Inflatable Erectile Device & Glans Implant

Inflatable Erectile Device & Glans Implant

Within months of my phalloplasty two things became very clear to me: 1) I did not want a permanently flaccid penis and 2) I needed a glans revision since about 80% had already flattened out. It is incredibly common for the glans ridge to flatten out over time and, since the start, it's been a big deal for me to have some kind of definition in that area. I was excited to learn that Dr. Crane had started doing silicone glans implants. He basically carves a circular disk from silicone and implants it under the skin like one would see with general body mod work. A few months post-op I scheduled an ED implant, glans implant, and testicular implant surgery set for exactly one year from the date of my initial phalloplasty.

Erections

I totally became that guy who felt sad and impotent with a flaccid penis. I know that some guys are totally okay without an ED, but jerking off a flaccid dick made my soul hurt. And, every bone in my feminist body did not want my experience to be like this...cause, come on, erections don't make a man. Ugh. I wanted to believe that and be okay with a dick that didn't need any more surgery. But alas, I succumbed the patriarchy once again and desired a dick that could stand up and maybe even wink at me in the mirror. I think I'd like a brazen penis.

For internal erectile devices, there are basically two options: semi-rigid/malleable rod or inflatable pump. If you want to read someone's thoughts on the pros/cons, check out the Pump vs. Rod post on the MyPhalloplasty blog. It's an awesome blog and there's great info - no need for me to repeat. The short version for me is that I wanted the sensation of becoming erect and I didn't want my dick to be somewhat firm all of the time. I had the length and girth that I wanted and I didn't want to manage anything thicker or harder in my pants on a daily basis.

The inflatable ED that my surgeon uses is the Coloplast Titan OTR 3-piece inflatable pump, with a strong preference for implanting the largest individual cylinder that can fit (many people get two cylinders). It's made up of three pieces: a reservoir that holds the saline in your abdomen until it's time to get hard; the cylinder that is sewn into your pubic bone and runs the top length of the shaft; and, the pump that helps push the saline into the cylinder, topped with a release button to return you to a flaccid state. The pump takes the place of one testicle, so if someone wanted two testes, they could have one testicle implant placed side-by-side with the pump.

Surgery and Recovery
On Dec. 1st 2017, I had I had the Coloplast Titan OTR 3-piece inflatable pump erectile device implanted (with one cylinder) as well as a glans implant. Unfortunately, my scrotum wasn't big enough to hold more than the bulb for the pump. The surgery lasted only 90 minutes and I will freely admit that I was in a ton of pain when I finally came to. The nurse only gave me one Percocet and then was trying to wheel me to the bathroom with my feet dragging on the floor.

I'm not sure if you can imagine this, but get into a sitting position and try pulling your feet up off the floor. Gotta use your ab muscles, right? Yeah, that's what was hurting like hell and she was asking me to lift my legs up or deal with them being dragged. Hell-to-the-fucking-no. After what felt like forever and me screaming that I needed a wheelchair that had feet stirrups, we resolved that issue (in addition to getting another Percocet). It still amazes me sometimes how bad medical providers are at their jobs.

I slept the rest of the day and then got this weird insomnia for the next few days. I hated being on Percocet (never again), so I weaned myself off of it within 48 hrs and transitioned onto full doses of acetaminophen and ibuprofen (and a multi-vitamin and probiotic). The day after surgery, I came down with a cold and spent most of the next few days laying around watching TV, drinking tea, and eating soup. I had surgery on a Friday and my post-op appointment was on the following Tuesday. Dr. Crane took a look and noticed that the bulb of the pump had already started to ride really high in my scrotum. He told me everything else was healing well, but that I needed to start tugging the bulb down at least once a day to keep it from riding up anymore. While I still had cold symptoms, I was generally feeling pretty good and wasn't experiencing any discomfort.

I was sent home with half a stiffy and the schedule I was given for recovery was as follows:

• Try to sit in a reclined position for the first 4 weeks as to not put pressure on the base where it's attached. Don't sit straight up with feet on the floor in a chair for more than an hour.
• Once the swelling goes down enough where you can feel the release button on the pump (2-4 weeks), start cycling the pump daily by inflating it all the way and deflating it all of the way. At that point, you can leave it deflated during the day.

Why half a stiffy, you ask? As you heal scar tissue is forming around the components of the pump. For your body to have enough room for the cylinder to fully inflate and the reservoir to fully inflate, there needs to be some saline in each for the first several days of healing. Hence, the semi-erect state, which ended up being about 3.5 weeks for me. 

The day after my post-op appointment I had a 14 hour travel day to get home, which included two flights and a 3-hr bus ride. It was totally fine. I had done the TSA Pre-check so there was no crotch groping and I made sure to get seats with extra legroom and as close to the front of the plane as possible. I carried on a sweatshirt in case I needed any propping up to get comfortable in the seat. It wasn't needed. I was surprised by how smooth the travel day was. Granted, I was obsessively reading my way through Ready Player One, so that helped.

...in my next post I'll go into more detail about my recovery from surgery and share tips/tricks for inflating and deflating the pump...cause it's not as easy as it looks.