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Author Topic: PRP & HYALURONIC ACID  (Read 30046 times)

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PPeroni

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PRP & HYALURONIC ACID
« on: May 17, 2014, 11:19:03 AM »

Hey guys,

I found this article dated April 30, 2014. It is written by Dr. Virag - the inventor of the Virag technique . Basically it is about four injections of the patient own plasma with hyaluronic acid as biological support with local anesthesy. It is supposed to be a two month process. It has been tested on 13 men only so far. More test are planned. Have a look at the (poorly google translated) article :

" [...] That is why any new therapeutic innovation is considered. That we have presented the first results is to treat the condition early enough before the plates are too thick and calcified .
 
A new innovation to regenerate diseased tissue
 
It is innovative in that it seeks not only to fight against its harmful effects but also promotes regeneration of normal tunica .
 
Is used to clean the patient's plasma rich in regenerative cellular components : platelets and growth factors. This is what is called autologous cell therapy is already widely used in other areas : muscle or joint burns, skin defect , tendon disease .
 
The plasma thus injected into the lesion sites is capable of regenerating or destroys the diseased tissue . In the particular case of Peyronie 's disease that were made ​​thirteen volunteer patients , this is to inject a mixed their own biological carrier serum ( hyaluronic acid ) in the plates identified by ultrasound and course under local anesthesia.
 
As is known experimentally with hyaluronic acid, injected plasma activity keeps a fortnight , it was realized in the space of two months, four sessions for each patient.
 
Eleven of the thirteen patients have a satisfactory result
 
Many criteria have been designed to monitor : the main ones being the maintenance or return of sexual activity, the disappearance of the angulation caused by the curvature and erasure of ultrasound images .
 
Eleven of our thirteen patients have a satisfactory outcome with a mean follow up of nine months. This is a very encouraging start that pushed us, with the help of the firm that produces the special tubes necessary for the collection and centrifugation of blood, to undertake a study involving nine centers , five in France and four in abroad in order to confirm the potential of this new therapeutic approach to Peyronie 's disease .
 
It goes in the direction of the future of medicine : use own resources of the individual and open the road to tissue engineering. Recreating tissues and organs from ourselves".


I am actually going to Paris for work next month. I am trying to meet the Doctor. Let's see.

Apologies if this developmental treatment has been already reported. 

original article :
Maladie de Lapeyronie, ou l'érection molle : vers un traitement pour les tordus du pénis ! - le Plus
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NeoV

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How is this different than PRP? aka Priapus Shot? Sounds great.
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PPeroni

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Good day NeoV,

I do not know if there is a difference. I am quite new here. Anyone ?

For those who understand french or who simply want to see how the injections are made and the results. The Doc introduce the treatment with a PowerPoint presentation including descriptives slides:

http://www2.academie-chirurgie.fr/sean/?cle_seance=592
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lgrace

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Thank you, very interesting.

Several forum members are currently undergoing this type of treatment, mainly in the US (and one in Indonesia!) with at least a few reporting success.
 
What is particularly interesting here is
 
- the addition of hyaluronic acid, which allows the PRP to remain longer (2 weeks).
- the injection directly into the plaque, guided by echography (ultrasound)

I do not know if this is also done by other practitioners, namely in the US (Dr. Runels).

The Powerpoint presentation is interesting and reveals a few additional details: the 2 "failures" as he calls them were the 2 only patients with calcified plaques.

However, he claims that 10 had improvement in curvature (but one got worse) and all had reduction of the plaques (confirmed by echography).

He says the improvement usually appears after the second injection (and injections take place every 2 weeks).

All patients reported improvement in erections I believe.

He did not give details about the study, but he says that they will compare results between patients injected directly into the plaques (echography assisted) and others injected without echography guidance (not in the plaque I suppose).

It is good to know that a specialist unrelated to penis enlargement bull* is conducting a study on this treatment.

It is worthy to note that it is the company that sells the centrifugation tubes that finances the study... I hope it doesn´t play a role though.
And it is always depressing to see that such a study would only be financed if a company sees potential gain.



