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Posted 9/19/2008 11:02 PM (GMT 0)

Greetings -

Over the last few months I have joined numerous boards to offer advice on penile implants.

I had my first implant at the age of 27, and now have lived with implants for the past 27 years.

At age 54, I feel I might be of some value to those who are thinking about the implant, or facing revision surgery.

Although everyone will respond differently to the implant - there are some common problems we all face with this medical device. Please feel free to contact me with any questions.

Posted 9/20/2008 3:08 AM (GMT 0)
ART....are you just a IPP or did you also have the AUS? Welcome to HW.....
KW
Posted 9/20/2008 3:58 AM (GMT 0)

Hi Art, and welcome.

I'm sure your input will be welcome to the members here -- we have a number here who have either had implants or are contemplating them.

One question I have is how long do they last in your experience before they need repair or replacement?  Are follow-up operations easier?  Sorry that was two questions  :-)

Posted 9/20/2008 1:44 PM (GMT 0)

Hi KW & Piano -

Thanks for the welcome.

Actually, I do not have prostate cancer - but due to the complications cancer patients face I thought my experience with penile implants would be useful. I was rendered organically impotent at the age of 25 due to a drug reaction to coumadin which caused Priapism. I was one of the youngest patients implanted in 1981 by the late F. Brantly Scott in Houston. I have only the IPP. Because I was a pro athlete and still active even after the implants, and being so young. I have had 7 implants going on 8. So I have an insight on the complications facing implants that have problems.

As for Piano’s questions. The implant has come along way over the past 27 years. Although I have had multiple implants so far, only two have had mechanical failures. I have always had the AMS 3 piece inflatable implant. 1st implant failure was due to surgeon nicking a tube on first implant. Second failure was loss of fluid. Typically the implant should last at least 10 years, depending on age and activity level. The first implantation was difficult for me. In 1981 it was not a common procedure. I was in for 3 1/2 weeks at Baylor University in Houston at the time. My last implant was 6 years ago and I was in for two days at UofW in Seattle. So you can see they have improved the techniques, as some new patients this is day surgery or overnight at the most.

As for revision surgeries, it can become much more complicated, depending on the patient. I won’t go into detailed topics, but they include scarring, nerve damage, penile shortening. I will be glad to answer any question as to my experience. There are some things that I would absolutely insist on when contemplating a revision.

So to keep this from being a novel, I’ll end it here.

Let me say one last thing. I am all for the IPP - if this is the only option. Usually, the 1st implant is the best. It is the long term issues that can cause some problems.
Posted 9/20/2008 4:20 PM (GMT 0)
Hi Art662,

I had not thought much about revisions once I decided to go forward with the surgery. But since you are averaging about 4 yrs/revision, maybe that should be revisited. Erosion was at the top of my questions list but at my age that probably should be discounted.

How about your list of absolutely necessary items when a revision is in the future?

Is it safe to assume that as a pro athlete you had no issues with physical activity? There is quite a bit of plumbing installed that could get jostled around. I still think a deranged plumber had a hand in designing the IPP and the AUS. ( A poor attempt at humor.)

Your extensive experience will be of increasing interest to us and welcome to the site. My email is in my profile.

Best,
leaky
Posted 9/20/2008 7:04 PM (GMT 0)
Hey leaky -

Although I have had 7 revisions so far, as I mentioned, only 2 were from mechanical failure.
Others implants were placed to revise penile shortening, bad placement and penile wall weakening.
Because of the designs of the new implants, erosion is not very common. The tip placement of the cylinders is usually sufficient to prevent erosion.
Top on my list of must haves on revision is making sure a new implant is placed immediately at the time of removal of the previous one.
Several of my implants were placed due to a famous Dr. at the Cleveland Clinic, who removed my implant and waited to reimplant for 2 months, for fear of infection.
The new design implants have an antibiotic coating that helps contol possible infection. As soon as the implant is removed, srarring will start to contract the penile shaft. The longer you wait, the shorter the outcome. Trust me on this one.

Physical activity was not a problem for me. I was a pro racquetball player at the end of the 1970's until mid-1980's.
It is true that you will have a small pump between your testicles, but you will learn to adapt. Not a really big concern.

