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Author Topic: Chapter 2, Excision/Grafting Journey  (Read 3350 times)

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TDix

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Chapter 2, Excision/Grafting Journey
« on: January 08, 2019, 12:48:07 PM »

To all who followed my thread in the Xiaflex forum, I am starting this new thread to continue to document my journey through this horrible condition.  You can read what happened to me with Xiaflex over there, and follow my next step forward into surgery here.  I went in for a ultrasound at UCI yesterday with Dr. Faysal Yafi.  I was diagnosed with a 50 degree curve, and calcified scar tissue all along the top and left side of my penis as well as in between the corpora.  Xiaflex was determined to no longer be effective, and plication, while it would fix the curve, would not remove the massive amount of scar tissue I have.  Dr Yafi and I agreed that excision of some of my scar tissue as well as a graft was the logical solution in my case.  I will be scheduled for surgery in March, 6 months after my last Xiaflex injection.  I hope to shed more light on this procedure for all of you by yet again documenting my journey here.  I hope this road is less "bumpy" (get it?) and leads to better results. 
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #1 on: January 08, 2019, 01:10:49 PM »

Just got the call to schedule the surgery.  Pre-op visit on March 1st, with surgery scheduled for March 12th
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #2 on: January 08, 2019, 06:36:07 PM »

So I’ve already hit a snag.  Looks like my insurance covers the doctor but does not have a contract with the hospital.  My wife has dealt with insurance before so we will see what can be done.  (Edit) we looked up our plan and both the doctor and hospital are in our network so not sure why I was denied.  Will look into it tomorrow and update
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #3 on: January 16, 2019, 03:25:56 PM »

So I am covered 100% for Dr Yafi in my tiered 𝐈𝐧𝐬𝐮𝐫𝐚𝐧𝐜𝐞, and found I am 90% covered for UCI.  Planning out the road to surgery
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

pfract

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Re: Chapter 2, Excision/Grafting Journey
« Reply #4 on: January 16, 2019, 08:40:43 PM »

So.... Are you not concerned about Erectile Dysfunction later? With excision and grafting? How are your erections right now? Strong?

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #5 on: January 16, 2019, 08:42:43 PM »

Erections are very strong, and that was confirmed by the ultrasound.  I am willing to go into this with a positive attitude as my scar tissue is growing and calcified
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

Bubba dawg

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Re: Chapter 2, Excision/Grafting Journey
« Reply #6 on: January 17, 2019, 05:50:53 AM »

One Surgery I had--unrelated. I had to drive 30 miles to another Hospital because of Insurance. I used a doctor in that hospital. Turned out better than the local hospital would have even though it was smaller.  Just was a PIA getting rides to the preop, surgery, follow ups with doctor etc etc. Great you are getting this done TDix. I know you are excited to get back to normal. Ya stay Positive!
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5 Rounds of Xiaflex. Good results

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #7 on: January 18, 2019, 03:29:25 AM »

Wouldn’t say I’m “excited” about surgery.  At this time last year that was the absolute last thing I wanted.  I opted for Xiaflex thinking it would be my meal ticket away from surgery, but my body told me otherwise.  Not easy decisions to be sure, and I wouldn’t wish that on anyone with a penis.  Just how the roll of the dice was with me.  I have to be open to whatever I can do to make this better for myself and my wife. 
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

Bubba dawg

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Re: Chapter 2, Excision/Grafting Journey
« Reply #8 on: January 18, 2019, 03:50:21 AM »

Excited to get back to normal. You still can dread the surgery. I have had 3 surgeries on different parts of my body. One was in the pelvic area. Then there was a  Vasectomy.  Surgery and the recovery are no fun at all. But there was a relief feeling to get rid of my physical problems. Recovery can be painful . You may have to do things differently in the short term. Just follow doctors orders to the letter. Many mess up surgery not doing that.
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5 Rounds of Xiaflex. Good results

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #9 on: January 28, 2019, 02:30:56 PM »

Quick update, my foot drop condition has pretty much resolved itself.  Turns out I crossed my legs too much, probably from all the pain in my groin!  Haha.  Still waiting to hear about insurance for surgery in March.  Should be covered, but if not I might put it off a little bit.
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

pfract

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Re: Chapter 2, Excision/Grafting Journey
« Reply #10 on: January 28, 2019, 03:54:25 PM »

Some good news is better than no news! Keep it up

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #11 on: February 15, 2019, 01:24:09 PM »

Update, have to postpone surgery until insurance gets their act together.  They tell me that I'm covered but when the office tries to pre-auth they state the facility is not contracted.  So confusing to be 100% covered for a doctor, but not for the hospital he works at.  Will update when I can get this procedure done.  In the past this would have been a devastating blow, but the antidepressants I am on have softened the blow.  I'm more of "it is what it is" right now.  Got to stay positive.  I'm not going to have such a major procedure done by just anyone because they are covered.
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #12 on: February 15, 2019, 02:57:09 PM »

Just as I updated this the doctor office called.  They found out the hospital IS contracted.  Will update when I get confirmation
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #13 on: February 27, 2019, 01:19:23 AM »

Surgery postponed. They don’t know why I keep getting denied when they have a contract with the hospital.  Never an easy road in this frickin journey!
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #14 on: February 27, 2019, 01:59:14 PM »

Just got the verdict, I am not covered for surgery at UCI.  I have to go to a Dignity Health facility to be covered.  This sucks, finally found a doctor that knew his stuff and unless I pay out of pocket he cannot perform my surgery.
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

pfract

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Re: Chapter 2, Excision/Grafting Journey
« Reply #15 on: February 27, 2019, 03:27:24 PM »

You will not consider it if it is not covered?

