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Author Topic: 1-week post-nesbit operation for congenital penile curvature and penile rotation  (Read 7884 times)

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WilliamJames94

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Hi all

I am a 20 year old student living in the UK. I was diagnosed by my GP and an Honorary Consultant Urologist with the following:

"50 - 60 degree lateral curvature of the penis and some clockwise rotation (which I perceive to be between 85 - 95 degrees, imagine instead of 12.00 o'clock my penis is rotated to 15.30pm)

So if you can imagine a curvature of 50+ degrees with the addition of an on average 90 degree rotation this has caused my penis to curve downwards with the bottom half of the penis shaft almost completely facing left. It looked just as curved as a banana. I wish I could show a picture but not so sure I am allowed such graphic images on this post. I have never had sex and to be honest I never planned to until the deformed nature of my penis was fixed.

I accepted counsel from my GP and Urologist and was proposed the nesbit procedure to fix the curvature and a possible suspensory ligament repair/division (which as far as I am aware did occur in the operation) to allow de-rotation of the penis. I was told on the day of the surgery that the suspensory ligament division may mean that my erections may be slightly limp for the rest of my life, but I didn't really have time to contemplate anymore as my surgery was in an hour and if was going to do this I had to do it that day, already being mentally prepared and all.

I will spare all the details pre-operation as they don't really add value. But I was the first patient in the operating room that day and went in at 9am and did not wake up in recovery until 13.40pm. My surgery was quite longer than your average nesbit procedures, possibly due to the additional suspensory ligament repair/devision and the fact I had two leading consultants performing my surgery who used my operation as a good - but very slow - teaching opportunity, which I don't mind, but is possibly the reason why my surgery took 3-4 hours (normal time would have been around an hour) and possibly why I ended up staying overnight.

Moving on, I woke up in recovery around 13.40pm with a very tight pressure bandage wrapped around my entire penis shaft only leaving space for my urethra. I had no pain immediately after surgery but I felt extreme pressure in my bladder to urinate - but due to the swollen nature of my penis and the tight bandage and couldn't urinate for about 20 minutes after which point I was urinating about every 15 minutes, which increased to every hour once I left recovery and almost every 2-3hours for the entire 5 days once I was home prior to the bandage removal. I reckon it was due to the amount of time I was under anaesthesia being pumped with fluids and the pressure of the bandage backing me up. 

Immediately after surgery I was completely numb at the exposed tip/head of my penis. I could not feel anything when I touched it and when I urinated I was urinating by placing pressure on the bladder and was only sure I was urinating by the sound of the urine hitting the bottom of the brown bottles they were providing me to urinate in. The numbness began to pass hours later and I began to feel better and more secure that the operation had possibly gone well, even though the nurse already told me it had when I woke in recovery.

That night I stayed in the hospital sleeping at intervals as I had to pee several times. The brown bottles were very useful, meaning I did not have to get up and use the toilet. I began to feel some pain that night and was given pain killers (tramadol and co-codamol) which helped for pain, but in the short-term made me very nauseous and in the long-term had me constipated for about 6 days. So I would recommend that if anyone ever does this surgery and the pain is not too bad to handle just stick to ibuprofen and paracetamol.


The next day I was due to be discharged. In my morning rounds when a different consultant Urologist came to see me I was told I had to keep the penis elevated (with pads and stretchy boxers) and that the surgeon had said that I had to keep the bandage on for a week - when I had initially been told 24-48 hours. 


This bandage was probably the worst part of the entire process. If my penis had stayed swollen for the recurring 6 days it would have been fine as the tip of the penis would be at the top of the bandage allowing a straight stream whenever I urinated. But the opposite obviously occurred.  As I began to lose swelling my penis became tucked further and further into the bandage and each time I urinated (which was several times a day remember) the urine would spray all over the top end of the bandage - (I forgot to say the doctor in to undo had asked me to keep it dry...HOW?) - and I would have to dry it with tissue each time. A lot of household toilet paper was used in the 5 days that I managed to bare with this bandage.

By day 4 the bandage would cease to dry as I would dab it with toilet paper and it was now always wet and cold; my penis swelling was going down a lot - which was good but - causing the spraying urine to seap to the incision site creating a burning sensation; I could smell the wet urine when I was in my bed; and to top it all off the antibiotics (clindamycin), pain killers (cocodamol) and hormone related anti-erecting (cyproterone acetate) tablets were making me awfully nauseous and giving me a horrible metallic taste in my mouth.

