10/09/2009 My one-year post op at Vanderbilt, Jack P story

Dear Readers:

For those of you who have followed my blog over the past couple years, Jack P has been a regular contributor to this blogsite as well as to other supports sites, most notably to Peyronies sufferers. Jack has been an inspiration to many men with his never say quit spirit. His first attempt to have implant surgery resulted in his doctor puncturing his urethra and having to stop. Jack has had Peyronies disease for many years. Peyronies disease is where there is scar tissue that builds up in the corpora cavernosa of the penis. The corpora are the spongy tissue that fills with blood to give rigidity to the penis during erection. The surgeon, in trying to push a pathway through the scar tissue and spongy tissue, caused a puncture through the urethra forcing him to stop the procedure. Jack opted to find a second opinion and found an excellent surgeon at Vanderbilt University Hospital. Just prior to having surgery, Jack choked on a piece of meat and what followed can be read on my February 28, 2009 blog Jack P, The Rest of my story. As I pulled everything together for that blog. Jack did have his implant revision on 10-23-08 where he had an AMS 700 LGX implanted quite sucessfully. Jack is at the one year anniversary of his implant surgery and he wishes to let all of you know about his success and the impact of what a penile implant has had upon his life. Jack's story is what this blog is all about. Bringing hope to men who have given up hope. It's restoring wonderful sexual lovemaking back in the bedroom between two people who very much love each other. Folks, here is Jack's story in his own words.

10/09/2009 My one-year post op at Vanderbilt by Jack P

The exam and follow up with Todd Doran PA, and Dr. Douglas Milam

I am delighted with my implant and all the care I received at Vanderbilt. During the exam and follow up questions I spent about 45 minutes with Todd and Dr. Milam. I had a few questions and learned a lot.

We started out with Todd and an intern. I pumped up my implant. Todd showed the intern where the tips of the implant extend into my glans. Of course the glans was flaccid and with a slight downward pressure on the tip you could see where the tip of the implants are. Both sides fit to the same size and approximately ½ way into the glans.

We discussed my success with the implant and the impact it had on my life. I am happy to say the impact has been better than I ever expected. During the discussion Todd asked what is the most common complaint with men with pryronies. Loss of size, length and girth. The AMS 700 LGX is the only implant that can help restore length.

I wish I had a recording but I will tell you basically what Todd said. The AMS 700 LGX will straighten out a peyronies curve. Peyronies is not normally in the erection chambers when the implant is activated it will straighten out the penis. I said to Todd that some men go into surgery expecting an LGX and come out with a CX or other implant. I asked if there was a reason for that. He said that when that happens the doctor does not fully understand the anatomy of the penis and the workings of the implant. Dr. Milam was an engineer before becoming a surgeon and fully understands the mechanical function of the implant and penis. He said that all there patients, with peyronies, that have the LGX have a straight erection like mine.

I have a diminished blood flow to the glans. I told Todd that it is more noticeable now that I have been off blood thinners for a year. He said that was what happens is a lot of men. I asked how could I help blood flow to the glans without the blood thinners. I asked if Cialis would help. He said it would and recommended the daily dosage of 5mg. He wrote me a prescription for the 5mg daily dosage. I will take it along with the coupon for a free months supply from http://www.cialis.com/ to the pharmacy today. My prescription drug plan (Medicare Part D) does not cover it so I need to shop around the cost.

I asked about the Ambicor 2 piece implant for a gentleman in the New England area. He said they only use it if they cannot get a reservoir in. He said it has a much lower satisfaction rate than the other implants.

I asked about pain with peyronies for another gentleman. He has been having pain with erections and other urinary symptoms. They know Dr. Levine and his work. They disagree with not doing any surgery for peyronies if you have pain. They did not get specific as to what they prescribe for pain only different men have different symptoms and they prescribe different things, and they also occasionally recommend surgery for the pain. They also recommended a second opinion on the urinary symptoms and said they would be glad to help him with that.

We talked about penile injection therapy for ED. They do not recommend it and do not prescribe it. Injection therapy caused my condition to get worse with corporal fibrosis.

