WIFE - GIRLFRIEND POINT OF VIEW

THE POINT OF VIEW FROM THE WIFE OR GIRLFRIEND

 

 

 

I was chatting with a gentleman that Dr. Milam did his implant last May. Like so many of us his wife was not thrilled with the prospect of him having implant surgery. There is so much on the internet about implants that is false or problems due to the surgery being done by less than qualified doctors.

 

 

His wife told him if it would make him happy to go ahead. She went with him for his consultation and Dr. Milam answered her questions, still she was skeptical. He went ahead and had the surgery.

He told me the other night his wife told him how thrilled she was he went ahead and had the implant. It has renewed there love live. They were talking about before he started having problems and now and she told him he felt just the same now as before he started having problems. They are both thrilled with the outcome.

 

For myself my wife and I had about the same talk. I told her I was doing it for us, she looked at me with those beautiful green eyes, as only she can, and I had to admit I was doing it for myself. She said that is what she wanted to hear and go ahead.  After I had the implant for a few months I asked her how I felt to her now. She said I feel the same as I always did. It is like we became young lovers again.

 

A 24 year old single young man had an implant for peyroies with hour glassing and venous leakage. He was so afraid that the girls would reject him he did not try to date for several months. At about 16 months a old girlfriend came back into his life and basically seduced him. He called me just as he was going to the motel to meet her and asked me what should he do. I told him to just be yourself and put her butt on a pillow for sex. About an hour and a half later he called back on top of the world. He said she told him he was the best she ever had and had 4 orgasms. She also admitted to being with about 8 men since she last saw him. About 2 weeks later she went back to her husband "for sake of the kids."

 

That weekend he meet another girl at a local club an set up a date for the next night. That evening they were sitting on the couch and she started trying to get into his pants. He told her WHOA there is something you need to know. She asked what? He told her he was BIONIC. She asked what that meant. He had made up a story about a 4 wheeler accident and told her he was in an accident and had to have an implant. She told him she wanted to be with him anyway. The next morning he called me again on top of the world. She also told him he was the best she ever had, even her former boyfriend with a 9" penis.  He has also been with several other girls and all have told him they enjoyed the sex with him.

 

I also know another gentleman that was divorced after he got his implant. He started dating and has been with about 11 other women. None turned him down and all were happy with the sex.

 

Now because of my cancer treatments I have lost almost over 60 pounds. The first of the year I was about 235 pounds. Dr. Milam told me at my one year check up that if I lost 20-30 pounds I would gain about another inch. I'm now 170 pounds and sure enough I have gained over an inch in length. My wife and I were talking and she said I still feel the same as before that the length did not matter. The fact is women get the most pleasure from foreplay an penile girth.  

 

Jackp

9 BOTCHED IMPLANTS

This story is about the worst case of botched implants I know of. 

A gentleman from North Carolina contacted me some time ago about what to expect. He was having an implant by a surgeon at a North Carolina VA hospital. It was done by a new surgeon. His first problem was the pump was stitched so high he could not use it. The doctor refused to help telling him everything was fine. The pump should never be stitched down!
Long story. He has now had 9, yes nine, implant attempts. Some at VA hospitals and some at outside hospitals and doctors the VA sent him to. He battled the VA from the first bad implant trying to get them to send him to Dr. Douglas Milam at Vanderbilt.
He finally got to Dr. Milam this week. To say he has a lot of surgical damage is an understatement. The last doctor, in Alabama, even cut his suspensory ligament, but denies it.
I can't tell you all the emotional and physical damage this has caused him.
Dr. Milam gave him hope of a usable erection. He will have surgery in September. A perfect result is not possible because of the botched 9 surgeries over the last 3+- years.

A lot of Dr. Milam's practice is helping men that other doctors messed up. Now Dr. Milam is the only doctor in the world that can help him.

Conclusion: Make sure the doctor you use does about 100 implants a year. Watch out on the internet about doctors with unrealistic claims and use pictures of  "well endowed" men to show results of there work. We all these doctors "self promoters."    

On a personal note: It has been about 7 years since my implant. It is still working well.
I am still fighting the effect of lung cancer. Right now it is in remission. I'm on a chemo break but still very anemic and weak. I miss my energy. Since February 2014 I have had 16 chemo's and 6 units of blood. At one point I lost 70 pounds but have regained to 195 and hope to stay there. The Murino has helped with my apatite. My main meal of the day is now breakfast.  My wife and I prepare breakfast together every morning. We have learned to "dance around" each other as I do one thing and she another.

I am not currently on any of the forums but still respond to emails. If you have questions I will be more than happy to respond, it may take me a few days, depending on how I feel.

My email is jwp104@att.net

Jackp

I have somethime better than Viagra

THE EFFECTS OF CHEMO AND HAVING AN IMPLANT

 

 

The end of October we planned a trip to Alabama for my nephew's wedding. My Oncologist told us to go and "have a good time." He offered a prescription for Viagra. I told him, "Doc I have something better than Viagra." He asked what? I told him about the implant. He smiled and said for us to "have a good time." WE DID !!!

 



 When I was released from the hospital I had a drain in my side and home health nurses for about 6 weeks. When I started chemo I could hardly walk and had to use a wheel chair. After getting the nausea under control I started to feel some better. The chemo also caused severe anemia. 

 

When I had moments that I felt a little better I began to inflate my implant. Daily inflation gave me a feeling of being normal again. My primary doctor also kept my testosterone level high to help.

 

Let me say it loud and clear. Being able to have an erection gave me strength and hope. A loving and caring wife also made a big difference.  Thanks to the implant we were able to start back making love after a few weeks. My wife did everything to make me feel wanted and needed. I was and am very weak and she made sure I had enough stimulation for intercourse.

 

Bottom Line: After almost a year my energy level is low and the anemia keeps me down. The "chemo effect" can come over me most any time and take all my strength. That said every night I can inflate my implant and feel normal. Our sex life has returned to almost normal (4-6 times a month.) The love and care I receive from my Beautiful Green Eyed Wife has been an important part of my recovery. 

 

Having the implant keeps our love life normal. Without it I doubt I could function.

 

Yes I follow my own advice and inflate my implant every day. Being able to have an erection is both emotionally and physically healing.

 

I have not posted on the blog for some time. I keep getting emails and am glad that I am now able to answer them and answer your questions.  I will have "maintenance chemo", with breaks, to keep the cancer from coming back and/or spreading. For me the fact I have the implant keeps me feeling normal.

 

Jackp

jwp104@att.net (email)

 

 

 

 

UPDATE

I have not posted here since February when I was diagnosed with cancer in the lining of my left lung. I have been undergoing intense chemo and now glad to report that my cancer no longer shows up on x-ray or CT. My last chemo was October 30. I will now have maintenance chemo starting January 8th. The chemo has left me very anemic and I had to have 2 units of blood twice. The break in chemo will give me a chance to recuperate.

At first I was not able to respond to email's but I have for the last several weeks. If I missed yours or anything I can do to help please send me an email again. My email is jwp104@att.net

To my friends that have sent me regards and prayed for me I thank you from the bottom of my heart. PRAYER WORKS :-)

Jackp

Loss of Penile Size

The number one complaint heard by urologist from men with peyronies is loss of penile size. It also happens with men that underwent prostate cancer surgery and other surgeries. It is very emotional for men. This is an article I published on a forum a couple of years ago.

Lost Penile Size

We guys obsess about our penis our ladies are just glad to be with us no matter what. Like I have told many a young man “The size of your penis does not make you a man.”

The beautiful green-eyed lady I have been married to over 45 years, (no she is not blond), has been with me through all my journey with peyronies, venous leakage, corporal fibrosis. Then a failed implant attempt. Now a successful implant. The one statement she made still brings joy to my life. “Jack, I did not marry you for your penis.” She was by my side through my journey.

I lost over 1-½ inches to peyronies. It concerned me but never bothered her. When I came out of surgery at Vanderbilt she had already talked with Dr. Milam. I saw that gleam in those beautiful green eyes and knew all was well.

The first night I was home after my implant was activated I lay on my back with a hard on sticking straight up, no pills, no shots just me. I was still 1 ½ “ shorter than before peyronies but it did not matter anymore.

Over the last 5 years I have been able to gain about 90% of the loss back because of the skills of Dr. Milam and the LGX. I asked her how if felt sexually now than before. She told me she never noticed the difference I feel just the same as always.

