Seeking grafting recommendation

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JamesM

Three years ago I had a reverse nesbit plication to correct a 80% curvature. 6 months after surgery that procedure had failed, the curvature returned

Two years ago I had a second reverse nesbit plication and that has also failed. I am still over 55% upward curvature and I have lost 2 couple of inches in length. To make matters worse I feel the plication sutures and they are painful with every erection.

My surgeon at UT SouthWestern Medical Center in Dallas Texas does not do any grafting, he says there is too much risk to the nerves in the area of the plaque. He is advocating for an AMS inflatable penile prosthesis implant to address the ED that has come with the two failed reverse nesbit plication procedures and the painful erections from the sutures. He has also said there will still be curvature after the implant surgery. This has me very alarmed and seeking grafting options to directly address the plaque causing the curvature.

If you can recommend anyone in the US (Dallas area would be helpful), that does grafting, please let me know.

TonySa

PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Jack1909

Oh gosh I'm so sorry and I feel for you. How often in this field the cure is far worse than the disease? Think twice. If Nesbit led you to ED, and it doesn't surprise me as it's pretty clear (not on this board anyway) that streitghteing surgeries make people impotent, what do you expect from a grafting surgery which is actually more invasive than the other ones?
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

Frank55

Tony - Did you proceed to work with Dr. Lue and the Xiaflex? Or are you considering surgery now?
Single and 58 yrs. old - first peyronies symptoms Fall 2015
Had grafting surgery by Franklin Kuehhas in June 2016 - complete failure
Borderline ED possible but not taking drugs, shots or using VED
Now evaluating options for next step

TonySa

Had my first round of Xiaflex...no improvement yet.  Seems Dr Lue only recommends surgery if calcified...guess I'll hang in there w the Xiaflex for now.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

JamesM

While I understand grafting is more invasive, I really want the curvature fixed, it's has been almost 4 1/2 years of dealing with this. I would definitely consider grafting and the implant at the same time. Removal of the painful sutures from the 2 failed Nesbit procedures would be helpful as well.
I have heard that with Xiaflex it is hard to control where that drug goes and it can do more harm than good.
I will look into Dr. Lue. Much appreciated!

Frank55

Tony - When do you go for your next treatment?
Single and 58 yrs. old - first peyronies symptoms Fall 2015
Had grafting surgery by Franklin Kuehhas in June 2016 - complete failure
Borderline ED possible but not taking drugs, shots or using VED
Now evaluating options for next step

TonySa

PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

LWillisjr

JamesM,
What was the original surgery for? To fix a Peyronies or congenital curve?
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

JamesM

The original surgery was treat an upward bend (almost 90 degrees) caused by Peyronies.

crookedjohn

My surgeon does grafting.  L. Dean Knoll, Urology Associates, Nashville,  TN. I  had incision and grafting surgery on Nov. 6th, 2017.  I am sharing my experience in this forum. So far my experience with Dr. Knoll is very positive  but I suggest you take into account that I am in the early stages of healing. It will be several more months before I am able to make a final recommendation.
Age 64, Incision and grafting surgery 11/6/2017 for rapid onset 90 degree dorsal curve as a result of injury during sexual intercourse.

JamesM

I went through with the AMS 700 implant three days ago. The bruising is substancial, actually the entire scrotum is swollen and very bruised. However, the pain is not as bad as I thought it would be. The penis itself does not hurt, the scrotum does. The pain medicine helps. I would suggest at least a week off of work if considering an implant. According to the doctor and staff the implant has completely worked, I have zero curvature. I won't know for myself until my implant is activated in about 5 1/2 weeks.

Sadguy

JamesM had you grafting and implant in the same time? Or only implant?
Please go to PROFILE then FORUM PROFILE to replace this text with your profile info such as age, date of onset, symptoms, treatments tried, etc

JohnWright

JamesM -- Who was the surgeon that you allowed to lay hands on your body?

JamesM

I am attaching an image of the bruising on the scrotum just so anyone considering an implant will know what to expect. The yellow cloth is just a microfiber car wash cloth used to hold the scrotum up high. This is three days after surgery




JohnW,

I choose only the implant, not the grafting. The location of my plaque, being dorsal, increased the risk of nerve damage had we attempted a graft. Some of the plaque was in the corpus Cavernosum (both sides). My surgeon was able to go through that plaque to place the implants eventhough there was some calcification of the plaque.

Dr. Moyer at the University of Texas Southwestern in Dallas is the surgeon that placed the implant. I am very pleased, so far, with his services.

