TOPIC: I am so damned scared right now.

So…I’m 11 days past my procedure and I’m pretty much in hell. Procedure was PMMA and the clinic was great, but I became infected within 36 hours. I was swollen, discolored, and painful to the touch, but seemed to recede a bit as the antibiotics kicked in.

When I ran out, the swelling came back and one of my entry points began leaking pus.

Concerned, I went to the ER and they were very ill equipped to handle this scenario. They did a cat scan and ran some blood work and the blood work came back negative for infection but “inflammation” markers were high. They did NOT take a sample of my drainage.

I was supposed to have an urology consult the next day so rather than spend the night there I checked myself and did come away with 2 prescriptions for antibiotics which I am now on.

While showering later that night the pus started coming out again. I decided to go with it and began to apply some pressure despite the pain. So much pus came out. I’ll have nightmares of it for the rest of my life.

This morning I awoke to the twin horrors of my urologist canceling due to illness and my penis having swollen back up just as bad as before.

My penis is purple and the skin is cracked and swollen but again, as I showered the pus came out and I aggressively expressed it from the same site as before. I did as much as I could and as you might expect it was horrible, and painful and awful. My dick is purple and dark red at this point. It’s just…so painful.

I’ve been told drainage is pretty common, but I probably squeezed a cup of pus out this morning. I’m torn between waiting for my rescheduled urology appointment which isn’t until tomorrow afternoon or going to a better ER in the So Cal area (recommendations welcome).

Of course my fear is that this abscess in my penis will result in necrosis or MRSA systemic infection or I already have both and just don’t know it yet because they didn’t do a wound culture. How could I be producing a cup of puss and have a normal T cell count?

My rate is over 90 constantly and I’m in pain but I’m terrified so that might just be stress.

Any advice would be welcome.

I’ve attached some pictures.

The one in the brown pants is just now. As you can see by the uneven swelling, I’ve been draining on its right side. It’s really hard to move the pus from the left to the hole to squeeze it out and it hurts like hell.

The drainage and puss is normal and is to be squeezed out. When was your second picture taken? The first one appears like it needs some healing but is normal. The second appears days old post-procedure, and if that's the case, that's also quite normal. And how certain are you that you became infected within 36 hours? This is the normal range in which the penis will have a notable inflammatory response.
Context for the 2nd photo's date will help me a lot.

You came back with a negative result for infection, which is superb news. Inflammation is to be expected, fillers induce an inflammatory response, especially hours and days after being poked with fillers.

Nothing you've said comes off as alarming to be quite frank, I think you're just not used to seeing your penis this way. The pain is likely from the soreness.
I would reach out to the Clinic who performed this and get their opinion. Was it Avanti Derma? You mentioned SoCal so that would be my assumption.

I think you'll be fine, unless your pain, redness, or swelling worsens now that you are approaching two weeks, I would continue to monitor it and heal.
If you aren't testing positive for infection, I suspect you just have a very fierce inflammatory response which will subside, and should do so in the coming days.

To be frank, I'm not sure what a Urologist would do in this instance and have a feeling your performing physician can impart better advice (assuming they aren't someone I've never heard of). Like I said, I think you'll be fine.

I’ve never felt the compulsion to kiss another man before, but here we are. Your words mean more to me than I can possibly say.

So a literal cup of drainage is still normal? That’s insane. But such a relief to hear.

That first pic was taken on the 19th. The one in the pants just a few minutes ago.

As for the pain, it’s real. Dull soreness with some stabbing kind of needle pain and some good old fashioned burning to top it off. I wouldn’t say it’s getting worse except for after I squeeze the pus out.

As to the clinic, knowing I might be just having a hysterical response, I’ve refrained from sharing because their reputation shouldn’t suffer because of my fear.

If I genuinely do have a bad outcome, I will share. I hope you can understand my discretion.

Again, thank you so much for the encouraging words. I’ll tough it out for now.

Keeper1 wrote: I’ve never felt the compulsion to kiss another man before, but here we are. Your words mean more to me than I can possibly say.

So a literal cup of drainage is still normal? That’s insane. But such a relief to hear.

That first pic was taken on the 19th. The one in the pants just a few minutes ago.

As for the pain, it’s real. Dull soreness with some stabbing kind of needle pain and some good old fashioned burning to top it off. I wouldn’t say it’s getting worse except for after I squeeze the pus out.

As to the clinic, knowing I might be just having a hysterical response, I’ve refrained from sharing because their reputation shouldn’t suffer because of my fear.

If I genuinely do have a bad outcome, I will share. I hope you can understand my discretion.

Again, thank you so much for the encouraging words. I’ll tough it out for now.

If you wish you can email me (This email address is being protected from spambots. You need JavaScript enabled to view it.) with the Clinic's name, I'm familiar with a lot of Physician Protocol and may be able to point you in the right direction. *It should be noted I'm not a medical professional, but a lot like you, a former penile dermal filler patient.

If you could send any additional pictures to that email (including the volume of pus, etc.) you have my assurances of confidentiality.

Again, I am providing reassurances but not diagnoses and you ought to keep monitoring it while getting in touch with your performing physician. Ultimately I think it's just a fierce inflammatory response (my penis looked like your second photo days out post-op), and the stabbing kind of needle pain wasn't unusual near the entry points. Given the thickness of your shaft it appears you had a lot injected, which may explain the excess pus-sing. Again, for as long as your tests results remain negative, you're just a bigtime sweller (if that's a word?).

