contemplating exploratory surgery, lengthy post, need advice

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diehardpatriot

Okay . This is gonna be pretty lengthy, so if you don't feel like reading a lot, leave now. But I need to explain everything to get the best advice. I'm confused, scared, and at a crossroads right now. If you read this all, bless you. Getting some advice and wisdom from those older than me is priceless to me right now because I am contemplating surgery. Not necessarily Peyronie's correction surgery either. Before I ask for advice, here's everything about my penile health history, and what's been happening to me including symptoms. If you have been reading my post already, or just too lazy to read through all my detailed history skiip to the bottom, where the blue "TLDR" is. There will be a TLDR version of my history down there along with what I really need advice on

-have had Peyronie's for a year or so, non injury related. About 10 degree curve up, about 20sometbing to the right. No palpable plaque for both of those. Never any pain or ed. Just hourglassing sometimes in flaccid state after sex
-So on March 13th, 2018 I had a penile injury due to my penis being bent on accident. Opposite of the curve (it bend left, my curve is right).. I felt a sharp sting which quickly went away. No swelling, no bruising. After that erections felt tight
- Two days after, I was messing around with my girlfriend, and I felt a sharp tearing sensation in the spot of injury which somehow caused me to ejaculate... the pain was worse after that. Pretty bad erect and flaccid pain.
-3 days after the injury I noticed a small ball of hardened or herniating tissue.. right under the glans, on the underside, just to the right or the frenulum. As well as a smallarea of really inflamed tissue (not swollen, maybe slightly, but nothing crazy like a huge lump you see in fracture pictures). just an area of tissue that stick out from the rest, it was tender to the touch and I could literally push it down, but it would come back up. Still no bruising or gross swelling. I went to the ER and they said it was a hematoma and to take ibuprofen,  freakin idiots.  This is when I also noticed what felt like a small gap in my tunica, just under the inflamed tissue, which creates a ridge like feeling above the "gap" I feel. I will include an illustration at the bottom to try and better explain this. whenever this gap is worse and the tissue above it is herniating more, erection quality takes a big dip.

-since then, It's been a roller coaster of getting better, then getting that tearing sensation over and over. Ultimately leading to almost 0 improvement since the day of injury. If I super abstain and avoid erections, the "gap" feels smaller although still there, and the tissue above it doesn't feel so much like a ridge, it sticks out a lot less Erection quality goes up, they get pretty close to 100 percent, but they definitely can't eben handle a blow Job. The mechanical stress is too much . although the erections are still uncomfortable, they're not painful. Until I get the tearing again.

-originally I had thought the ridge I was feeling was scar tissue, but now I question it. If it was scar tissue,  Why are my symptoms so dependent on avoiding erections and masturbation?. ejaculating just ONCE ruins everything. Even after abstaining for 10 days, one ejaculation ruins all progress. It's like a cut in my tunica that's not closing. Also, the gap has not caused any length loss or any new curvature when my erection quality is in a good state.

TLDR: I had what I believe to be a minor penile fracture almost 2 months ago and I've had almost 0 healing progress due to what I feel is the tear re opening over and over. There's either some herniating tunica tissue from inflammation or some scar tissue can't tell.

SO , here's what I really need advice on. The doctor I've been seeing to manage this, Dr goldstein. Has offered me the option of surgery due to the nature of my injury, (the constant re injury, how sensitive it is right now, the lack of progress). His plan would be to examine me in the erect state and ultrasound. Then if We both decide on surgey, hed make an incision on my scrotum, pull my penis out from under and inspect what's causing the issues. He thinks it's either one or two things. 1) an area of weak tissue thats having trouble becoming strong enough to handle the stress of ejaculation or holding erections for a long time. 2)a penile fracture that keeps re opening, but due to no bruising (blood leaking from hole in tunica) he doubts there's a hole large enough for him to suture and close up. So for the exploration
If it's weakened tissue, he says he would plicate the tissue on the area together to make it strong. If there's a hole large enough for him to suture up, hed repair it like any other fracture. The draw back of the placation is he would it would cause at least SOME degree of curve (which I have no problem with because it's on the underside, it'd probably even out some of my upward curve), but I'd also lose some length. But it would just be one or a few plications. He's been very honest with me saying even he isnnotntoo sure what the best course of action would be, but he's willing to do surgery because he sees how I am not healing and the effect this has had on my life. The main treatment for a fracture even minor is surgery , even though it's two months after, it seems as it hasn't closed.
.  Now if I wait this out. I'm guessing I can maybe heal to a good degree, but it would take at least 5 weeks to get back to 100 percent would be my guess.  I'm gonna be abstaining anyway, another reason that leads me toward surgery, I'm gonna be abstainkg anyway so why not do something to help me heal to highest degree. Another thought is that if I'm gonna get surgery and he opened up, might as well correct the curve I already have? 2 birds one stone? I'm actually gonna talk to Kuehass tomorrow on Skype about possibly doing that. Of course In that case I'd have to wait until the summer or something, at least a few months. the downside to that is I haven't even tried traction or VED for the curve I already have. If I don't get ANY surgery,  I wonder will the gap ever close? Will it manifest into a bend? Idk. That's why I'm thinking maybe a surgery can help me heal to the best degree possible. I hope the length of this post won't scare people away. Any advice or input would be greatly appreciated.
Penis injury in late 2017. A lump formed at injury site that caused no deformity, just pain and a palpable lump. Pain is improving through proper rest and use, diet, and mindfulness. I am always learning and looking to share things that have helped.

TonySa

Probably want to hold off on traction or VED anyway w the fracture injury recurring.  I see why you're leaning towards the surgery.  You may want to get a second opinion as your case sounds complicated.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

diehardpatriot

Thanks tony. Here's the two illustrations to get a better idea. The second picture is from the underside view, This whole small area feels detached from the rest of the tunica. When it's herniating really bad and feels like a ridge, can push it down and it feels like I'm reconnecting puzzle pieces, it Fits perfectly if I hold it down. Like when you rip a picture and put the pieces back.
Penis injury in late 2017. A lump formed at injury site that caused no deformity, just pain and a palpable lump. Pain is improving through proper rest and use, diet, and mindfulness. I am always learning and looking to share things that have helped.

diehardpatriot

Hey guys. I know this was a lengthy post. But please, I'm begging for any input. I know this is ultimately my choice, but I'm very young and I'm asking for any type of guidance. Here's a short TLDR. Thank you

I've had a 30 degree curve to the right for a while now, at least 2 years since I've noticed. 2 months ago I injured my penis and had what I believe to be a minor penile fracture . Since then it still hasn't healed. I have been having constant erevtion issues including pain and painful ejaculation since the injury. I gave myself 3 options now

1: wait at least 4 months to let the injury heal on its own, then deal with whatever happens (scar tissue) later
2: go get an ultrasound then decide on exploratory surgery with Dr Goldstein in San Diego (he's willing to)
3: get surgery in 2 months with Dr Kuehhas to fix my curve (I'm mostly sure it's congenital now). and address the injury (I've had a Skype consultation with him already). We are disccussing currently as well  
Penis injury in late 2017. A lump formed at injury site that caused no deformity, just pain and a palpable lump. Pain is improving through proper rest and use, diet, and mindfulness. I am always learning and looking to share things that have helped.

TonySa

I'd go w an in person consult w ultrasound before deciding.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.