TAP or original nesbit procedure?

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Moneer

I have downward curve due to congenital penile curvature, 30--40 degrees.

Which surgery would you guys recommend (and why): TAP or original Nesbit?

I've seen different urologist but seems each has a different opinion.

Would appreciate your feedback.

Thanks

BrooksBro

I am unsure what you mean by the "TAP" procedure.

I had a "modified" Nesbit procedure about 2 months ago (85 degrees upward, now 15).  It was a single transverse incision on the bottom side to place the restraining sutures.  My understanding is the traditional Nesbit is a full de-gloving.  I think there are few surgeons who do the full de-gloving now, because it simply is not necessary to achieve the same results.

Moneer

Quote from: BrooksBro on December 21, 2012, 01:27:44 PM
I am unsure what you mean by the "TAP" procedure.

I had a "modified" Nesbit procedure about 2 months ago (85 degrees upward, now 15).  It was a single transverse incision on the bottom side to place the restraining sutures.  My understanding is the traditional Nesbit is a full de-gloving.  I think there are few surgeons who do the full de-gloving now, because it simply is not necessary to achieve the same results.

TAP is the modified Nesbit procedure. Are you annoyed by the sutures? Is it true that they can be both seen and felt ? Did the doctor recommend this over the usual Nesbit procedure and why? Sorry for the many questions and thanks

frankyl

My doctor advised also me to do modified nesbit operation. It is the technique developed by Dr. Schroeder and Dr. Essed. In this technique there is no removal of material.
If some of you know more about this or have more information, please share it with me.

Moneer

Quote from: frankyl on December 21, 2012, 06:36:34 PM
My doctor advised also me to do modified nesbit operation. It is the technique developed by Dr. Schroeder and Dr. Essed. In this technique there is no removal of material.
If some of you know more about this or have more information, please share it with me.


The downside of the modified nesbit procedure, up to my understanding, is that it requires the installation of nonabsorbable sutures for the rest of your life, and they might burst causing pain and having the curvature return. But why do some doctors recommend it over the standard nesbit procedure?

LWillisjr

I believe that all Nesbit plication procedures (regular or modified) use permanent sutures. There are various methods of how many sutures to use, location, and procedure depending on each person's condition. Meaning degree, angle, and direction of curvature. I think all of these would be factors in determining how well the sutures could be buried or hidden. The sutures in all cases would be under the skin the covers the penis. So you would never see the actual sutures, but possibly as bumps under the skin.  
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

keepitstraight

Hi everyone. Let me try to help. Finally after these years with congenital ventro-lateral curvature i finally took the step and did the surgery, 6 years thinking about this.... yep a lot of research, reading, alternatives, techniques, doctors, etc... I'm at 10 days post-op, everything is going amazing. I was terrified and trembling when gone to the op theater but the Doctor was always an amazing human being and very very competent technically speaking and you all know there aren't many. Anyway i think i will let this story for a separate thread.

I must say that there are many techniques/procedures to correct a congenital deviation and even between the same techniques are slightly different approaches depending on the doctor, yeah still no paradigma whats the gold standard I have analyzed profoundly all the techniques, disadvantages and advantages. I will not mention all.

You have the Nesbitt traditional technique and approach (today i believe this technique can be/or should at some point be avoided). In fact many doctors started to abandon it. You have also a small group of modified nesbitt procedures (in this case the basic principles of the Nesbitt technique are maintained but the approach diverge, a good example might be using absorbable suture material instead of non absorbable, etc...). Then you have the plication techniques without excisions, the TAP of Dr. Levive is one case, then you have Dr. Tom Lue 16-dot, etc.... Then you have isolated techniques than not fall specifically in any of these techniques, like shaer rotation technique, Yachia Technique,... As you see the choice is not so small and all these years i balanced in detail all of their possible negative and positive aspects.

My honest advice would be if you don't feel comfortable at the moment think and study a bit more, take your time, be assured your problem have cure! I cant talk much right now because I'm at only 10 days post op, but i can assure you this was the most informed decision in my life so far, and until know the experience as been amazing, way better than i was afraid of... Be free to ask anything you want. I also had to travel outside my country because i was sure the best, or at least one of the best, solution was outside.