 
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james1947

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Some information in English:
: Uses, Side Effects, Interactions and Warnings - WebMD
Hyaluronan - Wikipedia, the free encyclopedia
Quote
- the injection directly into the plaque
Not new, if possible, (needle can penetrate the plaques) the PRP in also injected to the plaques.
What I don't understand is how they are extracting the hyaluronic acid.
From webmed:
Quote
The hyaluronic acid that is used as medicine is extracted from rooster combs or made by bacteria in the laboratory.
It is not clear for me if it is PRP with an other name, or hyaluronic acid is added to the PRP:
Quote
On utilise pour ce faire le propre plasma du patient riche en éléments cellulaires régénérateurs : plaquettes et facteurs de croissance.
Sounds exactly like PRP
Quote
Dans le cas particulier de la maladie de Lapeyronie ce que l’on a fait sur treize patients volontaires, c’est injecter leur propre sérum mélangé à un support biologique (l’acide hyaluronique) dans les plaques repérées par l’échographie et bien sûr sous anesthésie locale.
Is stating that the injected hyaluronic acid is from the patient itself.
No explanation on how they are extracting the hyaluronic acid.
Maybe my French is not as it was, but to me seems like PRP injections.

James
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lgrace

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it is PRP, of course. But hyaluronic acid is added, not extracted from the patient.
French is my mother tongue. But I am not a doctor, nor a chemist ;)
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james1947

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lgrace

So how you translate to English this sentence:
Quote
c’est injecter leur propre sérum mélangé à un support biologique (l’acide hyaluronique)
As I have said, my French is not as it was in the past.

James
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lgrace

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"Dans le cas particulier de la maladie de Lapeyronie ce que l’on a fait sur treize patients volontaires, c’est injecter leur propre sérum mélangé à un support biologique (l’acide hyaluronique)"

= "In the particular case of Peyronie´s disease, what was done on 13 voluntary patients was to inject their own serum mixed with a biological support (hyaluronic acid) ..."

It does not specify the source of the hyaluronic acid, but I am pretty sure it would have been mentioned if it was also extracted from the patients.
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lgrace

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loyalty, I will gladly translate the abstract for you. I am currently underway, but will be able to translate if you paste the abstract in your post. So far I have only seen an article in a newspaper (Nouvelobs) and the movie.
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james1947

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loyalty

Try to copy the article to google translate.
Not perfect, but maybe enough to understand.

James
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Chef Chris

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No mentioning of ved directly after the treatment or the weeks after?
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Chris

james1947

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No mention of VED from my understanding.
Hope lgrace can approve that.

James
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loyalty

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Thanks for offering to translate, Lgrace.  I am also going to see if the medical library where I work can get the entire article.  If so, the Methods and Materials section may be crucial.

Résumé
Plus de deux cents ans après sa description princeps par l’un des fondateurs de notre académie, la Maladie de Lapeyronie (LAP) reste assez méconnue et toujours dépourvue d’un traitement curateur efficace. Nombreux sont les traitements prometteurs proposés puis abandonnés. C’est avec humilité et espoir que nous vous présentons les premiers résultats d’un traitement novateur basé sur la régénération tissulaire autologue. Après un rapide état des lieux de la clinique et des concepts étiologiques actuels de LAP, nous expliquerons en quoi consiste le plasma enrichi en plaquettes (PRP) associé ou non à l’acide hyaluronique (HLA) et sa très large utilisation dans de nombreuses pathologies notamment cutanées, tendineuses, articulaires et ophtalmologiques. Depuis près de 4 ans nous utilisons le PRP dans diverses situations de troubles de l’érection et de LAP. C’est le résultat de notre expérience sur 13 patients porteurs de LAP et suivis de 3 à 36 mois que nous vous présentons.
La moyenne d’âge de cette courte série est de 57.5 ans (48 à 71). Huit patients n’ont pas d’étiologie reconnue, quatre invoquent la pratique d’injections intracaverneuses et un des interventions multiples sur la verge pour hypospadias. Dans 8 cas on relève une angulation > à 50°, et dans 5 cas un rétrécissement disharmonieux. Dans 7 cas l’activité sexuelle est gravement perturbée. Dans neuf cas c’est principalement l’albuginée dorsale qui est pathologique ; et pour les 4 autres la fibrose est disséminée sur le septum et/ou l’albuginée ventrale. Le traitement consiste en l’injection répétée (4 durant deux mois) de 4 à 8 ml de PRP+ HLA (kit Regenlab® prêt à l’emploi) dans les plaques préalablement repérées et mesurées à l’échographie. Chaque séance est pratiquée sous anesthésie locale par bloc pénien et les injections sont effectuées sous contrôle échographique. Le premier contrôle est effectué un mois après la 4°injection avec faculté de procéder à une cinquième séance suivant l’évolution. Le suivi est ensuite trimestriel la première année puis bisannuel. On ne déplore aucune complication en dehors d’un hématome important avant que les injections ne soient écho guidées. Neuf patients ont un recul = ou > à 3 mois avec une moyenne de 9,3 mois. L’angle de la courbure est < à 15° sauf dans un cas en cours où il s’est aggravé. L’activité sexuelle mesurée par l’Indice International de la fonction érectile (IIEF-5) est normalisée ou conservée dans tous les cas sauf un. Au total, onze des treize patients (dont 4 avec un recul =/ > 9 mois) enrôlés dans cette étude préliminaire ont vu une nette amélioration de leur état clinique sur le plan fonctionnel et sur le plan anatomique. Ces résultats encourageants demandent confirmation sur la durée et sur un plus grand nombre de cas. C’est pourquoi, une étude internationale impliquant neuf centres experts, dont quatre autres centres français sous l’égide de l’Association Française d’Urologie, va débuter incessamment.
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incautious

