Surgery for plaque near the glans?

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diehardpatriot

Does plaque very close to the glans make you a non-candidate for surgery? How about Dorsal?about dorsal,  I saw on a surgery video that they avoid the urethral ridge area and that is why I ask.  
Penis injury in late 2017. A lump formed at injury site that caused no deformity, just pain and a palpable lump. Pain is improving through proper rest and use, diet, and mindfulness. I am always learning and looking to share things that have helped.

blex

Hijacking an old post here.

Did someone find an answer to this question?
I'm still a long way from surgery, but my plaques are protuding into the glans, so this is interesting to me.  
36 years old, married
---
Symptoms since trauma in July 21:
First calcified nodule in septum near glans
Multiple calcified plaques developed on top
Pain (flaccid/erect), 75° upwards curvature, hourglassing
---
Nothing helped, looking for surgery now

salvavidal

I have the same question, because my peyronie is very near of glans.
Penile fracture while sex, i got a low curve, and loss of harness in erection

beaulieu1008

Quote from: blex on February 24, 2022, 10:35:41 AM
Hijacking an old post here.

Did someone find an answer to this question?
I'm still a long way from surgery, but my plaques are protuding into the glans, so this is interesting to me.

Never read on sites that it was an contra indication.  
60 years old. Peyronie disease since 2020. Upward curve 30 degrees. Thick calcified plaque, dorsal, just beneath glans. 2cm wide, 1cm long. No ED. Except soft glans.

blex

Have seen 4 doctors for surgery now.

1st said incision will do, didn't believe there is plaque under glans
2nd said it will be difficult but could be solved by combination of incision/excision and scratch technique.
3rd did not want to discuss surgery before pain is gone
4th said he would not do surgery, and below glans it would be impossible anyway.
36 years old, married
---
Symptoms since trauma in July 21:
First calcified nodule in septum near glans
Multiple calcified plaques developed on top
Pain (flaccid/erect), 75° upwards curvature, hourglassing
---
Nothing helped, looking for surgery now

damnthatdent

Hey Blex,

That sounds like a tough decision, considering the range of opinions. Which doctors did you end up going. Unfortunately, I'm starting to develop pain and I'm a bit frustrated with my doctors and I want to be prepared as it is so hard to get appointments.

All the best!
1 knot in the penis septum since end of 11/2021
No pain, no curve, small dent but not visible, hardly can feel the dent, could be there before Peyronies Disease.
First not calcified, now visible
Meds:Potaba & Citrullin
Diet:Plant based but meat & fish once a while

blex

I have not decided yet, as I have another appointment in November with a fifth one in Nuremberg.
So far most likely #2 in Kiel. #1 and #4 are obviously out.

Will post a big update after I have visited all five.
Can give you names via PM if interested.
36 years old, married
---
Symptoms since trauma in July 21:
First calcified nodule in septum near glans
Multiple calcified plaques developed on top
Pain (flaccid/erect), 75° upwards curvature, hourglassing
---
Nothing helped, looking for surgery now

takit

Well, my plaque decided to move towards the glans. Fun never ends with Peyronies Disease ::)

Quote from: blex on September 20, 2022, 07:41:56 AM
[...] Will post a big update after I have visited all five. [...]
Since I'm in a similar situation I'm looking forward to that.
Peyronies Disease: since October 2021, 35° dorsal, 5° sideways, strong hourglassing [active]
Medication: Tadalafil, L-Arginin, L-Carnitin, Coenzym Q10 and vitamins [canceld]
Physical therapy: PeniMaster Pro 4h daily [canceld]
Personal: 35, single

tenfour

Did you have a Doppler ultrasound with any of the four or five doctors? I have a similar situation and my plaque is also near my urethra. Doctors say they can't feel any plaque on me. It's supremely frustrating.  
28, diagnosed with mild Peyronies Disease march 2020

taking CoQ10, Acetyl L-Carnitine, L-Arginine
starting DIM

Lump on underside "neck" and hard bands on right and top left "neck" just before glans

blex

Small update for now, will make a big progression post some time in the near future.
My situation has changed a bit, curvature is now at least 60° (yes the gift that keeps on giving).
Plaque seams so have moved away from the glans abit, but also has grown towards the base.

5th appointment was kind of a letdown, which may have been because of my high expectations.
The staff in Nuremberg was very kind, and the Dr. explained the surgery in great detail.
He recommended PPEG (Partial Plaque Excision and Grafting) with Tachosil and mentioned I could gain back a cm of length.
Plaque excision is partial only to correct the curvature, so location near glans doesnt matter that much.
Curvature would be mostly gone, maybe hourglass too, depending on the location of the plaque.

Summary:

#. Method; Material; Circumcision
1. PIG; SIS; partial
2. PPEG & Perito Scratch; decided during surgery; yes
3. PEG; Tachosil; no (from publication, wants to discuss when pain is gone)
4. Plication; none; optional (corrected, received letter from him saying surgery is possible)
5. PPEG; Tachosil; yes

All doctors agreed I could have surgery, but stressed active phase needs to be over.
Surgery indicated through wether sex is possible, not from curvature itself.
Location of plaque was noted by some to have influence on grafting material (Tachosil is glued, so more difficult towards glans, whereas SIS can be sewn in easier).
Other than that, the plague location does not seem to be a hinderance to surgery.

