Two Questions for PMMA Patients

[Skeptical One]

I know this may seem like weird questions but I wanted to know if there was anything applied on or around your penis that would have a strong and/or distinct odor post-op? And if there is an odor, how long does that odor continue to persist?

The reason I ask is that I know that shower's are NOT recommended until the entry points are fully healed. I will probably be seeing relatives either much later that night or the following day, and didn't want to seem suspicious with the stench of medical chemicals emanating off of me. I don't think he uses betadine (which I'm not even sure if it has a distinct odor in itself), and all I can imagine being applied to the skin is rubbing alcohol? Please let me know.

My second question is about showering. Is it possible one could wear a clean towel around the waist, and "spot" bathe/shower the rest of the body, or is this recommended against altogether?

Thanks!

[emptyyogurtcup]

Hey SO,

He rubs your entire penis with antiseptic gel and then uses betadine around the insertion points. The nurse occasionally sprays your penis with rubbing alcohol. It all depends on how fast you heal really. My points closed up almost right after he was done. There were two in the middle of my penis to get to the glad that required bandaids I was told to keep on overnight but when I removed them the next day there was no blood.

There was no odor coming from that area afterwards though if that answers your question. I think the showering is incase your bleeding, but I don't see anything wrong with taking one if you need. Just replace any bandaids if you have them and/or the main bandaid. If you're really worried you can get some clear medical tape and cover your junk with a sheet of plastic like a trash bag/sandwich bag and use the tap to seal it.

I showered the next morning no problems.

[Skeptical One]

Thanks!

[wisher]

your concerns seem logical but i can assure you that you will be fine. i wasn't aware of any smells even during the actual procedure. the only odor would be that from not showering but it shouln't be that much in a couple days. if i remember correctly dr. C also had no problem with the shower thing. he said i can shower whenever. i did so two days later and no problems.

[Skeptical One]

If Dr. C is okay with showering after the procedure, I wonder where the whole "no shower until the entry points are closed," tip came from? I think it was probably in some post in the super huge PMMA thread, but I'm wondering what the reasoning behind it was. I mean... I can't imagine what harm running water over my groin/pubic area would do, and if anything it would probably aid in cleansing the area that much more, no??

I just want to be sure I do EVERYTHING to avoid complications that were a result of negligence.

And as for the odor thing, I suspected as much, I'd probably be stinking more than anything Dr. C put on me. I was just concerned since I might have to come in close contact with relatives and well, didn't need any extra paranoia lol.

[wisher]

it's seems that showering can cause an infection if it get's it there somehow. i remember speaking with rosenthal when i was going to do bella and he told me that he had a case of infection due to the patient showering. to be honest i don't see how soap and water can hurt you. also i had NO infection from showering post adult circumcision, and that was an opeing all the way around the shaft. but it's alway best to be safe and wait a couple of days. better safe than sorry.

[hoddle10]

Apr 13, 2011 13:01:50 GMT -5 wisher said:

it's seems that showering can cause an infection if it get's it there somehow. i remember speaking with rosenthal when i was going to do bella and he told me that he had a case of infection due to the patient showering. to be honest i don't see how soap and water can hurt you. also i had NO infection from showering post adult circumcision, and that was an opeing all the way around the shaft. but it's alway best to be safe and wait a couple of days. better safe than sorry.

I think the key difference is that the consequences of infection are far greater with implant material, than they are with a circ. So the small risk of infection from showering post circumcision isn't worth worrying about, as it will usually clear up on it's own. But if implant material gets infected it's best to remove the implant, which means secondary surgery. With PMMA I'm not sure if that would be possible without damaging the skin.

[smartman]

I have mentioned before the danger of showering after pmma injection ( in people who had previous graft surgery (alloderm or belladerm or DFG) esp. if the entry holes were not completely closed .

I remember a patient who had alloderrm one year before his pmma injection and he had a shower before the entry holes were closed ---->severe infection of his ( remnant alloderm ) penis.

So who has a graft before ---> please no water reaching the entry holes until they are completely closed .

Be careful guys

SM

[sheldon]

Apr 13, 2011 13:47:24 GMT -5 smartman said:

I have mentioned before the danger of showering after pmma injection ( in people who had previous graft surgery (alloderm or belladerm or DFG) esp. if the entry holes were not completely closed .

I remember a patient who had alloderrm one year before his pmma injection and he had a shower before the entry holes were closed ---->severe infection of his ( remnant alloderm ) penis.

So who has a graft before ---> please no water reaching the entry holes until they are completely closed .

Be careful guys

SM

Thanks for this information, SM.

[Skeptical One]

smartman

thanks, so this means no showering for prior dfg/alloderm/belladerm patients only? So if I have never had those procedures, would it be okay for me to shower then?

[hoddle10]

Apr 13, 2011 14:49:01 GMT -5 Skeptical One said:

smartman

thanks, so this means no showering for prior dfg/alloderm/belladerm patients only? So if I have never had those procedures, would it be okay for me to shower then?

Don't take the risk. Even is Dr C says it's ok. If you get the PMMA infected you have a problem. I'd say the problem is worse than with Alloderm or DFG's, as they can be removed more easily.

[skatezy777]

I would agree with hoddle. Why even take the risk for something so important?

[smartman]

SO,

As everybody know: water + wound ---> infection.

Dr.C. said (as far as I remember): you can have a shower even if the entry holes didn't close (anybody can correct me if I am wrong ), and all of us know that he has a great experience in pmma bioplasty ( he injected pmma in any part of the body ) so if he had any infection post injection ( from water ) he would tell all his patients to avoid water .

