Experience with 16-dot plication

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WestCoast

Hello, all. This board has been a tremendous resource for me, so now that I can contribute to discussion, it's my pleasure to do so. (My apologies if this belongs in the surgery forum instead.)

I'm in my mid-20s with congenital curvature, and have a 16-dot plication procedure scheduled for tomorrow with Dr. Tom Lue. I'll keep a running journal of my experience and recovery here. The months of research and waiting for availability have been a bit emotionally draining, so I am deeply relieved to be within 24 hours of addressing this (once and for all, I hope). I'm uncircumcised and wish to remain that way, so I've chosen a longitudinal incision. Some quick background and baselines for comparisons as I recover:

Curvature: Ventral, in the ballpark of 55 degrees. The bend is about halfway down the shaft, and it's fairly abrupt, as opposed to a long, gradual arc. Glanular hypospadias as well, but it's so mild that there are no functional issues (the meatus is basically a slit rather than a hole, as it were). The corpus spongiosum is a bit constricted around the center of the curvature, too. I bet spongiosal/urethral underdevelopment contributed to the curvature, but Dr. Lue reassured me that since I can urinate just fine, disproportionate growth is the main cause. He'll leave well enough alone and simply do plication, which is fine by me.

Stretched length: About 6.25"-6.5", depending on how hard I pull ;) A little lost length isn't a concern, but a lot of guys seem (quite reasonably) concerned, so for whatever it's worth, I'll check this later on, once fully healed.

Erection quality: Rigidity seems adequate, but since I'm not sexually active right now, take this with a grain of salt. Nocturnal erections on a regular basis, and sometimes spontaneous diurnal erections as well. Theoretically, nothing should really change; however, I recall one paper (don't remember which, unfortunately) reporting erection quality improvements in something like 24% of the Essed-Schroeder technique patients they evaluated, so this seems worth noting anyhow. Perhaps getting rid of the bend occasionally allow fuller expansion and thus better rigidity, but that's just a guess, of course.

Concerns: Nothing major. The risk of persistent pain is a little worrisome, but it's apparently less likely for young patients, and the sutures could be removed if absolutely necessary, so I'm not terribly worried. Recurrence of the curvature seems highly unlikely, since it's a congenital case, of course, and apparently the dorsal aspect of the tunica is the thickest, so the sutures should hold well. Finally, with the longitudinal incision, significant loss of sensation is really unlikely.

Recovery plans: I'll follow the recommended aftercare to the letter. And in any case, I do not smoke or use drugs, drink moderately and without binges, exercise a lot, and consume a fruit- and vegetable-heavy diet, and keep up with vitamin and other supplements. I'll emphasize juicing and little to no alcohol and caffeine for the next few weeks; maybe this 'clean living' helps, maybe not, but it surely doesn't hurt. I'll also make note of anything that seems to help with the scar.

That's about it for now, but I'll update this thread whenever I've got something worth sharing.

james1947

WestCoast

Thank you for the post and keep updating us.
Wish you excellent outcome and fast recovery.
What is the Essed-Schroeder technique? Can you explain it in a few words?

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 again WestCoast.
A lot of information. :)

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

WestCoast

Day 0:

My procedure ended about three hours ago, so I'm icing myself back at my hotel, and grateful to report that everything went as planned (to my knowledge). Extremely swollen around the base of the penis, since I think he placed the incision pretty proximally and probably pulled the tissue down even further for sutures. Negligible pain, but might just be numb still. Hard to say with all the dressing. Hoping to avoid the hydrocodone, but we'll see.

I requested local anaesthetic and no sedation, so I was fully awake for the two hours from prep to operation to clean-up/dressing. I'd guess the surgery itself took about an hour. The injection to cause an erection was not painful, and the anaesthetic (which came next) was bearable. One numbing shot in the foreskin (or so it felt) stung like crazy...but was over in just a second. Occasional discomfort during the procedure, but of course they added more anaesthetic whenever I felt more than just pressure. Only the most proximal pair of stitches was significantly uncomfortable (he said they were the deepest), but they took only a second or two each. I don't have the world's highest pain tolerance, and frankly two hours awake in the OR is not enjoyable(!), but I would still recommend all that over the wooziness, upset stomach, and whatnot after sedation.