Guys, we have to stop obsessing over our problems. The women that love us don’t care about the size or shape of our penis. That is a man thing. They love us for the man we are.

I have had the privilege of talking with many men that have progressed to the stage I have with this mess I have. One single young man kept telling me I can’t a girl will reject me. I can’t I have lost too much size to satisfy her, just on and on. Well 2 months ago (November 2011) he meets a young lady and it was love at first sight for her. One evening after a date he was with her and she started trying to get in his pants. He told her WHOA!! You need to know something. She asked what? He told her “I’m Bionic.” She asked what did that mean; he briefly told her he had an implant. She told him I don’t care I want you anyway.

That night he learned a couple of things. The fact he had an implant did not matter, the size of his penis did not matter, that he could satisfy her and he could go longer than any guy his age. Since then they have been almost constant companions.

What I am trying to say is we cannot let this damn disease get us down. There is help and hope for all of us. Love the lady you are with and she will give you more than you ever expected. The most important thing is NEVER – EVER / NEVER – EVER / NEVER – EVER EVER GIVE UP.

Just my feeling this morning.

Jackp
http://jackp-penileimplant.blogspot.com

Reprint from my post on another forum a couple of years ago.

Floppy Head (Glans)

Floppy Head (Glans) was the most common complaint I found when researching implants.

The discussion came up recently and this is a copy of emails with Todd Doran at Vanderbilt.

From: Jackpjwp104@att.net
Sent: Tuesday, December 03, 2013 2:23 PM
To: Doran, Todd James
Subject: Floppy Head


Todd

A gentleman I have been in contact with went to and implant surgeon Monday. He has not had peyronies, prostate cancer or any other penile shortening problems. Just ED from venous leakage that the pills are of little help. His gitth is just slightly smaller than normal at just under 1 1/2" diamiter. About 4.33 inch girth. When he told the doctor he would like a little more girth he recommended the Titan. He asked about all the stories we hear about "Floppy Head" from men that do not have the length expanding implant. He basicially skirted the issue and told him to just pull the skin back.

Your thoughts.'

Jack


RE: Floppy Head
From
Doran, Todd James

To
Jackp

SST deformity (penis looks like the Concorde SST plane erect), aka floppy glans is a phenomena where the terminal end of the corporal body ends proximal (before) to the glans. This can occur in any penis and can be congenital (born with) or acquired through scarring events such as Peyronie's or the aftermath from a priapism episode. We see this in our LGX population rarely and I think in 10 years we've provided an operative fix maybe three times and really is the only way to correct the situation. I can see the advantage of a device like an LGX providing that needed support as it expands distally and circumferentially. Interesting that the forum talks about that advantage as being real. Clinical experience has demonstrated to me that girth improves as the years go by and rigidity improves with LGX.

I do agree that Titan gives a rigid shaft and I can see where someone would see a more rapid girth difference immediately postop. Problem is that it is less likely to change over time due to the mechanical properties of the device and if there is an SST deformity then it will probably stay that way but the risk should be low if performed by a high volume surgeon which is really the key. Hope that was helpful.

Todd

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

PEYRONIES

PEYRONIES WITH HOURGLASSING THE DAY BEFORE SURGERY



TWO MONTHS AFTER SURGERY WITH MODELING

The most common complaint Male Sexual Function Specialist hears is shortening of the penis.

From Mayo Clinic Staff
Peyronie's (pa-ro-NEEZ) disease is the development of fibrous scar tissue inside the penis that causes curved, painful erections.
Men's penises vary in shape and size, and having a curved erection is common and isn't necessarily a cause for concern. However, in some men, Peyronie's disease causes a significant bend or pain. This can prevent a man from having sex or may make it difficult to get or maintain an erection (erectile dysfunction). For many men, Peyronie's disease also causes stress and anxiety.
In some cases, medications may help. Surgery to treat Peyronie's disease is generally only recommended if the curvature and pain are severe enough to prevent sexual intercourse.

Peyronie's disease symptoms may appear suddenly or may develop gradually. The most common signs and symptoms include:
· Scar tissue. The scar tissue (plaques) associated with Peyronie's disease can be felt under the skin of the penis as flat lumps or a band of hard tissue.
· A significant bend to the penis. Your penis may be curved upward, downward or bent to one side. In some cases, the erect penis has an "hourglass" appearance, with a tight, narrow band around the shaft.
· Erection problems. Peyronie's disease may cause problems getting or maintaining an erection (erectile dysfunction).
· Shortening of the penis. Your penis may become shorter as a result of Peyronie's disease.
· Pain. You may have pain during an erection, only during an orgasm or anytime your penis is touched.
The curvature associated with Peyronie's disease may gradually worsen. At some point, it generally stops getting worse. In most men, pain during erections improves within one to two years but the scar tissue and curvature remain. Rarely, both the curvature and pain associated with Peyronie's disease improve without treatment.
When to see a doctor
See your doctor if pain or curvature of your penis prevents you from having sex or causes you anxiety. An accurate diagnosis is needed to determine whether treatment may help and to rule out other causes of your symptoms.
The day before implant surgery with modeling by Dr. Douglas Milam at Vanderbilt in Nashville TN. A 24 year old single young man had peyronies with hour glassing and ED. Erections would only last a few seconds.
His surgery was an implant with the AMS 700 LGX and modeling.
Two months after implant surgery and modeling by Dr. Douglas Milam at Vanderbilt in Nashville TN.
With the AMS 700 LGX implant and modeling he has now regained to within 1cm of his normal penile size. The LGX is the only implant that expands in both length and girth. CAUTUON: a very skilled Male Sexual Function Specialist that does about 100 a year should only do this surgery. Only less than 4 or 5 qualified doctors worldwide.
He now has a normal sex life and many girl friends. The girls tell him he is the best they ever had.
Pictures used with permission.
Jackp

Healing Broken Hearts

http://www.medscape.com/viewarticle/807829

Cardiologists and Peyronie's Disease: Helping Mend These 'Broken Hearts'
By: Dr Melissa Walton-Shirley
Jul 15, 2013

Not until fictional Grey's Anatomy character Dr Mark Sloane suffered a "broken penis" in a 2009 episode did most of the world know this malady even existed. Peyronie's disease is a condition in which the erect penis is angulated or misshapen to the point that it makes intercourse uncomfortable or impossible. Rarely, it's heralded by an obvious injury, a "miscue" during sex, but more commonly nothing unusual has been noted in the days or weeks preceding presentation. Nine percent of males, mostly over the age of 55, develop the problem and tens of thousands are diagnosed annually.

Why cardiologists?

Although cardiovascular healthcare providers interface with this "at-risk" population daily, cardiologists rarely discuss it. What's worse, many of us are uninformed about the near-miraculous surgical fixes available.

Healthcare professionals should not only screen for this malady but also be ready with information that can save relationships and quality of life.

What's the pathology?

The development of a "plaque" occurs at the site of an injury or weak point in the shaft of the penis. When it heals, it's woven of a different fabric of plaque that is less pliable or distensible. When an erection occurs this new unforgiving fabric pulls the penis to one side or flexes it upward or downward.

I once made weekend rounds on a patient in his early 60s who for reasons unclear had never told his regular cardiologist of 20 years about his malady.

"It's difficult to maintain a relationship with my wife," he said, "because sex is impossible."

"What do you mean?" I inquired.

"Ever heard of Peyronie's disease?" he asked.

I answered truthfully that I'd heard of it but didn't know exactly what it was. He shrugged and said, "Life is miserable." I suggested he see a urologist and discharged him home, never knowing if he ever got the courage to bring it up again. The one time he was brave enough to mention his problem, the cardiologist who stood before him was an inadequate information resource. I sooth my conscience by thinking perhaps there really wasn't much help for him way back then.

Morning glory

Fast forward to just three years ago when a patient described in horror his awakening one morning to urinate. He called his wife to see the curiosity staring back at him as he stood over the toilet bowl. "It's shaped like a morning-glory vine," he lamented, a rather unusual description for a 90° upward angulation of his penis, but he got the point across. I recognized his description from my quick review many years before and referred him to the late great local urologist Dr Bo Marcol, who started him on verapamil injections. After weeks of no improvement, he was referred to Dr Douglas Milam, associate professor of urologic surgery at Vanderbilt University in Nashville, TN.