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It appears that they may use the hyaluronic acid in place of the VED which does the same thing( at least in theory) in keeping the PRP localized. It is exciting in that they have gotten very similar results as the priapus shot in that there is a reduction in curvature and an improvement in Erectile Dysfunction. Hyaluronic acid is needed for wound repair, and by injecting PRP your body is tricked into thinking that there is a wound and works to heal the area. I've stated in that past that the theory of PRP is of sound medical science and that it does have the potential to repair damaged areas of the body even one's manhood.
A side note about the VED, since the priapus shot was initially developed as a way for male enhancement, the VED most likely served a dual purpose that is keeping the prp localized and working to increase size.
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lgrace

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This is my unofficial translation.
Hope it will help.



More than 200 years since its description by one of the founders of our academy, Peyronies Disease remains rather unknown and still devoid of efficient (curating) treatment. Many treatments have been promising and were then abandoned. It is with humility and hope that we present the first results of an innovative treatment based on autologous tissue (adjective of tissue) regeneration.  After a brief overview of the current clinical and etiological of Peyronies Disease, we will explain what is the PRP associated or not with hyaluronic acid (HLA) and its very wide use for numerous pathologies, namely cutaneous, tendinous (adj. of tendon), articular and ophtalmological. It has been almost 4 years that we have been using PRP in different occurrences of Erectile Dysfunction and Peyronies Disease. We present the results of our experience on 13 Peyronies Disease patients followed over periods of 3 to 36 months.
Medium age: 57.5 (48 to 71). 8 patients with no recognized etiology, 4 report having practiced intracavernous injections and 1 had multiple interventions on the penis for hypospadias. in 8 cases the angulation was > to 50 degrees, and in 5 cases there was a disharmonious shortening. In 7 cases sexual activity was severely disturbed. In 9 cases it was mainly the dorsal albuginea that was pathological; and for the other 4 the fibrosis was disseminated on the septum and/or the "opposite of dorsal" albuginea. The treatment consists of repeated injections (4 over 2 months) of 4 to 8 ml of PRP +  HLA (kit from Regenlab, ready to use) in the plaques that have previously been located and measured through echography (ultrasound). Every session is done under local anesthetic (by penal bloc) an the injections are done under echographic control. The first control is done one month after the 4th injection with a possibility to administer a 5th round, according to the evolution. The controls are then every trimester for the first year, then twice a year. No complications were observed except for one important hematoma before the injections were guided through echography. 9 patients have been followed for 3 or more months with an average of 9.3 months. The angle of curvature is less than 15 degrees except in one case in which the angle aggravated. Sexual activity measured through IIEF-5 was normalized or preserved in all but one case. In total, 11 of 13 patients (out of which 4 were followed for a period equal or superior to 9 months) enrolled in this preliminary study have noticed a clear improvement of their clinical status on the functional level as well as on the anatomical level. These encouraging results call for confirmation on a longer period and on larger number of patients. This is why an international study involving 9 expert centres, including 4 other French (...), will commence very soon.
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PPeroni

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Gentlemen,

I might have an appointment with Dr. Virag next month (I ll be in Paris for work). Is there any questions (I cannot ask dozens but a few might do) that might be really important and relevant regarding this treatment ?
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james1947

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lgrace

Thanks for the translation.
The bellow sentence is bothering me somehow, as PRP to my knowledge is from ones own blood.
Quote
PRP +  HLA (kit from Regenlab, ready to use

PProni
If question, I think have no answer in the translation to:
Is the PRP from the patients own blood?
From where the HLA?
No rejection or other allergic reactions were observed?


