Stretching Post Surgery

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newguy


I received an email (away from this forum) from a peyronie's patient:

QuoteI just had the Nesbit procedure done 4 days ago. Of course i knew going in that i was going to lose some length. Is one of the stretch devices used post surgery to regain the length that is lost?

I am planning on sending this reply:

QuoteHi XXXXX,

I think it would be unwise to engage in any stretching as healing needs to take place. What is of primary importance is that there is a positive outcome from the surgery and that erectile function returns to normal. Typically peyronie's patients engaging in use of stretching or vaccum devices do so because of existing curvature and not for penis enlargement reasons. I would be hesitant to advise a former peyronie's patient with a now straight(er) penis to engage in this type of activity because the potential for further injury probably outweighs any positive that can be seen over an extended period of time achieved through  stretching.

Thanks,

xxxxxxx

I thought I'd post this here, as it's an area that I haven't seen covered much previously. I'll also send a link to him to this thread, so that he can view replies and hopefully/possibly actually sign up and join us :). If you have a contrasting view feel free to post it!


Old Man

newguy:

Since you do not have all the circumstances surrounding his physical condition before and after surgery, you should advise him to follow the post op instructions from the surgeon who did the surgery. Improper exercising of his penis post surgery may not be correct therapy.

He may have extenuating circumstances that may or may not be conducive to any stretching post surgery. Most surgeons that I have dealt with on Peyronies Disease surgeries do promote some form of stretching whether it is by natural erections for the mild VED exercises. This is, of course, based on ones tolerance of any pain that may accompany the stretching exercises.

The above is just MHO from working with guys over the years in the Peyronies Disease realm.

Old Man
Age 92. Peyronies Disease at age 24, Peyronies Disease after
stage four radical prostatectomy in 1995, Heart surgery 2004 with three bypasses/three stents.
Three more stents in 2016. Hiatal hernia surgery 2017 with 1/3 stomach reduction. Many other surgeries too.

LWillisjr

I'm in total agreement with Old Man. My doctor was VERY specific about instructions for the first 6 weeks post op. After which time he did put me back on traction. So there may be a time and place for it, but it MUST be under his surgeon's direction.
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

newguy

Thanks for the replies OldMan and Les, so very relevant points made. I have sent my email along with a link to this thread, so hopefully he will either join the forum and discussion, or at least read the replies made here :).

My concern is that people will look to rush into these things when healing is still taking place. The reply I made was perhaps on the cautious side for that reason, and I certainly agree that asking the actual surgeon should be the primary consideration at this time.  

Tim468

There is at least one article in the urologic literature about stretching post-op that showed a benefit in terms of length. I think they started three days post-op. It is not standard yet in the surgical arena (not yet adopted by all practitioners). I think either Hellestrom or a uro in Seattle authored it.

Tim
52, Peyronies Disease for 30 years, upward curve and some new lesions.

UK

Info on post surgery stretching

http://www.peyronies-surgery.com/peyronies-cure-post-operative-care.htm


Tim468

Interesting suggestions in the link.

I found the article (I had it in a PDF file) and it was written by Lue.

Quoting from Methods:

"At discharge home the patient was instructed to change the dressing once a day for 10 days and to abstain from sexual
intercourse for 6 weeks. We advised all patients to stretch the penis with a vacuum device for 30 minutes daily for 6 months
starting 1 month after surgery."

"Results: At 6-month followup 1 patient who did not use the vacuum device gained 1 inch in penile length and was not available for further followup. The other 3 patients each gained 2 inches but had decreased erectile rigidity due to narrowing in the grafted area (hourglass deformity). One patient who wanted a more natural erection elected penile prosthesis implantation
about 1 year after grafting. The remaining 2 patients gained 3 inches at 18-month followup and regained partial penile rigidity similar to preoperative erections when the hourglass deformity improved. All patients were satisfied and indicated that surgery improved psychological well-being as well as relationships with partners."

The entire title and abstract:

LENGTHENING SHORTENED PENIS CAUSED BY PEYRONIE'S DISEASE USING CIRCULAR VENOUS GRAFTING AND DAILY STRETCHING WITH A VACUUM ERECTION DEVICE
TOM F. LUE* AND AHMED I. EL-SAKKA
From the Department of Urology, University of California School of Medicine, San Francisco, California

ABSTRACT
Purpose: We evaluated the results of chronic intermittent stretching with a vacuum erection
device after circumferential tunical incision and circular venous grafting in 4 patients with penile
shortening from severe Peyronie's disease.

Materials and Methods: We performed complete circumferential tunical incision and covered
the defect with a circular venous graft in 4 patients with shortened penis as a result of Peyronie's
disease. Preoperative evaluation included determination of patient and partner expectations,
potency status, measurement of penile length after intracavernous injection and color duplex
ultrasonography to determine possible vascular communication. Lower saphenous, upper saphenous
and deep dorsal veins served as graft materials. We advised patients to use a vacuum device
on a daily basis for 6 months starting 1 month after surgery. Postoperative evaluations were done
at 6 and 18 months postoperatively.

Results: At 6-month followup 1 patient who did not use the vacuum device gained 1 inch in
penile length and was not available for further followup. The other 3 patients each gained 2
inches but had decreased erectile rigidity due to narrowing in the grafted area (hourglass
deformity). One patient who wanted a more natural erection elected penile prosthesis implantation
about 1 year after grafting. The remaining 2 patients gained 3 inches at 18-month followup
and regained partial penile rigidity similar to preoperative erections when the hourglass deformity
improved. All patients were satisfied and indicated that surgery improved psychological
well-being as well as relationships with partners.

Conclusions: The results in this small group are satisfactory. Our technique offers a reasonable
solution for correction of penile shortening in patients with Peyronie's disease.
52, Peyronies Disease for 30 years, upward curve and some new lesions.

jackp

Tim

Just a note of caution for those that choose a penile implant. Do Not use any kind of stretching device, VED or Traction etc. It can damage not only the implant but your penis.

Twice daily inflation of the IPP stretches the implant and the penis.

Per MS Rea at AMS.

Jackp

Bart2

Hey guys,

According to the FastSize website, there was a study done using the extender post-op for penile lengthening.

http://www.fast-size.com/peyronies-disease/

All they state at the bottom of the page is:

The use of the FastSize Extender can aid in regaining the lost length after such surgery. During Levine's clinical trial, length improvements were observed as a subjunctive for patients who had previously had a surgical operation as their first line of Peyronie's Disease treatment. The goal of the evaluation was to determine if the Extender could prevent length loss after surgery. The results are shown below. 40 individuals were sampled in the trial, 12 who had grafting surgery for Peyronie's correction, and 28 who had plication procedures. The data was then accumulated and sampled verse 20 control patients.



I cannot find the results myself. I emailed Dr. Levine one time asking him for another study, which he said he could fax me, so I am sure he could fax this one too. However, he did tell me from this study that there was no compromise in the surgical site using the extender in this study for what it's worth.

Bart  

LWillisjr

I think this is consistent with what we have been saying. I know in my case the traction post surgery did help. The point is you don't start the traction/VED like the day after surgery. There is a healing period after which you can safely start the VED/traction.

Les
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History