Dr Milam and his team completely restored the erectile function of the patient whose sex life had become nonexistent overnight. The couple no longer sits with furrowed brows from the frustration and denial of their favorite expression of mutual affection. The cause of their temporary stress is still a bit of a mystery. The patient recalled no episode of "rough sex" or injury prior to developing Peyronie's. He also denied any pain with erections. He was on cholesterol medication as his only cardiovascular drug but had noted decreased rigidity after he was placed on finasteride for hair loss. The patient fully blames this medication for his difficulties because the issue was temporally related.

Surgical options

When I inquired regarding surgical procedures available for repair of Peyronie's disease, Dr Milam replied, "We have found that the least invasive procedures involve a longitudinal incision and transverse closure, which works well in patients with up to 50° to 60° degrees of curvature. Patients who have more severe curvature, many of which are up to 90°, are usually better managed with a plaque incision and placement of a graft. Graft material can include small intestinal submucosa from a sheep, which is what I use. Others will use Tutoplast. Some previously used dermis donated from the patient himself," he explained.

Who's right for surgery?

"Other types of [erectile dysfunction] ED could be present," Dr Milam pointed out. "One must ascertain if the patient has adequate rigidity for intercourse. None of the Peyronie's procedures, other than an implant, improve rigidity at all. So up front if they don't have adequate rigidity, a surgical procedure is not helpful unless it's a penile implant. We have several questionnaires that tease out the history, and data support the use of these questionnaires" to guide surgical options.

Medications

Dr Milam listed a number of treatments that are largely viewed as failures by the urology community, including steroid injections, vitamins, verapamil injections, stretching devices, etc. There is, however, some hope for an up-and-coming medication called Xiaflex (collagenase clostridium histolyticum, Auxilium Pharmaceuticals/Pfizer), a collagenase enzyme that attacks the plaque. It was approved in 2010 for the treatment of Dupuytren's contracture, a disorder in which collagen buildup in the fingers causes them to flex permanently. "Treatment involves as many as eight injections of the drug into the penile plaque over a period of a few months," according to company press releases. "Physicians may also manipulate the penis manually to help break up the plaque." The company reported that the treatment yielded a 37.6% reduction in penile curvature in one trial and a 30.5% reduction in the second. "That's a pretty good result for patients with moderate curvature, but for patients with severe angulation, that is not an acceptable result," according to Dr Milam.

After an overnight stay in the hospital with six-week break from any attempts at intercourse, the surgical patient is placed on a daily dose of tadalafil (Cialis, Lilly) 5 mg postoperatively. This encourages nocturnal erections that in theory should provide adequate stretching of the graft to avoid shortening and improve function. "Even at that, nonrigorous sex is recommended for several months," said Dr Milam. "Woman on top and no bending backward is recommended. Adequate lubrication is a must. I've had a few gentlemen require two separate surgeries, and we never want to see that happen. I once had to give the partner of one of my patients a talking to," he said.

Fixing broken hearts

Thanks to the expertise of Dr Milam and his surgical team at Vanderbilt, the two-year long ordeal for my patient and his wife was finally over. This procedure is of course also available at other sites around the world, but it is perhaps "a best-kept secret" of the urologic world. Thanks to a quick referral, erectile dysfunction is no longer a topic for conversation for this couple. I am grateful I had the forethought to refer this patient to an excellent local urologist who knew where he could send his patient for definitive therapy.

As cardiologists, we must admit that a broken penis is really tantamount to not just one, but usually two, broken hearts. Thankfully, there is real help to mend them. As healthcare providers, we owe it our patients to take the time to find out where that help is. Just in case.

Questions and Concerns

This is a email I received from Mike a few days ago. He had just had his implant activated and tried it for the first time.

Jack, Hope this finds you doing well. Thank you for you blog it was very beneficial to me as I prepared and finally made the decision to get a AMS LGX implant. I made it through the surgery and recovery ok with little or no complications. There was one thing that I felt was a complication and that was one cylinder seems to be about 3/8" shorter than the other. This is the case whether the implant is inflated or deflated. The Doc agreed that one was shorter that the other and mumbled a word or two about possible causes but said it should not cause any problems. Now onto my sand concerns. The first "go around" at 6 weeks was very disappointing to both my wife and I. I had quiet a bit of uncomfort which bordered on pain and felt very little sensation. My wife didn't enjoy the act at all and she did not get much sensation either. To be honest it was a very big let down. Prior to this I have been inflating and deflating twice a day and initially felt pain and discomfort but had gotten over that. When I inflate I notice that things seem smaller that before surgery. Before I could get a erection 25 percent of time for a very brief period and. I was not surprise by the shorter length as I had read that this could be suspected. I do still have good blood flow to the glands which helps things look closer to normal. When inflated the erection looks fair but it is not as rigid as I thought it would be. Things are hard so to speak but just not rigid. I pump the bulb until it gets hard and can still make small pumps but am afraid to pump to much and damage something. I know I have given you a lot of info but I wanted give you enough details so you might could give me some advice. I guess my main question is the performance of the implant supposed to be like this at 6 weeks? Will things get better for the wife and I or is this it? I know there is a learning curve and I have read several places that sensation returns and things stretch out over the course of the next year. I hope this is the case. Thanks again for you blog and any advice you can give. Mike-




Hi Mike

First RELAX things you are experiencing are perfectly normal. Let me give you some pointers.

My left cylinder is 1cm shorter than the right, it is not a problem. Dr. Milam told me about it right after surgery he said it may have been from the urethra puncture by the first doctor or it could just be the way I am. I know a few men with severe peyronies that one cylinder is 3cm shorter than the other. It is not a problem for sex and over the next several months you will be the only one that knows it.

The first "go round" is not easy on either of you. Our first time I had to quit less than half way through because it hurt!!! It will get better each time you use it. Try 800mg (4 200mg pills)of ibuprofen about 30 minutes before you try again. Do Not take prescription pain meds because they will dull the sensations in your glans.

Yes we all are shorter after surgery until the LGX expands. A tip that works well is to put your wife's butt on a pillow and use a little astroglide. (With astroglide a little goes a long way.) This changes the angle of penetration just enough and makes for better penetration. Try shorter strokes for a while, just enough for a good feel in the glans.

It will get harder in the shaft. The glans takes a while. Just before penetration try to squeeze the pump a few times you may get a little more expansion. Do this for at least a year. Continue to inflate the implant twice a day for the first 18 months. I recommend holding for about 5 minutes then deflate. Do this about 3 or 4 times twice a day. This gets the implant expanding as soon as possible. YOU CAN NOT PUMP TOO MUCH AND DAMAGE SOMETHING!!! I still inflate mine at least once a day and it has been over 4 years. Dr. Milam said to "knock my self out" trying to damage it doing this.

You are doing just fine at 6 weeks. Complete healing and expansion takes up to 18 months so don't rush things. The last time I saw Dr. Milam he said he is now seeing men with expansion up to 3 years.

What else can I tell you. Just relax and don't push it. Keep on trying to have sex with the wife every few days. The more you try the sooner the soreness will work out. It is just like physical therapy for the penis. Don't forget to put a pillow under her butt, all the couples that try it stay with it even after the implant heals.

Anything else I can help with let me know.

Jack



Jack,

Thanks for your response. You don't know what burden you have lifted off of me. Getting the implant was the light at the end of the tunnel so to speak and the first time out it looked like my light had went out. I have spent the last few days thinking that I may have made one of the worst mistakes of my life. My wife's apparent disappointment did not do anything but add to my anxiety. Prior to the surgery I was able to get a decent erection with Viagra about 25 percent of the time but when I took enough to achieve this, I had some of the worst headaches I have ever experienced and it took me a day or two to get over it. I had did a a lot of research during the year before the surgery at which time I went through the unsuccessful tries with the pump and injections. So I knew a little of what to expect but I guess I had to high of expectations so early in the ball game. I am also relieved about learning the one cylinder being shorter than the other is normal. This has been a big concern of mine since I first discovered it as I thought it might mean I would have surgery to fix the problem. Thanks again I will rest much better tonight and I am sure I will have more questions for you as things progress. Keep up the blog, I don't know if you are fully aware how much a help it is to those who are considering or already have the implant. -Mike



PS ED and other problems that lead to an implant make it hard on a couples sex life. I would like to recommend a book. Intended for Pleasure by Dr.Ed Wheat. It held us and other couples through this trying time in our life. The last time I checked it was available at amazon.com.