PS: Sorry Hawk i dont see many errors, but the ones i could find are edited. Thanks.

Hawk

Keepitstraight,

I think your post contains some very important information.  A problem with it however is that it was difficult to read. To help I went in and corrected about 20 spelling errors.  Some I was not sure of what you meant so I left them.  At one point you mention "Dr. Lebive".  Did you mean Dr. Levine?  If so could you fix that?

Maybe you could click on the modify button over your post then click on spell check to make it more readable.

My impression is that NO Nesbit removes material.  That is an excision surgery not a Nesbit plication or tuck surgery.  Then of course there is the excision with graft.  I don't see how they could ever have dissolving sutures on a Nesbit plication.  The entire principle is to simply suture the long side of the curve and cinch it as short as the short side to make the penis straight. With nothing removed, the sutures are all that keep it straight.

PS: I would be interested in reading about your surgical journey and to know who your doctor is.
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

keepitstraight

Hi Again,

Actually Hawk all nesbitt procedures make excicions of tunica albuginea. The plication technique is not in the same group of nesbitt they are different. We have plication and we have nesbitt. Then we have modified nesbitt (small or considerable changes to the original technique). Then we have some techniques that are outside these groups. I have mentioned some below. And by the way excision with graft, thats another story, that is not usually used to correct congenital deviation. But in some cases in the opinion of the surgeon it might be a viable option, depending on the patient, specially if the patient has dorsal curvature.
The nesbitt technique implicate shortening the longest side of the penis (convex), be it the dorsal, the ventral, the lateral, or combined, etc... For that the technique removes eliptical excisions of tunica albuginea until the deviation is corrected. Actually i think i have put some technical literature in this forum a few years ago, but probably the links are no longer working. But what might be the problematic sides of the nesbitt tech? well the most important is the size and depth of the excisions made. This technique involves full rupture of the tunica albuginea (when doing the excicions) and the size of the ellipses removed generally are too big, can go up to 1cm (transversal). Thats too big and can compromise future tunica/penile stability. Thats one reason some doctors started to abandon this technique and we have more viable options today be it modified nesbitt, be it other approaches. But there are other reasons.... Just a side note: the tunica albuginea has 2 layers of collagen fibers, the inner layer comprised of circular collagen fibers, and the outer layer comprised of longitudinal collagen fibers. And yes to suture back the tunica they can use absorbable material in the nesbitt tech. Remember the tunica will heal back again.
I will try to open up a thread in the future about my journey.

Merry Christmas to all!

Moneer

Quote from: keepitstraight on December 24, 2012, 04:13:56 AM
Hi Again,

Actually Hawk all nesbitt procedures make excicions of tunica albuginea. The plication technique is not in the same group of nesbitt they are different. We have plication and we have nesbitt. Then we have modified nesbitt (small or considerable changes to the original technique). Then we have some techniques that are outside these groups. I have mentioned some below. And by the way excision with graft, thats another story, that is not usually used to correct congenital deviation. But in some cases in the opinion of the surgeon it might be a viable option, depending on the patient, specially if the patient has dorsal curvature.
The nesbitt technique implicate shortening the longest side of the penis (convex), be it the dorsal, the ventral, the lateral, or combined, etc... For that the technique removes eliptical excisions of tunica albuginea until the deviation is corrected. Actually i think i have put some technical literature in this forum a few years ago, but probably the links are no longer working. But what might be the problematic sides of the nesbitt tech? well the most important is the size and depth of the excisions made. This technique involves full rupture of the tunica albuginea (when doing the excicions) and the size of the ellipses removed generally are too big, can go up to 1cm (transversal). Thats too big and can compromise future tunica/penile stability. Thats one reason some doctors started to abandon this technique and we have more viable options today be it modified nesbitt, be it other approaches. But there are other reasons.... Just a side note: the tunica albuginea has 2 layers of collagen fibers, the inner layer comprised of circular collagen fibers, and the outer layer comprised of longitudinal collagen fibers. And yes to suture back the tunica they can use absorbable material in the nesbitt tech. Remember the tunica will heal back again.
I will try to open up a thread in the future about my journey.

