calcified plaque and verapamil

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leftman

First post, kinda lost :)

I am 45 and had radical prostatectomy a year back at Brigham and Women, Boston. While my natural erections have started to come back and I use the bimix injection once a week, I have developed a 30 degree bend to the left due to a 3cm x 1cm calcified plaque. I have a very similar plaque on my right but there is no bend due to that. I firmly believe this is not from my injections as the plaques are not near the injection sites. This could be from not focusing on penile rehab for the first six months of my prostatectomy (cancer riddance first, sex can wait). Lesson learnt - for my next life, I guess :).

Went to Dr. Conners near Boston and have had 3 verapamil injections on the left plaque so far. During the last injection, he told me the plaque is starting to soften a little but it has a hard core. He also said there is a 50% chance verapamil will help and that it usually takes time and patience with results starting to show after the 4th injection. He also told me this will not make things worse. To me, the plaque feels like bone and from what I have read so far, there is no way to dissolve / reduce something like that besides surgery. Is that true?

I don't have pain, can have sex (for now), and desperately want to keep the bend from increasing. I don't think I have lost some length but not much. Can the injection trauma from Verapamil make the plaque grow? It is a lot of shaking with the needle if you know what I mean :).

When my plaques were tiny and soft, I had gone to Michael O'Leary at Brigham and Women. He shrugged, said nothing could be done and told me I could try CoQ10 if I wanted to. I wish I had gone someplace else and they put me on pentox. I will never recommend Dr. O'Leary to anyone for this. It was also my bad luck that those tiny soft plaques grew and calcified very quickly (about 3 months). I did start taking CoQ10 and K2 daily, been 3 months now. I have sex 1-2 times a week and masturbate 2-3 times a week.

I have not tried VEDs, Inferon, modeling, or traction. I also understand I am not a candidate for Xiaflex as my plaque is calcified. I like Dr. Conners but I fear the Verapamil journey will lead nowhere.

Any advice for me?
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Hawk

Welcome to the forum Leftman.

Now first things first STOP ALL BIMIX INJECTIONS NOW !

I am the founder of this forum.  Like you, I got Peyronies Disease from Bimix injections after a prostatectomy.  World class doctors have confirmed to me that bimix was the likely cause.

Read this once or twice for starters.  Also please edit your signature line that appears under your posts.  It will save a lot of questions and typing for you and those you communicate with. Peyronies Survival Guide - Information for New Members - Peyronies Society Forums

Hawk
Administrator

Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

TonySa

Great guide Hawk did.  In brief consider pentox, low dose daily PDE5 inhibitor, supplements in guide and VED or traction to halt progression and hopefully improve peyronies.  
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.

leftman

Hawk - this is eye opening, thank you so much!

The first time I had pain during intercourse was when I self-injected bimix for the first time (prior to this was only injected once by the nurse at the doc's office so I learnt). I had injected on the RIGHT and my pain and the subsequent plaque/bend was on the LEFT - that made me think bimix wasn't the cause. But reading your guide, it seems the body can respond by creating scar tissue at a completely different location!!

Did I understand it right?

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oscark

Coincidentally enough, I actually also saw Dr. Conners for calcified plaques.  However, I saw him while he as at MHB.  I probably had 10 rounds of Verapamil and sadly showed no improvement.  I just had my first round of Xiaflex with Dr. Morgenthaler at MHB.  Although I don't put my chances of improvement very high, I think you are wrong in your assumption Xiaflex will definitely not help.  Just reading the experiences of people on this forum, I saw at least one case of Xiaflex reducing a calcified plaque.  Dr. Conners actually wanted to try Xiaflex as well, but at the time, I was having trouble getting insurance approval.

On a side note, I very much liked Dr. Conners and his eternal optimism.  
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Hawk

Quote from: leftman on November 12, 2018, 09:43:26 AM
Hawk - this is eye opening, thank you so much!

I had injected on the RIGHT and my pain and the subsequent plaque/bend was on the LEFT - that made me think bimix wasn't the cause. But reading your guide, it seems the body can respond by creating scar tissue at a completely different location!!

Did I understand it right?

Not exactly. Scar tissue would typically start at the point of injury and over-run healthy tissue.  The fact remains that it is not just the needle puncture that can trigger fibrosis.  It is the drug which disperses throughout the penis. Also, any sex with an insufficient erection causes it to accordion and can damage tissue.  Finally, if you injected on the right, my guess it that is because the nurse injected on the left.  That could be your initial source of issues.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

leftman

oscark - good luck with Xiaflex, hope it works for you. Perhaps the high level of calcification I have is why Dr. Conners decided against Xiaflex in my case. I don't know if the scar is already bone, but it sure feels hard. That said, Dr. Conners seems to be able to inject. I am going in a couple of days for my 4th Verapamil shot and I will be sure to ask him about the degree of calcification and if he feels it is already bone.

Hawk - thanks, that could have been the case, although I will never know for sure. Your point about the bimix spreading and acting as a trigger is very interesting. Given each VI session involves 2 big needle pricks for numbing and another one for the med and no subsequent pain from those, I was bent on thinking a teeny bimix prick definitely wouldn't have been the trigger. Everyday I learn something new about this condition!
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Hawk

It is the Papaverine that is the most prone of the two drugs to cause fibrosis.  As long as you apply pressure to minimize bleeding I think the little needle prick is of minimal concern (my guess)
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Alibaba

leftman,  did Adam Kibel do your prostatectomy? He was at Brigam last year.  

Second, I do not think verapamil or Ziaflex works on calcium deposits not does pentoxifiline, or any PDE inhibitors. All are soft tissue treatments or vasodialators in my understanding. I don't think there are any treatment options for calcification though I understand some research is working in that area for hardening of the arteries which would be a similar situation.  
Milam 1/13/16-LGX 21cm - BAD service & surgical outcome Hated infrapubic.
Kramer revision 3/1/17 Titan 22cm + 1.5 cm extenders

betterbend

One theory with verapamils success is that by puncturing the plaque multiple times with a needle and flushing it with a liquid (verapamil) you break up the calcified area.  They do this technique with shoulder injuries that have calcified.  It called Ultrasound Guided Needle Biopsy Levage with saline.  Its effective for shoulder injury calcification.  My doctor and I originally discussed verapamil as a treatment and he felt that just the needle punctures alone might have an effect.... again this is theoretical for Peyronies.
55 - Onset May 2017.  38 degree bend up.  Failed Xiaflex treatment.  Still functional so I decided to stop treatments.  Only take 400mg Co-Q10 and occasionally use Restorex

leftman

@Alibaba - my surgery was done by Dr. Trinh

@betterbend - I will continue with the Verapamil and see if there is any difference.

You guys are great - I wish I had joined the forum earlier.
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TonySa

There is one study that showed injection w any of the three substances, including saline, reduced the curveature to some degree.
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.

leftman

TonySa - thanks for pointing that out, I have my hopes up but I realize I need to be prepared for the possibility that it doesn't work in my case :).

I was pretty depressed a couple of days back but then I read up on the implant solution, it isn't bad at all and people seem to be very happy with it. So, if nothing works I have that. So it isn't a death-to-sex sentence after all. Feeling much better today. Ordered the supplements from Amazon, and will ask the doc about pentox tomorrow :).  
Please go to PROFILE then FORUM PROFILE to replace this signature line text with your profile info such as age, date of onset, symptoms, treatments tried, etc

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.

Hawk

Topic locked because it exceeds the 10 post limit imposed on the introduction board.

Please continue the conversation on the appropriate forum discussion boards.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums