Surgery to regain size?

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JayGould

What type of surgery would be able to regain size lost from Peyronie's? EQ doesn't matter as I would install an implant right after.

JohnWright

An implant is the only surgery I'm aware of that can, depending on what one has to work with down below, restore some length.


Jack1909

Pelvic ligament cut as well..but I would not go for it.  
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

JayGould

JohnW - That's interesting. Surgeons have always told me that the implant won't give me more lenght, but perhaps they are trying to protect themselves legally.

Jack1909 - The worst thing is that I do have a lot of "empty space" in my tunica. My tunica can't just have shrunk 20-30%. Actually I can still get it to expand almost close to normal if I don't masturbate for say 8 weeks. If the little plague would simply be cut out, the tunica should be able to expand normally. So I would like to 1. Cut out the plague and 2. Install an implant (in the same operation).

Not sure if this is done. I don't see why it wouldn't be possible to do though?

redbullmaster


You could have a graft surgery with the implant, it should restore your size.
Which is your idea to cut out the plague.
Depending on how much they cut out, they use a graft or let your penis heal on its own.

Or you could look into the Sliding Technique, which is done with an implant.
But this is a much more dangerous surgery, as in loss of penis dangerous.

The plus is it can increase the penis size up to 5cm, but more likely closer 3cm.
Depends on your penis internal anatomy on how much you can gain.

I had this done with my implant, but I don't notice any size increase for me.
Surgeon says I got an extra 1.5cm, so not a lot when you consider the risks involved.  

JohnWright

Jay -- On YouTube search  Dr Andrew Kramer  and his channel. Set aside a couple of hours and just start watching his videos of him tending to the male penis. He's the senior urologist at the University of Baltimore, Maryland.

Young, old, and in between, whether scrawny or a body builder, he's doing implants in men for all variety of reasons - including Peyronie's. I started promoting his approach here on the Forum about a year ago.

Among other things you'll hear, he is "maximizing" available length for the man, "gaining some length," etc.

I don't currently need an implant, but if I ever do, Kramer is in my top three choices.

John

redbullmaster

I too have watched his videos and read the story's on FT, from the men who have had surgery from him.

If I ever won a large sum of money, I wouldn't hesitate going over to have a revision with him.
Not happy with the results I received on the NHS.

By looking at JayGould signature, looks like his UK based like me.
I'm guessing its going to cost about £30,000 to have surgery with him.

So may not be the most practical option for JayGould for surgery.
But if you got the money go, for one of the best.

But will add, which ever surgeon you choose, things can go wrong.




JayGould

redbullmaster - Grafting along with the implant sounds like a good idea. I hope I can convince one of the top surgeons to do this, maybe by adding some more money. I have actually spoken to Kramer personally but he does not do grafting. He also told me that he won't be able to increase the size of the penis. What you have when you get measured right before surgery, that's what you're going to end up with. Same with Dr Eid in New York. The cost of the surgery is only around $25,000 including everything.

Kramer actually said that grafting before an implant was an outdated thing that isn't really done anymore. I am guessing this may be because of the extra hassle for the surgeon however, and not because of any added risks for the patient.

But anyway, what are the other possible risks with grafting? Are they degloving the penis to do it? If so perhaps loss of sensation would be a risk? Could it also cause ED in the glans and corpus spongosium perhaps?

By the way, that's ballsy of you to go with the sliding technique! I remember I read your thread about it. I am glad that you didn't have any severe side effects (like loss of penis). What happens when it's time for a revision, will it be as easy to do as if you wouldn't have had it done with the sliding technique previously?

JohnW - I actually don't technically need an implant either, at least according to Doctor's recommendations. But I can't live with a penis that is 70% of the size of how big it used to be, and with only 50% EQ. While I am technically functional, that just isn't good enough for me. If I can't get 100% of my old size back, then at least I can compensate by having a rock hard erection that would last as long as I wanted it to (like I would get with an implant). If I would end up with the same girth as I once had, and perhaps just 1cm shorter with an implant, I would be a very happy man.

redbullmaster

With my sliding technique they didn't use any grafting material, as they said the penis should heal itself.  
So I'm guessing if they cut the plaque and not graft you be fine.

Yes it would be a degloving procedure, but you can be implanted that way at the same time.
So they wouldn't need to then go though your scrotal sack.

Risks I think are exactly what you outlined, anytime you cut into the penis you causing damage to it.