Merry Christmas to all!

Thank you for the detailed info, really appreciate it. Just wondering which procedure did you end up choosing and why? Since we have the same condition (but my curve is downward)

Thanks

keepitstraight

Hi Moneer,

Actually i also had downward curvature (you can say also ventral it means the same). Well the procedure i chose was a modified nesbitt. The principles of this procedure are correcting the ventro-lateral curvature (i also had a very slight rotation), depending on your case, using multiple small 3x2mm excisions of the outer tunica layer only. No full tunica rupture. This gives better and faster healing of the tunica itself, helps to distribute the bending forces when healing, more respecteful with the natural hemodynamics and physiology of the erection. To correct the deviation and to determine how much to correct geometric principles of Egydio are used (more objective correction). Only absorbable suture material is used. Please dont take me wrong, and guys, IM NOT MAKING PUBLICITY AT ALL! This is my experience,a long one. Like i said do your own research and also you have to really trust your surgeon and his competence. Until i reached here i consulted a few doctors, some very well known like Levine, David Ralph, i read a lot, i've talked to patients, all you can imagine.
Why i chose this procedure? Moneer it seemed to me that it had the best of both worlds so do speak or at least combined the best techical approaches with some inovations in one more promising technique. When you spend a big amount of time comparing techniques, studying, actually reading the articles, books, and medical case studies of these techniques you start to have more informed choices. You actually discuss it with your doctor. The most similar technique i find to this is Levine TAP technique, cause it works only with the outer tunica layer, but the rest is a bit different. Levine only does incision and i think uses non absorbable sutures if i remember well. Moneer another thing, despite the technique used, the Doctor who preforms it is paramount! Experience, expertise, technical hability, how it responds to your doubts or questions (i mean even technical ones. It is painful when talking to some doctors and you actually know more than them! Don't be ashamed to ask, if you have it if you need it, ASK! If he is a good doctor and sensible human beeing he will answer). Also ask him to show you how the procedure is done in detail, how many cases he has operated, preform penile doppler if possible, ask him to show you solved cases, you know real photos of penile corrections, normally they are sensible to that. No doctor should be presumptuous to you, and unfortunatly there are some that are. Be strong, have confidence you will solve your problem! I always was and am a positive person :-) I was before the surgery and still are.
I dont want to publicize anything but if the moderator and the community here allows me to reveal the Doctor and where i did it im willing to help, Otherwise no. Only two centers in the world use this approach and the most recent case study of this technique was presented to the ISSM World meeting on sexual medecine (chicago 2012) and ESSM (Amsterdam 2012) European Sociaty for Sexual Medecine congress.

PS: and Remember im only 13 days post op for now i cant give you a final veredict, but so far so good :-)

LWillisjr

Quote from: keepitstraight on December 25, 2012, 05:21:55 AM

I dont want to publicize anything but if the moderator and the community here allows me to reveal the Doctor and where i did it im willing to help, Otherwise no. Only two centers in the world use this approach and the most recent case study of this technique was presented to the ISSM World meeting on sexual medecine (chicago 2012) and ESSM (Amsterdam 2012) European Sociaty for Sexual Medecine congress.

keeitstraight,
Other's have posted their doctors names so I have no problem with it. We would all be very interested in further information on this procedure.

Les
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

keepitstraight

My Doctor was and is Dr. Franklin Kuehhas (Vienna, Austria in Europe). The other doctor that does this procedure is Dr. Paulo Egydio (São Paulo, Brazil). Actually they have been working closely. There is one article in the British Journal of Urology from September 2012 that explains this technique and gives the results of 211 men operated using this approach, just congenital downward cases, from 2006 to 2011. Dr. Paulo Egydio is known worldwide as one of the top in both congenital and aquired curvatures (Peyronie). The problem is for my economically it was not viable to go to Brazil. So i took the leap and went to Austria. After meeting Dr. Kuehhas i was sure this is it! Of course not that simple but i felt confident. You have to feel this with your doctor!

