Why Doesn't Surgery Trauma Trigger Peyronies Disease

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Hawk

A question I Have had for over a decade that I have never heard a good answer for is why trauma from incision, excision, grafting, degloving, catheterization, degloving, implants, remolding, and all the stuff you go through with surgery trigger a full-blown active phase?  We hear stories of far less trauma triggering Peyronies Disease.  In fact, theory has it that when there is no known trauma that a man's Peyronies Disease was likely caused by a micro-trauma.  If micro-trauma can trigger it what about the gross macro-trauma of surgery.  Why doesn't every surgery trigger a Peyronies Disease phase that un-does the surgery?

I would love for someone to pose that question to their surgeon specializing in Peyronies Disease.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Bubba dawg

Ya you would think it would since surgery anywhere   can  cause painful scarring. That is the last thing I would do to my penis. Unless there were no other options and I was in pain
5 Rounds of Xiaflex. Good results.

I am known to give out false information and post nonsense with little to no evidence to back up my claims.
I have ignored several warnings. Further reports to the moderators or Administrators and I will be banned.

Jack1909

simply because the majority of people are not genetically prone to develop peyronie.  
31 yrs old
Severe congenital curvature. 3 straightening surgeries
Big lump/stitch w/ left deviation after 2012 surgery
Severe ED after last one in 2014. Still crooked
Slightly improved w/ shockwave therapy
Looks like only one side of my penis works

TonySa

I get that jack, but if one already has peyronies...wouldn't the trauma from surgery likely result in it again?  I've wondered the same as Hawk.
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.

Hawk

If you knew nothing about this condition (like most of us at time of diagnosis) and you developed Peyronies Disease and went to a Peyronies Disease specialist the conversation could go like this.

Doc: Well you have Peyronies Disease with a 70% bend and significant erectile dysfunction.

Patient: What is Peyronies Disease ?.....how did I get it?

Doc:Peyronies is when your bodies scaring mechanism goes awry.  It is triggered by an injury.  Scar tissue starts to form at the injury site and then just keeps going and over-runs normal healthy tissue

Patient: But Doc, I have not had an injury that I know anything about

Doc: In many men with a strong tendency for Peyronies all it takes to trigger it is a micro-trauma to your penis.  It could be rough sex, sex with little lubricant, or sex without a firm erection.

Patient: Wow Doc something that minor to my penis caused all of this??  How do we fix it?

Doc: I propose degloving your entire penis, making multiple slashes in the short side at the location of the plaque.  Next, I will put in some grafting scaffold and reglove your penis.  Following that, I will cut into your cavernosa, shove some metal measuring rods in your dick to measure for cylinders.  I will pull the cylinders to the glans by stabbing a needle out through the glans with a suture to pull the cylinders up.  There are a few more steps but then I will close you up and in a couple months your penis will look and function as good as it did before that microtrauma.  
 
Patient:  HUH ????????

We know it works but without knowing it works how could you read any logic into that exchange?  Presumably, those that get Peyronies Disease without any memorable injury are the most prone for the scaring/healing process to turn into hyper scaring.  Why doesn't that happen from all the scarring from surgery?  I would LOVE to hear the logical explanation. I started this forum 15 years ago and have talked to many doctors, read tens of thousands of posts, but never heard that addressed. (or even attempted to be addressed)
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Hawk

Quote from: Bubba dawg on December 05, 2018, 11:43:21 AM
Ya you would think it would since surgery anywhere   can  cause painful scarring. That is the last thing I would do to my penis. Unless there were no other options and I was in pain

Bubba,  I had that same flawed logic for many years  It made me put off surgery I should have had 15 years ago.  I would be 1 1/2" inches longer now.  I would have saved thousands of dollars.  I would have saved literally many hundreds of hours working on solutions (thousands if you count my hours establishing this forum.  And I would have spared myself a ton of anxiety, regret, and replaced it with intimacy. I could have been having sex like an 18-year-old all of those lost years.

Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Old Man

Hey Guys:

All of your positions taken before this are right on. Since what is now called Peyronies disease/disorder has been known to exist since at least the 1700s simply means that there has never been any known causes. The French doctor from whom the title is now used did a lot of medical research to find a therapy/cure for it never succeeded. Since that time there have been numbers of men and physicians who never knew what caused it or what cured it.

It is like IMHO what cancer has gone through for centuries also. Nowadays, there is a lot of ''cures'' and treatments for curing or at least relieving the pain of that disease. As a 25 years survivor of prostate cancer and still test free of it, I am very thankful for having been spared the outcome of that also terrible devastating disease for all those years.

