Treatment at Morganstern Clinic in Atlanta during 2019

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Newbern

Hey Guys,

This is a review of my treatment at the Morganstern Clinic during 2019 and the ensuing results. About four years after a penis injury during sex I had a downward bend of about 45 degrees mid shaft. There was significant hourglassing at the base of my penis, mostly on the left side. That is how my penis was shaped when I went to the Morganstern Clinic for the first time in February.

Now, in December, I am taking a break for a few months. Instead of a downward bend I now have a downward curve of about 20-25 degrees. The hourglassing, or wasting, is much better and I anticipate further improvement.

The endostim treatments consist of three injections, one right after the other. First off is verapamil followed by ozone; the last injection is CO2. More on this is down below.

Until I go back to the clinic in a couple of months I will continue stretching with an ESL40, or a Chinese made equivalent, and taking 1500mg citrulline three times a day at meals. The endostim treatments at the clinic dissolves or breakup the scar tissue so the stretching can help normalize the shape. This is my simplified interpretation.

Currently I am taking testosterone injections weekly. The Nurse Practitioner I see at the clinic prescribes me testosterone for injecting while I am receiving treatments; my wife helps me with the injections. A big part of my healing has been working on hormones. Additionally, I am taking gelatinized black maca root from The Maca Team; this, I hope, will be a long term solution to having healthier hormones. DHEA makes difference; my dosage is 100mg in the morning. The taladafil seemed to have quit working so I have been giving this a break.

Interestingly, after my last two treatments, two days in a row, I gave myself a few days to heal. Then when I started stretching it felt like scar tissue was breaking up at the base of my penis and the worst section of the hourglass no longer had the indentation. Actually, this has happened several times where it is like I can feel the release and my penis seems to normalize a little more.

In total I have had 22 endostim treatments this year. The first seven were with verapamil followed by CO2, carbon dioxide. These last 15 treatments included ozone. I would not pursue endostim treatments without ozone. From what I was told I was one of the first patients to receive the ozone treatments at the clinic.

Ozone has a strong track record regarding health benefits in other countries. This is why I jumped at the chance to include ozone in my treatments. As far as I can tell this has made a significant difference. What I am certain of is that if I only took physician's advise on peer reviewed journal articles and did not think for myself I would not be healing like I am.

The verapamil and ozone help break up scar tissue. The CO2 can be excellent for indentations and hourglassing.

This treatment has not been easy. I drive four hours to Atlanta. What I started doing was getting the treatments two days in a row to reduce the traveling. Going three days in a row was more than I could handle.

As far as I can tell the scar tissue in my penis has been broken up enough by the endostim treatments that stretching and citrulline may normalize the shape of my penis to a large extent. The ESL40 is a silicone suction cup that goes onto the head of my penis with the attached strap being just below my knee. It doesn't take a lot of tugging; just a slight traction works for me. I go for two to six hours on most days. What I was told at the clinic is that it takes at least two hours of stretching to start making a difference.

Ordering ESL40 devices online may be problematic. While the website is functional the maker of the ESL40 has had health issues and hasn't been filling orders. So I found a Chinese knockoff which works as well as the ESL40.

The NP who works with me at the Morganstern Clinic is top notch. One of the benefits of working with a woman is that her hands are smaller than a man's so it is easier to feel the scaring and know where to inject. It did take a little time to get use to working with women down below. What I can say is that this NP is a real jewel. Overall, the staff at the clinic are really, really good.

Insurance only covers so much. About half the cost of endostim treatments are covered by my insurance. Insurance only covers a treatment every two weeks. So when I receive treatments two days in a row I pay the full $350 on the second day. With traveling and clinic fees I suspect the cost has been about $12K this year; this includes motels and gas.

With the progress I am making I will continue working with this clinic. I think what happens is that after a certain number of endostim treatments the scaring is broken up enough where stretching, supplements and hormones can normalize my penis. Really, there is a lot I do not know so I am guessing at what is going on.

Having had testicular cancer and losing a testicle, hormone balancing will be a lifetime endeavor. My plan is to have a long term relationship with the Morganstern Clinic and the NP I am seeing.

If I can answer any questions I will. I get a lot out of this forum and appreciate the posts.  

TonySa

Newbern, I'm confused in a July post you said you're curve was down to 10 degrees, now you report 20-25.  Did it improve and then worsen?  Also, is the insurance covering the verapamil injections?  I didn't know that was covered.
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.

Newbern

Hi TonySa,

The curve of my penis has changed over time to a very minimal curve and back to 20-25 degrees. The stronger my erection the slighter the curve. Also, at times the downward curve has been centered at the base of my penis to mid shaft or towards the end of my penis.