Jackp

Lee's Story

This is a message I received from Lee. He has quesions and concerns.

One thing he says about the differances in the Coloplast and the AMS LGX us regular size guys need to read it how the two feel different. For us men less than 7" this is from a man that has had both.

Jack

Good Morning Lee



After reading your message I had some concerns and sent a copy to Todd Doran at Vanderbilt for his opinion.



Let me go through your message and address my concerns and when I hear from Todd I will let you know what he says.

--- On Sat, 7/14/12, Leland Spring <> wrote:



From: Leland Spring <>
Subject: Penile Excercises
To: jwp104@att.net
Date: Saturday, July 14, 2012, 4:45 PM


Jack

I have very much enjoyed your posts in the blog. I e-mailed you a couple of weeks ago, I have had 4 implants done and am now recovering from # 4, surgery was on July 11, My uro has told me to start pumping. He said to pump it once a day for 15 minutes each day.
4 days seems real early to start inflating the implant to me.
He is not big on the AMS 700 implant, I don't know why he's not much of a talker.
He is probably old school and stuck on the old ways.
I had him install an AMS 700 LG .
Good for you!
Do you mind sharing who the doctor was and where he is at?
That is what I had the first time I had one and it was good for me, then I had a coloplast titan put in, two of them. Since my penis is less than 7 inches long it felt very stiff , not comfortable for my wife.
Thanks for letting me quote you. Todd and Dr. Milam have told me this but you are the first patient that has told me.
I would like to know if you could give me some more info, be more specific about the pumping you did when you first started pumping after surgery. My main concern is that I gather as much info as possible for the first three months post op so I do not miss any steps and insure my best chances for great success with this implant.
Was there any certain routine you followed as far as pumping was concerned?? Time, length of keeping implant fully pumped and how many times a day?? Did you do any special therapeutic exercises?
I am going to give you the entire routine at the end of this post, I am also attaching the AMS Double Handed Method of Inflation. The pump is very stiff until it is broken in. The key to starting the pump is to grasp the pump firmly and squeeze hard and quickly release this will activate the pump. I am also attaching a user's guide. Any questions let me know.
Any response that would help me be successful would be appreciated. If you would like to share this post feel free to do so.

Regards
Thank You
Lee

This is the inflation routine I used and was recommended by Dr. Milam and the staff at Vanderbilt.
You may only want to do this once a day for the first 6 weeks. After that do it twice a day. A hot shower or bath can also be helpful while doing the inflation.



Twice a day, every day for the first 18 months, inflate the implant for 15 minutes and hold it. Then every 3-4 minutes squeeze the pump a few times to help the ipp inflate to it's max. When you deflate the implant hold down the deflation button for about 6 seconds and then squeeze your penis from the head to the base a few times to get the fluid back to the reservoir. This will do a couple of things, give you a more natural flaccid look and make the implant easier to inflate the next time.



You should have been told to keep your penis up on your stomach for the first 6 weeks. This will help you heal straight and be less painful. I found that the Jockey Pouch Briefs did a great job helping. They have a special H cut that will help hold you up. I got mine at Macy's and Kohl's. I like them so well I still ware them and get them online at jockey.com They offer about the same support as a jock strap without the discomfort.



My concern for you,at this early stage, is pain and discomfort. If it is painful or very uncomfortable take 800mg of ibuprofen about 30 minutes before you inflate.



It takes the LGX up to 18 months to fully expand in length. (The last time I say Dr. Milam,last August, he said he is now seeing men with expansion up to 3 years.) You may not be happy with your size at first but do not despair. At 3 months post op you will see expansion, for me it was 1/2". Since my implant 10/08 I have gained back almost an inch and a half.



Anything else I can help with let me know.



Jack

Double Handed Inflation Method

I have been getting several email lately from men having difficulty inflating there implant. The AMS Double Handed Method is a great solution and I am posting a copy here. From AMS Enclosed is the standard User’s Guide for your general reference. However, you may prefer to use both hands (left-hand thumb over right-hand thumb on front side of the inflate bulb, with left-hand index finger over right-hand index finger on back side of the bulb) to squeeze the inflate bulb HARD/FAST to “pop” the valve into the inflate position, rather than just using one hand on the inflate bulb. This method will stabilize the inflate bulb between your fingers and provide you with double the squeeze strength. Be sure that after each complete squeeze of the inflate bulb, you relax your fingers and allow the bulb to refill. To give slight, partial squeezes will only increase greatly the number of squeezes you have to give the pump bulb because you’ll be pushing very little fluid into the cylinders with each little squeeze. After the initial very HARD/FAST squeeze of the pump to activate it, each subsequent squeeze of the inflate bulb is done with firmness. Follow the deflate instructions as shown in the AMS 700MS User’s Guide. Best regards, Elizabeth Rae AMS/Worldwide Senior Patient Liaison PH: 800-328-3881, ext. 6261 011609 USER TIP Fully depress the inflation bulb and hold it for 3-4 seconds after it is depressed. Release your grip on it and wait 5-8 seconds while the bulb refills with saline solution from the reservoir. Repeat that process over and over until the desired firmness is achieved. A stinging sensation is noticeable as the corpora cavernosa is stretched tighter and tighter -- a sensation that will disappear over time. Jack Other Tips: When you deflate the implant hold down the release button 4-6 seconds. Then squeeze your penis from the head to the base a few times. This gets most of the saline out and give you a more natural flaccid look, it also help with inflation the next time.

My Implant 3 1/2 Years Later

3 & ½ Years Later

I was at my local urologist for my check up yesterday. It has been 3 ½ years since he sent me to Dr. Milam at Vanderbilt. We chatted a while about the urethral puncture by another local doctor and then my progress to date.

Since I was hurt just before Thanksgiving getting hit while walking in a parking lot and having a ruptured disk he wanted to check the implant. At first he jokingly asked, “Do you get to use that thing”. I told him only 4 to 6 times a month.

He inflated my implant and was very pleased with the results and that it was not damaged when I was hit. I said something like peyronies did a number on me and he said you have had a great recovery.

My recovery has been a great gift from God. It restored the pleasure of marital sex that God intended for us to have. I fully believe that marital intercourse is a gift of pleasure from God.

I tell both men and women, yes I have women write me about their husbands, about my progress. All I asked for was a usable erection and with the skills of Dr. Milam and the staff at Vanderbilt I have so much more.

I don’t mind sharing my story and the results of my research. No I am not a doctor and am not any part of a doctor’s practice, hospital, or device manufacturer, just a layperson that has done tons of research and willing to share.

As we all know our penis is our pride and joy. In my case at 18 I was about 6”. At 50 I had gained weight and was about 5 ½”. That was just before peyronies struck. I lost a lot of length. At my stretch test just before my implant is was 4” on my best day. When my implant was activated I was measured at 4 ¼”, at my 3 month check up I was measured at 4 ¾” and at my one year check up just under 5”. At 18 months I had started to regain glands erections and was almost 5 ½”.

Last August I went back to Dr. Milam because of my bladder problems. I was sure I needed another TURP. I had a cystoscopy and Dr. Milam said I had an over active bladder and that another TURP was not in my future all I needed was Enablex. That has worked well for me.

During our conversation Dr. Milam and I discussed many things. One of his comments was he was now seeing men with expansion up to 3 years. When I got home I checked and sure enough I was just over 5 ½”.

I have learned many valuable things along my journey. The number one thing men need to know is the size of your penis does not make you a man. One day I asked the beautiful green-eyed girl I married is how does my penis feel to you now. (We have now been married over 43 years.) She said “Jack, you feel just the same as always.”

The first night home after my implant was activated I lay on my back with a hard penis sticking straight up. No Shots, No Pills, No VED and constriction ring. Just me!! I felt normal again for the first time in years.

The first several weeks with an implant there is a learning curve on using it. At one year I thought this is great how can it get better. Well it did. At 18 months my glands erections had returned. At 2 years I again thought it could not be better but again I was wrong. Today 3 ½ years my wife and I are like young lovers. I am 69 and she is 71. We have more fun now than when we first married.

My advice to any man needing an implant is do not use a general practice urologist. A Male Sexual Function / Urodynamic Specialist is the kind of doctor you need. If you have lost penile size, have peyronies or any related penile problem you need a doctor skilled in using the special instruments. For restoration of penile size the AMS 700 LGX is the only implant that expands in both length and girth. A good graphic is at www.amslgx.com/ To my knowledge there are only 3 or 4 doctors that have these skills so be prepared to travel. Those of us that have used Dr. Douglas Milam at Vanderbilt will tell you he is the best in the world.

