Had phone consultation with Dr. Eid

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chefcasey

I haven't been on this site in awhile, but I've finally decided to go the implant route after 8 years with this condition.  I can still get an erection, and don't have much of a curve, just general diffuse scarring and some slight narrowing and shortening.  However, the shortening(about 1 inch) and pain associated with erections and sex is too much for me and I can't take anymore worsening.  

Dr. Eid says the implant will take away most, if not all peyronies associated pain.  Can anyone attest to this?  If true, that would be huge for me.  He also straight up told me that I will not regain lost length with an implant, and at most will have what I have now, so I'm kind of confused as to how many people I've seen claim that they've gained back at least a mild amount of length with him as a surgeon.  

Anyways, I've made an appointment in person, as I really want an in-person examination and ultrasound and to see what he can offer me in terms of implants.  I'm currently around 6 5/8" bone-pressed, maybe 6.75 if I press really hard.  From what I've been reading on here it seems like I could expect a 22cm implant?  If all goes well I hope to get surgery before summer.

Xehonart

Hey man. I too just had my phone consultation and im around the same length and am told the 22cm as well. He told me since i can still get a semi erection that i may even gain a cm or two length wise and that my peyronies would not be a factor. My penis doesnt really bend either its just blood flow issue for me. No pain from my peyronies and i have multpile scars. From what i read and what not im told the peyronies will get better after and will be a non issue. Dr eid is the worlds best and has done this since the 80's so im sure if he says the pain will go away then it will. Also u can even gain some cm girth wise as well if you are less than 14 cm girth. Im scheduled for march 7 so ill let u and everyone know my process and how i feel as i go
30 years old - single. Peyronies 7 years. VI with slight improvement. Not allowed xiaflex - not enough curve. Maintaining blood flow pressure is the problem.
Solution. 22 cm Titan march 7 Dr.Eid. time to go on a legendary F^@$!ng spree.

Xehonart

For lost length id suggest using traction. Taking supplements. Streching. Kiegl etc. Cialis. Try and get as much lost length back before your implant. Because he can only put in an implant based on your current size. But youre around the same as me. So well above average. He told me most implants are around 5 inches dick length
30 years old - single. Peyronies 7 years. VI with slight improvement. Not allowed xiaflex - not enough curve. Maintaining blood flow pressure is the problem.
Solution. 22 cm Titan march 7 Dr.Eid. time to go on a legendary F^@$!ng spree.

chefcasey

I think he told me you can only gain back length if the implant corrects a curvature and therefore makes you longer by straightening you out, or maybe whatever extra length you can get with arousal in your glans.  I'd just be happy if I didn't lose anymore size at this point.  As far as the pain goes, my current uro seems to think it's just nerve pain where the nerves are bundled around the tissue where shortening occurred, up towards the glans.  I'm kind of interested to see if a sonogram shows any scarring in those areas, and I will be asking Dr. Eid a lot more specifics about that when I see him.  Anyways, good luck with the implant!

Frank55

Hey Chef - Who is your current uro who said your current pain is due to nerves bundled around the tissue? Did you mean Dr. Eid or someone else? Let me know - thanks.
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

chefcasey

Frank - not Dr. Eid, but my uro I've been seeing in Wisconsin thinks it's residual nerve pain.  Basically, he says there are nerves that would have been stretched apart normally, but due to shortening/scarring they contract and that's what's causing me pain.