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #16 on: February 27, 2019, 03:44:01 PM »

I am getting a price quote to see how much it will run.  I don't have the funds, so I will see what can be done
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

daved2

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Re: Chapter 2, Excision/Grafting Journey
« Reply #17 on: February 28, 2019, 01:30:16 AM »

After three surgeries, I finally found a surgeon who made my penis straight. If cost is the issue, then figure out a way to solve it.

The cure is the only way. Nothing else matters

I wish you the best
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50 years old, tried 5 rounds of Xiaflex, had Egydio grafting surgery, then Stage sutures for residual curve, then plication in 9/18, now finally I have a straight penis

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #18 on: March 02, 2019, 04:29:43 PM »

Doing my research I think Dr Karpman is associated with a Dignity Health location.  Crossing my fingers that it is true and will plan on him doing my surgery and local Dr Yafi handling the follow up care
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #19 on: March 04, 2019, 03:19:13 PM »

No luck with Dr Karpman.  Looking into Dr Jennifer Liu here in Long Beach
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

pfract

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Re: Chapter 2, Excision/Grafting Journey
« Reply #20 on: March 04, 2019, 06:05:09 PM »

Keep trying man!

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #21 on: March 05, 2019, 01:05:49 AM »

So Dr Liu operates in a Dignity Health location, but does not accept my insurance!  What the heck??  I find a doctor I like that is covered in Dr Yafi, but he does not operate in a Dignity Health hospital, so surgery is not covered.  I find a good Dr in Liu that DOES operate in a Dignity Health hospital, but does not accept my insurance!  So frustrating.
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #22 on: March 05, 2019, 02:04:49 PM »

got a call today from Dr Wachs.  Explained my situation and since he has privileges at Dignity Health, he is going to write a letter to get Dr Yafi involved at a Dignity Health location to get my surgery done.  He does the surgery, but says Dr Yafi is the specialist.  I appreciate the honesty and sincerity from Dr Wachs in regards to my situation.  Not many urologists would do this.  Hoping he can get me on the right path shortly.  Will keep you all updated.  See, there are good guys out there!
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #23 on: March 08, 2019, 02:18:20 PM »

Price quote from UCI for procedure without insurance is $16k.  Hoping Dr Wachs can help get Dr Yafi into a Dignity Health hospital
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

pfract

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Re: Chapter 2, Excision/Grafting Journey
« Reply #24 on: March 08, 2019, 02:59:59 PM »

Never quit till you are successful! Go go go!  8)

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #25 on: March 13, 2019, 06:33:30 PM »

UCI called today.  Dr Yafi talked to the board and was able to get the cost down to $3700.  Planning my next moves now
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #26 on: March 14, 2019, 05:49:42 PM »

Surgery scheduled for March 26th
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #27 on: March 19, 2019, 02:14:46 PM »

One week till surgery.  To say I'm nervous is an understatement, especially when looking at the procedure as "reconstruction".  Will keep you all updated on how it goes.
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

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Re: Chapter 2, Excision/Grafting Journey
« Reply #28 on: March 19, 2019, 04:17:06 PM »

Surgery can be scary that’s for sure.  I went through excision and grafting and it went well.  I did have initial loss in sensitivity-but it continually improved until regained.  My four anchoring sutures 6 months later are almost dissolved.  Is your doc using permanent or dissolvable sutures on the graft?
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PxD 2 yrs, failed all tx. 9/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS 18cm + 3rte

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #29 on: March 19, 2019, 04:28:55 PM »

I am finding out all the details later this week.  I’ll let you know
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #30 on: March 22, 2019, 07:57:24 PM »

I am getting dissolvable sutures on the graft, and if Plication is needed those will be permanent. 
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TonySa

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Re: Chapter 2, Excision/Grafting Journey
« Reply #31 on: March 22, 2019, 09:55:23 PM »

If their doing excision and grafting, plication should not be necessary,
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PxD 2 yrs, failed all tx. 9/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS 18cm + 3rte

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #32 on: March 22, 2019, 10:14:57 PM »

Yeah that is what dr Yafi said however he said not to rule it out.  In my case with all the trauma they really don’t know what to expect until they open me up
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #33 on: March 25, 2019, 02:01:03 AM »