Any one that has any questions please don’t hesitate to contact me. Plain language is fine with me, I am not offended.

Remember marital sex is Intended for Pleasure and a gift from God.

Jack

WHAT HAPPENS DURING IMPLANT SURGERY

There has been some debate on the peyronies society forum about what happens to the corpus cavernosum (CC) during penile implant (IPP) surgery. You may hear that the CC is removed among other things that are not true. To answer that question I sent an email to Todd Doran at Vanderbilt. Below is his responce.

This is one reason a man with peyronies or other penile damage should use a well qualified Male Sexual Function Specialist, not a general practice urologist. To my knowledge right now there are only 3 or 4 well qualified doctors for this procedure in the US.

The most common complaint from men with peyronies is loss of penile size. The only implant available to help restore this is the AMS 700 LGX length expanding implant.

Jack


February 15, 2012 11:28 PMFrom: "Doran, Todd James" to "Jack Pinner"
Tunica albuginea is an elastic thick fibrous outer covering of the erectile body and the inside are expansile sinusoids and collectively they are called the corpus cavernosum. We have a right and left one. Peyronie's disease can cause dysfunction, plaque, scarring of either the sinusoids or the tunica albuginea. Placement of IPP cylinders are more complex and tedious to perform in a man with PD. There are tools to dilate the sinusoids thereby causing their destruction through the dilating process. Sometimes we need to use cavertomes (resembles a cylindrical cheesegrater) that are extremely sharp. They are used to dilate/surgically cut open a space within the corpus cavernosum. The destruction of the architecture of the erectile bodies in order to place the inflatable cylinders are why you can't get an erection at all after an IPP. We don't remove any of the corpus cavernosum to place an IPP, we dilate and create a space to place the cylinders.

Feel free to place this on site verbatim.


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

Norman's Feelings

This was posted by my friend Norman yesterday on the Impotance Group. With his permission I an adding it to my blog.

Good morning men,


Once again it is one of those times of year when the expression of love and
pro-creation is abundant in the world. I cringe and shake at times because the
accusation comes to mind that I am an outcast to these activities. The
previous past 4 years I continually descended into a deeper state of depression,
frustration, self pity, anguish and eventually torment.

I want to share a portion of an email I sent at the height of my depression when
I was looking for help. And I wantto share my first steps to a comeback.


*** 6/30/08 Heal my Perspective

I have suffered what I call dignity abuse. It is the assault of my self
perception. I am in search of seeing myself as whole and not broken. I have
many 'cut to the bone' experiences.
In this affliction I live a life hiding and fleeing all my days.

I have problems with concepts and statements like 'Live life to its fullest'.
I am exhausted and no longer trust hope. I am as a man that hides from a savage
wild beast. It see me and I see it.

Impotence is crushing me. It is killing me slowly. Has anyone had growth or
life to their withered blossom? Can you help me heal my perspective. It is
always from the torment of brokenness and never from the state of a good
beginning.

Hope has made me lie to myself. I fear accepting this because it is not the
real me. It is a disease or an affliction but it is not me. I have it but I
can't get rid of it. I am like a blind man who has sight for 15 seconds and
then returns to blindness.

How can I understand manhood and the natural use of the sex. For those of you
who have read the Bible. I am in distress as the man at the pool of Bethesda.
Someone always gets in before me and I have no one to truly help me. Year after
year I know, wait, and hope but in the end I am just unhealed and let down.

I don't know how to do this anymore. I need closure. Existing in the state of
continual trying is a sore evil and daily vexation. Help me escape the prison
of my mind. The scars of heart, the let downs and the mis understanding.

The initial joy when I see men who are whole; and then the sorrow for to me it
is withheld. Rejections, poverty, death- Nothing hurts me more than this.

If you have the power of truth-Please set me free.


***

12/24/2011 Perspective in Healing

Men we are more than the sum of our parts. Today I am reminded of Master Po.
A fictional character in a old Tv show called Kung Fu. Fully blind but every
other sense in his body was maxed out to its fullest. Hearing, smelling,
tasting, touching, mental prowess.

If he were able to see yet was impotent he would use all of his other senses to
live out and maintain a wonderful relationship. He would appreciate her beauty,
her scent, her voice, her person. He would caress her with tender love and he
would sexually stimulate her. He would hold her close and he would smile and
delight to be in her presence.

He would receive and give necking with all the joy of youth;as a boy reaching
first base. He would enjoy the tickling as she touched him, the hardness and
sensuality of their firm nipples with all the joy of a youth;as a boy reaching
second base.

She would stimulate him in the perineum and prostate if he had one. The massage
between the thigh and groin would ever so move him. He would stimulate her
clitoris and caress her vagina. He would receive this with all the joy of
youth; as a boy reaching third base.

Together they were fulfilled one climaxing bodily, one climaxing in the heart
both climaxing in spirit for the two are more than one part.! He would recieve
this with all the joy of youth; as a boy reaching fourth base.

***

Whether your impotence is temporary of permanent in physical ability. Follow
the example of Master Po and re align your perspective. Be not mis informed by
mis informed people. Often a NO is a Yes somewhere else.

It feels GREAT to be on the road to recovery. Both mentally and physically.
If I had a friend like the analogy of Master Po. I would have never wasted 4
years of my life and damaging 4 years with my wife. I could have been as the
joy of a youthful boy running around the bases!!!!


Try it. Allow it to happen. It's Truth.


Merry Christmas and Happy Holidays,

I walk with you!


Norman

THE PHYSIOLOGICAL ASPECT

MEN OBSESS ABOUT OUR PENIS

I posted this on the Peyronies Society Fourm and it needs repeated here.

Re: She didn't notice
« Reply #5 on: December 03, 2011, 09:47:33 AM » Quote Modify

--------------------------------------------------------------------------------
Can I say something:

We guys obsess about our penis our ladies are just glad to be with us no matter what. Like I have told many a young man "The size of your penis does not make you a man."

The beautiful green eyed lady I have been married to for over 43 years, (no she is not blond), has been with me through all my journey with peyronies, ED, venous leakage, corporal fibrosis. Then a failed implant attempt. Now a successful implant. The one statement she made to me still brings a joy to my life. "Jack, I did not marry you for your penis." She was by my side through my journey.

I lost over 1 1/2" inches to peyronies. It concerned me but never bothered her. When I came out of surgery at Vanderbilt she had talked with Dr. Milam. I saw that gleam in those beautiful green eyes and knew all was well.

The first night I was home after my implant was activated I lay on my back with a hard on sticking straight up, no pills, no shots just me. I was still 1 1/2" shorter than before peyronies but it did not matter any more.

Over the last 3 years I have been able to gain about 90% of the loss back because of the skills of Dr. Milam and the LGX. I asked her how I felt sexually now to her than before. She told me she never noticed the difference I feel just the same as always.

Guys, we have to stop obsessing over our problems. The women that love us don't care about the size or shape of our penis. That is a man thing. They love us for the man we are.

I have had the privilege of talking with many men that had progressed to the stage with this mess I have. It takes time for implant surgery to heal. One single young man kept telling me I can't a girl will reject me, I can't I have lost too much size to satisfy her, just on and on. Well about 2 months ago he meet a young lady and it was love at first sight for her. One evening after a date he was with her and she started to try to get into his pants. He told he whoa! you need to know something. She asked what? He told her "I'm Bionic." She asked what did that mean, he briefly told her he had an implant. She told him I don't care I want you anyway.

That night he learned a couple of things. The fact he had an implant did not matter, the size of his penis did not matter, that he could satisfy her and he could go longer than any guy his age. Since then they have been almost constant companions.

What I am trying to say is we can not let this damn disease get us down. There is help and hope for all of us. Love the lady you are with and she will give you more than you ever expected. The most important thing is NEVER - EVER / NEVER - EVER / NEVER - EVER - EVER GIVE UP!!!!

Just my feeling this morning.

Jackp
http://jackp-penileimplant.blogspot.com/

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

--------------------------------------------------------------------------


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.

----------------------------------------------------------------------

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

Implant Protocal Helps Reduce Penile Shortning

Larry was kind enough to send me the article from the October 2009 Issue of Urology Times.

Included is the update and VED exercise I used developed on the peyroniessociety.org forum. A personal comment. IT Works.