Moneer

Quote from: keepitstraight on December 25, 2012, 12:29:13 PM
My Doctor was and is Dr. Franklin Kuehhas (Vienna, Austria in Europe). The other doctor that does this procedure is Dr. Paulo Egydio (São Paulo, Brazil). Actually they have been working closely. There is one article in the British Journal of Urology from September 2012 that explains this technique and gives the results of 211 men operated using this approach, just congenital downward cases, from 2006 to 2011. Dr. Paulo Egydio is known worldwide as one of the top in both congenital and aquired curvatures (Peyronie). The problem is for my economically it was not viable to go to Brazil. So i took the leap and went to Austria. After meeting Dr. Kuehhas i was sure this is it! Of course not that simple but i felt confident. You have to feel this with your doctor!


Thanks for the info. You mentioned that you consulted Dr. Levine, what was his feedback? Just curious as he is a main figue in penile curvature correction.

On a side note, how are you feeling post op? I know its probably too early to decide but an overall feeling?

keepitstraight

Hi Moneer,

Actually i exchanged some emails and photos with doctor Levine not a physical appointment. My case was definitly surgery. around 60 degrees bend downwards, a left lateral curvature (maybe 20º degrees) and a slight rotation along the shaft. Its called complex biplanar deviation. Apparently rotation can be solved but my doctor prefered to correct 90% of it using the technique i described instead of using Nesbitt. He said "Alberto i could solved 100% you rotation but for that nesbitt was necessary, i didnt want to". The rotation is i would say very mild so does not bother me at all. The most important was the Ventro-lateral biplanar deviation.
Yes Dr. Levine is very good. I for example and honestly would prefer do the TAP technique from Levine than the 16-dot plication technique from Tom Lue if i had no other choice. I sometimes think they create techniques for the sake of creating something new but they dont think about the patients in long term. In this field you have to be an artist and a scientist at the same time. Actually medicine should be like that in all fields. My grand father is a orthopedic specialist/surgeon and always said " when i need a fellow surgeon i look for someone young in the beggining/peak of his career, because they have art, science and love what they do".
How do i feel? Honestly very good. I did circuncision with 17 years old (10 years ago), so this was my "second" one so do speak. So all that disconfort from the circuncision this time was very attenuated. Overall i feel confident, happy, no pain, still slightly swallow in circuncision area just between the glans and circuncision line, but thats normal. At touch there is no pain unless you rub a bit hard in the dorsal part, but even then i would not call it pain is more of a small disconfort, no problem. The stitches are almost or pratically unnoticeable and hard to feel, thats because the excisions are also very small and distributed and also they do inverted suture and the bucks fascia covers the stitches, so in the end all is very well covered and almost ommited. But there is one thing that bothers me a bit, im more and more becoming a bit horny, hahahahaha. You know you cant masturbate, etc... That could be a bit frustrating but you have to wait :-) They give you Androcur for 20 days just to reduce frequency of erections and you have to do manual but gentle stretching exercises along the shaft axis of the penis, starting around 1 week post op. This will help/promote even healing, less scarre, etc... Pretty easy, no pain, 3 times a day 5 minutes. Im writing to much again :-). Resume: im feeling very good, but a bit nervous/anxious to see the full result.

