.  I still get the pain out of nowhere in the scrotum from time to  time, but that issue is also becoming less frequent.  I am pretty much back to where I could get in terms of length and girth with the vacuum pump pre-surgery, so any gains from here on are icing on the cake.  The most important plus has been no more vascular leakage.  It is so great to pump up and know I am in total control and can take my time.  I can honestly say that the penile implant surgery was well worth the pain and recovery experience.  Dr. Lentz has been terrific as a doctor and a surgeon.  I highly recommend him.

Lee
I am so happy you are doing well.
We all say, your pain will become less over time...and it will.
The fantom pain is weird, but it will continue for years, but it is short and not long lasting. I guess I am going on 4 years now since my implant and although much less frequent, I still get it maybe once a month.
It's only been a few months for you now, so it's way to soon to imagine how good it will be and where you will be a year, two years, etc. I must tell you, it really does get better and better and better.
I never could have imagined how much better sex could get. I think most of us don't appreciate what we have until we loose it.
You are doing fine. Stay patient and consistent.
No pain = no gain.
Big hugs for you and your wife.
StepOne
PS, I have a lady friend that was experiencing vagina pain with sex. Her doctor put her on a cream and also told her to get a dildo to help open her up, since she hadn't had sex in over a year.
She told me last week, her pain is gone and she and her husband are back to having regular mind blowing sex. But, it too was a process for her.

Hey Lee! Really nice to hear about your progress and the fact that everything seems to go well. I also saw the post from your wife great to see that you have such a supportive wife.

Quite a few people on here have made implants so you will always have a lot of info and support from them on here.

hello lee
great to hear your recovery. Yes you and I are on same timelines and have great spouse's! I was also pumping with VED. It was optioned to me to use VED after implant just after me asking can I use it to speed up things. I tried it once and I don't suggest it. For one it pulls the one tube up  from reseviour  and you get a stabbing pain from it and two with a titan thats the one spot that there could be weakness over time and that pressure on it could make that get there faster. So mine was a once and done with the VED. Just putting that out there because we are men and we all will go through the thoughts.
Yes my measurements are the same as yours. I am bigger in girth than before but 1/2 inch shorter but I am happy with it and as it expands over next months and years it just gets better!

waveboy out!

Waveboy--Man, I am so glad to hear of the success with your revision surgery.  You and I are very blessed to have such supportive wives.  Still getting back into the groove with the wife but the early results are beyond encouraging.  Thank you for all the encouragement and prayers.  The penile implant surgery was definitely the right decision for me.  God Bless!  Lee

Stepone and Sonic, thank you for all the encouragement these last several months.  I feel like a man that has cleared the last mountain and am now looking at the promised land.  It looks great and feels great!  Lee 

Great news Lee!!!!
keep ya head up..  Haha had to say it! Yep that promise land. woohoo.

waveboy out!

Hello Everyone,
I've come back to the forum to post about an issue I'm having some 16 months post surgery, and need some advice.

I've been doing really well with the pump and my sex life. However, about a month ago I noticed tenderness around the prostate area and a feeling of unease. I felt around and no pain anywhere in the pump area. My family doc put me on Bactrim for 2 weeks for a possible prostate infection to clear it up. A few days later I noticed a nickel sized place at the top of my scrotum, right under the base of my penis. At this point, I called Dr.Lentz's office and went in to be seen last Friday.

He told me that I had a pocket of infection, and he did some blood work. I told me to continue on and finish up the Bactrim until he had the labs back. He said if the labs were fine, he'd feel a lot better about the situation.

This morning I checked my Duke MyChart. The labs were there and WBC, ESR, and C-Reactive protein were elevated. Less than an hour later I received a call from Dr. Lentz. He told me that because of the lab values, he felt I had infection in the pump area and to begin a prescription of Clindamyacin. He said that the pump needed to come out and a non-inflatible placeholder implant put in. At some point he may be able to do a third surgery to replace the Coloplast. He's interrupting his vacation and flying back in to do the surgery on the 26th. He said to plan to stay overnight to receive IV antibiotics.

We don't know how I got an infection this far out. Dr. Lentz said this was fairly rare. Any ideas or advice for me?   

Thanks, Lee

Lee, it is strange.
It's a good thing you have Dr. Lentz.
I am sure he will take good care of you.
Be safe
StepOne

I have heard Dr. Eid say that infection can occur at any time.  He did not break it down to how common it is by month or year after implant.  Dr. Lentz is definitely taking the right steps to deal with this.  Best wishes and please keep us posted.

StepOne and Hawk--thanks for the replies. I'm starting to feel sorry for myself on top of the confusion of why this has happened--along with a lot of anger building up.

I was told yesterday by Dr. Lentz that the recovery from this surgery will be similar to the first.