Michiganguy19

Why do people bone press when measuring. You can't bone press while screwing, just measure it normal lol
Peyronies Disease December 2015.
Caused by Reactive Arthritis, November 2015.
Length before erect: 7.2in
Girth before erect: 6.5in? Just a guess. Was 5.9 after loosing girth/having hourglass and first measuring.
Length erect. 6.2in
Girth erect: 4.1

Hawk

The goal is not to see how much penis you can insert during sex.  The goal is to accurately see if you are gaining, maintaining, or losing length.  The only way to do that is with a bone pressed measurement.  If you happen to gain or lose weight it will affect a skin pressed measurement and leave you uncertain about any change in your penis.  Bone pressed length is consistent even with changes in body weight.   I might add that if you get fit and lean there is not much difference between bone pressed and usable length.
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

Frank55

Thanks for the info Chef. Do you get pain only during an erection or do you get it when flaccid as well?
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

chefcasey

Frank - I get pain both flaccid and erect.  Oddly enough, sometimes getting an erection actually relieves my flaccid pain though.  It's like a good stretch that can take some of the tension off the nerves. If I have an erection for an extended period of time though, then the pain will come back.  

Frank55

Thanks again Chef. I'm asking because I too have long term flaccid pain problems. I was originally told by Dr. Levine last September that my current pain is not from inflammation but instead from "tethered nerves." He recommended an implant.

I then had an online meeting with Dr. Eid last fall (after reading about him on this forum) and told him about the flaccid pain and his answer at the time was "I don't know what you can do about that." He went on to say that time may solve the problem, so I've been waiting to see what happens with the pain prior to making a decision on what to do next. Are you sure Dr. Eid is aware you are getting pain both flaccid and erect?

FYI, I've consulted also with Dean Knoll in Tennessee (another experienced peyronies urologist - and yes, I'm getting multiple opinions this time around) who is less confident that bundled/tethered nerves are the problem. Here are a few notes from my appointment with him (in quotes):

"Is your pain from a new peyronies process? Some patients develop a second site. Or is it stretching of the nerves within the plaque? To me, there are not a lot of nerves within the plaque because it is scar tissue.

Scar does not have a good blood supply. Scar also does not have good innervation. It is possible but more likely it is another site that initiates and starts off due to the severity of the pain.

(You have) Flaccid pain as well. That tells me you have another peyronies process that has reignited. A different site. There could be acute inflammation in the tunica from the peyronies process from a new site."

In your case, you've been dealing with it for so long I can't imagine it is inflammatory pain. I may be in the same boat - not sure yet. This June marks the two year point for the pain so I'm going to wait until then. I hate it when the urologists give you differing reasons/prognosis for this problem. Which one are we supposed to believe? Dean Knoll seems very knowledgeable though. Feel free to PM me if you want additional details.
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

chefcasey

So I finally took the trip to NY and had had an in-person visit with Dr Eid yesterday.  First I wanted to rule out the nerve pain that my uro at home seems convinced of, so I took a visit with him first and we did a test.  He injected me with lidocaine directly in the nerve towards the head of the penis with no local(ouch).  If the pain I experienced went numb, it would mean that the tethered nerves were the source of the pain.  I still felt the pain even after though, so that means it must be something else.  My uro at home really doesn't have anymore ideas except to give me nerve meds like Lyrica, but they don't work.  


Dr. Eid was very friendly.  He gave me the ultrasound and noted that my left side had excellent blood flow, but a small venous leak.  The right side however, was much weaker and he seemed to think the artery was at least partially blocked, which he said was very strange.  I could hear the pulse on the machine, but it was much weaker than the right side.  I asked how I could still have strong erections that point up at 1 o'clock with a blocked artery.  He seemed to think that the left side was supplying blood to the right, which compensated the weaker blood flow.


Next was sizing, which I knew would be tricky.  I have band of scar tissue that runs the length of the penis, so when it's flaccid it likes to contract with the "hard flaccid" a lot.  Added to that, I have flaccid pain, so if I try to stretch it gets very resistant and wants to contract, so it takes a bit of time and finesse to get a good stretch.  So the first time he stretched he got 12 cm and it hurt.  Second time he got 13 cm.  Induced erection first time and got 14 cm.  The induced erection was crap, maybe 40% of what I can get.  I had the same reaction years ago with Dr. Levine too.  I explained that to him, so he give it a little pull and we got 15 cm.  He then noticed his ruler had a clearance of about a half cm before it started to measure and he chuckled. So about 15.5 cm, still about a cm short of what I can get at home.  He was on the fence and said at the lowest a 20 cm implant, but he would try to fit a 22 cm or maybe chop off some length on the 22 to make it a 21 cm if need be.  I asked if I could send him some pics later to show what I can get with a full erection and he said yes. At the end of the day what matters is what fits the best on the operating table, and I trust his judgement on that, but I feel better just letting him have all the info I can give him.