Implant protocol helps reduce penile shortening Pre-procedure use of vacuum device can restore penis to original length, data shows
Publish date: Oct 1, 2009
By: Mac Overmyer
Source: Urology Times


Key Points
The average length of virgin implants and rear tip extenders grew 5.5 cm during the period that the protocol was used.
Daytona Beach, A new noninvasive vacuum protocol for erectile dysfunction patients using an inflatable penile prosthesis can prevent penile shortening, according to results of a study presented at the AUA annual meeting in Chicago.

Cylinder length of a penile prosthesis reflects the length of the penis at the time of the procedure. Penile shortening associated with implants is not an insignificant problem. The average length of implanted cylinders has increased 5.5 cm in patients who have undergone the new protocol.

"There is no question that overall implant length has grown anywhere from 3 to 5 centimeters," said study co-author Martin Dineen, MD, of Atlantic Urological Associates, Daytona Beach, FL. "The vacuum protocol in our hands has virtually eliminated patient complaints of penile shortening."


Dr. Dineen and co-author Steven Wilson, MD, of the Institute for Urologic Excellence, Indio, CA, credit Thomas Sellers, a physician's assistant working in Dr. Dineen's practice, with identifying and refining the protocol.

"It [the initial idea] came from listening to non-implant patients who were using vacuum devices for erections," Sellers said. "They were telling me that they thought they were getting larger. The key to the idea came when I started having the patients mark the device with a felt marker where the end of their penis reached. That is how the protocol was created."

Under the protocol, patients anticipating an implant are instructed to use a vacuum device once daily for 10 minutes, beginning 2 months before the scheduled procedure. Patients with Peyronie's disease should use it twice daily.

"Those who were using it for around 10 minutes without the constriction bands seemed to be getting the most length," Sellers said. "Those who were using it longer did not appear to be gaining any additional length, and those who were using it for a shorter period were not getting as much of a return as they might be."

Sellers and the doctors caution that patients should be told that while they may regain their original length or a length close to it, they should not expect any gains beyond their original length.

After implant surgery, the penile implant is left 50% erect for 2 days and then deflated to 25% for 9 to 14 days. Following that exercise, patients are advised to inflate the device daily for 2 months.

Dr. Dineen and Sellers conducted a review of cylinder sizes they have implanted beginning in 2002, the year the protocol was initiated, through December 2008. the average length of virgin implants and rear tip extenders grew 5.5 cm (from 18.4 cm to 23.89 cm), an increase that reflects both expanding use and modification of the protocol over those 6 years.

High rate of compliance

"When a patient does not have an erection for a long time... the tissues foreshorten," Dr. Dineen said. "The idea behind the pump is that it stretches these tissues back to their normal length gradually. I explain it to patients as having their arm in a cast for 8 weeks. It is a bad idea, a painful idea, to stretch it back out immediately after the cast is taken off."

Despite the rigors of the protocol's schedule, patient compliance is more than 95%, Sellers estimates.

"Having [patients] mark the cylinder every week allows them to see their penis growing longer," he said. "These become motivated patients."

The protocol is now a standard aspect of therapy for patients anticipating an implant in Dr. Dineen's practice. Dr. Wilson uses the protocol only in patients who voice a concern about penile length. He says he feels that patient motivation is important for compliance. An independent, randomized, prospective trial designed to test these initial data is under way.

Drs. Dineen and Wilson are consultants/advisers for American Medical Systems, which provided funding for the study and manufactures the implant used by the researchers.


Penile Implant Protocol Update

Tom Sellers (physician's assistant), an assistant to Dr. Martin Dineen, MD of Atlantic Urological Associates, one of the two researchers involved with the Penile Implant Protocol Study published in Urology Times) (2009), telephoned me on 7-19-2011 after receiving a letter regarding my questions about their protocol being used for patients prior to revision surgeries to replace their old implants. Here is what I was told about the protocol:

1. Through further studies, the protocol is now only needed to be used for 3-4 weeks, as opposed to 2 months prior to surgery. It was found that one month was sufficient. The results achieved should be nearly the same.

2. The Penile Implant Protocol is just as effective for those patients having revision surgeries, as those who are having first-time penile implant surgery.

Prior to First-Time Penile Implant and Penile Implant Revision Surgery:

3. The new Penile Implant Protocols are as follows:

· Use the VED twice a day, holding for 10 min. when fully erect.

· Allow a minimum of one hour between use of the VED.

· Use the VED for 3-4 weeks minimum, but no longer than 2 months.

· Upon first use of the VED, when fully erect, mark on the outside of the clear plastic vacuum tube the length of the penis. This first mark will be used for comparison to subsequent length gains in the penis.

· Weekly take a measurement and mark a new line on the clear plastic vacuum tube (same day of week), marking out the steady progress being made.

· With limited penis sensation (quadriplegic and paraplegics), pump up the VED until a normal full erection is achieved, then stop.

· Gradually continue to increase the vacuum pressure to stretch the penile tissues and rehabilitate them. Again, continue to bring yourself to full erection, then stop.

· The vacuum pump may bruise the blood vessels just below the surface of the skin, which may cause petechiae (very tiny spots beneath the skin) when you first begin using your System. This is a response to placing the penis under vacuum pressure too long, too quickly or after a long period of inactivity. If this happens, discontinue use of the System until discoloration completely disappears – about five to seven days.

· There could also be some blisters appear upon the penis or water appear just under the surface skin of the penis. If this happens, reduce the amount of vacuum suction being used for a while.

After First-Time Penile Implant and Penile Implant Revision Surgery:

4. The new Penile Implant Protocols continues:

· After implant surgery, the penile implant is left 50% erect for 9 days. Following that exercise, patients are advised to inflate the penile implant device daily for 3 months, for 1 hour duration. Add extra pumping every few minutes to increase the stretch.

This protocol should aid in bringing a patient's penis size to near their normal erect size. This is highly advantageous outcome for the patient in that a maximized length and width of a penile implant can be chosen by the surgeon during surgery.

Surgery should be performed by a doctor who has done a lot of penile implant surgeries and revisions. It should be done at a Center of Excellence.

There are many types of VED's available for purchase. Manual pumps are better most usually than those that are battery or electric powered.

A patient recommended high-quality VED is from a company named Firma Medical (www.firmamedical.com). A moderate priced $199 VED Classic model (no prescription needed) was offered as a good option. It has the greatest suction and ease of use, compared to other VED's.

--------------------------------------------------------------------------

This is the VED exercise I used starting in 2005. It was developed by men with peyronies on the peyroniessociety.org forum.

VED EXERCISE
FOR
ED, PEYRONIES, CORPORAL FIBROSIS AND VENOUS LEAKAGE

RECOMMENDED BEFORE PENILE IMPLANT SURGERY FOR A BETTER OUTCOME

The theory behind this exercise is the more fresh blood you can get to your penis the healthier it becomes.

As some of you know the instructions that come with the VED can be vague. Old Man at Peyroniessocitey.org developed this exercise to me.

NEVER PUMP TO THE POINT OF PAIN OR EXCESS PRESSURE!! I did at first and caused a bruise on my penis that took weeks to heal. With this more is not better. Also hair can be a problem getting a good seal. Some of us just keep it trimmed back and others shave around the penis, what ever works for you. Do Not use a constriction ring for exercise.

VED for exercise. Every day.
Start with a good seal and pump to about 80% erect. Hold for 15-20 seconds then release for 15-20 and repump, (do not break seal). Do this for about 5 minutes.

Over the next 5 minutes pump up to a 100% erection using the pump hold and release for 15-20 second method. Do Not Break The Seal.

The next 5 minutes keep pumping to 100% erection using the pump, hold and release. Cautions do not over pump to the point of pain. After about a month you should start to see results.

No you don’t need a stopwatch, approximate times are fine.

VED for sex.
Start by properly placing the constriction ring on the cylinder. Get a good seal and pump to about 80% erection using pump and hold about 5 times. Then increase to about 90% erection and place the constriction ring.

Constriction Rings.
Constriction ring fit is a personal thing what may be right for me will not work for you. It will not be comfortable the first few times you use it. Trial and error are the only way to find which ring holds you best. Do not use over 30 minutes.

IMHO Osborn makes the best constriction rings. I had severe venous leakage and corporal fibrosis so I had to use the Osborn D ring. (Very tight.)

Any questions just let me know.