Should have a good update after tomorrow morning's post-op appointment, but for now, time to kick back and rest.

Cheers.

james1947

WestCoast

Keep updating us, wish you excellent outcome and fast recovery.

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

WestCoast

Day 1:

Just returned from my post-op appointment. The doctor confirmed everything looks good, and all the rather ghastly looking swelling/bruising around the base is normal and should go away in roughly a week. Almost no bruising on the shaft, though. The incision is also covered with some sort of super-glue, so showering and even working out are already permitted (although I won't push my luck with the latter).

Pain: Basically no pain during the day, with half the suggested dose of hydrocodone. However, the slightest hint of an erection last night was pretty painful, as expected, so I slept very briefly and intermittently. Should go on for about a month, so...I may be one tired man for a while. We shall see.

Concerns: None so far. I just need to be meticulous about placing the dressing to keep the foreskin fully retracted and compressed (to avoid paraphimosis), but it's not rocket science, either.

Knight

Best of luck WestCoast!

May you heal quickly and completely!

Straighter days!

Knight

WestCoast

Day 2:

Nearly 48 hours post-op, so this might be my last icing session. Besides, I fly home today, and pants-less icing is discouraged in public ;) Maybe a bit less base/public swelling, but still a very squishy-firm and blackish purple scrotum. Just a matter of time.

Pain: Virtually none now, despite no medication today. Very mild discomfort from pressure/friction after walking a couple miles, but not even worth taking a Tylenol for.

There's glue over the stitches, so the bandage was only to limit nocturnal erections. Harder than expected to replace the bandage properly, so I followed the doctor's advice and left it off altogether. Consequently, nocturnal erections hurt a lot, enough to wake me up about seven times. Immediately icing and walking around seemed to help relieve it. Could have kept the bandage up to four more days, but I'd take poor sleep over poor bandaging that sends me back to the hospital. On the bright side, looks straight even at much less than 100% erection.

Concerns: None, besides how in the world to get adequate sleep these next few weeks!

Thanks for the support, gentlemen. This forum is biggest reason I was able to find Dr. Lue and proceed with confidence. Wishing you all the best, as well.

james1947

WestCoast

It seems Dr. Lue made a nice job :)

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

WestCoast

Day 3:

Little change. Slightly less swelling around the base, but still pretty tender there, as expected. Scrotal swelling/firmness and discoloration have improved a bit.

Pain: No need for ice or pills, and no daytime discomfort except from clothing pressure or careless movement. I figured out the bandage (just for nighttime) but still slept terribly with frequent interruptions. I'm sleeping on my back but realized a slight change might reduce pain...will try tonight and share if it works, since someone reading this surely has/will have the same problem.

Concerns: None.

james1947

WestCoast

Is the:
Quoteslept terribly with frequent interruptions
Connected to night time erections? If yes, it is an other sign that Dr. Lue made a good job.

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

WestCoast

Yes, due to night time erections. Agreed...it's a good problem to have!

LWillisjr

Thanks for posting. Sharing everyone's experience with each other helps.
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

WestCoast

Day 6:

Still some deep soreness of course, but base/pubic and scrotal swelling are almost gone, and the  scrotal discoloration is slowly improving. The shaft skin became a bit swollen around day 2 or 3, but that's disappearing, too. Thankfully, all is well.

Pain: None besides nocturnal erections, which are a tiny bit better, but still awfully unpleasant. Waking up perhaps 8x/night on average.

Concerns: None. Surely unrelated, but last night I noticed the right testicle was facing the opposite direction (had basically done a 180)...then was normal this morning, then reversed again shortly after my shower, and now finally back to normal. No pain, visible inflammation, or other symptoms whatsoever...go figure! I'm concerned it'll fail to correct itself in the future, and leave me with a nasty testicular torsion, so I'll probably follow up with a local uro in a week or two, once more completely healed from the plication. Anyone dealt with that before?

WestCoast

Day 12:

Base/pubic area back to normal. Almost no more shaft inflammation except along the incision, where the surgical glue is beginning to come off. Almost no signs of surgery now besides the incision itself.