James 
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lgrace

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Of course James, the PRP is extracted from the patient's blood. The kiit only refers to the HLA.
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Conway96

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PPeroni - at the end of the presentation it's mentioned that there's an international study beginning soon. Maybe you can get some additional information about this study? I've searched online, but have yet to find anything. Has anybody had any luck?
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UrsusMinor

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I'm not sure that the Hyaluronic acid with PRP is all that new--although injecting it into the penis is!

Here's what it says on the Priapus Shot website:

So, back to the Priapus Shot ® procedure, here’s thepotential complications of using hyaluronic acid fillers(Restylane & Juvederm):

 1.With Restylane you can, especially in the forehead, see the side effect ofskin necrosis(it turns black and dies and must be surgically removed)! Not a pleasant thought when considering part of the skin of the face, so I never inject the forehead with Restylane where this is known to occur. But, even more disturbing it is to think of necrosis of the penis.

 2.Lumpiness and nodules can occur with Juvederm and Restylane. Not common in my practice (reported in research as 1 in 10,000). But, I discontinued the use of another hyaluronic acid filler, Hydrelle, because I did see a higher than expected rate of nodule formation. In the face, a nodule is bad enough but in the penis, I just did not want to accept the possibility.


So, I never injected my penis with Restylane.

So, I'll be following the Frech research with great interest, but for the moment I'd be disinclined to let them anywhere near my little buddy with any HLA injections!
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james1947

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Skin necrosis?
No thank you, not for my penis, I will stick with PRP and VED.

James
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Milouzze

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Hi everybody,

This is my first post on this forum, I'll do my best to give you my feedback on that treatment (I'm French). I hope you will catch my English...

First I have to tell you a bit about my situation. A plaque appeared 1 month after a trauma in Sept 2013.
At that time the plaque was tiny and located at the center of my penis (septum area) with no deformation of my penis. But I could feel it was growing and moving weeks after weeks.
First time I heard about Lapeyronie's disease was in January 2014. Then I saw 3 urologist between January 2014 and September 2014. They all made the same conclusion: "we can't do anything".
After 1 year, my plaque had turned quite big (10mm diameter I would say; I will not speak here about doctors measurements as I'm not sure to understand what they explained to me). In addition, I had 2 more plaques: a small one (distal, again at septum area, 4mm diameter) plus a medium size one on the top ("standard shape"), provoking a bend (around 30°).
My erections went poor (rigidity problem above plaques areas) and the additional consequence was a significant reduction of the length of my penis . I was really depressed.

Then I heard about this new treatment.
After a discussion with my "preferred" urologist, I decided to contact the doctor who wrote this article. One month after I had my first visit, and I started the treatment November 2014.

This treatment is experimental: it is a mix of PRP and Hyaluronic Acid injections. In addition, you have to take a L-Aginine based nutriment daily.
You start with 4 cessions during 2 month (one every 2 weeks). Two doctors are working together: Dr Sussman is manipulating the echography machine while Dr Virag is injecting the mixture of PRP (from your own blood) +HA. Both are highly skilled and experienced. Their dexterity is remarkable I have to say. This point is really important as my main plaque is "septal" and very difficult to access.
After those cessions, we decided to continue with one cession every month. For personal reasons (nothing to do with the treatment), I had to stop from February to now.

Today I had my 6th cession.
My feed back: from one cession to another one, the results were very variable, but mainly positive: I can remember only one cession (the third?) that didn't brought significant positive results.

I don't want to give people "false hope" as we would say in France. Maybe my case is unique, maybe not. Future will tell us.
What I can say now is: my 2 "additional" plaques have totally disappeared. The original "big" one is still here but is now around 3~4mm thick. Curvature is almost not noticeable to me (it was the quickest result, maybe 2 cessions were enough to get rid of it).
Unfortunately my main problem (erection rigidity) is still here, even if the situation is much better, rigidity hasn't be back as I would like it to be. So I'll continue this treatment.

My feeling is the plaques density has dramatically decreased which is tremendous but the fibrosis is still present. I hope today's injections will give good results.

To conclude I have to say, even if it is not perfect, the results are very good. I feel much better.

