Grafting surgery in less than 45 degree cases?

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yepyeni

Hi,

I'm 23 and have peyronie's for 7 years now. I've been researching a lot, been trying hypertermia for 3 months, with no results unfortunately, and finally end up with researching the surgery techniques that exist, for maybe one day in the future.

To my understanding,
1) There is a technique that doesn't cause weight loss, known as "grafting" technique, which is wiping off the plaque, techically restores the penis to its state that before the peyronie's. (sounds like totally pros?)

2) And there is plication technique that causes weight loss and leaves the plaque in its place. (seems totally cons)

My question is; under these conditions why does one (or doctors?) prefers the plication technique? Is it an easier operation? And why can't i have graft surgery although i have under 45 degree peyronie's? Why would under 45 degree case owners want their penises shrink? Because actually i had an average penis before the peyronie's and now i don't have any more length to spare.

Thanks for replies already now.

takesix

its about your risk appetite and the doctor's risk appetite. grafting can be applied to any kind of curvature no matter what the degree

plication is definitely a much easier surgery for the surgeon so they will push that

Jack1909

'Cause the post op ED in grafting surgery is extremely high..
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

yepyeni

Quote from: Jack1909 on July 19, 2017, 12:47:23 AM
'Cause the post op ED in grafting surgery is extremely high..

oh not so totally pros then :/

LWillisjr

I have to disagree with what Jack1909 stated.

I asked my doctor that very question prior to my surgery. Of course there is some risk with every surgery, but he told me that since I could achieve and maintain good erections before the surgery, that he had high confidence that I would be able to after the surgery. And he was correct.

I really think it comes down to the knowledge and experience of the surgeon involved. The risk is not with the procedure, it is with the surgeon.
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

JohnWright

Regarding what takesix said, I didn't find this to be the case among the many urologists I interviewed in 2016 when I was researching an approach to my curved dick.

Regarding what Jack1909 said, I have not read any data that supports this statement.

Let's de-emotionalize the subject by focusing on surgery for, say, a broken arm or a hernia. Here are the kinds of factors which any intelligent consumer of medical services takes into consideration (hopefully). The point is to stop and think about how you feel about a prospective surgeon's answers to any of these BEFORE you hire them to lay hands on your own body for any reason:

- Is the surgeon brand new or have they completed hundreds of surgeries previously? Ask for detail. Would you hire someone who won't take the time to share their experience and quantity of surgeries? Would you hire a surgeon that has only completed five of these surgeries to work on you?
- Is the surgeon a specialist in the specific surgery one is seeking, or only a specialist in another field and "willing" to help out? Hmmm.
- Will the surgeon you think you want to hire actually be the one doing the work on you or MERELY supervising another surgeon? They don't disclose this up front -- you must ask. I have a friend who had a really screwy hernia surgery experience as a result of not asking. He thought he was hiring A+ surgeon, turns out the surgeon only supervises the theater (because he's SO successful you know, and they can cram more patients through the money mill if he supervises the wannabes). Now, my friend's penis dribbles urine and ejaculate because the junior surgeon screwed up the hernia operation!!!! (All male plumbing comes through that part of a man's body where the hernias appear -- before arriving at the family jewels).
- If the surgeon gets sick the day of the operation, is there a commitment from all involved that your surgery will be canceled? The answer better be certifiably "YES."
- What is the infection rate at the facility where you are considering? This can be obtained by asking.
- What is the complication rate with the surgeon for the specific type of surgery being considered? Ask. This number is two part: 1) Some surgeries are complicated and there is global data to review. 2) The surgeon could be attempting a routine surgery with globally low complication rate BUT the surgeon hasn't figured the procedure out yet (they're still butchering people), which means they'll be practicing on you (you know, butchering). Oh, yeah. So, drill down, nail down these numbers and your understanding is essential of which part (1 or 2) the surgeon is speaking to. Both parts count.
- What is the surgeon's attitude? Pompous? Rude? Arrogant? God-like? Thoughtful? Conversational? A listener who can and does respond to your questions? Passionate about your experience? As a human being, if you don't like what you see and you let it work on you... just saying.