I am not mentioning who did the two nesbit procedures. While I am sure the nesbit procedure works well for some people, in my case it had not. Possibly because the plaque had not fully stabilized.

One thing that everyone should be aware of, at least with the AMS product and my surgeon recommendation, is for the first three weeks after surgery you may have a slight/partial erection the entire time because some saline is in the cylinders. This is a little annoying. My surgeon intentionally left some saline in the cylinders for optimal healing. Very loose clothing is helpful...




Hrvat21

My problem is that one of my fractures is at perineum, under the muscle and on the side to my body, i don't know how they can graft that part of my penis, do you guys think it would work well with just implant inside? I don't have drastic ED, but my penis is curved even at it's perineal part and it can't be pushed down or it looses erection and it's shortened and curved there, etc.

JamesM

It sounds like the fracture needs sutures. What does your surgeon recommend? Have you been diagnosed with Peyronies?

Hrvat21

[Use REPLY instead of QUOTE  -  PM sent]

I have symptoms of peyronie's (curves and hourglasses, shorter side) on those three fractured parts, i still have to go to uro as i don't have a specialist in county and the others don't give a crap if it doesn't have complete ed, and to go to specialist i need to finish my first half year of college first, so i'm mostly interested in what can i expect, as only surgery seems only options from what i've gained on this. It's and old fracture, so i think it's too late for sutures?

JamesM

Just a quick update. 11 days after implant surgery, most all pain has past, only taking a small amount of Advil. Nearly all of the substantial bruising is gone. Bloodflow to the penis since surgery has drastically improved. I'm pretty sure the dorsal peyronies plaque was impacting the blood flow. Since the implant has a small amount of saline in the cylinders, keeping the penis straight and minimally erect, it's clear to me and my wife that the curvature is gone and blood flow has returned to normal.

So far, I am very happy with the implant as the final fix for my specific situation.

I highly recommend Dr. Moyer at the University of Texas Southwestern in Dallas.

Sadguy

James M i am going to implant too, can you tell me how is the pain after surgery?
What is the worst day after surgery? Is it very painful? Is it bearable?

Did your doctor tell you if your peyronies fibrosis was a problem for your implant surgery??
Thank you
Please go to PROFILE then FORUM PROFILE to replace this text with your profile info such as age, date of onset, symptoms, treatments tried, etc

JamesM

The pain is manageable with narcotic pain killers for the first week. For me day 3 was the most painful. I would recommend staying home for the first week, don't lift anything and rest as much as you can.
My surgeon was able to go through peyronies plaque without difficulty.

Years ago I had bone surgery on my knee. That was much more painful than the implant. Also, I think the implant is less painful than impacted wisdom teeth. That also was more painful than the implant.

I would say the implant surgery "looks" more painful than it actually is.

Good luck with your implant surgery.

JamesM

6 weeks after implant surgery, the incision is completely healed, I am 100% straight, 0 % curvature. The 4+ year nightmare is finally over.

At the moment, I am only able to pump 7 or 8 times before I have some minor pain at the tip of the glad. I will need to pump daily until I can reach 20 pumps without pain which should be by the end of 2018.



JamesM


6 months post surgery update.

The ams700 implant as a solution to peyronies dorsal curvature has way exceeded expectations.  The ability to stay firm well after ejaculation has changed everything.  The curvature and the hourglass are completely resolved.

For those considering implant surgery, I can only say it was the best money we ever spent.

james1947

Hi JamesM

Congratulations and thank you for the update :)

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

Ricardo70


Hello James,

You have taken the best of the decisions.
It is hard to accept the idea, but for peironyes severe, there is no alternative to the implant.

I believe that we all have to accept this idea.

They can very turn, but in the end the implant will come.

A hug.

JamesM

UPDATE:
13 months since the implant. The AMS product is working perfectly. All signs of curvature and hourglass are entirely gone.

On a personal note, this forum was extremely helpful in the decision making process to go for the implant.

Regards to all who helped!

JamesM

One other significant benefit to the implant is there is never a need for any ED medicine ever again and stamina is nearly off the chart...

TonySa

Congrats!  Some need ED meds to inflate their glans, but only if it was an issue before the implant as well.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

shrunken_dick

29 year old. I was taking 400 Mg spironolactone to treat hair loss. Xanax withdrawal in combination with spironolactone shrunk my penis from 6" to 4".
I am seeking information about the sliding technique.