He says he usually tries to fit the 22 cm on people if they're close to it because the girth expansion is really nice when you step up from the 20 cm, and even if you chop off a cm to make it 21, you still get that effect.  He really seems to love his job.  I asked him all about RTEs and his eyes lit up. He talked to me about the drawbacks of using them, and the history of all the old style implants.  He likes to talk about implants the same way Ted Williams liked to talk about hitting lol.  It's really refreshing to to see someone so passionate about their job, especially when I've had so many urologists just shuffle me in and out the door.


As far as pain goes, he is very sure that an implant will eliminate all of my pain.  He doesn't think it's tethered or bundled nerves that's causing it like my other doctor.  He thinks it's just pain from Peyronies Disease and an implant will solve it.  I pressed him on this because I really wanted to know the mechanism with that type of pain.  Is it the nerves inside the corpora or tunica?  He says he doesn't really know how the pain sensation works, it may be inside the tunica or corpora, but for some reason all of his patients with similar pain have it gone after implantation.  He was very adamant about this. So that sounds promising.  


I thought for sure I'd be in a lot of pain the next day from all the stretching, since my pain tends to react like that, but pleasantly surprised that I have no increased pain today.  That got me thinking.  I haven't really tried to regain my lost length since my penis began to shorten a few years ago, simply because of the pain I have and did not want it to worsen.  I tried traction about 8 years ago before my penis shortened(I was trying to regain girth back then) and I actually noticed improvements.  The narrowing was less prominent, and I had a better flaccid stretch and overall more soft, flexible tissue.  Unfortunately the old style noose on those models back then began to upset some scar tissue near the glans and I had to stop using it.  I think there are some newer models nowadays that have a more gentle way of securing the penis than that damn noose?  If so, I was thinking about using that for awhile, maybe see if I can gain some length back to make sure I get the largest implant considering Dr. Eid has me right in between 20-22cm right now.  

TonySa

I'd def try traction to regain lost length.  I seem to recall most gains in studies come in the first 60-90 days.  The PMP and ESL40 use a suction cup for the glans and restorex a clamp.
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.

chefcasey

Thanks Tony, I'm checking all those out right now.

Hawk

ChefCasey,

I know your feeling of being in good hands.  I too would try traction.  You will make some gains and your fear or worry of a flair-up is almost behind you.  You can now finally see the light at the end of the tunnel.
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

SW01

I definitely got some length back with traction. I used the andropeyronies but it has the silicone tube which goes around the top of the glans. Not the most comfortable for sure. Glad to put it away for good.

3 months with my titan. Had a slight curve still the week after surgery. Over time it got better and better. Now it is pretty much gone. Stretched at 6.25 and am there right now. When I started traction it was about 5.5. Hope over time or on a revision in the future I get closer to my old 7.

So glad I went ahead and got it done this year. I have an erection I can use and happy where my length is if it does not get any longer.

Dealt with ED, Peyronies, & venous leak for 3 yrs.
implant on March 7, 2019 w/ a Titan 18 cm plus 1cm RTE
Revision after hernia surgery. Dr. Andrew Todd, Richmond KY
Removed Titan and put in LGX 18 cm plus 2 RTE's, 20 cm total.

Pfract

Quote

He says he usually tries to fit the 22 cm on people if they're close to it because the girth expansion is really nice when you step up from the 20 cm, and even if you chop off a cm to make it 21, you still get that effect.  He really seems to love his job.  I asked him all about RTEs and his eyes lit up. He talked to me about the drawbacks of using them, and the history of all the old style implants.  He likes to talk about implants the same way Ted Williams liked to talk about hitting lol.  It's really refreshing to see someone so passionate about their job, especially when I've had so many urologists just shuffle me in and out the door.