Pain: Still none during the day, and significantly less from nocturnal erections (but still enough that I keep ice on hand by the bed). Awoke just 2-3 times the last couple nights, which is a welcome improvement! Erections are also more painful when standing than lying, since the weight of all that blood pulls downward on the proximal sutures.

Concerns: None.

Knight

Glad to hear you're on the mend! Have they said how long before the painful nocturnal erections go away?  

WestCoast

Thanks, Knight. I was told to expect painful erections for anywhere from 2-6 weeks. Lately, though, it gets better every night.

WestCoast

Day 20:

I'm doing very well, and am grateful finally to be sleeping through the night. The glue has almost completely fallen off, but the dissolving sutures should remain for another week or so. (Not the plication sutures; those are permanent.)

Pain: Basically none. Erections are a bit uncomfortable, but not truly painful except when the pelvic floor muscles reflexively contract (since that increases rigidity, of course). And glue fragments catching on underwear is not so pleasant, either!

Concerns: Nope.

WestCoast

9 weeks:

Been gone awhile, but no news is good news :) In any case, thought I'd post a quick update.

Pain: Still mild pain when absolutely 100% rigid (pelvic floor contracted), and still uncomfortable if underwear, bedding, etc. firmly pushes an erection downward. However, it's bearable, and seems better every couple weeks. Not sure whether sex would be more pleasure than pain right now, but it's only been two months, so I'm not worried in the long run.

Concerns: Nothing much. The external portions of sutures have long since fallen out. There are still some tiny lumps right beneath the scar (presumably around some internal sutures). Apparently sutures can take a few months to absorb completely, and probably more time for inflammation to subside. Those, plus the inelasticity of the scar, keep the foreskin from sliding quite as smoothly and fully as before, but it's probably just a matter of time.

Long story short, the recovery seems slow but steady at this point, and thankfully I have no cause for concern.

Wishing you all a happy and healthful 2015!

james1947

WestCoast

Your healing sound fine. 100% erections sound excellent.
Wish you continues improving and have a happy sexual life.

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

Knight

Thanks for the update and Happy New Year to you as well!

MisterBee

Curious how this past month has treated you? I'm almost three weeks into my recovery from a plication. Things are going good so far.

Are you back in action? Still having any pain/discomfort during erections?

WestCoast

MisterBee - just read your thread, actually, and will reply shortly.

Glad you reminded me to update this! I'm doing very well this past month. There's basically no more pain during erections (only occasionally and very mildly when extremely rigid, but even that is nearly gone).

I imagine the scar will continue to diminish and soften over a year or so; has anyone had success with ointments/supplement to improve scarring? I think the constant nocturnal erections during early stages of healing led to a slightly gnarlier scar than usual (not that it makes any practical difference).

james1947

WestCoast

I know a Chinese oil that woman here are using to eliminate the scar after cesarean surgery, but it is made locally.
I used it also with very big success on a few wounds, including my glans after my traction accident.
I am sure you can find such oil in the US in Chinese herbal shops.

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

James

Does this oil really work?

Can you tell me its name or give me a link to buy it? thanks

james1947

yyy

The only link I found by google that explains somehow what it is:
Wolf Tracks Massage Therapy: Post-Injury Rehab - Day 5
For the pack front:
https://www.tokopedia.com/balivela/minyak-san-hong-tjap-pida/review
https://www.tokopedia.com/balivela/minyak-san-hong-tjap-pida
on the pack back side is written:
Zingiberis Rizhoma 14%
Criyophylli Flos 5%
Cymbopogonis Folium 10%
Oleum Cocos 50%
Foeniculi Fructus 2.5%
Andragraphidis Herbs 2%
Piperis Folium 2%
Sesami Semen 3.5%
Sulphur 1%
By the way, a friend of mine made a new tattoo, healed in one week.
If you have problem to find it and still want it, send me a PM, will see how I can send you from here.
I bought lat time a 50 ml bottle for $6 if I am not wrong. As it is applied 3 to 4 times a day a thin layer, it will keep for long time.
The manufacturer is in Surabaya, Indonesian main industrial hub, Jawa (Java) island and can be found in many pharmacies here. Have even production and expire date on the pack :)

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

6inchcowboy

Did you get permanent sutures or absorbable sutures?