It may be the scar tissue in the hourglassing at the base of my penis is what is contributing to the curve; I was told this may cause the changes in where the curve is centered due to a piece of scar tissue which has been difficult to locate. So the NP is focusing now on this region of my penis which has a slight hourglass.

The hourglassing seems to increase and decrease depending on the day. But the severe hourglassing has filled out. The CO2 has begun being very effective on helping to heal this part of my penis. It may be that the treatments have hit the point to where they are producing visible changes after clearing much of the scarring.

Having both the bend and hourglassing complicated matters. Plus having a downward bend meant Xiaflex could not be used.

This doesn't seem like this is an exact science. I am sure it isn't. The NP palpates for the scarring and injects into that tissue. Other times it is a shotgun approach. I suspect this is why results vary so much between people - it can be very difficult to find and treat all the scar tissue. At this point the NP is having a difficult time palpating scar tissue anywhere but at the base of my penis where the houglassing is located.

Here is what I know about insurance reimbursement. Every two weeks insurance will pay for a treatment. When insurance pays, my out of pocket expense is about $200. But when I do two days in a row, the second day is $350 total. Each treatment is verapamil, ozone and CO2. When the ozone was added there was no change in cost. Technically, "Endostim treatment" actually only refers to the CO2 injecting, but I used the term to include the verapamil and ozone as well. I do not know if insurance is paying for only the CO2 and not verapamil.

As an FYI, the ozone and CO2 are gasses. Only the verapamil is a liquid injection.

Before starting treatment at the Morganstern Clinic I contacted Dr. Levine in Chicago. He had written in a paper that he was showing results with verapamil injections. I did not see any follow up articles substantiating this finding. What he told me was to use citrulline twice daily and stretch for six months, then get back with him. The cost of the 15 minute conversation was $200. I think if I had followed this advice my current treatment would be further along.

After a couple months of treatment at the Morganstern Clinic I started stretching regularly. Even today, on vacation, I plan on getting four to six hours in. My belief now is the the injections allow the stretching to be successful. What I mean is that without stretching on most days the injection treatments will not work. To be clear, injections to clear scar tissue will not work without mechanical stretching.

Candidly, the 22 treatments I have had are difficult and trying, physically and emotionally. But I feel like I have not had much of a choice so I have pushed through this. Now I am happy I have persevered. I am 63 and would like to have a penis that works; other than this I am now healthy and in decent shape.

What I did not have a clue about was how much my hormones were off. Getting testosterone pellets or injections have made a huge difference. The DHEA and maca help significantly as well. Without a good level of testosterone my penis probably would not be healing. I suspect some men are trying to straighten their penis while having a low level of testosterone; I know I was.  

hope794

26 yo from Italy.
Peyronie's since abt 2014
Abt 20-25° bend, w/ a moderate twist to the left
ED for 4 years and getting worse
From pornstar-like to moderately depressed - still fighting for a solution.

john.doe.550

Newbern, thank for providing thorough detail about treatments, costs, and impressions.  All this is much appreciated.
Age: 65. Peyronies Disease in MAR 2019. 90 dgree upward curve.. Immediate &  severe. Xiaflex, APR 2019 to early 2021, slow but minor improvement through 2021. Incisional corporoplasty surgery completed in late 2022.

Newbern

Hi Guys,

This is follow up after a couple of years. It has been that long since I stopped treatment at the Morganstern Clinic. In the following update it has nothing to do with the clinic; but it makes sense to complete the information I can offer on this thread.

A couple years ago, after spending time at the Morganstern Clinic, I had a moderate downward bend, maybe 20 degrees, and a hourglassing at the base of my penis. The hourglassing was much more predominant on one side than the other.

I went on a journey of hormonal and endocrine balancing. This has been very helpful. I routinely take 100mg DHEA, Nettle Root extract, Grape Seed extract, and Muira Puama. What I know now is that at 65 years I need these supplements. By taking these items I have better overall health and I have morning wood on a regular basis which is a a sign of balanced hormones. At this point, supporting myself with these male supplements is something I would not want to go without. Testosterone supplementation is a poor choice and leads to long term hormonal disruption; it is about supporting my body to increase and maintain testosterone.

Recently I have had success in diminishing the hourglassing and the downward bend has decreased to about 10 degrees. Another supplement I have been taking is rutin. Rutin is good for strengthening the circulatory system and enhancing blood flow. I take 500-1000mg per day. I believe this has had a significant effect.

There is another product I believe is making a significant difference. Have you considered topical versus oral arginine? A topical arginine with several essential oils that I am having success with is Urban ReLeaf, Warm Relief L-Arginine Salve. I ordered this from Amazon. Most arginine topicals have poor ingredients. This is the only one I have found which has natural ingredients. Arginine cream is used by diabetics to enhance blood flow as an FYI.

