93 Questions To Ask
Your Surgeon Before IPP Surgery
You can, of course, pick and choose, but you should cover these bases.
1) Is floppy glans an inevitable outcome of the IPP procedure. If yes, how
is this addressed and resolved post-op.
2) Which IPP device results in a firmer, less floppy glans.
3) Does the surgeon perform post-op glans rejuvenation if necessary and, if
so, what is the protocol.
4) Which of all IPP devices will provide the maximum amount of post-op
glans engorgement.
5) What can the surgeon do intraoperatively to minimize risk
of post-op reduced glans engorgement.
6) How many Titan OTR’s has the surgeon placed.
7) How many AMS 700’s has the surgeon placed.
8) Which of the two IPP devices does the surgeon prefer to
implant and why.
9) What are the pros and cons of each device.
10) Given this patient’s frame and anatomy, which device does the surgeon
recommend and why.
11) In this surgeon’s patients, what complications have arisen post-op over
the last 2 years.
12) What is the surgeon’s infection ratio.
13) Where does the surgeon place the pump and does the patient have any
discretion in indicating where the pump is placed.
14) Is the IPP surgical methodology infrapubic or scrotal.
15) Which method (infrapubic or scrotal) does the surgeon prefer and
why.
16) Which method of IPP placement (infrapubic or scrotal) results in less
post-op complication.
17) Which method of Ipp placement produces the least amount of risk
to patient.
18) Does the patient have any discretion in determining the method of IPP
placement.
19) What is the surgeon’s ratio of infrapubic to scrotal
placements.
20) Intraoperatively, does the surgeon ever find a requirement for both
infrapubic and scrotal incisions and placements.
21) How many IPP devices (and what brands) will the surgeon be provided
with in the OR on the day of surgery.
22) Is the IPP device’s length measurement determined and material
specified pre-operatively or intra-operatively.
23) Is the device’s girth measurement determined and material specified
pre-operatively or intra-operatively.
24) Which of the two IPP devices will provide the maximum girth measurement
for this patient’s particular anatomy.
25) Which of the two IPP devices will preserve or provide the most penile
length.
26) Which of the two IPP devices will result in potential penile length
increase post-op.
27) Which of the two IPP devices usually results in length shortening and
why.
28) Which of the two IPP devices is easier to pump.
29) Which of the IPP devices require revision surgery more than the
other.
30) What steps should the patient take post-op to provide the
quickest recovery.
31) Titan OTR post-op 6-12 months: Will the penis be pendulous or
protruding and, if protruding, to what degree. (Pendulous: penis
rests in the 5:00 to 6:00 o’clock position.)
32) AMS 700 post-op 6-12 months: Will the penis be pendulous or protruding
and, if protruding, to what degree.
33) Which of the two IPP devices likely will result in a larger
package.
34) Which of the two IPP devices will result in a more flaccid, floppy
appearance.
35) Will the patient be able to wear boxers post-op.
36) Does the procedure in any way affect pendulous testicles (shortening,
lengthening).
37) When can the IPP surgical procedure be scheduled.
38) How much time should the patient take off from work post-op.
39) Will the procedure result in an overnight stay at the hospital.
40) Does the patient have the option of deciding whether or not
to stay overnight in the hospital.
41) What urological tests are performed post-op before discharge.
42) What urological tests are performed pre-op.
43) What urological tests are performed on day of surgery pre- and
post-op.
44) Are these tests required or optional.
45) What medical records, if any, does the surgeon require from current
physician(s).
46) Obtain statement of probable fees and insurance benefits.
47) Which method of anesthesia produces the least risk; which method does
the surgeon prefer and why.
48) Which method of anesthesia produces a better surgical outcome.
49) What medications are prescribed post-op for pain; does the patient have
any discretion in the selection of pain medications.
50) Is the IPP device left inflated immediately after surgery and, if so,
to what degree and for how long.