As far as pain goes, he is very sure that an implant will eliminate all of my pain.  He doesn't think it's tethered or bundled nerves that's causing it like my other doctor.  He thinks it's just pain from Peyronies Disease and an implant will solve it.  I pressed him on this because I really wanted to know the mechanism with that type of pain.  Is it the nerves inside the corpora or tunica?  He says he doesn't really know how the pain sensation works, it may be inside the tunica or corpora, but for some reason all of his patients with similar pain have it gone after implantation.  He was very adamant about this. So that sounds promising.  


I thought for sure I'd be in a lot of pain the next day from all the stretching, since my pain tends to react like that, but pleasantly surprised that I have no increased pain today.  That got me thinking.  I haven't really tried to regain my lost length since my penis began to shorten a few years ago, simply because of the pain I have and did not want it to worsen.  I tried traction about 8 years ago before my penis shortened(I was trying to regain girth back then) and I actually noticed improvements.  The narrowing was less prominent, and I had a better flaccid stretch and overall more soft, flexible tissue.  Unfortunately, the old style noose on those models back then began to upset some scar tissue near the glans and I had to stop using it.  I think there are some newer models nowadays that have a more gentle way of securing the penis than that damn noose?  If so, I was thinking about using that for a while, maybe see if I can gain some length back to make sure I get the largest implant considering Dr. Eid has me right in between 20-22cm right now.

hey chef! I had a bigger post written up, but my browser crashed. Thank you for going there and updating this thread for us to read. I was very impressed with the amount of stretching you had there. Another thing which i found very interesting was the sizing statements he made diameter wise. I always think about it in terms of length, and forget that the circumference matters too for girth. And we can easily check it out on the manufacturers website, on the model spec webpage.

What he told you about the pain resolving itself with the implant is encouraging. I am in a very similar boat, and if I could get rid of it, along with solving my Erectile Dysfunction would be gold.

As for traction, definitely try it out before you have the procedure. That and VED device, to help out stretching the penis. There are some medical papers on this, showing very good data on size gain (with pictures) with VED regimen before the procedure.

edit#1:

https://www.coloplast.us/titan-en-us.aspx#section=product-variants_4

Just went to their website, but it only lists in length. I was going to swear I have seen more data somwhere on a pdf!

Frank55

Chef - many thanks for this excellent post. Very interesting that Dr. Eid stated a secondary implant benefit is pain elimination.

I'm still on the fence regarding an implant, but if the choice comes down to continuing to live with pain or get an implant, the choice is done. I'm sick of living with pain.

I actually think it is good news that your pain source does not appear to be "tethered nerves." That prognosis seems to be a point of contention among peyronies specialists. Not sure if it is legitimate as an ongoing pain source or not. Dr. Knoll is skeptical of that, as I mentioned before.

Please keep us posted on your results using traction. I too have been leery of it in the past 12 months due to the possibility of making the pain worse.  
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

Stepone

Peyronie's Disease is tough, yes I had pain too, I was injecting trimix, taking viagra, and sex was sometimes possible, but I would always have pain too. I was losing girth, losing length, and decided I was in a no win battle.
I have to be honest and I did say it in my journal, but an implant is tough, it's frustrating, painful, and depressing, but if you can share your concerns on this site and manage your pain, you can make it.
The result is some amazing sex and a better self acceptance.
The tough part is you are not married, so going through it alone could be harder.
I stayed overnight, but it was still tough once I got home.
I also used a male urinal which made urinating a lot easier. I still use it sometimes when needed.
Feel free to ask any questions and good luck.  
Nesbit surgery 2015, 66 years young, Titan Implant 4/25/19, 22cm, Dr. Lentz, Duke University NC