TOPIC: PMMA infection

Sorry to hear about your ordeal, and I apologize to the forum for my brief absence as I was out of town on personal matters, and would much prefer responding substantively from my work computer then trying to get a few general replies in via mobile phone (so I hope you all have my understanding).

The reality is that infection(s) can happen from virtually any elective procedure. Even outpatient dental procedures have varying infection risks, no matter how low (figures range 1%-3% from some sources online). Combine this reality with the something like male enhancement and the potential of infections that are inherent in coitus in general, you can see how being extra careful can't hurt (and I'm not even suggesting STDs which are obvious, but lesser realized risks like UTIs and such).

It's hard to ascertain the exact reason for your ailments, and short of some clear & irrefutable biopsy, I'm afraid we never will... but I think it's an essential reminder that these risks are always present in elective & cosmetic endeavors, and that while many men see benefits from pursuing penis enlargement, not all end up as intended. If there is any solace, it appears @Zep83 condition has improved significantly and I hope that despite this unfortunate series of events, your unit will have healed in such a way that you'll have retained the health & function of your unit indefinitely, and I hope you do follow-up with pictures. Heck, given you've had 69 total cc's over multiple sessions, you'll still be girthy even if some tissue was lost due to the medical intervention involving your infection.

Good luck and we'll be here.

Yeah they say wait 6 weeks. If you can squeeze filler out of your penis that means the holes are still open, correct?

Zomar wrote: Yeah they say wait 6 weeks. If you can squeeze filler out of your penis that means the holes are still open, correct?

If you can squeeze anything out on the shaft post-op, it means there remains a break between the surface and layers of skin/tissue that hasn't fully healed (typically entry points). Until you are absolutely certain (which includes meeting the minimum recovery time prescribed by the Doctor), there is no reason to chance any activities that may open you up to pathogens unnecessarily (this includes oral, anal, vaginal, and heck, uncleaned hands before masturbation!).

Update 10 days after infection. I'm fine, I'm still in hospital, I'm waiting for the result of the swab they took to understand the type of bacteria that infected me. I did a second Doppler ultrasound check and everything was clear, scrotum and spongy bodies, I have no functional damage from what appears. Unfortunately, as Dr. M. and also the Urologist here in the hospital told me, the problem is that the white part that can be seen with the scanner cannot tell whether it is just pus or pus mixed with PMMA, therefore the right path to follow for doctors it is that of drainage. To date I can exclude that there is a need to make an impact but the situation will need to be re-evaluated in the next few days. AD wrote to me telling me that the PMMA of the 2nd round is stable and will be present even after the infection has passed, while that of the third round a part can be drained with pus. I was told that PMMA has a similar color to pus and this cannot even be seen with a machine, you can only see a white layer. For now I'm only thinking about healing, then externally we'll see. The thing that I didn't understand in my entire history with PMMA is how it is possible that after 2 weeks it can still be liquid and not solid as I always thought. The inflammation due to PMMA creates collagen which traps the microspheres already 5/6 days after the liquid carrier has been reabsorbed. At this point everything should be encapsulated and collagen begins to form around it. If unfortunately you get an infection as happened in my case I would never have thought that it would be possible to drain liquid PMMA mixed with pus. This worried me because the collagen phase will continue even with the infection present because on the one hand the antibiotic and anti-inflammatory block the infection and on the other the collagen will tend to inflame due to the construction of collagen. This is a situation that is not easy to understand and manage.

Great to hear you are doing better Zep. That is a hard situation. Hopefully the drainage will be minimal for many reasons.

Wishing you a speedy and full recovery.

After everything you've been through would you still try again to get the 3 rd time right?

I think for now my priority is to wait for healing, if there were aesthetic problems on the right side I have no alternative but to try a 4 round to fix the area, for now it's just a hypothesis, I've never been scared of procedure and I have always recovered well, the infection was my bad luck due to unprotected sex. I hope there won't be a need to do another round because from what I was told only a small amount of PMMA mixed with the pus and was drained. I'll wait until everything is resolved.

Glad to hear you're home now and focused on recovery/healing. What an ordeal! Please share progress pics. The experience should help most of us here who decide to ignore the docs recommendations and risk everything for 15 minutes of pleasure.

First off, I’m terribly sorry this is happening to you. I’m rooting for you, as I’m sure everyone here is.

Disclaimer: I’m going to suggest something but I’m not a healthcare provider, so don’t take this as fact, but just as something to ask your actual doctors. I would ask your AD provider, but also the doctor overseeing your infection. I also don’t know if this information applies specifically to your scenario, it’s just layperson factoids I’ve heard from various sources like TV shows and biology class. I can’t stress enough how utterly unqualified I am.