Our very first PMMA report in late 2010 was a picture of a penis so black and blue I was convinced he was going to have to have it amputated. He ended up just fine and still comes back to this day to update me on how things are... point is our body's all react differently to the same kind of stimuli. Good luck and seriously consider my email proposition.

Any updates on your situation?

Doing ok.

I’m aggressively squeezing the pus out while in the shower every couple of hours and trying to keep the skin moisturized.

Keeping the size down to something that actually fits in my skin will hopefully give it a chance to heal.

I have a few tips for anyone going through this kind of swelling situation.

1) don’t let it get that bad right from the start. either don’t leave it out of a wrap long enough to swell or start squeezing. If I had started doing what I am doing now when it first started my skin wouldn’t be ruptured all over the place.

2) if you do have to express it, do it in the shower. I promise you never ever want to see your penis become an inexhaustible pimple or boil. The water from the shower thins it out before you have to see it and keeps the site clean and the warm water makes it easier to get it out. BE GENTLE. You might have to be doing this for days.

3) try to keep both cannula holes near your glans open. This would be SO much easier if I didn’t have to get the pus on the left side of my Dick over to the right to squeeze it out.

4) better get a Urologist familiar with this procedure before you need a Urologist familiar with this procedure. They don’t accept walk ins.

5) have someone you can talk to about it. Skeptical was amazing in calming me down, but I don’t have anyone I could physically discuss it with. Sucks.

6) last and most importantly, you’ll want to google wtf you think might be happening to your Dick. Don’t. Just…don’t. Down that road, there’s nothing but anxiety and fear.

Thanks again to Skeptical. Good dude.

I’ll keep you posted.

Edit: there’s vs they’re… stupid auto fill

Well…thirteen days later and on two anti-biotics and my Dick is still producing pus although I’m keeping it drained as much as possible.

The pus IS thinner but I imagine that is due to it not having time to accumulate.

does anyone know a way to get the pus tested without having to go to the ER? I’d like to know if this stuff is the result of infection or perhaps just a side effect of PMMA.

Also, anyone have a timeline on, if it isn’t infection, on when the drainage and pus stops?

Have you talked with the Dr. who did the injections for you? If so, what are they saying? Maybe it wouldn't be a bad idea to get on a plane or shuttle or something and see them in person. Besides the pus, did the inflammation go down? How did the PMMA settle thus far?

Yes. I’ve been talking to them, but I may need head to them again. This is nuts.

Without knowing what clinic you went to, it is difficult to give advice on next steps. If you went to a reputable clinic like Avanti Derma you should keep working with them as they have a wealth of experience and strong record of safety. If you went somewhere else, such as the other clinic in TJ (which claims to use massive quantities of PMMA but is actually injecting silicone) then your situation is more complicated and you should probably reach out to a Urologist with experience in Phalloplasty complications such as Mark Solomon, Gary Alter, or Joel Gelman.

At first I was reluctant to share the name of the clinic as I didn’t want what was happening to me to unfairly taint someone’s opinion of them. However folks seem to understand that it’s just part of the spectrum of risk associated with the procedure no matter who does it.

It was Avanti Derma and yes, I have been in touch with Ian. He’s been great, but they can’t actually render treatment for me from down there.

I appreciate the names of the urologists. That’s a big help. Thank you!

By way of “progress” update, here’s a picture of what is going on now. Swelling has been kept in check but at a price. My drainage is on the right side very close to where that dark spot just formed. I’m pretty sure that’s a blood blister from just squeezing too hard.

If I don’t drain however, then I get the splitting which you can see in the middle where the skin just…ruptured from being too big.

And for the record, I didn’t actually get a ton of filler. It’s just so much damn swelling. What is concerning is that there is a space between my actual erectile tissue and the sheathe of filler material. I kind of think the pus just fills it every time I drain because it’s there.

Never a hint of blood in the drainage either. It leads me to believe this might be like an abscess and sort of isolated from the rest of my system. Just don’t know what to think at this point.

Ian just says to keep draining and let the antibiotics do their work. I’m almost done with them though and this thing isn’t better.

I’ll let you know how it goes.

Glad to hear it was AD you went to, you're in good hands with them. IMHO it's not unfair to them at all to post publicly about your case -- it's important to highlight cases where things go less than perfectly so people understand the risks of phalloplasty. Now that you have posted about it though, I think the fair thing to do is keep the board updated until it's resolved (not that you aren't already doing that, I'm just saying). My one question (and they have probably already asked you this) is are you taking anything else to treat this? I ask because I'm reminded of this case: avantiderma.com/wp-content/uploads/2023/...ient-gallery-31.jpeg

No other medications being used.

The only thing I’ve been applying to the skin (away from the drainage spot, and only after I got the go ahead from AD) is cetaphil healing ointment to try to limit some of the cracking.

Were you uncircumcised or had any prior procedures done?

I was Circumcised and had no prior procedures. Our thinking at this point is that it’s just a violent inflammatory response rather than infection though so that’s a good thing! Headed to clinic later this week to confirm. Once again, I’m grateful for everyone’s kind words and reassurances.

I’ll keep you posted.