Coronary Artery Disease and Peyroines

[jan.schaller1958]

I have Coronary Artery Disease (CAD),which I thought affected the heart. I had a telephone consult with a Peyroines urologist at Kaiser San Francisco and I didn't think much of that guy. First, he told me since I have CAD it's likely to make my Peyroines worse, because, unbeknownst to me, CAD affects all the blood vessels in the body, including those to the penis. And it adds to penile shrinkage."  My God. He says, ,,You don't understand. You have plaque build-up throughout ALL your blood vessels, including those to your penis." And that guy kept telling me to stop interrupting him and talking over him (what a rude guy). I told him I didn't have Erectile Dysfunction, and he said I was very very lucky, because at my age (62) and having high blood pressure, I was definitely at high risk of Erectile Dysfunction. He said ,,You must have better blood flow to the penis than most". What? So, I'm supposed to email him erect pics using the viagra and erect pics (from 3 different angles) without it. At the appointment he's going to inject something to induce an erection for an ultrasound I guess. Gosh, he sure wasn't encouraging like Dr Lue. Maybe he's trying to say the Xiaflex won't work just to save Kaiser the money? I asked him about surgeries and he said there were many options today. Then he said "I don't exactly get many guys lined up at my door for a surgery that will shrink their penis." Well obviously. He didn't have to say that. He made me feel like, with this CAD I was lucky to still be alive! What a miserable doctor. I just hope he doesn't recommend some crazy implant. I think I'm too young for that.  

[TonySa]

I'd request a different doc...

[jan.schaller1958]

Thanks for your reply Tony,  but this guy is the only game in town (as far as Peyroines goes) with my insurance, Kaiser. He's the only one they have licensed to use Xiaflex. And telling me to listen and stop interrupting him, and talking over him? Well, excuse me, but it's my dick we're talking about here. It kind of means a lot to me! He made me sound like my Peyroines was a hopeless case. What an experience.  

[TonySa]

Can you change insurance during open enrollment
T?

[jan.schaller1958]

I wish I could. Rather doubt it. I'll probably go to an appointment with this fool, send him the fotos and see what he says. He's going to inject something to give me an erection during my exam, but who knows what he's going to say? What kind of floored me was when I said I had Peyroines was when he said, ,,Well you and Dr Lue (whom he knows obviously) say you have Peyroines." What? He questions the diagnosis, when two of his own Kaiser doctors, one a urologist, and one Internist confirmed it 5 years ago? And Dr Lue did a thorough exam with ultrasound 5 years ago and diagnosed it and then re-diagnosed it with another ultrasound in February? What? Does this guy think my coronary artery disease (CAD) shrunk me down and bent my penis?

And he tells me to stop interrupting him. My god.  

[jan.schaller1958]

You know Tony, what I should do is email those people at Kaiser and say, ,,I want an outside referral. Not that rude Dr Otero you sent me to." Yeah, I'll say his name here. I don't care. Don't go to that guy. Some bedside manner he has. I swear I thought that guy was gonna say, ,,Well, at 62 with coronary artery disease (CAD) and high blood pressure you're lucky to still be around." what an encouraging guy.  

[jan.schaller1958]

I talked to an internist today about what that urologist told me yesterday, and he said it was not true. CAD does NOT make peyroines worse, it does NOT contribute to skrinkage from Peyroines, it does not affect length of the penis at all in fact,  and it doesn't always affect all blood vessels in the body. This internist said this was absolutely untrue what that guy told me. He said yes, it might, but not in all cases, in combination with hypertension, lead to ED, but not necessarily. The internist told me this urologist should stick with urology and stay out of internal medicine.  

[TonySa]

I agree!

[peyroniesurprise]

I talked to an internist today about what that urologist told me yesterday, and he said it was not true. CAD does NOT make peyroines worse, it does NOT contribute to skrinkage from Peyroines, it does not affect length of the penis at all in fact,  and it doesn't always affect all blood vessels in the body. This internist said this was absolutely untrue what that guy told me. He said yes, it might, but not in all cases, in combination with hypertension, lead to Erectile Dysfunction, but not necessarily. The internist told me this urologist should stick with urology and stay out of internal medicine.

Honestly this doesn't make sense and i think that the first doctor was right. Artery disease is systemic and it's only expected to make peyronie's worse and some degree of Erectile Dysfunction would be expected too. It's true that it may not apply to all but i would say peyronie is inherently a vascularization problem.

The first doctor probably insisted on the seriousness of CAD because it's something one should not take lightly and fix up their diet/exercise etc routine accordingly. It's i think the #1 killer.

[NeoV]

Yes there was even a study this year that mentioned that the penile arteries are affected BEFORE the other arteries. Will post it in a bit.

[peter123]

obviously because they have a smaller diameter.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442980/

Artery   Diameter (mm)   Clinical Event
Penile   1–2   ED
Coronary   3–4   Ischaemic heart disease
Carotid   5–7   TIA/stroke
Femoral   6–8   Claudication

[jan.schaller1958]

CAD affects different arteries differently, it would seem, depending in their size. They couldn't put in stents in my heart a year and a half ago because the blood vessels affected were too small. So they are just treating it medically. They have me on Atorvastatin, 80mgs a day, the maximum dose, and two blood pressure pills. The big dose of Atorvastatin really fixed things pretty well. No chest pain while walking, nothing. And, although I didn't expect this, is caused a huge increase in erections and libido. I tried telling the docs this, but they didn't believe me.

I couldn't imagine having had even occasional ED or Peyroines at 22. That would make anyone depressed. I was 22 in 1980 and I had all the girls I wanted too and life was good. When I was 22, I had never even heard of Peyroines and I had never even heard of ED either to be honest. That was when I was working in Braunschweig and living near Helmstedt, near the then East German border.

So when I hear someone say they have early onset Peyroines or any kind of ED at 22, that person has my sympathy and total support for sure. Back in 1980 they didn't even have any ED pills, no cialis, no viagra, nothing. No internet. And I assume they couldn't do much for Peyroines except a Nesbit, which is a crappy surgery and shortens the penis.

Many thanks to Peter for the link. That was helpful.