I just hope that sooner or later some form of successful therapy can be found to cure Peyronies Disease. I often wonder if it is not some flaw of our genetic makeup based on where we live in the entire world. As represented by the makeup of the members of this forum presenting Peyronies Disease when only certain areas of the earth presents with this malady as frequently as shown by location of our registered members.

Anyway, this post is only my 2 cents that present what I suspect MAY BE what triggers the symptoms. Thanks for listening to an old man in his ''last days of living on this earth"!!.

Regards to everyone, Old Man
Age 92. Peyronies Disease at age 24, Peyronies Disease after
stage four radical prostatectomy in 1995, Heart surgery 2004 with three bypasses/three stents.
Three more stents in 2016. Hiatal hernia surgery 2017 with 1/3 stomach reduction. Many other surgeries too.

DELETED

I'm also wondering why is on this board almost no people from China and Japan? In total these countries have 1.5 billion population, half of which is males. Are they don't have Peyronies Disease at all?

Hawk

Alex, not quite sure what that has to do with the topic I started on why surgery trauma does not seem to trigger Peyronies Disease but just for your info we do have about 20 members from China and over 30 from Japan, or at least living in those countries.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

diehardpatriot

Hawk , amazing question. I think there's two types of Peyronies
1) either a single injury happens and the scarring doesn't occur properly, OR a persons body in one odd occurrence overreacts to either micro injury or no injury by laying scar down for no reason. Again, this is a 1 time coincidence for person #1

2) a lifelong metabolic issue. Person #2 will most likely always have scarring after a penis injury no matter how big or small. I believe I am one of these people. An injection in my dick that Levine has given me has caused inflammation for weeks. I have been in mild pain since. This is not normal. Person #2 has to be always cautious. ANY trauma can trigger more scarring.

I believe in person #2 surgery CAN cause some new active phase. Since even an injection has given me inflammation, I am now even scared to get any time of surgery ever. But to answer the question . I think for people who don't get an active phase it's because they are person #1. And of course the very very fine knives the doctor uses as well as avoiding sex and traction therapy to help it heal all play a role  
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.

2Oldfords

   Hawk, that is a very good question and one I have wondered about myself. I think this can come from some trauma but I think it is more genetic. I'm no doctor but I think as we age and our bodies cells change with it some of us are predisposed by genetics for this to happen. I kind of think BS to micro-trauma.
  I for one have had surgery to correct Dupuytren's  contracture which tends to run in family's. Research into dupuytrens will show a connection as hands, feet and penis can be affected. Peyronies for penis and ledderhose for the feet. I think it is just another process of ageing like going bald.
   My 2 cents
Age - 65
Peyronies of unknown length of time
70 Deg curve 10-11 o'clock
first 2 uro's offer for xiaflex and referral
incision/grafting 12/18/18, Implant 9/11/20

Hawk

Quote from: diehardpatriot on December 06, 2018, 09:16:47 AM
I believe in person #2 surgery CAN cause some new active phase. Since even an injection has given me inflammation, I am now even scared to get any time of surgery ever. But to answer the question . I think for people who don't get an active phase it's because they are person #1. And of course the very very fine knives the doctor uses as well as avoiding sex and traction therapy to help it heal all play a role

I somewhat agree.  I think the difference between Persons 1 & 2 is simply the degree of susceptibility and the degree of a trigger it takes to start the process.  I no of no one Either person 1 or 2 however that was thrown into an active phase of Peyronies Disease by surgical trauma.  If so procedures like Nesbit and grafting would be a set back not an improvement.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

DELETED

Hawk,

"Old Man" post:
Quoteoften wonder if it is not some flaw of our genetic makeup based on where we live in the entire world. As represented by the makeup of the members of this forum presenting Peyronies Disease when only certain areas of the earth presents with this malady as frequently as shown by location of our registered members.

What if some of ethnic groups are more predisposed to Peyronies Disease than other? That's why I was wondering why here's not as much people from Asia, despite the fact of huge population in Asian countries in total. If I'm not mistaken, this board is mostly presents Americans and Europeans and most of them are white caucasians, am I right or am I wrong?

That's partly the answer to your question: I guess it's simply genetic predisposition to this disease.