Jack


7/29/11 Footnote: In response to questions and comments from others I added this footnote. Remember I am a layperson and not affiliated with any doctor, hospital, or device manufacture. Just my own personal research and opinion.

I recommend this exercise for at least a couple of months before implant surgery. It will help keep your penis healthy and you will have a better outcome. Dr. Milam told me to keep up the exercise until about 2 days before my surgery and be careful not to hurt myself.

If you have read my story I call “One Mans Journey” it tells of my 10day hospital stay and recovery where I did not use the VED for almost a month. It looked like I had lost all the progress I had made with the VED exercise. When I was able to start back using the exercise within a week I had recovered the gains I had made.

Peyronies and Implants

Published on modernmedicine.com April 1, 2011

Implantable penile prostheses aid curvature, function in men with Peyronie's disease, erectile dysfunction
Two prostheses avoid perceived or real loss of penile length, research showsPublish date: Apr 1, 2011
By: Mac Overmyer
Source: Urology Times

In men with erectile dysfunction due to Peyronie's disease, use of a girth-expanding, length-extending implantable penile prosthesis appears to improve both erectile function and curvature while addressing the frequent problem of real or perceived shortening, researchers say.

Researchers from Vanderbilt University Medical Center, Nashville, TN, presented a study on two such prostheses at the 2010 AUA annual meeting in San Francisco. The devices—the AMS Ultrex and AMS LGX (American Medical Systems, Minnetonka, MN)—significantly improve curvature and erectile function and "contribute substantially to the patient's sexual health," said Benjamin Whittam, MD, a urologic surgery resident at Vanderbilt working with Douglas Milam, MD, and colleagues.

Dr. Whittam told Urology Times that being able to model during the implant procedure, coupled with the device's ability to enhance both girth and length, plays an important role in improving patient self-perception and subsequent sexual health.


In presenting the study, Dr. Whittam noted that some other prostheses allowed for length extension but were associated with concerns about achieving adequate rigidity for modeling and straightening. Other prostheses that allow a degree of modeling and straightening are associated with perceived or real shortening.

Of the two main types of penile prostheses, girth-expanding devices are currently supported by the Peyronie's disease literature, Dr. Whittam said. These devices include the CX (American Medical Systems) and the Titan (Coloplast, Minneapolis).

"However, neither of these has length-expanding attributes," he said. "Length- and girth-expanding devices such as the AMS Ultrex and AMS LGX are associated with risks of urethral dilation. There is also a concern that these devices might not tolerate intraoperative modeling and because of this, would not be that useful in patients with severe curves."
See Footnote

To define the potential benefits of the Ultrex and LGX, the Vanderbilt team conducted a retrospective review of 49 patients who had undergone an Ultrex or LGX implant procedure between 2006 and 2009. The patients had ED associated with penile curvature, and the average curvature was 52.9 degrees. A total of 37 patients received the AMS LGX, and 31 underwent modeling during the implant procedure.

Curvature, SHIM scores improve

The benefits associated with the device were substantial. Of 40 patients with sufficient follow-up (those who presented for activation at 6 weeks), 22 were without any residual curve, and 18 had an average residual curve of 17.7 degrees. Scores on the Sexual Health Inventory for Men (SHIM) improved from a mean of 6.97 preoperatively to 18.54 postoperatively with a mean follow-up of 7.3 months. The percentage of men able to have intercourse increased from 30.8% preoperatively to 97.3% at 7.3 months' follow-up.

There was no incidence of aneurysmal dilatation or device infection observed. One patient had a hematoma that resolved spontaneously, and one patient evidenced reduced glans support. This was resolved with a revision.

"We feel that the use of these devices allows a significant improvement in penile curvature and benefits erectile function as well as sexual health. This is now a standing clinical strategy that allows both girth expansion and length extension and is a viable therapeutic option for patients with Peyronie's disease," Dr. Whittam said.

Dr. Milam is a consultant/adviser for American Medical Systems.

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Footnote from a email from Dr. Milam's assistant Todd Doran MS PAC 7/26/11

The argument to use a CX in severe peyronies/modeling is due to aneurysmal dilation seen in older Ultrex (predecessor to LGX) and the false belief that an LGX will accentuate the curve. We disagree with that argument and it's still a largely held belief by a lot of implanters. Remember that there are few that have the volume like Dr. Milam, especially with concurrent Peyronie's Disease. The large volume implanter peer group would be less critical in using an LGX in that setting in 2011 than 3 yrs ago even due to success and spreading of the word.

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

I am happy to report that my case was included in the above mentioned study.

Jack

Ever consider an implant? Here's some entertainment. By LGX Man

Ever consider an implant? Here's some entertainment.


So much talk of ED. Thought I'd give you guys an encyclopedia of "the flip side". It's lengthy, it's fun! ;-)



I've been the proud owner of an AMS 700-LGX Penile Implant for nearly 7 months. It has turned out to be an amazing, life-changing product. I do notice a big difference in size now, After so many years living with ED, it had become a turtle. The new implant is 21cm. plus base extenders, which hold the whole shebang together. I've got some length and yes, it does grow your penis. Here's a truth that not many implanted men talk about. To put these new chambers into your penis, they cauterize, dilate or "hollow-out" the old corpora cavernosa. The "CC" is the part of your penis that has swollen up when sexually aroused. "used to be huh? heh" They then install the new chambers into the "dilated right thru the middle" old chambers. This is the part that causes the increase in girth, right off the bat. After working with my penis for many months, it gets BIG now. Magnum XL size in girth. I had previously been considered about normal, 6" regular. The length is worked on every day and is definitely growing. Read on...
I've followed all instructions from the doctor & manufacturer since the day I had it installed. Nowadays, I keep it inflated to the MAX twice a day for as long as I can stand it. I often go to sleep with it fully inflated. Sometimes I can stand it for an hour and other times I can go all night and have spontaneous sex. The mind once again works with the penis and there are times when the mind "just knows" that it will be having sex in the middle of the night. This is one of my improved thoughts since being implanted. Yeah … nice! I have the AMS LGX (stands for Length/Girth Expansion) and it grows. The more it’s used, the more it gets broken-in (a very good thing, kinda like an old leather jacket). After a period of uncomfortableness (based on your level of tolerance, but 1-3 months average), you will suddenly wake up one day and it will all be working again. Loss of sensation? Not necessarily. I became much more sensitive because it had never really gotten hard enough before to sense the new zones that I’m feeling nowadays. This has caused a huge boost in my self-esteem and confidence level. Before all of this happened, I had gotten to the point of using depression meds. and psych counseling. Suddenly one day I just realized: Many things in my life seem wrong. Many of them are caused by my low self-esteem. Why don't I quit bitching about it do something about it. I decided to use a proven method to fix, at least, the biggest problem. ED. It sure couldn't be much worse than where I was at, right? Those were bleak times.

I watched the chatter on the penile-implant and other discussion forums, as well as the enlightening ED chatroom,at FrankTalk.org. It's clear that people prefer one type (AMS/Titan) over the other. The debate goes on over which one is better, especially with the newer guys who do not read the backlog of postings in the message banks, and have similar new questions all the time. After the operation is done life gets back to normal and guys often just go on with their new lives. The forums go round and round.

DOCTORS AND COSTS: After a short period with my newest BFF, I could honestly say that I LOVE MY LGX I have no regrets and nothing but good things going on in my life now. So MUCH has changed! I've also met many nice men on these forums who LOVE their Titan. The key is finding the right doctor and the right implant. That begins the journey. Hopefully you have insurance as the operation can run up to around $32,000. Maybe you're lucky enough to have insurance that will cover the best of the best doctors. It seems that there are increasingly fewer of those doctors and health plans around. The "best of the best" ones are called SEXUAL FUNCTION SPECILISTS. They perform MANY of these operations per year. Some say as many as “thousands” per year. You can get lists of doctors here, just ask and a list will be sent to you. Perhaps your insurance is more limited, as was mine, and you’ll have fewer doctors to choose from. In that case you want to research each of the doctors in your plan as carefully as you can. The amount of research done is up to you. I’m part of a medical foundation on the west coast and found the doctor who had done the most work with implants for the foundation. If you ask here, you’ll get many names of doctors from satisfied IPP recipients. But guys, know when to decide! Too much research can just get you nauseous. Be informed and ask questions of us implanted guys. Believe me, I had new questions each and every day and the guys here on the forums got me through it all.