From watching Kramer videos, he says he breaks up as much of the scar tissue when he makes the passage though the corpus spongosium.

So that should restore some size I think.

Have you tried  VED or a traction device to help recover lost size?

Not sure what the long term risks are for my surgery when it comes for a revision, as its still a new surgery.

You can get a implant with a graft with the NHS in the UK, or private at International London andrology.


Kind Regards

JayGould

Ok, that's interesting. Just cutting the plague out without replacing it with a graft is something I have thought must be possible as well. As long as you put an implant under it right then and there, it should heal above the implant.

I have tried VED but unfortunately it made it worse in my case. One little pump and my curvature increased another 10-20 degrees immediately. Haven't been able to use the traction device as I can't fit the nozzle on my glans.

For the implant I am looking at either Kramer or Eid. I will have to speak with them again to see what they say about size.

Are you at the same size now compared to pre-Peyronie's at least?  

redbullmaster

That's unfortunate about VED, have you tried the Phallosan forte traction device.
Use's a suction devise on the head rather than a noose, much more comfortable to wear.

My size is maybe a bit bigger, but its hard to compare as I lose size with the soft glans.

I do have much better girth at the base of my penis, but its not even and drops from 6inchs to about 4.5 with the soft glans at the top.  


JayGould

Yes I have the Phallosan. Unfortunately I can't get the suction device on. Will have to try again at some point.

Did you have a soft glans prior to the implant as well? I also have one currently. What kind of implant do you have btw, a Titan or an AMS?

redbullmaster

Yes soft glans before the implant, I have a Titan.

The phallosan can be hard at first, had issues with foreskin.
But with practice gets a lot easier to use mate.

JayGould

Cool, will try it again.

Titan will be my choice as well.

Hrvat21

Would "Egydio" surgery deal with the plaque, remove the curve and restore lenght and girth lost since injury? Even if penis size got reduced by peyronie's? Can that surgery fix hourglassing, too? And also what surgery of implant would you recommend in mid europe.

Edit: F^@% why are those surgeries so costly, where should i find that money to fix my dick

Id there any surgery that could deal with the curve and hourglassing, restoring the penis to it's before peyronie's state without an implant

takesix

Grafts for curvature will only lengthen shorter side to longer side. If you want to increase it to pre-disease length, or just more length in general you will need to look into circular grafting or the sliding technique (2 birds with one stone). Max length will be determine by neurovascular bundle stretch length to prevent traction nerve damage.

Grafts for girth will give you girth either to pre-disease measurements or even more depending on surgery planning. You can get say, 3cm increase in girth by adding 2 x 1.5 cm wide grafts longditunally on the penis.


Hrvat21

Thanks takesix, you seem really knowlegdable. Do you know those surgery could even fix hourglass in perineal part (root) of penis? As there i have worst thinning situation after my injury (fracture). And if i have mild ED,  do you think i should do just grafting or go straight to implant? I am kimda afraid of more size loss with it.

takesix

yes grafting can be done to the buried portion of the penis. but i do not know how deep exactly they can go, the root is encased in muscle so it might be off limits. have to ask the surgeon about that one. my curvature is also quite deep in the base.

if you have mild ED which bearable with medication, then maybe the implant might be a little hasty. if the ED is considered unretractable perhaps due to your injury then maybe an implant would be a good idea. you can always insert an implant in the future.

Hrvat21

Thanks takesix. I apologize about privatising this thread, but it's tempting when you seem to know so much about this stuff. I am full of questions, as i am trying to predict any possible outcomes and i don't have any good uros here in croatia. Do you perhaps know if a torn bulbocavernosus muscle (i thnk i tore half of that muscle durring my injury and that it's literaly "dead", bit painful to touch around sides of my penis, can be felt but doesn't flex) can be somehow fixed/stiched up in surgical procedure? And if my thinning in penis base is due to corporal fibrosis, do you think the size and function of my penis can still be restored?

takesix

do you have a confirm tear via imaging? are you sure it is a muscle tear or ligament tear? I don't see why you can't repair it just like any other part in the body e.g your knee IF it is truly damaged.

yes you can expand the size due to fibrosis in both length, girth or both. what exactly is your expected outcome? you need to be very specific with the surgeon.

if you can't find anyone worth working with in croatia, you're a short flight away from many good surgeons in the rest of europe anyway. alternatively you can email one of the 'big'' name european surgeon and see if they can do a remote consult with you.