I had enough on the bandage, so I scheduled to have a specialist nurse in the clinic remove the bandage on day 5 post-op. As for all the medications, I stopped taking the anti-erecting pills and cocodamol pain killers and today I feel so much better for it. I'd rather take paracetamol,  ibuprofen and anadin extra - which are not as effective but don't make you feel ill. Also Id rather have a few painful erections than feel as ill as I was. I'm not trying to put anyone off these medications because at the end of the day everyone's body reacts differently to different drugs so do what feels right for you. Obviously I had to finish the course of antibiotics as that is essential and bad not to finish a course otherwise.

So I went to the clinic on day 5 (2 days ago) and I think this was possibly the happiest day of my life. I didn't care about anything I just wanted the disgusting bandage off. The nurse's removed the bandage and I had finally seen my penis for the first time after the operation. I was previously circumcised before the operation so it surprised me when after the operation I appeared to have a bit of a foreskin. It's not really a foreskin, just where the incision had been made and rollsd up in the bandage... I think. She said I need to be pulling that part down and cleaning inside that area. I am sure as the swelling goes down further I will have a flat circumcised penis shaft again.

The penis was flaccid upon removal of the bandage and appeared as though some of the rotation (about half, so it is 45 degrees now while flaccid) had been cured. The nurse said the incision was healing well and I could finally shower - Yes just so everyone is aware I hadn't showered for 5 days after surgery to prevent the bandage falling off, be prepared to flannel wipe. I was to wash and allow water to roll over the penis and gently clean the closed off foreskin-look-alike area. As for the curvature I could not tell as I was not erect - my penis has always been straight when flaccid - and I didn't want to be for fear of disappoint and mostly pain. 

I did ask the nurse why I had to where the bandage for a week and how they could ask me not to get it wet. She told me that the surgeon had recommended it as my penis would be very bruised and that it will preserve as much length as possible. I have since measured and I am 12cm whereas I was 13cm before so I guess it worked. But I am still slightly swollen and might take some more loss, I will have to wait and see. The nurse told me the urine in the bandage will not cause an infection because urine is sterile. 

I was told I still have to keep the penis elevated and padded for another 6 days - So that means I can finally leave my penis to hang on Tuesday morning and hopefully return to work.

I had never really felt any pain from the penis shaft or incision sight until the bandage was removed. The majority of the pain I felt with the bandage on was in the pubic region of my groin, the base of my penis (where I believe stitches have been placed) and the scrotum had some swelling. In the past two days since the bandage has been removed the incision sight will suddenly shock me with a burning sensation in the middle of the night and the penis shaft if sore and heavy from where it has been degloved. The stitches too bother me every now and then pricking my skin but hopefully they will dissolve soon. I am not sure if you are allowed to do this but I put vasiline on my incision sight to prevent infection and keeping my wound moist. It was burning too much so I felt like I had to as water may dissolve the stitches, but vaseline may do so too... I don't know.

So that is my experience with the nesbit operation and my road to recovery so far. I would have written sooner and therefore written less and kept everyone updated day by day but I was so ill and out of it from the drug cocktails that it would not have been possible. I know this is a lengthy post but I hope some of you can take the time to read it and take note from my experience and use this information to prepare yourself or help you benefit with your own experiences. 

If anyone has any questions you would like to ask me go ahead and reply to this post. I have also allowed my email to be seen so anyone can contact me privately. I too also have some questions and would be very grateful to anyone who may be able to answer any of the following:

1. Should my penis still look curved/rotated (in my case) while flaccid after correction? When I had an appointment with my Urologist he had said that would be the case but I am still seeking second opinions. I have had semi-erections at night but I never allowed them to go too far to check the state of the erect penis due to the pain. 

2. Very small sections of the incision site seem to be opening up and I can seen whitish yellow fluid in them. Will these close naturally and is the fluid anything to be worried about?

3. I have sensation on the back/under part of the penis shaft, the head of the penis and scrotum. I have much less sensation of the left side of the penile shaft and little to no sensation anywhere else on the shaft. Is this something to be worried about? As I am unaware if there were any sensations in these regions in the first place.