@tenfour
Yes all did doppler ultrasound and found plaques.

I hope I didnt forget anything.
For German readers, all appointments but the last are 100% covered by insurance, as are all kinds of surgery.
36 years old, married
---
Symptoms since trauma in July 21:
First calcified nodule in septum near glans
Multiple calcified plaques developed on top
Pain (flaccid/erect), 75° upwards curvature, hourglassing
---
Nothing helped, looking for surgery now

takit

Quote from: blex on November 29, 2022, 11:28:30 AM
Small update for now, ...

Thank's for the update. Why does it feel like a letdown? Sounds like a "good" outlook for me.
Peyronies Disease: since October 2021, 35° dorsal, 5° sideways, strong hourglassing [active]
Medication: Tadalafil, L-Arginin, L-Carnitin, Coenzym Q10 and vitamins [canceld]
Physical therapy: PeniMaster Pro 4h daily [canceld]
Personal: 35, single

blex

Well, Dr. H. is the one who made the most surgeries in Germany, so I expected much.
I was told pain and worsening needs to be gone for 6-9 months. This basically means I probably won't be able to do anything for at least another year.
Also he really did not want to discuss the methods, i.e. when asked about if circumcision is really needed, he said if I don't like it, I should go somewhere else.
As I said the problem was likely my expectation of some kind of miracle...
36 years old, married
---
Symptoms since trauma in July 21:
First calcified nodule in septum near glans
Multiple calcified plaques developed on top
Pain (flaccid/erect), 75° upwards curvature, hourglassing
---
Nothing helped, looking for surgery now

Gerald12345

That does not sound good. Did you already try the minimal invasive approaches like traction or VED?
Peyronie's onset in 11/2021. Age 39
Two plaques under the glans. Minimal pain, only congenital curvature.
Tadalafil 2.5 - 5 mg per day + TRT

takit

Quote from: blex on December 08, 2022, 08:47:39 AM
Well, Dr. H. is the one who made the most surgeries in Germany, so I expected much.
I was told pain and worsening needs to be gone for 6-9 months. This basically means I probably won't be able to do anything for at least another year.
Also he really did not want to discuss the methods, i.e. when asked about if circumcision is really needed, he said if I don't like it, I should go somewhere else.
As I said the problem was likely my expectation of some kind of miracle...

I also had my appointment with him and I'm also a bit disappointed. Mainly because he didn't take much time for me.
And maybe because there was no miracle for me either ;-) I'll write a little more about it in my diary if you're interested.
Peyronies Disease: since October 2021, 35° dorsal, 5° sideways, strong hourglassing [active]
Medication: Tadalafil, L-Arginin, L-Carnitin, Coenzym Q10 and vitamins [canceld]
Physical therapy: PeniMaster Pro 4h daily [canceld]
Personal: 35, single

blex

@geralt
No I didn't dare trying traction because of pain 24/7.
Too scared to hurt myself more...

@takit
Sounds like you had a similar experience...
Yes, please, reports are always appreciated.
36 years old, married
---
Symptoms since trauma in July 21:
First calcified nodule in septum near glans
Multiple calcified plaques developed on top
Pain (flaccid/erect), 75° upwards curvature, hourglassing
---
Nothing helped, looking for surgery now

damnthatdent

I wanted to give ab update as well. So the good news is the one plaque below the glans is almost gone(can hardly feel it) and the indentation during erection that's left behind is really small. Bad news I got a new indentation now, just below it. When will this ever stop this is driving me crazy it's such a roller coaster. What is interesting that it always happens 3 to 4 months after I stop Potaba. But of course correlation and causality are not the same thing. I thought it's supposed to stop after 12 to 18 months. Does it stop for you guys?
1 knot in the penis septum since end of 11/2021
No pain, no curve, small dent but not visible, hardly can feel the dent, could be there before Peyronies Disease.
First not calcified, now visible
Meds:Potaba & Citrullin
Diet:Plant based but meat & fish once a while

beaulieu1008

I went to an urologist a few weeks ago. I also asked for a second opinion by mail from another one.

What they both agreed on was that when having a plaque on top near the glans, they must put the sutures on the other side near the frenulum. They said those would definitely irritate when having sex. They considered this a contra-indication. Besides, since my curve is 30 degrees they thought it was unethical to do surgery since they mostly tried to bring back the curves to 30 degrees, which they considered the critical decisive amount.

I was a bit relieved that I didn't have to do surgery on the one hand. On the other I still have this curve I don't like and a soft glans which I think is the result there off.

I must find out to see if my plaque is calcified so I will know traction is a possibility.

And stay positive  
60 years old. Peyronie disease since 2020. Upward curve 30 degrees. Thick calcified plaque, dorsal, just beneath glans. 2cm wide, 1cm long. No ED. Except soft glans.