We talked about the peyronies society web site. Todd said that now he has a face to put with those coming in after visiting the web site. He said that they have been able to help several men after viewing the site. Todd said he has looked at the site and likes the fact that we are straightforward and informative. The information is usually straight and factual.

We talked about the difference in the pubic and scrotal approach. 98% of the implant that Dr. Milam does is the pubic approach. He said that the dorsal nerves are easy to identify and keep out of harms way. He said that if there is a problem with the corporatomy it is much easier to repair with the pubic approach. We discussed my punctured urethra that happened with the local doctor using the scrotal approach. Todd said that the instrument to dilate the corpora is curved and if not done properly with the scrotal approach that a punctured urethra can happen. He said Dr. Milam is very detailed about this and reminds his students all the time of this.

I asked about revisions. Dr. Milam said that they do “a ton” of revisions.

I asked about the life expectancy of the implant. Dr. Milam said 93% were performing normally at five years. Both Dr. Milam and I have some engineering background. I am a retired Boiler Inspector and Mechanical Contractor. We compared it this way; you can buy the best HVAC system on the market and use the worst or cheapest contractor in town. The system will not perform properly because of an improper installation. If you buy the same equipment from a first rate contractor you get a properly performing system that will save you money in the long run. I said it to him like this; I charge an A/C system with a digital thermostat to the manufacturer’s specifications. 90% of the systems I go to the first time are at least ½ to 1 pound of Freon overcharged. This cuts the efficiency of the system by about 20-30%. Moral, to get the best results use the best equipment and an experienced well qualified people.

We discussed additional penile length. I have gained weight and need to loose 20-30 pounds. Yes I am a big guy 6’2’, 255 pounds. I was told that if I loose the weight I would gain 1 to 1 ½ inches. That will put me back at my length before peyronies. Now all I have to do is get off my butt and do it. I have started back walking 2 miles a day, but as my wife says I need to cut back on the sweets, bread and portions. I lost over 20 pounds several years ago on the Atkins Diet and considering going back to it.

Girth: My erect girth is back to where I was as a teen’s or early 20”s. If I remember my algebra correctly 2” diameter x 3.14 = 6.28” or 1” radios x 3.14 squared = 6.28”. Any way the wife and I are very happy with it.

The best part of this whole experience is the renewed confidence I have. I feel NORMAL for the first time in years.

There was the pain of surgery, the 6 weeks waiting to activate the device, the discomfort when the device was first activated, getting used to the pump in the scrotum and the about 3 month learning curve of using the implant. The small amount of discouragement when first activated that I was not as long as in the VED but as Dr. Milam said at my 3
Month check up I regained it as the AMS 700 LGX continues to expand

Dr. Milam, Todd and I talked about the publication on using the AMS 700 LGX. It has just been submitted to The Journal of Urology and will take 6 to 9 months before it is published. There is a meeting next month (11/09) in California of the Sexual Medicine Society. Dr. Milam has a major presentation at that meeting on the AMS 700 LGX. Dr. Milam will send me a copy of the publication when it is printed and I have his permission to publish it on the peyronies society web site a yahoo implant group.

I also have kidney stones 3 on the left side and 2 on the right. I showed Dr. Milam the report from a CT I had the end of May. He said so long as I was not in pain the wait and see that my local doctor recommended is normal.

Dr. Milam and I discussed that when my local urologist did a bladder scope, after the ultra sound for kidney stones, that he said that with an implant I was limited with options if I had prostate problems. I had a couple of TURP’s about 12 years ago. Dr. Milam said that with the implant there was no problem with any prostate procedure with the implant.

Dr. Milam and his team do all kinds of penile surgery from surgical correction of penile curvature, penile implants, and artificial urinary sphincter to control incontinence, circumcision and lots more.

Before anyone asks, No you cannot gain additional length or girth with the implant above what you normally have. Any one that tells you their product or device will is selling “snake oil.”


Dr. Milam told me I did not need to make the trip back to Nashville any more but if I needed him just let him know. I will always be a patient of his and Vanderbilt.

JackP