But not to forget that may be Dr. C. doesn't have experience about (or met a lot of) patients with previous girth surgery (e.g. alloderm...) so what he ment ( patients who had no previous graft).

N.B. I will guarantee everybody who had a graft before his pmma and allow water to his wounds ----> he will have a DISASTER .

But I cannot guarantee that you will have the same complication if you had no graft previously ( to prove that it is not serious is from Dr.C.'s experience he injected every part of the body and never advice his patients to avoid water ).

In conclusion : I would advice EVERYONE if I was in your place (with or without graft) to avoid water to the entry holes just to be on the safe side ( it will be only for few days ) we have only one penis take care of him, please.

SM

[Skeptical One]

@hoddle, skatezy, and smartman

thanks, and I agree, why even risk it at all if others have reported complication in the past. I'll just be patient and wait till the entry points are closed. And if I'm really stinky, I'll "Spot-clean," that is, I'd wear a dry towel around my waste, and take a wet & soapy sponge to other parts of my body and rinse with a separate moist sponge/towel. That way water is no where near my bioplasty site and I can maintain some level of hygiene (I may be obliged to attend a dinner the evening of or the following evening after my procedure with relatives).

[docsavage]

Report: Postop Showering

I'm not recommending this to anyone, but I can report that I took showers in the evening when I got home the same day of the procedure both times. The insertion points appeared to be closed. Dr. C made no recommendations to me about the timing of any postop event (shower, sex, or otherwise) besides massaging the penis frequently for for about 48 hours to help the PMMA settle more evenly. Other than being a little more gentle with the penis & the immediate surrounding area, I didn't make any special effort to keep the water from it & cleaned it very thoroughly with soap & H2O. Then, not wanting the area to stay moist, I dried it completely with a clean towel. Subsequently, there were absolutely no complications, infection or otherwise.

My rationale for washing the area was due to a few reasons. First, I have an almost pathological compulsion (not quite that bad but almost) to shower every day. If I don't, I perceive that I'm a lot less clean than I am in reality. It's kind of like the 6" girth goal: the idea has super-glued in my mind & is impossible to get out. Secondly, Betadine and particularly alcohol do not retain antimicrobial effects for indefinite periods. Also soap & water work well to keep the area clean of substances that may harbor infection (dirt, sweat, blood, etc.) as well as dealing with the microbes.

Alcohol exerts its action by evaporating, causing dehydration of the microbes. Unfortunately it dries quickly & the desired effect goes with it. I believe it is used before, during, and after the procedure to prevent immediate intra-operative contamination of the cannula insertion points, since puncturing the protective barrier of skin (the first line of defense) with a foreign object inherently involves some risk of infection. The antimicrobial mechanism of action of Betadine is not completely understood (it may act in more than one way) and I could not readily find a reference for the duration of its antimicrobial effects. While Betadine is highly effective at killing a broad spectrum of microbes, it is indiscriminately cytotoxic and can destroy good cells as well as infectious microbes. However, the risk of cytotoxic damage to intact skin is likely very low in brief or intermittent treatment.

Soap is highly effective in reducing the spread of microbes. In large well-designed clinical trials handwashing with soap & water was more effective than alcohol-based hand sanitizers & caused less damage to the skin. As an aside, hand sanitizers contain 62.5% ethyl alcohol which is 125 proof--if you are at the hospital and desire a quick drink you can get a few squirts of Purell: it's the Grey Goose of hand sanitizers (just joking!). In addition soap does not inactivate Betadine if it's still present.

It has long been known that most infectious agents thrive in still, warm, moist environments of which a surgical incision is a prime example. The postop instruction to avoid getting it wet for a certain period of time has been around for almost as long. It originated in a time of less scientific knowledge, less hygeine in general, few effective treatments for infection, unsophisticated surgeries requiring large incisions, and the list goes on. For many surgeries today it may still be appropriate-always defer to the judgment of the surgeon in this.

Like practically any patient-care decision that is made, You have to first rely on the highest-quality scientific evidence available. Unfortunately, there may not be good evidence that can be applied to your individual patient (which is you). This situation is not infrequent. If a decision has to be made, & there are still holes in your process, you have to plug them with experience (yours or another's), judgment (ditto), patient/family preference, and occasionally (frighteningly enough!) something as unscientific as tradition. When I was being educated for my profession, we were sometimes required to give a rationale for every single tiny decision that we made. What we were really being taught is that scientific knowledge is still lacking in many areas and a lot of decisions are made on a non-scientific basis. While we may not follow a certain well-defined process consciously, many of us here at the forum, including me, make decisions about the PMMA procedure, postop care, etc. in a quite similar way and I believe it's the appropriate method right now. Combined with our individual comfort with different levels of risk, it's the best we can possibly do with what we currently have available.

I am 44. I knew if I waited for all the evidence to come in about PMMA girth enhancement before having it done, I would not have nearly as long to enjoy making love with my wife or benefit from the increased confidence and self-esteem that inevitably affects most other areas of my life.

Gentlemen, I'm very sorry I have gotten so far off track, but this has been therapeutic for me at the very least.

Anyway, to make a long story short, which doesn't seem possible anymore, in light of my general good health & the very small size and closure of the insertion points, and no infections after the first two procedures my conclusion is that showering quickly, cleaning thoroughly, & drying quickly & completely will actually reduce my chance of infection rather than increasing it. And I won't be committed to the state mental hospital for at least one more day (at least not on the basis of compulsive showering).

Again, this is not a recommendation, only a personal report.