First shower leading up to surgery with the “special” soap.  Definitely making it more real....nervous, anxious, all of the above.  I just keep hearing what Dr Yafi told me, “we will fix you”
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

pfract

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Re: Chapter 2, Excision/Grafting Journey
« Reply #34 on: March 25, 2019, 06:53:07 AM »

So this is really happening! Oh boy! ✌good luck man

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #35 on: March 26, 2019, 01:21:02 AM »

Thanks pfract much appreciated.  8am check in tomorrow for what I hope straightens things out.  I know I know I had to say it
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #36 on: March 26, 2019, 01:58:50 PM »

About to be wheeled into the OR....wish me luck guys
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #37 on: March 26, 2019, 08:05:21 PM »

On my way home from hospital.  Dr said all went really well.  Removed most but not all the plaque, I am straight, and he did have to use one stitch of Plication but said it was so minor it won’t affect any length.  Currently swollen and wrapped.  Used to the feeling from my Xiaflex injections.  Picking up pain meds now and then lots of rest
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

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Re: Chapter 2, Excision/Grafting Journey
« Reply #38 on: March 27, 2019, 02:31:29 AM »

I also had my wife ask the big question of why such invasive surgery doesn’t create Peyronies when micro trauma does?  Dr Yafi had a pretty good answer...clean incisions and proper suturing always heal much better than tears.  For example if you split your chin open and let it heal on its own as opposed to going to the hospital and getting stitches, the results are drastically different.  Hope that answers some questions out there.
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

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Re: Chapter 2, Excision/Grafting Journey
« Reply #39 on: March 27, 2019, 02:12:05 PM »

Great explanation
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PxD 2 yrs, failed all tx. 9/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS 18cm + 3rte

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Re: Chapter 2, Excision/Grafting Journey
« Reply #40 on: March 27, 2019, 06:42:44 PM »

Removed first wrap today, a little bloody but not bad.  I had a nerve block done so pain is minimal.  A few small hematomas around the glans but nothing major.  Turning out to be a lot less traumatic than I thought it would be, especially after what happened to me with Xiaflex.  So glad I did what I did at this point.  Find that specialist who knows what they’re doing and get yourself fixed.  Thank you to everyone who has been following my experience.  You have helped me more than you know
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

pfract

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Re: Chapter 2, Excision/Grafting Journey
« Reply #41 on: March 27, 2019, 09:57:04 PM »

Nice to know man. I don't want to rain on your parade, but I would let everything heal up and then judge :#

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Re: Chapter 2, Excision/Grafting Journey
« Reply #42 on: March 27, 2019, 10:14:19 PM »

I hear ya pfract, just relating my personal experience of 2 Er visits from an in office procedure to none so far after a major surgery.  No pain, many medical staff involved, just such a better experience all around.  I will definitely stick around and post my progress.  Success is all I want
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #43 on: March 28, 2019, 01:02:15 PM »

still swollen pretty bad and have pain at night due to probably the start of nocturnal erections.  Wakes me up before they happen due to the pain, but the positive is I can still get erections, just can't stand the pain of them long enough to get hard.  Good news is they are happening!  Today is the day to unwrap the final wrap and finally take a shower.
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

pfract

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Re: Chapter 2, Excision/Grafting Journey
« Reply #44 on: March 28, 2019, 02:07:17 PM »

He did not prescribe anti erection medication?

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #45 on: March 28, 2019, 02:47:24 PM »

No he said they are not that effective and that blood flow to the area is good, even if it hurts at first.  Will be on low dose Cialis soon once the swelling goes down
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #46 on: March 28, 2019, 05:56:25 PM »

So good to take a shower and take all the wraps off!  My wife calls me “frankenweenie”😂
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #47 on: March 29, 2019, 02:03:55 PM »

Penis is swollen but no real pain thanks to the painkillers.  Pelvic area is black and blue as well.  Would I do this again?  Heck yes.  Much better than the Xiaflex injections.  Was it Dr Wachs?  Not sure, but I highly recommend going to a specialist like Dr Yafi.  Makes a huge difference
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

TDix

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Re: Chapter 2, Excision/Grafting Journey
« Reply #48 on: March 31, 2019, 02:45:37 PM »

A lot of pain today at base of penis.  Penis itself is fine, but the base is very tender and painful.  Looks like I got roughed up in the OR😂
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45 yrs old, 1.5 yrs diagnosed, 3 shots of Xiaflex resulting in hematomas/burst dorsal vein or fracture at tip, excision/grafting surgery March 26th successfully performed by Dr Yafi

tonyode

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Re: Chapter 2, Excision/Grafting Journey
« Reply #49 on: March 31, 2019, 07:27:37 PM »

Good to hear things are going ok TD. The pain in base, pubic are sounds similar to xiaflex. My doc said it is result of wrapping penis, forces blood to that area, thus the tenderness, pain. Hang in there and keep us up to date!
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Early 50s, 7 months diagnosed. 55 degree curve, indentation at base to the left.
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