PRP & HYALURONIC ACID

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Jack1909

I don't know the percentage of the mix.

On Friday I'll have the second round of my PRP plus HLA injections. It seems I have had a very very little improvement with the firs shot. The fibrotic area (my fibrosis area is very superficial, on the Buck and Dartos..so very noticeable by touching) may be a little less stiff. No improvements on the curvature for the while, but I want to remind you my condition is very peculiar. If I had a plaque, I'm quite sure I'd have had a more effective improvement.

Moreover, I'm in contact with the doctor from the Denmark group that Kuehhas talked me about. They are setting up the clinic and nothing is going to happen before this autumn. Once there, he told me he wants me to be seen by one of his team urologists. Kuehhas told me, without going into detail, the group is leading in the field of stem cells and he feels very positive about their work (they offer penile regeneration, of course).

Thus, I have been starting for one week a ointment as that one it was described by a member somewhere in here, with pentox. Being said that my problems are very superficial, using the right carrier, it could lead me to some unexpected results.

I think I'm a solid contributor :)

31 yrs old
Severe congenital curvature. 3 straightening surgeries
Big lump/stitch w/ left deviation after 2012 surgery
Severe ED after last one in 2014. Still crooked
Slightly improved w/ shockwave therapy
Looks like only one side of my penis works

Jack1909

...and two granulomas popped out where the needle was stuck. Just for completing information.  
31 yrs old
Severe congenital curvature. 3 straightening surgeries
Big lump/stitch w/ left deviation after 2012 surgery
Severe ED after last one in 2014. Still crooked
Slightly improved w/ shockwave therapy
Looks like only one side of my penis works

james1947

You are indeed a solid contributor Jack :)
Still struggling to find out the %.

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

drew67

Quote from: rellisacct on December 12, 2014, 12:19:36 PM
Penis replacement trials are going to begin much sooner than that, but not in America. ...In order to get things moving, the clinical trials will begin in Mexico by Spring 2016 at the latest.

How do you know this?

james1947

Thanks for the link itachi
Unfortunately my French those days not enough for fully understand the PDF.
Maybe someone can translate to English?
If not, maybe someone can find out the the % is mentioned or not?

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

Jack1909

Dr Virag said that from a comparison between the ultrasound before and after the first shot fibrosis has reduced. This I why I'll have another shot in the first days of September..
31 yrs old
Severe congenital curvature. 3 straightening surgeries
Big lump/stitch w/ left deviation after 2012 surgery
Severe ED after last one in 2014. Still crooked
Slightly improved w/ shockwave therapy
Looks like only one side of my penis works

Jack1909

James I don't know the percentage of HLA but from what I saw it seems it has some kind of phials (or test tube) already ready that contain a standard amount of HCLA. Maybe it buys them somewhere.  
31 yrs old
Severe congenital curvature. 3 straightening surgeries
Big lump/stitch w/ left deviation after 2012 surgery
Severe ED after last one in 2014. Still crooked
Slightly improved w/ shockwave therapy
Looks like only one side of my penis works

yyy

Will start the treatment too in September. Virag looks really skilled

James I dont suggest you to reply the mixture elsewhere as you need an expert to inject HLA. It could lead to skin necrosis If bad injected, dont risk.

james1947

Thanks for the advice yyy
The doctor that injected me the PRP is very skilled, she is using HLA, but I will reconsider the subject :)

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

yyy

Ok 1st session finished. No pain, he uses a different approach And goes  into The lump with The help of the ultrasound so he always knows where exactly the needle is. We discovered 2 new spots, this time inside the corpora: they are clearly the result of my xiapex shot, because The "skilled" Salamanca injected The drug inside the corpora. Hope The spots will dissolve with other prp shots. Peace men

james1947

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

yyy

If I get results The everyone will do. My plaque is big and strong as fu.ck. Ill keep u all updated

Dros

Just as a quick side-note for those of you asking for percentages. The treatment protocol is actually described in much detail in the paper itself:

"A chaque séance on prélève dans deux tubes sous vide, 4 ml de sang total dans chacun des tubes. Ceux-ci contiennent en outre 2 ml d'acide hyaluronique en gel, 2 ml d'un gel polyester inactif et filtrant, et 0.6 ml de citrate de sodium à titre d'anticoagulant"

So two tubes, in each tube there is 4ml of blood, 2ml of HAL, 2ml inactive and filtered 'polyester-gel' (whatever that is) and 0.6ml sodium-citrate.