This is a bit of a paradigm shift away from prescribed medicines. I am taking tadalafil and this helps. But since taking the topical I am seeing a significant difference. The rutin helps as well. If I wasn't supplementing and using this topical I would not be having the success that I am. By enhancing my maleness my penis has a better chance to heal. This is what I want to convey: supplementation to support hormonal balancing and blood flow is making a difference compared to just going along with physicians advice.

There is a caveat though. Each man has to try various supplements to see what works best for them. I dug deep into this topic. It wasn't the Horny Goat Weed or Yohimbe that worked for me, not at all. For example, Nettle Root blocks the binding of testosterone to the sex hormone binding globulin to help maintain circulating testosterone. Muira Pauma helps with desire and hormonal balancing. I also take Grape Seed extract which blocks aromatase to reduce conversion of testosterone to estradiol. DHEA increases muscle mass and IMO is very important in male health for older men.

See what I mean? This is a complex topic. Supplements are hit or miss. If someone wants more information on this topic I will do what I can. I put together an outline of which supplements to try and spent months seeing and feeling what works best for me. For herbs Soloaray is one of the best brands.


Anbil

Quote from: Newbern on December 14, 2021, 07:51:42 AM
Hi Guys,

This is follow up after a couple of years. It has been that long since I stopped treatment at the Morganstern Clinic. In the following update it has nothing to do with the clinic; but it makes sense to complete the information I can offer on this thread.

A couple years ago, after spending time at the Morganstern Clinic, I had a moderate downward bend, maybe 20 degrees, and a hourglassing at the base of my penis. The hourglassing was much more predominant on one side than the other.

I went on a journey of hormonal and endocrine balancing. This has been very helpful. I routinely take 100mg DHEA, Nettle Root extract, Grape Seed extract, and Muira Puama. What I know now is that at 65 years I need these supplements. By taking these items I have better overall health and I have morning wood on a regular basis which is a a sign of balanced hormones. At this point, supporting myself with these male supplements is something I would not want to go without. Testosterone supplementation is a poor choice and leads to long term hormonal disruption; it is about supporting my body to increase and maintain testosterone.

Recently I have had success in diminishing the hourglassing and the downward bend has decreased to about 10 degrees. Another supplement I have been taking is rutin. Rutin is good for strengthening the circulatory system and enhancing blood flow. I take 500-1000mg per day. I believe this has had a significant effect.

There is another product I believe is making a significant difference. Have you considered topical versus oral arginine? A topical arginine with several essential oils that I am having success with is Urban ReLeaf, Warm Relief L-Arginine Salve. I ordered this from Amazon. Most arginine topicals have poor ingredients. This is the only one I have found which has natural ingredients. Arginine cream is used by diabetics to enhance blood flow as an FYI.

This is a bit of a paradigm shift away from prescribed medicines. I am taking tadalafil and this helps. But since taking the topical I am seeing a significant difference. The rutin helps as well. If I wasn't supplementing and using this topical I would not be having the success that I am. By enhancing my maleness my penis has a better chance to heal. This is what I want to convey: supplementation to support hormonal balancing and blood flow is making a difference compared to just going along with physicians advice.

There is a caveat though. Each man has to try various supplements to see what works best for them. I dug deep into this topic. It wasn't the Horny Goat Weed or Yohimbe that worked for me, not at all. For example, Nettle Root blocks the binding of testosterone to the sex hormone binding globulin to help maintain circulating testosterone. Muira Pauma helps with desire and hormonal balancing. I also take Grape Seed extract which blocks aromatase to reduce conversion of testosterone to estradiol. DHEA increases muscle mass and IMO is very important in male health for older men.

See what I mean? This is a complex topic. Supplements are hit or miss. If someone wants more information on this topic I will do what I can. I put together an outline of which supplements to try and spent months seeing and feeling what works best for me. For herbs Soloaray is one of the best brands.

I agree with you, weak erections are the cause and can greatly worsen peyronies. Thats why improving overall health and male hormones is important to allow your body the best chance at repairing itself.

I'm curious about rutin, what sort of effects did it have for you and what brand do you use?
Onset of pain in March 2021
Progressed to loss of girth to dent under the glans left side

Been doing daily heat,traction,pentox,ved,cialis since initial onset of pain

Currently still experiencing pain and dent unchanged

westerntown

Hey that's amazing that you were able to look heavily into the correct supplements.

Where you able to rid yourself of the hourglassing?
20, late 2020 masturbation injury leads to semi erect hourglass, then try manual stretching leads to pudendal neuralgia like symptoms, corpus spongiosum and glans do not fill, severe ed- floppy unstable erections that feel like water balloon .