Hope this helps - anything else, just ask.

Art
Posted 9/21/2008 2:20 AM (GMT 0)

Art,

Welcome to Healing Well.  I received a double implant nearly ten weeks ago and was activated five weeks ago.  Will you please scroll down and note (on about page 3 now) two related posts I made: "Had AUS and IPP Implanted" and "Implant Humor".  The reason I ask you to do that is twofold:  First, you can find there my email address and second, to let you know what I have been through with these two implants. Unless you do not want anyone having your email address, please email me so that I can share some things that probably would not be appropriate on this forum. 

I am doing well with the AUS and IPP, although there is the challenge of being shorter and that does change things.  I had a healing problem with my scrotal incision, but that is now history.  I really struggled trying to find guys who had experienced these implants.  I finally did, but it was difficult.  That is why I posted both pre and post implant experiences.  Some of the guys reading here will no doubt give serious consideration to both the AUS and the IPP implants... out of necessity. I am convinced the implant(s) was right for me.  My main interest in communicating with you has to do with my continuing to adapt to the IPP and for any future references. 

 Thanks, Gene214


Posted 9/21/2008 2:58 AM (GMT 0)
Hi Gene -

Yes, I took a look at your posts. I can certainly relate with your trials with your condition.
I didn't realize that my email wasn't listed - it is now.
I am glad that your implants are settling in.
I will be glad to correspond with you here or in private concerning what I know of the IPP.
We'll talk -

Art
Posted 1/18/2009 9:15 PM (GMT 0)

Hi Art662

  I have a question about penile revisions, do all penile revisions cause you to lose length of erection or do you lose length due to the surgeon not placing the prosthesis in right when its taking out?

Do you also lose alot of sensitivity after the 2nd implant. Can you explain to me. Thanks

Posted 1/22/2009 1:29 PM (GMT 0)

Hi Chris -

Sorry - I have been out of town for a week - As to loss of length - It all depends. The major loss of length in a revision is due to scarring of the 'pocket' when the cylinders are removed. After years in place, once disturbed there can be tissue contraction. Not everyone will have this issue. If you look at my signature, most of my procedures were due to the fact my body didn't tolerate the removal and replacement, also I have penile wall weakening, which is more problematic. Not that common, but then I have had implants for 27 years. Placement of the implant also depends on your individual architecture - the cylinders must be placed far enough back to prevent erosion of the tips through the front. Sizing is critical of the implant cylinders. Sensitivity loss can all so be an issue - but then everyone is different. I have had massive surgeries down there - and I lost all (and I mean all) sensitivity for several years. Since my last surgery in 2002, I have regained general sensitivity - but not the erotic sensations I faintly remember when I was 25. Again, it all depends on the individual. But be mindful a revision is more complicated that the original implant. New designs are supposed to resolve the issue of loss of fluid, the primary issue in my implant problems. any questions please feel free to respond. Art

Posted 1/22/2009 1:39 PM (GMT 0)
Art, if you don't mind answering, my wife is a nurse and wondered why you were on the drug coumadin at age 25. david
Posted 1/22/2009 6:30 PM (GMT 0)

Hi Purgatory -

Sure, no problem - I was a pro racquetball player and did a marathon racquetball event for Muscular Dystrophy in 1979. I was sponsored by Ektelon at the time. We set to break the world endurance record of 102 hours of continuous play. I went 120 hours and had to be admitted with deep vein Thrombophlebitis. I was given Heparin for several days in the hospital and then given coumadin, which immediately caused Priapism. I later threw a clot and had emergency surgery to have a vena cava clip (old style– thought the abdomen) placed. I was really a sick puppy.

Posted 1/22/2009 7:41 PM (GMT 0)
Art, thankful for sharing that info. Some impressive sports background you had then. I will share this post with my wife, her specialty in nursing is with the elderly, and she has many patients on that med due mostly to strokes. My mother, 81, is currently on it herself for a recent stroke. That was a terrible experience you went through at such a young age. I wish you the best.