Hope that helps :-)

I'm thinking about visiting Dr. Virag myself, even though it is very expensive...

DrRunels

Hello,

It's been a while since I was on the forum and am honored to see the continued intelligent discussions and sharing of ideas world wide.  If you'll permit me, I'll share a few up dates that relate to the current discussion. I am NOT looking for more patients so please do not think I'm soliciting nor contact me to see me as a patient...I'm here to help provide information to this very useful forum. Hope it's useful, if not just delete me, no hard feelings... :)

First, a little background.  I was the first to inject the penis with PRP and coined the name Priapus Shot® so that I could protect patients by helping them identify doctors who use our methods and agree to use FDA-approved kits for preparing PRP.  One of the FDA approved kits I have used for the procedure is Regen and I shared my ideas with the Regen company.

The Regen® prp company (based in Europe) hired Dr. Virag to extend my ideas with research using a kit that has not yet been approved by the FDA here in the US--where the PRP is activated by an HA filler. The kit is available in Europe. Dr. Virag and I both lectured in Venice Italy 2 years ago and have shared our ideas and research. He's also world renown and brilliant researcher and one of the first to write about injectable vasodilators for the penis. Because he's researching that particular form of PRP, he's keeping the study clean by not introducing another powerful variable (like a pump). If he includes more than one variable, then the positive results become confusing (was it the PRP or was it the pump?).

There's much discussion about what PRP actually is and about which method works best for which technology. Here's one of the recent research papers on the topic to show you how complicated the issue can be.http://www.ncbi.nlm.nih.gov/pubmed/?term=platelet+rich+fibrin+matrix+definition

From the beginning (6 years ago), in my own office, I made a mixture of Juvederm with PRP and injected my own penis.  There may be some increased benefit for growth but I do not think it's as needed for Peyronie's (I'll explain why later). But, the mixture must be done correctly and otherwise there could be some risk of granuloma or necrosis.  I think using the correct mixture, I can do it safely but the problem is that in the US, mixing PRP with Juvederm technically is making a new drug that's not been approved by the FDA so I can't roll this out and treat other people without spending millions for FDA approval.  But, here's the good news with Peyronie's...

The HA adds a scaffold for growth and activation, but is not needed to hold the PRP in place (otherwise, you'd have to inject juvederm to hold the PRP in place to heal from normal surgery or from a simple cut on the hand).  The PRP forms a natural gel--platelet-rich fibrin matrix which holds the PRP in place.  http://www.ncbi.nlm.nih.gov/pubmed/?term=platelet+rich+fibrin+matrix

How to form that matrix (activation with calcium outside the body, activation with and HA --what's in the Regen kit used by Dr. Virag, or activation by collagen in the body (what happens with a normal wound like surgery or a simple cut on the hand)...how to form that matrix is debatable, but in the case of Dr. Virag's study, the main function of the HA is to activate the PRP and form a ready made matrix.  But the matrix may be more useful for healing scars where volume is needed. See this video about a scar I treated.https://vimeo.com/47093322

For now, we don't really know...but here's a summary for now when it comes to Peyronie's disease...(summary posted here)http://priapusshot.com/peyronies/
1. A combination therapy for Peyronie's has been shown in multiple studies to work better than single therapy. (you can see that research on this page)http://priapusshot.com/research/
2. The pump when used with the Priapus Shot®, I originally intended to help hold the material in the penis until PRP turned into platelet rich fibrin matrix.  Over the past 6 years, I've found the pump may not be needed for that purpose but still serves much function to improve results with ED, Peyronie's, and with growth.
3. A pump alone helps many people (see the research page)http://priapusshot.com/research/
4. PRP mixed with HA is not approved by the FDA yet in the US.
5. Dr. Virag is a brilliant researcher who has done amazing work to build on my original ideas and I highly recommend him as a physician but recommend you do the whole protocol here unless you're part of his study where he's watching to see what happens with PRP & HA alone.
6. Other excellent providers can be found on our list. If you're in Europe and want to use one of the kits with PRP mixed with HA, our providers there can use those kits....which I think are excellent.  Other kits can actually provide a higher concentration of platelets...we do not yet know which PRP preparation method works the best.