you can PM me so we don't muck up the thread.


lstlmh56



I had radical prostate surgery in 2010 and suddenly developed Peyronies months after, when the erections returned. That being said, I deal with mild ED and many natural erections are not quite as hard as I'd like. Taking Viagra gives me a harder and more sustainable erection. Following the surgery, I had a straight-up curve of 85 degrees and now, seven years later, it has improved to 65 degrees, which still makes comfortable intercourse impossible. I can't explain the 20 degree improvement, except that I've been taking Pentoxifylline daily. Back then, they suggested the implant and I chose the "wait and see" option, thinking and hoping it might improve on its own?.

Jump to today - my new surgeon, a renowned authority on Peyronies Disease, gave me two surgical choices to completely straighten my erection, and believe me, it's a horribly tough choice to make. Both involve degloving the penis and both come with some risk of disrupting my natural ability to get erections.

The first is to excise the plaque and add a pericardial graft as you described on the buried portion or inside curve of the erection (for me, it's the top of my erect penis). He claims this procedure will regain every bit of my pre-Peyronies length but comes with a slightly greater risk of disrupting my "natural" ability to get erections, meaning I may need Viagra 100% of the time.

The second surgical procedure is to leave the plaque where it is and suture tissue together from the outside of the curve until the penis is straightened. This is at the cost of shortening the overall length of my erection by an inch to an inch and a half. This second (shortening) procedure carries less risk of disrupting my natural ability to get erections. But, to clarify, both surgeries come with some risk of that. It's just that with the first surgical procedure, the risk is greater.

Tough choice. Any suggestions guys? Should I go risky and keep my length (if I'm still able to get erections afterward) or play it safe and live with shorter erections? My surgeon said my erection is longer than 50% of the male population, but I'd still hate to lose any length. Has anyone here had the plaque removal and grafting surgery and came away happy with the success of it?

I'm new to this board and apologize for the lengthy message. Going forward, I'll try to keep them brief.

lessor

How old are you Istlmh56? I guess you are an old man because your prostate surgery? sorry if it isnt so
But if you are an old person and you have mild ED and dont want to lose size why not considerer the implant?

lstlmh56



Thanks for your response. I'm glad I came across this forum. I'm 61 years old. I gave the implant serious consideration almost seven years ago when my surgeon first suggested it, but at THAT time, I was not able to get erections even with Viagra. I was only maybe six months out of surgery and was still hopeful I would regain the ability to get natural erections and I eventually did. I sometimes even wake up with a rock hard erection. Having said that, for a good sustained erection that I would need during sex, I likely would do better with Viagra. Since the Peyronies struck, I haven't attempted intercourse and basically retired from the whole dating scene mainly due to embarrassment. No Match.com for me.

Knowing I'm able to get natural erections and better with Viagra, my surgeon said he would no longer suggest the implant and felt I was now a good candidate for the Pericardial Grafting. I know it's a risk (the whole natural erections getting worse thing, which is some scary $hit) but I'm leaning toward it the more I read on this forum. Seems several members have had a lot of success with the grafting surgery. I read on this forum that only 15% of patients experience issues after this surgery but, of course, I'll have to do more research between now and my surgery and more reading on this forum.

The other procedure is less risky, yes, but I'm afraid with a 65-degree curve, he may have to shorten my erection by as much as 2 inches. I really haven't decided for sure yet which procedure I'll do but my surgery date has been set and my surgeon is Laurence Levine of Chicago's Rush Hospital. Google his name and you should find that he's the nation's leading authority on Peyronies Disease or at least he was seven years ago and I believe he's even written a book or two on the subject. I feel I'm in very good hands with this surgeon and the risks may be less for the grafting.

I'm also maxed out of pocket with my insurance and want to get this surgery done before the end of the year. :) Darnit if I didn't go with a long post again.

takesix

curvatures at the base will incur the largest perceivable length loss, because the surgeon will correct the angle of the erection to the angle of root of the penis (aka true straight). if i recall correctly it is around 0.5" per every 20 degrees when the nesbit procedure is used, so the 2 inch guesstimate is about right

i would take the risk, since you are already using viagra anyhow, and patients with pre-operative erectile dysfunction satisfactory treated by pharmacology are considered candidates for grafting. if you're getting satisfactory natural erections without the need for viagra then maybe I would think twice.

Dr-Oates

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