Moneer

Quote from: keepitstraight on December 26, 2012, 04:48:02 AM
Hi Moneer,

Actually i exchanged some emails and photos with doctor Levine not a physical appointment. My case was definitly surgery. around 60 degrees bend downwards, a left lateral curvature (maybe 20º degrees) and a slight rotation along the shaft. Its called complex biplanar deviation. Apparently rotation can be solved but my doctor prefered to correct 90% of it using the technique i described instead of using Nesbitt. He said "Alberto i could solved 100% you rotation but for that nesbitt was necessary, i didnt want to". The rotation is i would say very mild so does not bother me at all. The most important was the Ventro-lateral biplanar deviation.
Yes Dr. Levine is very good. I for example and honestly would prefer do the TAP technique from Levine than the 16-dot plication technique from Tom Lue if i had no other choice. I sometimes think they create techniques for the sake of creating something new but they dont think about the patients in long term. In this field you have to be an artist and a scientist at the same time. Actually medicine should be like that in all fields. My grand father is a orthopedic specialist/surgeon and always said " when i need a fellow surgeon i look for someone young in the beggining/peak of his career, because they have art, science and love what they do".
How do i feel? Honestly very good. I did circuncision with 17 years old (10 years ago), so this was my "second" one so do speak. So all that disconfort from the circuncision this time was very attenuated. Overall i feel confident, happy, no pain, still slightly swallow in circuncision area just between the glans and circuncision line, but thats normal. At touch there is no pain unless you rub a bit hard in the dorsal part, but even then i would not call it pain is more of a small disconfort, no problem. The stitches are almost or pratically unnoticeable and hard to feel, thats because the excisions are also very small and distributed and also they do inverted suture and the bucks fascia covers the stitches, so in the end all is very well covered and almost ommited. But there is one thing that bothers me a bit, im more and more becoming a bit horny, hahahahaha. You know you cant masturbate, etc... That could be a bit frustrating but you have to wait :-) They give you Androcur for 20 days just to reduce frequency of erections and you have to do manual but gentle stretching exercises along the shaft axis of the penis, starting around 1 week post op. This will help/promote even healing, less scarre, etc... Pretty easy, no pain, 3 times a day 5 minutes. Im writing to much again :-). Resume: im feeling very good, but a bit nervous/anxious to see the full result.

I hope you fully recover very soon my friend, and that you are in best health and shape :-)  In my case, the more I read the more I get confused. I simply do not want any non-absorbable sutures in my body but it seems majority of the wellknown doctors only perform procedures that involve non-absorbable sutures. I dont know what to do actually, any advice would be appreciated. Thanks

keepitstraight

Thank you Moneer. Yes thats true the more you read the more you get messed with information. Thats good and normal because you know you have different choices, but also bad because as i explained no definite consensus exists whats the gold standard to correct congenital deviation. Obviously the majority will probably say that Nesbitt still is the gold standard. Well not really true, at least in our days.
Moneer i have to be honest i dont understand why some doctors today still use non absorbable sutures. It only makes sense if you are doing a plication where the corrected bend depends on the forces of the sutures to remain straight, or in cases of pediatric penile deviation correction where the penis of the child is still developing so you dont wanna excise or incise the tunica to compromise that development. Even in incicion/excision and graft techniques absorbable sutures are used why shouldnt they be in the other techniques?
A normal delayed absorption suture material like 3-0 polydioxanone at 6 weeks it is supposed to still maintain 60% of its strength and it absorbable between 3 to 6 months.
Obviously there are some reasons why some doctors prefer non absorbable, its supposed to be safer specially when doing big cuts like in nesbitt where you have to have very high tension strength resistance along the healing process. If you compare a excision of 3mm and another of 1 cm lenght you need diferent forces. Well lets say you want to correct a congenital ventral deviation. Lets say you have two alternatives: 1. you do a big ellipse excision and correct the curvature at once with high tensile resistance suture material 2. you do four very small excisions or incisions (like yachia for example) and suture the tunica with delayed absorbable sutures. In one case all the tension is concentrated in one place, in the other case you are distributing the bending forces. In one case you will have a big scarre, permanent sutures, probably formation of little scarre nodules do to sutures messing with the maturation process of a wound. You might or might not have pain a touch or erections, feel the sutures, etc... In the other case imagine the inverse. Thats why nesbitt is a bit debatable today and some modified procedures have appeared.
Im not sure but i think Dr. David Ralph from UK does nesbitt with absorbable suture material and Rados Djanovic in Serbia.
Moneer i understand perfectly the confusion, lot of information. It took me some time to digest and do the most informed step in my life. Like me take time, do more research if you have to. Relax there is treatment that is for sure, be positive. I dont know how messed up is your mind with all this info but if you have the financial possibilities why dont you travel to those who might be the best and see how you feel talking and beeing evaluated by them. I give you 4 Doctors (Tom Lue, Laurence Levine, Paulo Egydio, David Ralph). All use different techniques, the ones that i think are missing here are the Yachia technique, Shaeer rotation technique, and maybe some others. I know this might be a bit costly thats why i say only if you have the possibilities. Otherwise keep researching, im sure soon you will find solution. I have to be honest i too would like to be with permanent suture material.