Bacteria can hide out. They can form pockets around themselves called biofilm to hide from the immune system and antibiotics. They can hang out in areas that have low blood flow. The Dartos and Bucks Fascia where the PMMA is placed has relatively low blood flow I believe, and scar tissue, like you can get after an infection, can also have lower blood flow. Staphylococcus is apparently good at hiding out. Some strains are known to form biofilms over non organic things like implants. This can include forming biofilms over PMMA in some cases, at least when it’s used in other locations. This dormant bacteria can be reactivated by being physically disturbed. Because of this, when you get an infection from a procedure, you are now at increased risk for infection after follow procedures in the same location. The increased risk can last for months or years. I don’t have any clue how much the increased risk is.

Again… I’m not a doctor. I know these individual things are correct to some degree, in some specific cases, but I don’t know if they are meaningful in your scenario or go together in the way I suggested. What I mean is, it’s a fact that houses are made of wood, bricks, doors, windows, and roof tiles, but if you throw all things things into a big pile, you wouldn’t have a house you would just have a pile of garbage. I don’t know if what I suggested above about recurrent infection is a house or just a pile of garbage. Your doctor will probably just tell you that I’m an idiot, and he would right.

I know this isn’t a super supportive thing to say right now while you’re still healing, I apologize. It’s information that, if I was in your position, I would want to know because I would already be thinking about getting a corrective procedure done and I’d want to know the risks and I’d definitely want to know how long I’d have to wait. If it’s remotely correct and applicable to your situation, I don’t think it means that you can never get a corrective procedure done, it just means being more careful and maybe waiting longer.

Anyway, sorry to be a bummer. The pictures you showed at the top honestly don’t look that gruesome. I’m sure it’s stressful but your unit looks good. All the exterior skin looks like it’s mostly in really good shape, is that still the case?

13 day hospital update. Almost 15 days have passed since the beginning of the infection, the test of the type of bacterium showed enterococcus gallinarium, it is not very common among bacteria, I have been treated for 2 days with a new antibiotic targeted for this type of bacterium. The infection and swelling have significantly decreased. I couldn't say 15 days after the procedure how collagen production starts with an ongoing infection. I think that after 2 weeks the induced inflammation and pmmma were already in place. I think that I am producing collagen even with the ongoing infection and that part of the bacteria will try to attach to the fibrotic tissue, which is why it is important antibiotic therapy continues to avoid this and until the infection is completely healed I will have to continue with antibiotics. I hope to be able to completely deflate and expel the infection in a definitive way, for now I'm still fighting for this and I will certainly remain in hospital for another 5/6 days. It's not an easy situation to manage, either physically or mentally

Has there been any talk of surgery? Has your Urologist dealt with stuff like this before? Any new pics? I’m rooting for you.

Thanks for the support, surgery is the worst case scenario, a small incision was made after 5 days to drain but it was of little use. I wouldn't know who to turn to for surgery, here in the hospital they have no experience with PMMA. For the moment I continue with antibiotics, no more pus comes out but only transparent liquid, unfortunately there is still swelling and the infection has not gone away but has only stopped.

@Zep83 sorry you’re going through this but keep a positive attitude and I’m confident it will get resolved.

@Dr_Sullivan and @Rejuvall is it safe to assume that this would be far less tricky to treat if the product were HA? I’ve read reports of infections post HA years later but they typically just pump the penis full of hyaluronidase which makes it easier to treat. Does a product like pmma or PLLA further complicate things when infections come into play vs Hyaluronic Acid?

Hylaluronidase is an enzyme that breaks down HA. Without the HA as a substrate for biotilm to attach to, the infection goes away. So tx for HA infection is Hylase and antibiotic, with possible Inision and drainage.

PMMA can not be dissolved. Therefore it may act as a substrate that biofilm can adhere to and colonize. One can take
Antibiotics however, biofilm replicate very slowly and have a very difficult protective layer, that usually makes cure and long term treatment difficult. Sometimes, PMMA needs to be surgically removed to cure infection.

PLLA over time breaks down

Update 15 days in hospital, 16 since infection. I continue to have an infection and a swollen penis, I have had some improvements but I have not yet been able to completely resolve the infection. I am asking someone on the forum who can point me to a surgeon in Europe who is able to remove the PMMA from the penis if the infection does not resolve. I was told about Dr. Lemperle in Frankfurt but I don't know if he has a clinic or still practices given his age. If anyone can help me. Thank you