Thank you for allowing me to comment on this very helpful and intelligently monitored forum.

Very best regards,

Charles

Charles Runels, MD
Inventor of the Priapus Shot® procedure

yyy

The problem is that you need 6+ injections to PROBABLY see some results. Some of us (Europeans) cannot go every 2 weeks in Paris because our jobs don't allow this. Without considering the money you have to spend to go 6 times in Paris and do 6 injections. Wasting 3-4000 euros, with a simple hope it could help, is not something that everyone can afford.
I did 1 injection with no results so I quit for the reasons I mentioned above. I believe only stem cells would possibly help us concretely.
Moreover the risk of necrosis due to HA is really disquienting, because a penile necrosis is the end of everything.

Too many of you only think about how to earn money, no matter if this gives results or if it could create permanent damages. The proof?
Offer the injections for free, in order to help also the "non-rich patients" and to collect a serious amount of data and cases with tangible results, to be published worldwide. Naa, it's Pure utopia, I know it.
I remember you that We are taking all the risks exactly like guinea pigs, spending a fortune, and the best possibilty is that nothing negative will happen. and I'm fed up with all of you.

kuaka

While this is not a "new" condition, it seems to have grown as far as % of men affected by it.  At least I would hope that it is not simply a matter of more discussion of the issue.  If indeed the % has increased, then an epidemiological examination is in order.  Epidemiology is basically population changes which take, in the case of humans, years to manifest the results.  Perhaps we have reached a threshold of Magnesium deficiency in combination with an increase in aberrant sexual behavior.  The latter in an effort to become more "accepting" of "lifestyle" choices.  The former due to the accumulated effects of modern farming techniques and the continued departure from "natural" food sources.  Magnesium is best obtained through the consumption of nutritious green vegetables...and who eats enough of those?

At any rate, my personal opinion is that we should look first to metabolic deficiencies, THEN at "medications".

Freemason

Thanks so much Dr Runelsfor your feedback and efforts! This disease cam be psychologically devastating.  Have you thought about a mixture of Superoxide Disumtase, PRP, and HA?

Dros

I have an appointment with Dr. Virag on January 11th, and I'm planning on doing at least 4 sessions if the first session isn't a complete failure. I hope this will give those of you interested in the treatment some new information. For those interested in my background: 30th birthday present - Peyronies Society Forums

Let me know if you have any specific questions for Dr. Virag :-)

james1947

Hi Dr. Runels

Happy to see you still around.
I was a very big fun of the PRP shots, unfortunately it didn't helped me and almost no one on the forum.
I even considered a few new round of PRP with HA, but nobody knows the % of PRP and HA except I suppose Dr. Virag and to fly to France from where I am living is $1500 at least, ticket only.

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

Dros

James, read my comment below, the % of HLA is actually mentioned in the paper :-)

james1947

Thank you for the tip Dros, unfortunately I didn't find the %.
The links on Dr Runel post not mentioning HA and %.
Can you give me a better connection?

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

james1947

Thanks Dros

The content of the two tubes will be injected as two separate injections at the same time?
If yes, why the separate tubes?
How many injections in how many places?
I don't understand also the inactive and filtered 'polyester-gel' as polyester I am using in boats building and it is used also in cloths fabrication.
Sorry Dros for my many many questions, I just don't understand and would like to know as I can make the treatment quiet cheep here.

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

yyy

from what I remember the substances are mixed in a machine and injected together, so the tubes are not separated when ready to be injected

Dros

Ok, James, here is the protocol from the study, translated with the help of google translate (I tried to correct obvious mistakes, but my french skills are quite basic):