What of you?:
- Are you feeble? Sickly in general? Immuno-compromised? Subject to infections? Depressed? In poor health? Eating poorly? Making bad life choices? Making bad sexual choices? Crappy personal hygiene? These are all factors in a man's recovery.
- Are you able to exercise self-control or has your body mastered you, and you are its slave to every desire? Post-surgery a patient must follow common sense (again, here's hoping the patient has any of that) as well as ask for the surgeon's recommendations on post-surgery self-care. [I'm focused on broken arms and hernias here, but I just want to note that with dick surgery, the gold-standard is for a man to 100% refrain from sex of any kind and masturbation for a minimum of six weeks. This Forum is filled with the confessions of so many men who are not the masters of their body, and they could not follow simple instructions, and jeopardized if not fully created complications in their recovery.] Got self-control? It's a thing.
- Are you able to research things for yourself and make judgements after reading lots of information? Yepyeni, this is important because your description of grafting is totally bogus. If you read thoroughly on the subject (which we all encourage you to do): there is no "wiping" of the plaque; length and girth are the considerations, not weight loss (related to your dick); and you omitted the fact that tissue harvested either from a dead human being (the typical approach) or from somewhere on your body will be "grafted" into the short side of your dick to allow for some degree of straightening.

Checking the boxes will improve the odds of any surgery one contemplates. Now, you can consider your own dick.

Cheering you on!!

John
 

yepyeni

[Full quote removed - Use 'REPLY' instead of 'QUOTE']

May i ask who is your doctor?

LWillisjr

Dr. Laurence Levine.    Rush University in Chicago
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

takesix

all surgeons will push whatever they are comfortable with. you're just a face in his production line and he's just waiting to sign you off and go to the next guy. the last thing he wants is to have a functionally worse off patient of his own doing and inadequacy. keep in mind this surgery is elective and non-critical in nature so most will push the simplest procedure possible with the least risk despite having only a modest result. hence the arbitrary - need to be more then XX degree - prerequisites.

cohort studies that document grafting and its long term effects do present with conflicting sides to the argument. but the papers are mostly self-serving both ways, so keep that in mind.

since its clear you don't want to lose any length just find someone who is a match with your surgery goals


JayGould

As impotence is a major risk with graft surgery, does this include the glans and the corpus spongosium as well? Or is it only the corpus cavernosas that would risk ED?

Jonbinspain

Jay;

Any surgery to such a complex and sensitive part of the male anatomy carries a risk of post op ED Whilst the risk is minimal with a highly competent surgeon it's still there nonetheless.

As far as graft surgery is concerned, excision and graft carries the greater risk versus incision and graft. Having said that, my surgery with Dr Kuehhas included some necessary excision. Which I came through with no post op ED

JayGould

Thanks Jon, but the reason I asked about the glans specifically is that if I had a graft surgery, I would put an implant in the same surgery. So ED wouldn't be an issue. But, implant doesn't affect the glans. Would a graft do?

Jonbinspain

Jay;

I'd strongly suggest you consult a surgeon who specializes in this field before you finalise any plans.  

LWillisjr

Quote from: JayGould on August 23, 2017, 04:35:59 PM
As impotence is a major risk with graft surgery,

I don't quite agree. Clearly impotence is a risk and something to be considered. The the degree of risk is very dependent on the procedure, the skill of the doctor, and the location of the surgery to be done on the penis.  
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

Dared

Would it be better to go for grafting or implant in the case of severe peyronies?

lessor

Quote from: Dared on September 04, 2017, 01:12:40 AM
Would it be better to go for grafting or implant in the case of severe peyronies?
If you have ED implant, if you didnt get ED is more difficult I guess, you should value risks, lenght etc