BrooksBro

TAP = Tunica Albuginea Plication
plication = shortening

The use of absorbable or non-absorbable sutures depends on the plication technique being used.  There are two primary penile plication techniques, with significant differences.  

I had the first method performed 9 weeks ago (85 degree curve reduced to 15).  The recovery and healing was quick and without complications.  My wife and I am very pleased with the outcome.


FIRST METHOD:
One method is to place non-absorbable placating sutures in the tunica albuginea opposite the curvature to straighten the penis. Advantages of this method of penile curvature correction include technical ease and decreased dissection and operative time.  One disadvantage is if the suture were to ever break, there can be recurrence of the curvature. Some patients find the permanent sutures and knots uncomfortable.

http://www.hawaii.edu/hivandaids/Tunica_Albuginea_Plication_for_the_Correction_of_Penile_Curvature.pdf



SECOND METHOD:
The other method is wedge excision plications with a 2 layer closure. Upward curvature is corrected by plicating the undersurface (ventral aspect) of the penis. Since the urethra is midline, the plication sutures are placed on each side of the urethra.

This surgery begins with a circumcising incision to "de-glove" the penis, exposing the tunica albuginea and the sensitive nerves and blood vessels adherent to the tunica. These structures are very carefully dissected away from the tunica using optical magnification and fine specialized instruments.  

The patient is given an artificial erection. Saline is rapidly infused into the spongy tissue inside the penis as compression is applied under the scrotum to restrict outflow. The area of maximal curvature is identified, and temporary placating sutures are placed. An artificial erection is again achieved to confirm beneficial straightening.

The plications are made then permanent with creation of an oval shaped incision (excising a portion of the tunica) and a 2 layer closure using absorbable sutures that eventually dissolve.

Peyronie's Disease Plication Surgery - Center for Reconstructive Urology






Moneer

Thanks keepitstraight and BrooksBro for the feedback.

@keepitstraight, how are you feeling now? hows the healing process going? curvature corrected? nocturnal erections happening?

I'm still researching and trying to find the best doctor/procedure to go with.

keepitstraight

Hi Moneer. Im feeling great. The healing process is going pretty good. It is a bit soon to give a veredict. Yes im having nocturnal erections but since im taking androcur they are less frequent and less strong, thats why i cant really "measure" the final results. Im at 3 weeks post op, more 3 weeks to go until the liberation. Today i end taking androcur so i think in the next days things will be more clear. But as far as i notice from the erections im having yep the curvature is totally solved and so far the results seem pretty amazing. It is funny when i had a ventral curvature and the erection started imediately the penis started to bend downwards, now it is amazing it starts straight and maintains straight. Also it seems that in the flacid state the penis seems a bit more up in base angle. The rotation seems also solved. Keep in mind that my curvature was complex but not really severe, i mean is a biplanar complex deviation. So you have to see it almost in 3D to correctly access the necessary deviation corrections. Thats why the more objective the technique is the better. Step by step and adapt the small excisions places to the geometric principles.
By the way i've read that in Dr. Levines Tap technique absrobable suture can be used. Read this small article by Levine: Congenital Penile Curvature/ Chordee: Treatment - The Institute For Sexual Medicine
In the fifth point he says that. But i dont know how it translates in real practice. Keep going you will certainly find the solution and best option! :-)