"The treatment consists of repeated injection (four for two months) from 4 to 8 ml of PRP + HLA (Regenlab ® kit ready for use) in the plaques previously identified and measured on ultrasound. In each session, two vacuum tubes are used with 4 ml of whole blood in each tube. Both tubes contain further 2 ml of hyaluronic acid gel, 2 ml of an inactive filter and polyester gel, and 0.6 ml of sodium citrate as an anticoagulant. After blood collection tubes are immediately centrifuged for five minutes at a force (RCF) of 1500 g. After centrifugation, in the sealed tube, the whole blood is fractionated: red blood cells are trapped in the gel, whereas the cellular components contained in the serum are deposited on the surface thereof. HLA is above the serum (Fig. 4). A slow and repeated inversion of the tubes is necessary to homogenize the preparation. During these preparations, a regional anesthesia is practiced by penile block with pure lidocaine (10mg / ml). Injections into the patient albuginea are then performed under ultrasound (Fig. 5 and 6) When the plaque is thick (> or = 3 mm) and very fibrous 18G needles are used with which the plaque is dilacerated before injecting . For less dense plaques and especially ventral or septal locations 25G needles are preferred. The same protocol will be repeated every two weeks for two months. An initial check is performed one month after the last injection, then three months, six months and annually."

no word on why they use two tubes, but I can ask next Monday when I have my first session.

skunkworks

Quote from: DrRunels on December 30, 2015, 10:40:56 AM
Hello,

Charles Runels, MD
Inventor of the Priapus Shot® procedure

Hi Dr Runels, some questions re points from a previous discussion on this forum with yourself:

Quote from: DrRunels on May 15, 2015, 11:07:06 AMThe studies everyone is looking for are being done; so, I tried to encourage by letting the group know what research is being done and gave the name of one physician (of 3 different urology groups) that is doing those studies.

Have any of those studies been completed yet and if so are the results available?

Also, do you have case studies of successful Peyronie's treatment from your procedure, and if so did any of the patients have Doppler Ultrasound testing (before and after) the procedure? If not, would you consider creating such a case study when opportunity presents?
This is an emotionally destructive condition, we all have it, let's be nice to each other.

Review of current treatment options by Levine and Sherer]

james1947

Dros

Thank you for your effort :)
Will be happy if you ask Dr. Virag why 2*4 ml andnot 8 ml
From what I read, I understandthat the mixing is before extracting PRP from the blood. It is correct?
My English is not something of a high level. :(

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

Dros

I had my first appointment with Dr. Virag yesterday. First of all, I have to say that he - as well as Dr. Sussman - seem to be very competent and professional. For those of you who are not aware, Dr. Virag is actually quite famous as an urologist (see: https://en.wikipedia.org/wiki/Ronald_Virag), so that (to me) makes the treatment more credible. He is also quite easy to talk to and he seems to take an interest in his patients, something that can't be said for many doctors. I brought along a memory stick with pictures (which I might share on this forum once (or if) I improve my curvature) showing my deformity, which was a 45 degree curve to the left when I took the pictures. Since then my curvature actually got worse and is at 60 degrees at the moment (even though I started taking Pentox one month ago). Dr. Virag seemed very sursprised that my curvature was this bad, especially at my age (30). This didn't help my nervousness...

After the survey I went to the other room where Dr. Sussman did the ultrasound. For the first 10 minutes, she actually did not find anything and was beginning to wonder if I had any plaque at all. She called in Dr. Virag and the two tried to find out what was going on together. To find out where to look they actually induced an erection, which meant a first injection already. They finally found the 'plaque' (if you can even call it that) and Dr. Virag was even more surprised, that the small amount of plaque was enough to give me such a bad curvature. After discussing my history some more and after I told him about a popping noise during sex before my Peyronie's started, he was actually convinced that I had a partial rupture of the tunica albuginea. What sounded bad to me seems to actually be very good news: Since my plaque is very soft and neither calcified nor very fibrous, and since only my tunica albuginea is affected and not my corpora cavernosa, he actually thinks that I'm the perfect candidate for the PRP treatment, which is very good news indeed. He wouldn't promise me anything (as no good doctor should), but he said that I should be able to achieve good results during the treatment (4-6 sessions). The PRP should - in his opinion - be able to heal the scar tissue. We will see. I talked a bit about the possibility of Xiaflex as well, and he was actually *very* confident, that his treatment is better than Xiaflex, since it is actually regenerative and doesn't just destroy the plaque. I'm not sure what to make of this, as many members reported good results with Xiaflex. My guess is that it really depends on the specific case, as (and he agreed on that) every case is different and bad scarring might no more be treatable with PRP.

