IMPROPER IMPLANT SIZING

It has recently come to my attention that some doctors are not implanting the AMS 700 LGX properly. They are not putting in a full length implant with the rear tip extenders, when needed, to fit the corpora's. This will quickly lead to problems.

This is a copy of an email I received recently regarding implanting an AMS 700 LGX or a Titan. Also a responce from Todd Doran of Dr. Milam's staff at Vanderbilt. The only editing I did was the doctors name.

This is how some doctors give the LGX a bad name. Be aware and put it on the list of questions you ask your doctor.

Jack

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Hi Jack,
Did you say you'd be seeing Dr. Milam soon? I wonder if you could ask him a certain question for me?
When I talked toDr. Mxxxxxxx, he said he could do either a Titan or a AMS700LGX, but he said if he put in an AMS700LGX, he'd have to put one in that was shorter than the corporas (because of the expansion in length).

I wondered if you might be able to ask Dr. Milam if he does the same thing, or something different, such as filling the corporas, which is what would be done with the Titan,I believe.
I just wonder if all doctors do this ,or only Dr. Mxxxxxxx, or what.

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Responce from Todd Doran MS PA-C


Here's the bottom line regarding RTE/corporal length, etc. Dr. Milam's philosophy is to measure the corporal length from rear tip to distal tip. We then place a cylinder that equals that length but sometimes RTE are used because the cylinders typically come in 2 cm increments and I can add RTE in 0.5 cm increments so we have infiinite possibilities to accomplish the goal. Here's an example-pt measures 15 cm so we place a 15 cm LGX cylinder with no rear tip because it's available in that size. We'd add 1.5 cm RTE if corporal body was 16.5 cm since next cylinder size is 17 cm. Hope that clarifies a simple concept that is complex for pts to understand and another concept that is misconstrued by surgeons and patients. The advantage of an LGX is that if you need 0.25 cm which is unavailable then we know that the expansion properties will achieve the desired goal where a Titan or CX wouldn't. That's our philosophy. Never agree with placing a device that's too short or too long, you're setting yourself up for disappointment right out of the box.


Todd Todd J. Doran, MS, PA-C Associate in Urologic Surgery Vanderbilt University Dept of Urologic Surgery A-1302 MCN Nashville, TN 37232 615-322-2880