Now I'm asking to myself if I should start VED in addition (to force the "full" irrigation of my penis) as some of you are doing in addition with PRP treatment. I'll probably ask Doctors next time.
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james1947

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Thank you for posting Milouzze
Reagding rigidity, did you try it also with some Erectile Dysfunction drug? Like Viagra, Cialis, etc'
Do you know what is the relation between the PRP and the Hyaluronic Acid? I mean % of the mixture?
The original post stated that the trial was made on 13 volunteers. Do you know how many people have done it until now?
Can you tell us the cost of the procedure?

James
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Milouzze

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James,

I'll start Cialis 5mg for a month. I already tried Spedra 100mg (didn't change much the situation: my problem seems to be 100% physical). I'll give you a feedback later.

Sorry I don't have the % of components of the mixture.

I can't say either how many people is trying this new treatment. The program seems to be quite active: each time I meet the doctors, I ask them about the others ones and their results. To sum up, the feed back I have is: "we have encouraging results, but it seems 4 cessions only are not enough". It is just my feeling but I would say the program could represent 10% of their activity. Could be 30-50 patients?

The cost is 350€ per cession. I couldn't say if this price is temporary (just to start the program) or not. 
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james1947

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Thanks for the information Milouzze.
I have asked the question I had 4 sessions of PRP with no help, but if I will know the % of the Hyaluronic Acid and the total volume of the injected I may want to try it here where I am living.

James
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Jack1909

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I'd love to know the combination too. I mean..it was nice if I found some doctor able to perform it in Italy. Nothing against France, but I have been jumping between London and Wien for a long time. I think it's enough.
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incautious

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Milouzze, Since you are seeing some results, If I were you I would use both VED and traction if you have not already. VED twice a day for 10 minuets each and traction twice a day if you can for about 30 minuets each.
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Jack1909

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I'm trying to get in touch with the dr. Virag, but I have been not responded until now. I'm available to start this treatment as soon as possible.
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koolx

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Jack, stay away from doctors in italy. I got a couple of friends who have had VERY bad experiences with stem cell/PRP treatment there. If anything, go with the french. Theyre honest and are more involved in trials.

From my reads and people's experiences with stem cell and PRP treatments, I'd say these following countries have the best track record:

1. Germany
2. France
3. Spain
4. England
5. Mexico
6. Argentina
7. Korea
8. Canada
9. China, Thailand, southeast Asian nations.
10. Russia
11. USA

USA is of course last on the list so I'd be careful of USA also. The stem cell treatments offered aren't really real stem cells, but stromal cells - soup of growth factors and some stem cells passed on and marketed as true stem cells when in reality theyre not.
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yyy

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hope it will work
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Jack1909

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Koolx thank you, unfortunately I experienced on my own body how much miserable is 'my' country.
I'm going to do PRP plus HLA in France soon.

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bonsomi

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Koolx, where in Germany? I am still unable to find prp here. Many people do it, but they refuse to inject my penis....

Regards
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james1947

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Jack

Who will make the PRP + HLA for you in France?

James
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Jack1909

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I'm in contact with dr Virag, the article author.
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james1947

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Thanks Jack
Too far from me to get to him.
The reason I have asked % is that I may give it a try here where I have done the PRP.

James

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Milouzze

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Hi,

Just to let you know the last cession wasn't that good: I can not feel any difference regarding the plaque's dimension. I'm not disappointed anyway: it happened already one time in the past. Maybe the next one will be the good one.

Cialis 5 mg is working fine, maybe it help more than I was expecting: I feel better as I don't have to worry about my erection.

I started VED, it makes a real positive difference, seriously, I will not wait 2 weeks after next time's PRP+HA cession before starting VED (maybe 1 week is enough).

Regarding Dr Virag drug and HA %, I think the best would be to ask him directly. I'll ask. To be honest, I don't know if he wants to disclose this information.
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james1947

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Thanks for the information Milouzze.
You are right regarding:
Quote
.....I don't know if he wants to disclose this information

James
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yyy

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Quote deleted by moderator - James

how many degrees of curvature did you have at the beginning?
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Milouzze

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Hi Yyy,

My first plaque was very central so the curvature wasn't my real concern at the beginning (I was more concerned about the pain during erection and the restriction). After few month other plaques appeared, including one that made a noticable curvature and we decided to start injections for it. I think at its maximum it was around 30-35°. After a unique cession it came back "normal" (less than 10°). This very quick result was probabely due to the quick action.