After they marked the location of my plaque they drew blood from me and prepared the serum. James, I was able to ask Dr. Virag why they use two tubes, and the answer is really simple. The HLA kit they use (from RegenLab, I think it is this one: http://www.regenlab.com/PRP-HA-CellularMatrix) is sold in tubes already, and the tubes are not large enough for 8ml of blood. That's the only reason, and since they inject 8ml of PRP they have to use two tubes. I asked him about the use of hyaluronic acid and he confirmed that it is mainly to keep the PRP in place (he was very confident that PRP alone would not be a good treatment because the PRP wouldn't stay put long enough, but I didn't ask him if a vaccuum pump could also do that job). I didn't ask him about the possibility of skin necrosis (I'm not sure I would want to know), but he told me that he didn't have any serious side effects in over 100 patients. If that's true then that's very, very impressive.

They added the blood to the tubes and started the centrifuge. After 5 minutes, everything was ready for the injections. First, I was given two shots for local anesthesia, after that Dr. Virag started to inject the PRP/HLA mixture. Dr. Virag told me that it is very important that Dr. Sussman used the ultrasound to show him where the needle goes, so that he was able to inject the serum exactly at the right place. He thought it to be really careless that doctors who use Xiaflex don't use ultrasound, as injecting the wrong spot can have very serious side effects with Xiaflex. The injections itself where somewhat painful, but not as bad as I expected. I really do think that it is extremely important to have the right person do injections on your penis. As I understand, Dr. Virag was actually the first doctor to use injections for ED and he has literally done thousands of injections in the last 30 years, so that definitely helps. One day after the injections I have to say that I have no pain and no swelling, which is amazing to me.

On a side note. I read on here that the Priapus shot is administered at different locations of the penis and people had a very 'full' penis afterwards. My injections were very different, as they were ONLY administered to the plaque itself and the surrounding area. So, in my case, only to the middle of the left side. As the HLA is supposed to keep the PRP in place I'm not sure if there is any PRP in the rest of my penis... As the rest of my penis is fine, I don't really care, but I thought that I mention it nonetheless.

To sum it up, as of yet I don't know if the shots had any positive effect. I have my next appointment in two weeks and Dr. Virag told me that I shouldn't expect any results before that. If I do notice anything, I will let you know though. All I can say is that I have a much more hopeful outlook on my Peyronie's (at least for now) and I feel like there is actually a silver lining... let's hope that I won't get disappointed. With my curve, sex seems to be out of the question for the time being...

yyy

thanks for keeping us updated. Dr Virag is a competent urologist, you are in good hands

krazylord

Hi Dros,

Thanks for your detailed and explanatory post. It is great to hear and I really hope that it works for you. Please, keep us posted on your results.


james1947

Thank you for the details Dros
I am sure your post is very helpful for many of us

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

Dros

A short update: After 4 days, I don't see any improvements yet. Still hopeful though :-)

yyy


Dros

yes, that's what he told me. I'm just surprised that there are some people in the PRP trial who claim that they had results in the first 24 hours...

yyy


skunkworks

So he estimates 4-6 sessions for you to see considerable improvement, how long between sessions?

Did he give you an overall estimate of how long the whole course of treatment would take?
This is an emotionally destructive condition, we all have it, let's be nice to each other.

Review of current treatment options by Levine and Sherer]

yyy


skunkworks

So between 8 and 18 weeks for the full treatment course?
This is an emotionally destructive condition, we all have it, let's be nice to each other.

Review of current treatment options by Levine and Sherer]

Dros

four sessions, two weeks apart, and then two more sessions, one month apart.

X - 2 - X - 2 - X - 2 - X - 4 - X - 4 - X

14 weeks...

When the paper was published, they actually only did the first four (and for financial reasons I might do the same). That would mean 6 weeks in total :-)

Dros

Had my second session yesterday. So far, there has been no improvement. Dr. Sussman told me that most people notice improvements after the third shot (statistically speaking). Considering the price, it kind of sucks to do a treatment that might not help, but I will at least do the third shot before I consider stopping the treatment. Will keep you updated.

james1947

Thanks Dros for the update.
As a veteran of PRP injections, waiting to see your results.
If they are positive, I will try to see if my PRP doctor can inject me with this compound :)
Wish you good results :)

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

Dros

So, I had the third session on Monday. So far, my condition has not improved, unfortunately... still a 60 degree curve. According to the Doppler ultrasound, my fibrosis has decreased in thickness though, from 3.4mm to 2.8... Dr. Sussman and Dr. Virag think that the curve will not improve while the fibrotic area is thicker than 2.5mm... So all I can do is hope for the best and continue the treatment I guess... even though my money is running out fast :(

To those that have seen improvements with PRP, could you elaborate on how quickly you noticed the results?

james1947

Thanks for posting Dros
Wish you will start having results.


