But the story ends okay...
WHEN AN IMPLANT GOES BAD: REPLACEMENT TIME
[This is a story of an implant that went bad and had to be replaced. It is not meant to represent all implants but is a story that should be known by those who are considering one. It begins on July 19, 2000, when Gerry wrote about a problem he had with his penile implant/prostehesis, a story that subsequently turned out well.]
Wendy recommended a penile prosthesis to Alan, who is doing better with his potency than I did. Maybe there is hope for improvement with time.
Life with an implant and normal testosterone is good. Mine was installed Oct 97. I think it is probably the same as her husband's, a Pfizer AMS Ambicor. This device is activated by a bulb pump in the scrotum which requires 3 or 4 squeezes. There is no separate fluid reservoir. It is deactivated by holding the penis in a bent down position for a few seconds, then returning to upright with a squeeze if necessary. It comes with a lifetime parts but no labor warranty. I've read that normal life expectancy for the newer devices is about 10 years.
Unfortunately, mine began to malfunction a couple of weeks ago. After one squeeze the bulb remains flat. At first I thought it had leaked, but now I think some of the silicone material may have flaked off and is causing a clogging problem. I've discovered a work-around: keep it mostly pumped all the time so that it needs only one squeeze of the bulb to activate.
Anyway, I have an appointment to get it replaced 22 Aug, insurance company willing. My doc asked if I would like to change types. Does anyone have any info to offer about the types with a separate fluid reservoir, as shown in the healthology video? Does the fluid reservoir cause any problem, or are you aware of it?
I had cryo Aug 94, RRP Jan 96. PCa in lymph nodes. So far, I've used only Eulexin/Casodex and Proscar. PSA rose to 3.1 under 50 mg Casodex. 150 mg Casodex brought it down to 1.8, but it rose to 3.9 on 4/7/00 at which time Casodex was stopped, hoping for antiandrogen withdrawal PSA reduction.
I'm afraid they are going to want me to take Lupron at next doc appointment. It is a little comforting to hear some of you say that life is still liveable under Lupron.
Low PSAs to all, Gerry
P.S. I neglected to mention that I am 57 and still quite active--work full time in a job that requires a lot of walking and stair climbing. Also, I bike to work (6 miles/day) and do yard and house work with a lot of stooping and squatting.
[On 11/22/00, I wrote Gerry to get an further update. He replied on 11/27/00.]
I did have my implant replaced on 22 Aug. The problem was that one of the hoses had pulled loose from the bulb pump. The AMS rep that was present said that was a problem that they were aware of, and that the design had been improved.
I was kept in the hospital two nights this time only to receive IV antibiotics. I was not told to expect easier recovery than for the original installation, but recovery was much easier. I used only one Vicodin after coming home and could easily have gone to work the following Monday.
Unfortunately, I am in a fight with the insurance company over the surgeon and anesthetist's fees. Blue Cross Federal Employees Plan has backed off the coverage that paid for the original installation. They formerly had a clause that said that a disability or disfigurement caused by treatment of a covered disease was also covered. Now they refuse to pay for anything relevant to sexual performance, even though they will pay for implants for women who have had mastectomies.
One benefit is that the new device is 1.5 cm longer. That doesn't sound like much, but I notice it.
[I replied that same day.]
Sorry to hear about that problem but I'm glad you made it alright. Thanks. I'll include this update. I'm glad AMS "solved" it but it could make one very uneasy, if one has the earlier model.
Which makes me want to ask: which model went bad and what design do you have? Robert
[He replied that same day, 11/27/00.]
My device is called the Ambicor by American Medical Systems a division of Pfizer. It is a two piece type with a bulb pump in the scrotum, but no separately implanted fluid reservoir. It requires about three squeezes of the bulb to activate. It is deactivated by bending the penis down for about ten seconds, returning to straight, and squeezing.
Both the implant doc and my regular uro said that the RRP scar can sometimes cause some problems with implanting the separate reservoir used in the three piece type.
[The Ambicor model he cites is illlustrated at the P5 page on types of implants.]
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