I still have a light curvature but I don't really care.
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Jack1909

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Tomorrow I'm turning 25, so I've decided to make me a big present: I'll be in Paris to have an injection from Dr. Virag :D
I'll keep you updated.
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james1947

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Please Jack, keep us updated :)
If you can find the % of the HLA will be very grateful  :)
Wish you excellent results :)

James
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Jack1909

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On my way home back from Paris..what I can say, Virag and hus assistant looked very experienced and skillful. The procedure was quite painful, more than i expected..a dorsal injection made me jump..let's see if I have improvements on my diffuse but superficial fibrosis. Virag said it may be very useful.
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james1947

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Keep us updated Jack :)
Hope Dr. Virag is right and the results will be very good. :)

james
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Jack1909

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I'll do it, but I don't know how much my case can be taken as example since my condition is almost unique. From it has been pointed out by an ultrasound properly done, my tunica is 4 times thicker than normal.  Superficial Fibrosis is everywhere and this explains why I can't reach my stretched length when I have an erection (even using cialis high dosage)..it's not just Erectile Dysfunction, in my opinion my tunica has been damaged so much than it has lost its elastic ability to lengthen. I need a new tunica..this is the reality probably.
Anyway I'll have a second shot on the first days of July, and if I don't see improvements, I'll quit. I will not go for Xiaflex, it would be just a waste of money in my condition.
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james1947

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jack

Is Dr. Virag also in the opinion that if the second round will not help no need to try third and fourth?
You made the first round on June 20 and will make the next on the first days of July, it means two weeks.
This is the interval Dr. Virag recommends?
You are now 5 days after the first round. Can see some improvements?

James
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Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe Erectile Dysfunction.
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Jack1909

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Yeah He told me if we don't see any improvement after the second shot, it better quit.
And yes, around two weeks is the right time between shots since the PRP is supposed to stay inside the penis for two weeks.

At the moment I'm not seeing improvements.
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james1947

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Thanks for the answer Jack
Try to ask him what is the % of the mix, maybe will tell you. Who knows?

James
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Re: Stem Cells & Adult stem cell injections for Peyronie's
« Reply #47 on: July 04, 2015, 12:58:01 PM »

James,

Unfortunately, a peyronie's sufferer.
About Dr kuehass, i have read only one publication in wich he participated (with dr Egydio). But Dr Sansalone seems to have participated in much more publications (in peyronie correcting surgery) and he worked with both Dr Egydio and Dr Perovic. So, could Dr Sansalone be a better option than Dr Kuehass. Maybe Dr Kuehass can be better to correct congenital curvature as he seems to have developed the STAGE technique with Dr Egydio. But when it comes to peyronie's disease, Dr Sansalone have done WAY MORE surgeries than Dr Kuehass. Dr Sansalone knows the Egydio technique since many years and he has done it in more patients than Dr Kuehass did. So after Dr egydio, the second surgeon who are more experienced with the Egydio technique seems to be Dr Sansalone. But you can argue that even if a surgeon is more experienced than an other surgeon it not means he does a better job. I just can say that Dr Sansalone has more experience with this technique but does he give better results ? i don't know...

JAMES, i also want to share an other interesting publication about PRP to treat Peyronie's disease. It had been done by french doctors. They did intralesional injection of PRP and Hyaluronic Acid. It's a really promising therapy showing really good results in curvature (in my opinion). I post the link here. The publication is in french but there is an abstract in english (maybe you can also find the entire publication in english). And as i told for the publication on stem cell, this is an INTRAlesional injection. They inject the PRP and HA INSIDE the plaque (and not only around as it was the case for some guys in these forum).


http://www.academie-chirurgie.fr/ememoires/005_2014_13_3_096x100.pdf
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Jack1909

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Re: Re: Stem Cells & Adult stem cell injections for Peyronie's
« Reply #48 on: July 05, 2015, 02:54:23 AM »

We already know the publication and we know Ronald Virag. Thank you anyway.

Dr Kuehhas performs 100/150 peyronie surgeries per year.
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james1947

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Re: Re: Stem Cells & Adult stem cell injections for Peyronie's
« Reply #49 on: July 05, 2015, 04:37:56 AM »

Back to hyaluronic acid (HLA).
Can somebody tell the % of PRP and HLA?
Regarding doctors, I am not arguing who is better.
The only point I have is that on the forum we know Dr. Kuehass, we don't know Dr. Sansalone.
We also don't know how much surgery Dr. Sansalone makes a year.

James
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