Chapter 2, Excision/Grafting Journey

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TDix

To all who followed my thread in the Xiaflex forum, I am starting this new thread to continue to document my journey through this horrible condition.  You can read what happened to me with Xiaflex over there, and follow my next step forward into surgery here.  I went in for a ultrasound at UCI yesterday with Dr. Faysal Yafi.  I was diagnosed with a 50 degree curve, and calcified scar tissue all along the top and left side of my penis as well as in between the corpora.  Xiaflex was determined to no longer be effective, and plication, while it would fix the curve, would not remove the massive amount of scar tissue I have.  Dr Yafi and I agreed that excision of some of my scar tissue as well as a graft was the logical solution in my case.  I will be scheduled for surgery in March, 6 months after my last Xiaflex injection.  I hope to shed more light on this procedure for all of you by yet again documenting my journey here.  I hope this road is less "bumpy" (get it?) and leads to better results.  
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Just got the call to schedule the surgery.  Pre-op visit on March 1st, with surgery scheduled for March 12th
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

So I've already hit a snag.  Looks like my insurance covers the doctor but does not have a contract with the hospital.  My wife has dealt with insurance before so we will see what can be done.  (Edit) we looked up our plan and both the doctor and hospital are in our network so not sure why I was denied.  Will look into it tomorrow and update
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

So I am covered 100% for Dr Yafi in my tiered 𝐈𝐧𝐬𝐮𝐫𝐚𝐧𝐜𝐞, and found I am 90% covered for UCI.  Planning out the road to surgery
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

Pfract

So.... Are you not concerned about ed later? With excision and grafting? How are your erections right now? Strong?  

TDix

Erections are very strong, and that was confirmed by the ultrasound.  I am willing to go into this with a positive attitude as my scar tissue is growing and calcified  
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

Bubba dawg

One Surgery I had--unrelated. I had to drive 30 miles to another Hospital because of Insurance. I used a doctor in that hospital. Turned out better than the local hospital would have even though it was smaller.  Just was a PIA getting rides to the preop, surgery, follow ups with doctor etc etc. Great you are getting this done TDix. I know you are excited to get back to normal. Ya stay Positive!
5 Rounds of Xiaflex. Good results.

I am known to give out false information and post nonsense with little to no evidence to back up my claims.
I have ignored several warnings. Further reports to the moderators or Administrators and I will be banned.

TDix

Wouldn't say I'm "excited" about surgery.  At this time last year that was the absolute last thing I wanted.  I opted for Xiaflex thinking it would be my meal ticket away from surgery, but my body told me otherwise.  Not easy decisions to be sure, and I wouldn't wish that on anyone with a penis.  Just how the roll of the dice was with me.  I have to be open to whatever I can do to make this better for myself and my wife.  
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

Bubba dawg

Excited to get back to normal. You still can dread the surgery. I have had 3 surgeries on different parts of my body. One was in the pelvic area. Then there was a  Vasectomy.  Surgery and the recovery are no fun at all. But there was a relief feeling to get rid of my physical problems. Recovery can be painful . You may have to do things differently in the short term. Just follow doctors orders to the letter. Many mess up surgery not doing that.
5 Rounds of Xiaflex. Good results.

I am known to give out false information and post nonsense with little to no evidence to back up my claims.
I have ignored several warnings. Further reports to the moderators or Administrators and I will be banned.

TDix

Quick update, my foot drop condition has pretty much resolved itself.  Turns out I crossed my legs too much, probably from all the pain in my groin!  Haha.  Still waiting to hear about insurance for surgery in March.  Should be covered, but if not I might put it off a little bit.
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

Pfract

Some good news is better than no news! Keep it up  

TDix

Update, have to postpone surgery until insurance gets their act together.  They tell me that I'm covered but when the office tries to pre-auth they state the facility is not contracted.  So confusing to be 100% covered for a doctor, but not for the hospital he works at.  Will update when I can get this procedure done.  In the past this would have been a devastating blow, but the antidepressants I am on have softened the blow.  I'm more of "it is what it is" right now.  Got to stay positive.  I'm not going to have such a major procedure done by just anyone because they are covered.
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Just as I updated this the doctor office called.  They found out the hospital IS contracted.  Will update when I get confirmation  
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Surgery postponed. They don't know why I keep getting denied when they have a contract with the hospital.  Never an easy road in this frickin journey!
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Just got the verdict, I am not covered for surgery at UCI.  I have to go to a Dignity Health facility to be covered.  This sucks, finally found a doctor that knew his stuff and unless I pay out of pocket he cannot perform my surgery.
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

Pfract

You will not consider it if it is not covered?  

TDix

I am getting a price quote to see how much it will run.  I don't have the funds, so I will see what can be done
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

daved2

After three surgeries, I finally found a surgeon who made my penis straight. If cost is the issue, then figure out a way to solve it.