2Oldfords

   The whole dupytrens thing is genetic." Vikings disease" The countries involved in the rape and pillage have a higher percent of this disease. All of my brothers and sisters have some form of this disease as well as aunts and uncles on my mothers side of the family.
  I think when they do surgery and remove the diseased tissue it breaks the chain of cells making the contracture. I have had other surgeries on other parts of my body that didn't spark the scarring associated with peyronies or dupytrens. My hands and now my penis are involved because that is where the tissue has changed and made the contraction. I think normal cells just heal from injury make a scar or whatever. That is why we don't just scar worse after surgery.
  Again my 2 cents
Age - 65
Peyronies of unknown length of time
70 Deg curve 10-11 o'clock
first 2 uro's offer for xiaflex and referral
incision/grafting 12/18/18, Implant 9/11/20

Hawk

Alex,

Peyronies Disease is more associated with some sections of Europe but regions of the world have it to some degree.  Even if it was true that only some men from some DNA line got Peyronies Disease it still would not explain how a person that got Peyronies Disease (because he is more predisposed) can then have surgery and not aggravate his Peyronies Disease.

The question was: Why do men that are predisposed to get Peyronies Disease from an injury not also get a bad flare-up from surgery which causes greater injury.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Bubba dawg

Quote removed by moderator

There are a lot of internet access restrictions in  China. Where there is a will there is a way around them
5 Rounds of Xiaflex. Good results.

I am known to give out false information and post nonsense with little to no evidence to back up my claims.
I have ignored several warnings. Further reports to the moderators or Administrators and I will be banned.

2Oldfords

    If peyronies disease happens at the cellular level and it is all about the changes in some cells that cause them to contract then you could liken it to cancer. Cancer cells are just cells that have changed from normal. When they operate to remove cancers why doesn't this just increase the cancer? Could it be that a new injury (surgery) is repaired by the body with new cells and the peyronies cells are not what the body uses to repair itself. When they do stem cell therapy are not those cells like blank and take on the attributes of the tissue needed for the repair? Large severe burns repair with scar tissue that contracts, Therapy is done to correct the contraction so the use of ved , Viagra, modeling corrects the scar contraction from grafting. But it is new tissue that makes the repair from surgery even if it is normal scar tissue.
   Ok my guess is only that, a guess.
Age - 65
Peyronies of unknown length of time
70 Deg curve 10-11 o'clock
first 2 uro's offer for xiaflex and referral
incision/grafting 12/18/18, Implant 9/11/20

Frank55

Hawk - I have pending appointments with both Dr. Levine and Dean Knoll in Tennessee (who I was referred to as a potential grafting surgeon.) I'll ask that question of both.  
Single and 58 yrs. old - first peyronies symptoms Fall 2015
Had grafting surgery by Franklin Kuehhas in June 2016 - complete failure
Borderline ED possible but not taking drugs, shots or using VED
Now evaluating options for next step

Hawk

Thanks Frank

Oldfords - There is nothing I know of that is identifiable in the tunics cells of a man prone to Peyronies Disease.  There is also nothing identifiable in the plaque cells of a man that has developed Peyronies Disease that is any different than the scar cells of any other penis injury.  With Peyronies Disease the problem is that hypertrophic scaring happens where the scaring is not turned off.  So.. it is normal scar tissue replacing normal tunica tissue.  It is just a normal immune response gone awry.  Also, surgery does not cause more cancer because cancer is not triggered by trauma.  Peyronies Disease is triggered by trauma.  Many surgeries for Peyronies Disease do not remove plaque, unlike cancer surgery which does remove cancer.  

In a susceptible man, Peyronies Disease can be triggered by the trauma of rough masturbation.  Why is it not triggered by shoving cylinders in the cavernosa and forcefully remolding or reshaping the penis not to mention cutting on the penis?
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Frank55

Here is Dr. Levine's response to this question.

"Why doesn't the body react to surgery as an additional penile injury? No one knows for sure. There are many unanswered questions among peyronies gurus. Why is peyronies a site specific scarring process? Why does it happen at this particular time and then never happen again?

Presumably, if you fix it and you are having erections/sex again, why can't you re-injure it? But rarely do I have people come back and have more peyronies 5 – 15 – 20 years after surgery. So we don't have a real answer for that.

One theory is that it may be since the trauma is contained within the tissue of the tunic in a sense it may be a "trapped injury." The chemicals that trigger the scarring process may be trapped within the injury site. With surgery, there is no trapping because we cut it open. Fluids and cytokines which are part of the scarring process flow in or flow out freely."
Single and 58 yrs. old - first peyronies symptoms Fall 2015
Had grafting surgery by Franklin Kuehhas in June 2016 - complete failure
Borderline ED possible but not taking drugs, shots or using VED
Now evaluating options for next step