Thank you for any responses received and I will do my best to answer any questions directed at me ASAP! 

I will update all on my situation on Monday after I no longer have to elevate the penis.


Regards,


William James

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Knight

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Excellent, detailed post! I'm sorry I cannot answer any of your questions but thank you for sharing and know that there is at least one stranger 1/2 a world away pulling for you.

May you experience a fast and complete recovery!
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WilliamJames94

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Hi Knight

No problem if you couldn't answer my questions - I'll use those to bombard my urologist - because the real aim of my post was the hope my story might help someone else with their own.

Thank you for taking the time to read my post and commenting! I really appreciate the support.
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Stevew87

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Did they offer you STAGE surgery? I don't mean to spam this forum with STAGE technique propaganda but it seems to be superior to nesbit. I mean i'm not sure if they would offer the correction to your tilted penis. By the way do you mean if you look into the mirror like your left or right side is further up then the other? So  it rotates to 3pm... so your penis is basically sideways? Also is that natural or due to some kind of injury or masturbation?
Good luck with your recovery!
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WilliamJames94

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Hi Stevew87

I was never offered STAGE procedure. And with all my research prior to my surgery I had never heard of it to even be able to ask my urologist at our initial appointment. My urologist had mentioned the LUE procedure, but made clear that for me my best bet would be the NESBIT procedure.

But so be it, even if it was a better option, I have been under the knife now and do not plan to do so again anytime soon or ever if it is my own choice.

Yes you are correct. Before the surgery if I was to stand sideways looking in a mirror my penis was as you correctly said "basically sideways". This occurring while flaccid and made worse by erection.

According to my GP and Urologist I had congenital penile curvature so it's is apparently a naturally occurring curvature. I assume there was no injury to my penis or curvature being due to masturbation as the surgeons would probably have found plaque/scar tissue while operating and would probably have told me afterwards.

Thanks you for your comment.
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Stevew87

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That must be so rare though? Like your penis twisting? Well the surgery went well that's all that matters! I'm going to see a urologist from the NHS in about a week i'm guessing they will offer me nesbit too. Luckily i have done some research so i can talk to them about STAGE... they seem to be quite stubborn i was discussing other methods of treating my severe phimosis but they almost started laughing as i was anxious and they said the only way to correct it, if creams didn't work is circmcision...
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WilliamJames94

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Stevew87

It must be rare as I have seen nothing on the Internet about penile rotation. In all the forums I look at I see individuals only talking about penile curvature.

When you do see your urologist and bring up the STAGE procedure please do feedback on what they advise for you. I assume because you said only 2 doctors do it that you are either going to see one of them or your urologist will refer you back to one of them.

Good luck with your appointment and keep us updated.

P.s. Regarding you phimosis, most likely in any procedure to fix your curvature - as most involve degloving the penis - they will recommend a circumcision and also tell you that they may have had to circumcise you to carry out the operation effectively.
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james1947

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Stevew87

Quote
It must be rare as I have seen nothing on the Internet about penile rotation
You didn't invest enough time to read the posts on the forum

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

Stevew87

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Sorry i was on a different forum before and spent alot of time reading threw many posts. I haven't done the same on this one although on the one before i never heard of penis rotation although some people did mention their penis being twisted. Then again that wasn't a forum based on pure congential curves so. Yeah i will check out some more posts on this forum then!
Steve
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james1947

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Myself had the penis rotated at around 45 degree.
The VED corrected that by eliminating hourglasses.
I also think that when people says twisted, they mean rotated. I can understand the difference.

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

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hope you will get excellent results, you deserve it.

Btw every surgeon suggests the Nesbit technique because it's much easier to be performed and the only "known technique" with a good % of rate success, NOT because it's the best.