After checking out doctors, reading as much information as I could get my hands on, and reading the blogs, forums and discussion rooms, I chose to just do it and took that big chance, with great worry, trepidation and fear. Luckily, I had also developed lots of confidence in my doctor through many of his chats, tests, emails and demonstrations. He showed honest excitement to get me fitted into an implant, but had made sure that every other conceivable option was exhausted beforehand (pills, pumps, injections with various mixes). It was determined that I had venous leakage on one side, which kept my penis from staying hard. There are many theories and reasons for ED so I won’t go into it, research!

I worked on myself (swimming often) for a few months to get as healthy as I could be before I underwent surgery. My muscles and skin were toned up, and my veins were standing at attention, ready to have intravenous needles stuck in them, joy!. The operation was a success and I spent the night in the hospital so that they could remove the catheter in the morning, when needed. I was lucky, and was treated like a king all night. I was sent home to recuperate. All was fine until about the 4th day when the intensity of what I had done sunk in. This is where I learned the smart use of ice or something cold. Personally, I kept a bowl of ice water and a few white towels nearby. I had a thick towel underneath me. After wringing the towels out, I used the cold towels to wrap around my scrotum and penis, causing an immense amount of relief. Whatever your method for getting the swelling to subside, do it. Very important at this stage. Ibuprofen and other meds may be necessary, based on you.

Since my first inflation, I've been instructed to "work it" at least twice a day. For the first 2 to 4 weeks, this just meant to inflate the penis and leave it there for 10 to 20 minutes. After that, or when your doctor instructs you to ...you can start keeping it pumped to the MAX whenever you want. The material of the pump is strong and it can take whatever you want it to do. You SHOULD do this at least 2x daily for the first 18 months. It's an investment in time, but heh it's not really so bad now is it? Some days it does seem like a chore but once it's inflated, that’s usually all quickly forgotten or I leave it up and play with it. This is when you can start working on keeping your newly dilated corpora cavernosa (cc) chambers inflated or, in the case of the LGX-700, start pumping it to stretch/grow your penis. It’s pretty much the same idea as how muscles are made. Pump it! I work on keeping the LGX chambers aligned from the shaft into the GLANS. I work on keeping the shaft free of scar tissue growth. Scar tissue grows in immediately and throughout the first 2-6 months after the IPP operation, and is always a threat. You’ll know what it is when it sets in. if you don't WORK IT on a regular basis, at least for the first year to 18 months, you will regret it later. The more you work it, the better the results! Make sure the head of the penis get a full workout. Am I stressing the importance of this task guys? Talk about a wicked new set of feelings during the first few weeks! Now, when I use my penis, it's finally doing exactly what I want it to do, on command (on command of my fingers pumping it up that is) and for however long I want it to perform. I think of the daily routine as something that’s been prescribed and MUST be done. Twice a day! I have to admit that this is one chore that I’ve really grown happy to get done quite often nowadays!

KEEPING THAT PESKY PUMP IN PLACE: You need make sure that you keep that new testicle, known as the pump, adjusted to wherever it has to be in your scrotum. It's up to YOU to follow your doctor and manufacturer’s orders and get the new equipment to where it needs to eventually rest. If you have problems, get to, email or call your doctor! When it comes time to get the pump into the correct position in the scrotum, I found that taking warm showers with lots of soap or better, conditioner and working the pump (and shaft) to where it’s intended to be helped a lot. If the pump is already where it needs to be, you got very lucky but need to make sure that it stays in the proper place in your scrotum. While in the shower, pull gently on the pump and direct it to where you want it to be. You only have just so long before scar tissue forms and that pump takes up residence wherever it has ended up.

WHY I CHOSE THE LGX: My medical foundation ONLY uses the LGX. Why? Because all of the urologists from the foundation (some more skilled than others) went to a few conventions sponsored by each of the two IPP companies. Many did operations based on what type of IPP the various patients had requested. Then they compared results. The doctors at Kaiser, together, as a team, decided that the LGX-700 would be the implant of choice, and the one sponsored by the foundation. I’m not sure if this would be fair to our brother’s with a large penis, who are better suited for a Titan. Luckily, The LGX is generally suited for guys around the normal range, 6” more or less. The Titan is for the bigger guys. Both work differently, research!

After about 3-1/2 months of general aching and re-arranging, suddenly one day it all suddenly “stopped” and my new always half-stiff penis "dropped" about 20 degrees. I stood looking at it in disbelief! Yaay! I was able to get it nearly back to normal flaccid droop. The penis never gets small again, it is always a bit of a shower after one of these implants. Most guys don’t mind that too much for some reason. The chambers are just larger! Whatever pain that had remained was gone and my mind was once again free to start thinking of other things, besides JUST my penis! Guys, LGX / Coloplast Titan, either way... how comfortable are YOU to do the utmost research that you can do, get all the information that you can from the doctor and his staff, and then just do it!

FINDING DOCTORS: We can worry all we want and ask and argue and debate but let's get real. Like most things, it's the luck of the draw when finding a good doctor. If you have fantastic insurance plan, finding the best is probably a lot easier. If your insurance is limited, then you need to find the best that you can get! My LGX was FREE just because the foundation states that all that’s needed is for the urologist to state that it’s needed. Had I realized this, I probably would have approached the subject years earlier. Sticky point: The size of the implant is up to the doctor and any representative of the company that may be there assisting. Make sure that you discuss your options with the doctor that will be performing the operation. The doctor SHOULD BE giving you the proper sized implant for your particular penis. YOU HAVE ONE TIME TO GET THIS RIGHT, MAKE SURE YOU AND YOUR DOCTOR ARE IN SYNC WITH THE SIZE ISSUE. Don’t give yourself reason to complain afterward!

RETURN OF THE CORPORAS: The “corpora spongiosum" (cs), the one surrounding the urethra (around the pee canal, underneath the penis) and also the GLANS. They are supposed to (and HAVE in me) come back to life. When really "aroused", as you often will be after receiving an IPP, you'll suddenly notice that your entire shaft will become engorged. The bottom of your penis as well as the head will finally again fill up with blood as the penis is made to do naturally. This may not happen to everybody, but it WILL happen to many. Once the rest of your penis is working, eventually you will be able to have a fully hard (what many implantee's begin to think of as "natural") penis, not the oval penis that we live with for the first 18 to 24 months after the operation before the CS returns to life. Truth be told: Most guys will eventually get full use of their penis back after a length of time, living with their new implants. The confidence level can become so good that the old parts (CC) may eventually come to life and join the party! Seriously, just do it

Well, that's my story. Now I'm having lots of FUN in life. Picture the PERMANENT BIG SMILE! I hope that you'll consider the fact that it all could be a lot better just by doing it, like I did?

Now, back to the show...

Rick's Story

This is an email I received today from Rick. He has had a long struggle with ED and other penile problems.

Dr. Milam has a training program at Vanderbilt for Urologist that want to be male sexual function specialist. That work is paying off with new doctors. Dr. Milessa Kaufman is one of those.

His doctor at Vanderbilt was Dr. Milessa Kaufman. She went to medical school at Vanderbilt, Interned at Vanderbilt and then went through Dr. Milam's program on male sexual function and urodynaics. She is now on staff at Vanderbilt.

This is Rick's email:

It was done Tues. the 14th.

Lots to tell...the surgery went great and so did the next day on the hospital. Dr Kaufman has been great. I'
l'll quote her as best as possible. She said "her and everyone in the OR were very impressed with the implant when she filled it up and that I would be very pleased with the result. That result is exactly what the manufacturer wants". Ok you talk about being on cloud 9. Now that's some bedisde manners!

Had a 4 hour drive Wed. morning to get home. It's been a long week. I tried to do to much with Father's Day. I paid. I had to take an oxycodone at 3am. I'll take another this mornning. All the pain is at the incision sight. Not surprising. Vandy calls daily to check on me. I have learned my lesson and will keep a much lower profile for the next week.

I can't wait to use the implant. I feel like a new man. Unbelievable really what a surgery can do for the male ego.

I'll keep you informed as I go forward. Thanks for all your help. I can never state the way finding you and having this done has changed my outlook on life. God Bless you Jack for sharing your story with me.
Rick

Footnote: I have received some feedback, by some men, that say that want a male doctor to preform a implant. That is fine I would have felt that way years ago. If you prefere a male doctor Dr. Milam is always happy to help.