51) Must the IPP device remain inflated during the patient’s travel home,
especially if traveling a far distance.
52) Is a catheter placed intraoperatively.
53) Is a catheter placed or removed immediately after surgery.
54) When is the catheter removed.
55) What kind of catheter is placed (inflatable bulb).
56) When is the patient usually able to void without a
catheter post-op.
57) Can the IPP device be deflated upon patient’s return to
work; if not, how is the inflated penis best concealed.
58) In what position may the penis be worn immediately post-op.
59) In what position may the penis be worn upon return to work
post-op.
60) Does the patient need to return to the clinic
for removal of sutures post-op or can the sutures be removed by patient or local
physician.
61) How soon after surgery is the patient required to be seen
on follow up; how often thereafter.
62) Describe the pre-surgical protocol for fitting the IPP both lengthwise
and girth wise (the circumference around your penis).
63) Do you have variously sized IPP’s on the OR tray at the time of
surgical implant—or do you only have one IPP with RTE’s on the OP tray (optional
girth IPP’s)?
64) Is there an AMS or Coloplast company representative in the OR at the
time of implant and, if so, what is the purpose for their presence.
65) Are any photographs made of the patient pre-surgery, intra-operatively,
and post-op?
66) If photographs are taken, is the patient’s face visible in the
photograph?
67) What are the photographs used for.
68) What causes loss of length of penis post-op; how can loss of length be
minimized; does pre-op VED therapy improve post-op length of penis.
69) Is there a pre-op VED protocol that results in maximum dilation or
length at time of implant.
70) What is the dilation protocol at time of implant
71) What is the purpose of dilation at time of implant.
72) What protocol do patients follow prior to implant
to achieve best results?
73) During patient’s evaluation for IPP surgery, do you have specimens of
the AMS and Coloplast implants for patient to see and handle.
74) What argument, if any, does the surgeon offer for not undertaking IPP
surgery in my case.
75) Who will actually perform the IPP surgery and placement; list all who
will be in the OR at time of surgery. Will a physician’s assistant or resident
perform any surgical procedure in the OR? Under what circumstances, if any,
would the surgeon step aside to allow a physician’s assistant or
resident to operate? This issue is vitally important. At teaching hospitals, resident's sometimes "assist" in surgeries. Even private physicians sometimes "train" other practicing physicians. BEWARE!
76) What would be the most length he felt you could possibly loose from the
implant.
77) Discuss post op penis length and eventual girth and length one year
post-op.
78) May I see pictures of the surgeon’s previous patients’ post-op
results.
79) Length of stay in hospital?
80) What is the post-op recovery time for incision, first pump up, and
first intercourse.
81) How many IPP’s has the surgeon placed over the past three years.
82) What is the life expectancy of the IPP.
83) How long, if at all, will the patient need to have his
penis pointed up post-op.
84) In what state of inflation are the cylinders left post-op (empty,
partial inflation, full inflation) and for how long.
85) What activity restrictions will the patient have post-op, and for how
long (e.g. limitations on lifting weights, driving, etc.).
86) If the patient is traveling from a distance, what are the stay
requirements (or recommendations) for being near the surgeon.
87) What other travel considerations are there?
88) If the patient is traveling alone, does the patient need, and can the
surgeon’s office arrange, a local medical companion.
89) Does the surgeon place the pump in the final scrotal location
intraoperatively, or must the patient manipulate the pump post-operatively into
a scrotal position most comfortable for the patient.
90) How much real benefit to the LGX is there in terms of
post-op length gains.
91) What pre-op tests (e.g. flaccid stretch, injected erection or injected
stretch, or VED) can predict post-op length and what realistic expectations
should the patient have with regard to these pre-op tests.
92) When does the patient begin to cycle the IPP.
93) Will the surgeon provide you wish a list of IPP patients and their
phone numbers for the purpose interviewing patients for their experiences with
the surgeon and the post-op results.
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