Do we have anyone on the forum that has gone through a removal surgery for infection post implant? I was searching but didn't have any luck.--Lee

Lee, I don't think there is currently anyone active that has gone through this.  We did have one or two who experienced a similar situation, but they had the implant before they found the forum, so their posts were not in real-time. 

I know your primary concern is for your outcome as it should be, but your experience and outcome, as well as the way you navigate this, will be priceless information and support for others.

As far as I know, Dr Lentz is a skilled, competent implant doctor.  I think you are in good hands for a good outcome.  The decision to use a mailable implant to preserve size is the correct one.  There are still men who opt for that implant today. As I recall, you are married, with a very supportive wife. I think your healing will be quicker and less painful than your inflatable implant.  I also think that since you are married and not trying to hide this, your sexual intimacy with your wife will only take a brief hit. You will make it through this, and we are here rooting for you.

Hawk--thank you for the support--I'm going to hang onto those words as I go through the next several weeks.
Do you want me to start a new thread on the removal and recovery? I'll try to make it as detailed as possible for other men who might have to go through this unfortunate circumstance.--Lee

Lee, My opinion is that it is only a complete story if it is part of your ongoing story.  I changed the name of your journal to reflect the content and make it easier for others to We have a lot of stories without significant difficulties.  It is important for men to understand that there are risks even with good surgeons and men who do everything right.  It gives a realistic picture that is needed.  We don't need to sum up implants with the phrase, "And they all lived happily ever after."

I would encourage Dr. Lentz to give you the largest malleable implant he can.  My experience with malleable implant stories is limited, but I think you will be relatively happy after learning the nuances of hiding it. If you drive yourself crazy comparing it to your inflatable implant, you will fret yourself crazy, but if you compare it to days of unreliable erections, you will be static.  Perspective is everything.

Lee, I am so sorry you have to go through this.

Sadly, with any surgery there is always a small percentage of infections and it's a huge bummer that you got that small percentage. I can't imagine!!!!!

I had surgery from Dr. Lentz 4 years ago and was fortunate to not get any infection. It is so odd, your infection took so long to appear. I am curious as to why Dr Lentz said it took so long. It would be interesting to share what he says.

Prayers for your successful repair,
StepOne

I am sorry to hear you went through this lee! It is in fact very uncommon, like others said that this happened so long after your implant. I remember reading about this and Dr.'s place a malleable to address the infection but after a certain time they give you the ok to have another revision to switch back to a three piece. Sending you words of encouragement as you go through these hard times!

Hi Guys, Lee's wife here.

Thank you Hawk and StepOne, Pfract, for the messages of support.

It's December 26, about 8:30 at night. Lee is in a hospital room at Duke Raleigh recovering. We drove down this morning, a five hour trip for his two o'clock surgery.

Dr. Lentz came in to see us in Pre-Op and explained that with Lee's labs pointing towards infection/inflammation, and his pain and a hardness in certain areas around the implant, the weird swelling that looked nickel sized at the base of his penis, that it must come out. Even though it looked better than it had a week or so prior when he saw Lee proving the Clindamycin had helped, there was more hardness in the area than previously.

Dr. Lentz explained that with every implant, there is exposure to a minimal amount of bacteria during insertion. He said that usually, the area around the implant seals off very quickly and that minimal amount of bacteria stays tucked away and usually never causes an issue. But rarely, sometimes it does.

The reason why now, after all this time, will remain a mystery. I did mention that Lee had a rapid weight loss of over 30 lbs. in the last year-but in addition, he had quite a bit of muscle atrophy all over from that weight loss. His family doctor put him on Ozempic for his diabetes, and it was worked very well at keeping his A1C down around 5-6 and controlling his appetite.

He hasn't been sick in the last year. Nothing that would lower his immune system function. His labs four months ago for a wellness check with his family doctor showed a completely normal labs including a CBC and Metabolic Panel. Yet, that's around the time he started feeling "run down" and complaining of feeling really tired at times, and wanting to nap after work before dinner and around noon for a few hours on the weekends. There was one weekend that he did run a low grade fever, but it was gone in 24 hours. After that, he started to complain at times of feeling unease, like something was off. So, we feel that this infection started back four months ago.

As before, Lee was treated very well by his nurses and Anesthesia Tech Pre-Op. Every effort was made to make sure he was comfortable and he didn't wait long to be taken into surgery.

After surgery, Dr. Lentz called me personally while I was in the waiting room. He sounded both concerned and relieved at the same time. The first thing he said to me was that we got it in the nick of time-that if we had waited another week to ten days, we would have had a serious problem to deal with. So even though the Bactrim and Clindamycin had helped, it wasn't enough to stop what was coming. He said that the cylinders and pump and reservoir were surrounded by a thick, tea-colored infection, which he felt was a weaker bug but nonetheless there was quite a bit of it. He has cultured it. He said however, that a week to ten days would have seen that turn to pus and more serious.