The cure is the only way. Nothing else matters

I wish you the best
50 years old, tried 5 rounds of Xiaflex, had Egydio grafting surgery, then Stage sutures for residual curve, then plication in 9/18, now finally I have a straight penis

TDix

Doing my research I think Dr Karpman is associated with a Dignity Health location.  Crossing my fingers that it is true and will plan on him doing my surgery and local Dr Yafi handling the follow up care
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

No luck with Dr Karpman.  Looking into Dr Jennifer Liu here in Long Beach
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

Pfract


TDix

So Dr Liu operates in a Dignity Health location, but does not accept my insurance!  What the heck??  I find a doctor I like that is covered in Dr Yafi, but he does not operate in a Dignity Health hospital, so surgery is not covered.  I find a good Dr in Liu that DOES operate in a Dignity Health hospital, but does not accept my insurance!  So frustrating.
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

got a call today from Dr Wachs.  Explained my situation and since he has privileges at Dignity Health, he is going to write a letter to get Dr Yafi involved at a Dignity Health location to get my surgery done.  He does the surgery, but says Dr Yafi is the specialist.  I appreciate the honesty and sincerity from Dr Wachs in regards to my situation.  Not many urologists would do this.  Hoping he can get me on the right path shortly.  Will keep you all updated.  See, there are good guys out there!
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Price quote from UCI for procedure without insurance is $16k.  Hoping Dr Wachs can help get Dr Yafi into a Dignity Health hospital
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

Pfract

Never quit till you are successful! Go go go!  8)

TDix

UCI called today.  Dr Yafi talked to the board and was able to get the cost down to $3700.  Planning my next moves now
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

One week till surgery.  To say I'm nervous is an understatement, especially when looking at the procedure as "reconstruction".  Will keep you all updated on how it goes.
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TonySa

Surgery can be scary that's for sure.  I went through excision and grafting and it went well.  I did have initial loss in sensitivity-but it continually improved until regained.  My four anchoring sutures 6 months later are almost dissolved.  Is your doc using permanent or dissolvable sutures on the graft?
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.

TDix

I am finding out all the details later this week.  I'll let you know
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

I am getting dissolvable sutures on the graft, and if Plication is needed those will be permanent.  
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TonySa

If their doing excision and grafting, plication should not be necessary,
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.

TDix

Yeah that is what dr Yafi said however he said not to rule it out.  In my case with all the trauma they really don't know what to expect until they open me up
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

First shower leading up to surgery with the "special" soap.  Definitely making it more real....nervous, anxious, all of the above.  I just keep hearing what Dr Yafi told me, "we will fix you"
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

Pfract

So this is really happening! Oh boy! ✌good luck man

TDix

Thanks pfract much appreciated.  8am check in tomorrow for what I hope straightens things out.  I know I know I had to say it
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

About to be wheeled into the OR....wish me luck guys
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

On my way home from hospital.  Dr said all went really well.  Removed most but not all the plaque, I am straight, and he did have to use one stitch of Plication but said it was so minor it won't affect any length.  Currently swollen and wrapped.  Used to the feeling from my Xiaflex injections.  Picking up pain meds now and then lots of rest
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

I also had my wife ask the big question of why such invasive surgery doesn't create Peyronies when micro trauma does?  Dr Yafi had a pretty good answer...clean incisions and proper suturing always heal much better than tears.  For example if you split your chin open and let it heal on its own as opposed to going to the hospital and getting stitches, the results are drastically different.  Hope that answers some questions out there.
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

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.

TDix

Removed first wrap today, a little bloody but not bad.  I had a nerve block done so pain is minimal.  A few small hematomas around the glans but nothing major.  Turning out to be a lot less traumatic than I thought it would be, especially after what happened to me with Xiaflex.  So glad I did what I did at this point.  Find that specialist who knows what they're doing and get yourself fixed.  Thank you to everyone who has been following my experience.  You have helped me more than you know
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

Pfract

Nice to know man. I don't want to rain on your parade, but I would let everything heal up and then judge :#

TDix

I hear ya pfract, just relating my personal experience of 2 Er visits from an in office procedure to none so far after a major surgery.  No pain, many medical staff involved, just such a better experience all around.  I will definitely stick around and post my progress.  Success is all I want
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

still swollen pretty bad and have pain at night due to probably the start of nocturnal erections.  Wakes me up before they happen due to the pain, but the positive is I can still get erections, just can't stand the pain of them long enough to get hard.  Good news is they are happening!  Today is the day to unwrap the final wrap and finally take a shower.
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

Pfract

He did not prescribe anti erection medication?  

TDix

No he said they are not that effective and that blood flow to the area is good, even if it hurts at first.  Will be on low dose Cialis soon once the swelling goes down
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

So good to take a shower and take all the wraps off!  My wife calls me "frankenweenie"😂
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Penis is swollen but no real pain thanks to the painkillers.  Pelvic area is black and blue as well.  Would I do this again?  Heck yes.  Much better than the Xiaflex injections.  Was it Dr Wachs?  Not sure, but I highly recommend going to a specialist like Dr Yafi.  Makes a huge difference
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

A lot of pain today at base of penis.  Penis itself is fine, but the base is very tender and painful.  Looks like I got roughed up in the OR😂
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

tonyode

Good to hear things are going ok TD. The pain in base, pubic are sounds similar to xiaflex. My doc said it is result of wrapping penis, forces blood to that area, thus the tenderness, pain. Hang in there and keep us up to date!
Early 50s, 7 months diagnosed. 55 degree curve, indentation at base to the left.