David
Posted 1/22/2009 8:58 PM (GMT 0)
Hi David -

Not a problem - you know, I admire you guys here that face the beast every day. I am thankful it has yet to touch me, but wanted to post here for those who deal not only with cancer, but all the related issues. My hat is off to each and every one of you.

art

Posted 1/22/2009 9:10 PM (GMT 0)
Your information on the Penile Implants posted is important to some here, appreciate your willingness to share, and the fact that you have had one for 27 years is incredible in itself. Thanks again.
Posted 1/28/2009 3:48 PM (GMT 0)
Hello all I am new to this forum and I am not use to the acronyms yet so I don't know what IPP and AUS mean. I do not have cancer, but I am contemplating, a penile implant. I am 39 years old and I had a reaction (priapism) from trazadone. Because of this my urologist believe that the corpora in my penis are damaged to a point where my options are the pump or an implant. I have a referral to the May Clinic to see they're urlogy deparment later this month. I found this Forum and saw Art662's post. There are several questions I have but I guess I should may be try try a couple at a time as not to overwhelm anyone. Since I am still in the contemplating stage I have a fear of the "shortening." But on your signature Art you have listed in "1985 IPP replaced, penile degloving to correct scarring, shortening and cylinder contracture. Suspensatory Ligament procedure - 2 1/2 weeks Mayo Clinic by William Furlow" This procedure, was it useful in correcting the shortening?
Posted 1/28/2009 6:54 PM (GMT 0)

Hi EDman - I have send you an email so you can ask all the questions you like.

art

EDman said...
Hello all I am new to this forum and I am not use to the acronyms yet so I don't know what IPP and AUS mean. I do not have cancer, but I am contemplating, a penile implant. I am 39 years old and I had a reaction (priapism) from trazadone. Because of this my urologist believe that the corpora in my penis are damaged to a point where my options are the pump or an implant. I have a referral to the May Clinic to see they're urlogy deparment later this month. I found this Forum and saw Art662's post. There are several questions I have but I guess I should may be try try a couple at a time as not to overwhelm anyone. Since I am still in the contemplating stage I have a fear of the "shortening." But on your signature Art you have listed in "1985 IPP replaced, penile degloving to correct scarring, shortening and cylinder contracture. Suspensatory Ligament procedure - 2 1/2 weeks Mayo Clinic by William Furlow" This procedure, was it useful in correcting the shortening?

Posted 3/4/2009 11:29 PM (GMT 0)
Hi, I have recently had an inflatable 3-piece installed, and would like some advice, experience/etc. on a possible complication I am having. I am 6 weeks post-op.

A specific, intermittent, throbbing pain about an inch below the base of the glans, centered just left of the urethra, has persisted since week 2 post-op as a notable pain. This is also a bit less than an inch below the tip of the device. This pain had receded by week 4, when the device was inflated and has been inflated periodically since then and apparently has provoked whatever is at work here to resume being more painful. This is distinct and unlike the stretching-type pain as the device is initially used. The area is sensitive to palpitation and movement in general. The pain can be felt when pressed inflated or not. There is no apparent swelling.

I assume this is an area of the original procedure which had not quite healed when inflation began. I have no fever (aside from a cold). No apparent urinary issues present.

Does anyone have experience with this? I assume I will need to leave it uninflated for a few weeks to see if it heals, but I don't really know what the etiology of the problem is, which would help me understand what needs to happen next.

Any thoughts appreciated.

sorry for the edits, I tend to proofread retroactively...

Post Edited (Woofmutt) : 3/4/2009 4:38:17 PM (GMT-7)

Posted 3/5/2009 12:39 AM (GMT 0)

hi Woofmutt -

Welcome to the forum -

I am not physician, but do know a little bit about those pesky implant issues. I had a similar problem with one implant. The area near the urethra can be sensitive - I had a throbbing, almost burning sensation just as you mentioned. Pressing on the area was very painful as well. I did consult my implant surgeon and he suggested that it would go away with time. And it did. One other issue to consider - and it is fairly rare, is that the implant can migrate forward, this would eventually lead to an erosion of the implant through the glans. This is very uncommon, but possible. You did not specify the model you have, but if it is the LGX, the type with length and girth expansion, this might aggravate the problem. I would certainly consult your doctor, just to make sure that the glans tissues are intact and the implant is properly seated.