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

NeoV

Those two doctor's seem pretty good. It's interesting to see them seem so confident that the PRP could straighten you out and get rid of the scar tissue. My PRP shots definitely made it straighter during those few weeks it was in my penis. Other than that I have no idea what it did, but I am better off than I was for sure. In fact, my erections are really really good these days, to the point where my wife comments that it got longer and bigger than before.

When I had the PRP in my penis, I got myself as hard as possible several time a day and even used VED a bit. My penis was much bigger and the erections from all the fluid seemed to stretch out the scar tissue. I only did one round though : (

I think it's a good thing to do and mostly harmless. But there is no real consensus and no real studies that I know of that demonstrate it's effectiveness.

yyy

mine is 4 mm, worse than yours.

Did you see any other improvements like better morning wood, better erections or increase in length?

Dros

yes, I have seen some improvements like better erection quality, a more natural flaccid hang, and I also believe that my curvature has somewhat improved when not fully erect...

BUT I'm not sure what is responsible for those changes. I have been taking Pentox, L-Arginine, ALCAR, low dose Cialis and Q10 daily and have also continued with traction (2-3 hours daily, continued a couple days after each session) and VED (started one week after each session)... the PRP might have contributed, but I guess the erection quality is mostly due to the supplements...

Dros

So I compared pictures of my penis in Photoshop and I can say that my curvature definitely hasn't improved. This condition really starts to eat at me, especially since I'm ready to move on from my last relationship. I have my 4th session with Dr. Virag next Tuesday, and I'm very curious whether he thinks that this treatment might yet be beneficial for me...

yyy

ask him to show you clearly the improvement of the fibrosis comparing the ultrasounds.

lespleen

Presumably your fibrosis has decreased in thickness from  3.4mm to 2.8. This is as clear an indication as any. And according to Virag, no visible alteration will occur so long as the plaque is < 2.5. So why are you worried about before and after pics? If the decrease from  3.4mm to 2.8 is attributable to prp,  you're clearly on the right track. Ideally, you would stop the other treatment modalities for a time in order to fully assess the effectiveness of prp? It is conceivable , however unlikely, that the period during which you're receiving the prp therapy coincides with a period during which the  other supplements/medications have begun to make a difference? Or that the prp enables the  supplements/medications to act more effectively... in which case the prp is still doing the heavy lifting. If  prp is really the difference maker here, seems like you would want to be at least  85% sure so that you can continue to allocate resources toward this end ... and not give up on the heels of a breakthrough.

Dros

Thanks lespleen. I actually just came home from my 4th session. The fibrosis has not improved between the 3rd and 4th session and is still at 2.8mm. I asked Dr. Virag whether I should continue with the treatment and explained to him that money is a big issue and I would rather know now whether I have to save up for another treatment. He told me that it was indeed strange that I did not see any improvements yet and that most people with conditions such as mine see results faster (he told me: "when it doesn't work, usually we know why, but with you I don't know. you should be much better considering the small amount of fibrosis you have"). We agreed to wait three more weeks, after which I send him an up-to-date image of my dick. If there is still no improvement I will look at Xiaflex. If I see at least *some* improvements however, he would advise me to continue as that would mean that we are on the right track.

I will not use the VED for the next three weeks (he advised against it) and just use traction (and warming pads, as it seemed to work for some on here and I read that heat might activate PRP even more). What I found quite interesting is that he actually advised me to use manual traction while fully erect (pushing against the curve). I know that this is not encouraged here and I asked him if that wasn't dangerous. He seems to believe that it isn't (though I don't know if that is a general statement or just regarding my condition + PRP). So I will do that and use more force with traction...

Lucketts



I imagine that pushing (not stretching) against the curve would be fine.  The protocol after a xiaflex injection is that if you have a nonsexual erection, then one time a day or night,  you can gently bend against the curve.