As of now, his pain is being well controlled with Oxycodone every four hours. He said when he came to from surgery, his pain was a 9 out of 10, but the Post-Op nurse got it under control quickly for him.

Dr. Lentz said he sized him about as aggressively as he could with the malleable implant. He told Lee that in time he could come back and try an inflatable implant like again, but I'm not sure Lee will. It would have to be a dandy of a thing to make him want to go through all of that again and the risk of infection.

Tomorrow morning the plan is for him to be discharged. He will have the catheter removed, but the JP drain will stay for a few days, and I'll remove that as I did in his previous surgery. He has staples in and will have to come back to have those removed. Dr. Lentz is checking him often-first for staple removal in two weeks and in six weeks.

We are going to stay two nights at the Hampton Inn 1/2 mile down from the hospital, and re-assess then how he feels and if we can make it back home in a somewhat comfortable way for him with pain meds.

I'll update again tomorrow evening. He could really use your prayers and good thoughts.He is really down about all of this.

Thanks for updating us.  Just for the record, antibiotics NEVER resolve an implant infection. They only make you feel enough improvement to put off the inevitable surgery until you have a total mess and maybe go septic.

I am anxious for Lee to feel better physically and psychologically.  I will be anxious to hear back once he is healed, but I am not at all sure that both of you won't find the new implant to be as satisfactory as the one that was removed.  It might cause him some inconvenience when not in use because it remains fairly rigid, but when having intimate time, I see no downside.

Both of you are in our thoughts and prayers.  Keep us posted.

Hawk,Founder/Administrator

Lee's wife here.

Hawk, very true about antibiotics-especially with an infection around an implant. I once had an acquaintance who had breast implants done. A very smart lady, a wonderful nurse who knew what to look out for in the way of complications. Within a week she was septic and passed away.

Dear men, NEVER ignore symptoms of infection. Lee has been lucky in that he had time to get the care he needed and his system fought it off for awhile. That is not always the case. And, he was running out of time. Another week to 10 days and we would have had a major problem and scare. I cannot emphasize this enough, along with Hawk's warning.

If you have pain, swelling, hardness of the tissue along the implant, weakness and tiredness, a low grade fever or worse-seek help immediately.

Lee has told me that he was afraid it was just all in his head, that it would go away and he didn't want to bother me or take time off from work (lots of stress from heavy case load and County Supervisors needing things done) that possibly was really nothing to come back down to North Carolina and waste time during the week.

Now on to where the situation stands today on 12/28. He wasn't released from the hospital until 7 p.m. last night, and received another round of Vancomycin and Zosyn, Fluconazole during the day. He was given Neurontin, Oxycodone 5 mg., and Meloxicam for pain for 7 days. He is also to take Bactrim twice a day for five days, and Augmentin twice a day for fourteen days. His re-check and to have staples out is January 17.

His recovery is different this time. He has much less pain, and is sleeping very well. A healing sleep. He hasn't had an Oxycodone since midnight last night, and he managed to walk down to the breakfast room here at the hotel and have breakfast this morning. That wore him out and he is back in the room sleeping. He is going to take a pain pill before we start our trip home, and we will take out the JP drain this evening if drainage is minimal. He hasn't had to use any ice packs or the boppy pillow to sit on.

We don't know much about the malleable implant, we just went with Dr. Lentz's advice and were relieved with Hawk's comments about it. I know Lee will let you know how that is working out. I really don't think he will have another inflatable implant. This has been a truly scary experience.

I want to sing the praises again of Duke Raleigh hospital where Dr. Lentz practices. The nurses and assistive personnel were all top notch and he received excellent care. Dr. Lentz flew back out to his vacation early the next morning after Lee's surgery and his PA, while very young, took good care of Lee yesterday. I thanked Dr. Lentz for interrupting his vacation to come back to care for Lee and he was so kind about it all.

This will probably be the last post from me, and Lee will update you all tomorrow. Take good care of yourselves and always be proactive about your care. Thank you all for what you do here on the forum, you are lifesavers and a needed, compassionate ear to listen and give advice when needed.

Really sad to read about what has happened to Lee. What a wonderful wife you are and thanks for giving these thorough updates. It sounds like he is on the right path and that is at least something good in the midst of all this trouble. I hope all goes well sending both of you my thoughts and love.

Wow, so hard to read. I too was a Dr Lentz patient, but as I have read, sometimes bad things happen.
My thoughts go out to Lee and his wife. I can't imagine what he is going through.
I am so glad his wife spoke so highly of Dr. Lentz.
I wish Lee a speedy recovery and still wonder how this infection took so long to materialize.
StepOne