Art

Woofmutt said...
Hi, I have recently had an inflatable 3-piece installed, and would like some advice, experience/etc. on a possible complication I am having. I am 6 weeks post-op.

A specific, intermittent, throbbing pain about an inch below the base of the glans, centered just left of the urethra, has persisted since week 2 post-op as a notable pain. This is also a bit less than an inch below the tip of the device. This pain had receded by week 4, when the device was inflated and has been inflated periodically since then and apparently has provoked whatever is at work here to resume being more painful. This is distinct and unlike the stretching-type pain as the device is initially used. The area is sensitive to palpitation and movement in general. The pain can be felt when pressed inflated or not. There is no apparent swelling.

I assume this is an area of the original procedure which had not quite healed when inflation began. I have no fever (aside from a cold). No apparent urinary issues present.

Does anyone have experience with this? I assume I will need to leave it uninflated for a few weeks to see if it heals, but I don't really know what the etiology of the problem is, which would help me understand what needs to happen next.

Any thoughts appreciated.

sorry for the edits, I tend to proofread retroactively...

Posted 3/5/2009 1:50 AM (GMT 0)
Thanks for your reply. The model name I heard was Titan XG, which apparently was a very new product from one of the major companies with length expansion (not sure on girth). I am not sure if the implant is actually longer than my natural length (I need to ask surgeon this, I told him not to put anything longer and I have no reason to think he did), but girth to my eye looks a little less than pre-priapism...,

Your own experience sounds like mine to date, and I will keep it in mind when I see the md.
Posted 3/5/2009 5:40 PM (GMT 0)
This is a followup to Art662 -

When you discussed the burning/throbbing pain issue with your md, do you recall if he instructed you to cease inflation for a while, or otherwise commented on what you could do (time aside) to try to help matters?

Thanks
Posted 3/5/2009 7:49 PM (GMT 0)

Hi Woofmutt

In my situation, I was instructed to keep inflating the implant, so to avoid adhesion or scarring issues. He instructed me to go easy on using it - which was not a problem, as it hurt too much to go poking it around. But I had already been checked out by the doc to eliminate any question about implant migration or erosion.

It subsided over time - but it took several months for all the tenderness to go away.

art

Woofmutt said...
This is a followup to Art662 -

When you discussed the burning/throbbing pain issue with your md, do you recall if he instructed you to cease inflation for a while, or otherwise commented on what you could do (time aside) to try to help matters?

Thanks

Posted 3/9/2009 9:06 PM (GMT 0)
Thanks again.

After any of your procedures did you ever experience perineal pain (from the prosthesis lower tips) in the perineum? I have recently developed some fairly sharp left pain when I tighten kegel muscles when the device is fully inflated, but am not exactly sure if this is a mal-positioning issue or something less serious. Will be speaking to MD soon but googling this isn't turning much up. Device migration +6 wks post-op seems unusual, but it is the only thing that pops up.

sorry to ask repeat questions, and I appreciate the time you have taken to answer my previous worries.
Posted 3/9/2009 11:49 PM (GMT 0)

Hey Woofmutt -

I can't say that I have ever had any symptoms like this. I too doubt that is from the implant movement -

There is a whole lot of issues that could cause the pain you have. If you do a search for perineal pain / male - there are lots of possible conditions. So it's off the doc, I would go.

Hope you feel better soon.

Art

Woofmutt said...
Thanks again.

After any of your procedures did you ever experience perineal pain (from the prosthesis lower tips) in the perineum? I have recently developed some fairly sharp left pain when I tighten kegel muscles when the device is fully inflated, but am not exactly sure if this is a mal-positioning issue or something less serious. Will be speaking to MD soon but googling this isn't turning much up. Device migration +6 wks post-op seems unusual, but it is the only thing that pops up.

sorry to ask repeat questions, and I appreciate the time you have taken to answer my previous worries.

Posted 2/13/2011 1:53 PM (GMT 0)
I won't to learn about penile implants to decide if I should have this done. Can anyone help oeb71?
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