Tim_B

hi alberto!
any news on your progress? i have been following your comments. i had also a congenital curvature. since i live in vienna i also went to dr kuehhas. everything went out well. after extensive explanation of the modified nesbit technique i finally (after 2 years) underwent surgery. i think one of the most important things is the support you get from your physician. dr kuehhas was very helpful during the pre- and postop phase...! all the other urologists that i visited (5!!) did not understand my problem or suggested Nesbit. i think that this is a universal problem, isn t it?
yours
tim

keepitstraight

Hi Tim,

So far doing great. Really Vienna!? You could have told me before, for a cup of coffee :-) Well i stayed in Doebling district and the surgery was in Rudolfinerhaus. Support from the doctor is PARAMOUNT! Yep Dr. Kuehhas is a very honest and competent doctor technically, and above all very confident/secure in what he's doing. I cant talk much about is experience cause he seems a fairly young doctor, but the fact he worked and published with Dr. Egydio for me is a very good sign. But it seems he is very confortable with curvature correction surgery. The same week i was operated he already perfomed 2 congenital surgeries and one more was scheduled. Yep the feedback you get from, lets say, general urologists is indeed very disappointing. By the way when did you have your surgery?

Regards
Alberto

james1947

Tim and keepitstraight

Please give us much as you can information regarding Dr. Kuehhas as a reply to:
Peyronie's Doctors – Locations and forum opinion - Open for Comment - Peyronies Society Forums
We are trying to make a list of good Peyronies doctors. :)

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

keepitstraight

Hi James,

This is what i know:

Dr. Franklin Emmanuel Kuehhas
Medical University of Vienna
Department of Urology
Währinger Gürtel 18-20, 1090 Wien
E-mail: franklin.kuehhas@meduniwien.ac.at

Moneer

Hi Alberto,

How are you feeling now? I guess 4 weeks have passed since you've had the operation. All in all, what so you think of the outcome?

Thanks
Moneer

Tim_B

Quote from: keepitstraight on January 16, 2013, 11:09:11 AM
Hi Tim,

So far doing great. Really Vienna!? You could have told me before, for a cup of coffee :-) Well i stayed in Doebling district and the surgery was in Rudolfinerhaus. Support from the doctor is PARAMOUNT! Yep Dr. Kuehhas is a very honest and competent doctor technically, and above all very confident/secure in what he's doing. I cant talk much about is experience cause he seems a fairly young doctor, but the fact he worked and published with Dr. Egydio for me is a very good sign. But it seems he is very confortable with curvature correction surgery. The same week i was operated he already perfomed 2 congenital surgeries and one more was scheduled. Yep the feedback you get from, lets say, general urologists is indeed very disappointing. By the way when did you have your surgery?

Regards
Alberto

alberto i hope you are doing fine. maybe we can meet next time in vienna:-)

i had my surgery almost 6 months ago. The first few weeks i was nervous but
everything went out as Dr kuehhas kept telling me. now i am happier than ever,
my girlfriend never had a lot of problems with my curvature, but i had...

from what i understand Dr kuehhas is the urologist with most experience in congenital
curvature in austria... although he seems young.

personally i found my personal urologist!

tell me when you come to vienna!!

coh

hi tim

what kind of surgery did you do?

are you also a member of german forum ? htttp://www.induratio.com



coh

Hawk

If we do have members of that German site perhaps you could suggest adding a link to the PDS Forum on their "links" page.

Hawk
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

Tim_B

Quote from: coh on January 18, 2013, 07:11:06 PM
hi tim

what kind of surgery did you do?

are you also a member of german forum ? htttp://www.induratio.com



coh

hi coh!

i had a modified nesbit technique which dr kuehhas and dr egydio invented. they use some geometrical
principles and they do not cut the through the tunica...
i do not have the original publication but you can read the summary of it:
Superficial tunica albuginea excision, using geometr... [BJU Int. 2012] - PubMed - NCBI

personally i am very happy with the outcome of the surgery and my new life!

i do not know the german forum.... do you recommend it?

tim

coh

hi tim

thanx, the german forum is smaller and the activity is there is less highly.

I have siend you a message with some questions.

Coh