I would say 90% of the most famous urologists does not know the STAGE technique existence either.
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Stevew87

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That makes sense because only 1 person does it in the UK and like 1 other person in the world. I'm glad i found out about it otherwise i will have only had nesbit for an option. The fact that it can't cause Erectile Dysfunction and other possible health issues should make it more noticed? I mean why don't more surgeons try and learn it? The fact that it gives safer and better results yet no one seems to know about it...
Anyways hopefully i can get it!
Oh ok James i understand now. When people said twisted i was thinking like their penis curved at the base one way then almost changed or something.
I contacted the people at STAGE and they said that jelqing can cause long term complications so... i mean it's given me a big ass vein along my shaft and 2 small dimples on my penis. But in all fairness i didn't even warm up properly but still i think the surgery is safer then jelqing.
I think a downwards curve is by fair the worse i mean the only thing you can really do is doggy... apparently alot of girls find that painful too.. also my penis at the base is 5.9 girth 2 inches wide.... i mean that will hurt combined with a 35 degree curve...
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james1947

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I have posted already my opinion on jelqing.
We have a few members that they Peyronies started with jelqing.

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

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Following my surgeon, Jelquing is not godd at all, while extenders and VED help a lot if used with caution.

He said that a combination of everyday use of cialis 5mg + VED 15min can reduce fibrosis and restore 1-3cm after one year
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Stevew87

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After seeing the James's attachments which showed a bent and curved penis. I'm defintley curves it goes down by in a smooth curve. With surgery you need a circumcision i think hopefully they will give me a loose one... need on anyways severe phimosis. Is foreskin restoration possible guys? I've heard quite a bit about it.
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yyy

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Dr Kuehhas tols me that it's possible to keep your foreskin, but if you have phimosis I don't think it's a good idea. By removing it you will get rid of another big issue, believe me.
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Stevew87

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Yeah i'm hoping to get a loose circumcision because my foreskin is severely tight... like less than 1cm in diameter. You said if it's not peyronies and if you can have good sex leave it. Well thing is 30 degrees - 35 downwards and a bit to the left is pretty bad... even if sex was good i'd still worry about future relationships and i feel that it will limit me in sex positions. Isn't STAGE surgery safe though? I mean no Erectile Dysfunction... loose very little... it will probably look bigger after to be honest. Also as mine isn't severe the surgery should hopefully be safer?
Did he mention how much you loose in size like depending on your curve i heard it was 1mm per 10 degrees.
Thanks for the help yyy!
Steve
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yyy

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you can do it if dr Kuehhas will say yes. It is a safe surgery, but It will not look longer, maybe tighter. You should lose about 3mm for every 30 degrees. Do an assessment with him as soon as possible, he will tell you what's the best option.
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Dadoone

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Hi William James,

I've read throw your post and it's related and/or similar to me... I'm now 6 days post-op and it seems everything is working.

Back a year ago when I went to my surgeon/ urologist and explained how bad it was to have intercourse, so he measured it and it was 45 degrees downwards and 15 degrees to the left and as we know I had Nesbit procedure. My curvature wasn't congenital curvature as my urologist/surgeon said because I explained to him that when I was little I had quite bad injuries, I was at elementary school and basically I was walking on top of a border I slipped with my left left, and obviously hit with the left part of my urotha I think that is the reason that mi penis is rotated at 11:00 o'clock and curved to the left, and caused me swell penis and lots of liquids come out from it, went to hospital (in Italy) at 7 years old all the doctor did was gloves on and sticked his finger  with some sort of cream to reduce the inflammation liquids and etc... they did not go throw and inspect it well enough to see what was going on, (by saying that I've never had problems with my urotha). However my downward bent as I always complained to my parents about my curvature my mom told me that when I was little and I had my panties she'd always put it facing down because of me that when I'd wee it'd go everywhere and so my mum decided to put it downwards and I think by doing that I think it might of cause as we call it peyronie...

I have a few question as I've been throw surgery and out by now...

On the day of discharged from hospital the doctor or the assistant because my surgeon wasn't there said to me everything went well bla bla bla... and I said about my degrees of curvature he said downwards curvature is gone now is completely straight and but for the left curvature he said 5 degrees is left off but didn't ask the reason... I'm a bit worried about it, would that effect later on and would it become the same as before? I've tried to watch some porn to see how it looks abit of painful when erected, obviously wasn't fully erected because of been 5 days post-op my surgery... brushing is gone already as well... and when do you guys think I will get a full erection? When will my stitches come off? I'm still not able to pull my skin down ...

PS: sorry for my bad spelling a grammar I will edit my post if I see something wrong on it and maybe try to explain better my story as I'm new to the forum! 19th of September  (week5) I'm going to see my surgeon to see how is going and ask him as much questions as I can and will report and update this post or either write a new one with a better story.
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