Excision and grafting - results?

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Fltru

Hello,

I have been monitoring this site but now that I have been schedule for "Excision and grafting" surgery I went ahead and joined, thank for allowing me to participate.

I have been Googling searching for patient experience after having "Excision and grafting" for treatment of Peyronies Disease and not really finding much. Can I find any here? I don't presently have issues with ED, it is just that the erection I get is useless due to shortness, hinging, and folding that occurs. My Googling seems to indicate doctors feel excision and grafting is successful 70-80% of the time. Do patients agree with the doctors?

Here is the scoop on me.
1. In 2016 doctors told me what I had suspected, I have Peyronies Disease which makes relations with my wife almost impossible due to hinge, folding, and resulting shortening.
2. I was referred to Texas Medical center where I started seeing Dr. Mohit Khera (he claims to be an expert in Peyronies Disease).
   Dr. Mohit Khera indicated I'm not really a candidate for the tuck procedure due to God given length issues prior to Peyronies Disease, a tuck on the long side might straight it but would leave me very short.
   Dr. Mohit Khera suggested XIAFLEX which was a huge disappointment, it separated me from a lot of my money, zero improvement in quality of life, and felt very much like a part of Dr. Mohit
   Khera "practicing" with me being the test.
   After XIAFLEX failed Dr. Mohit Khera only suggestion was rip and replace with a pump and I'm just not ready to swallow that pill based on one opinion.
3. Since 2017 I have continued my annual checkups with Dr. Khera but I am not sure why.
   I have tried to just live with Peyronies Disease and without intimacy in my life which is hard on a relationship.
   The tuff part of living with it is I do get erections and if they are related to needing to urinate can have really embarrassing side effect. When I void there is no telling where it will go. I got
   caught in a meeting at work that ran long and once I finally got to the bathroom I pee'd over my right shoulder. Waking in the middle of the night and mindlessly going to the bathroom can
   be messy until reality kicks in, "awe crap, not again!"
4. Beginning mid summer (2020) I finally reached out for second opinions. May urologist have suggested "excision and grafting' even though Dr. Khera refuses. Long story short I have met a
  doctor I am very comfortable with and on 11/6/2020 I am scheduled for "Excision and grafting" which only leaves me a little time to double check my decision.

Thanks in advance for any and all help, I really will/do appreciate it
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Benjamin62

Sorry to hear of your troubles.
I'm sure you've researched the heck outta this.
Who is your surgeon and where do you live.
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TDix

I've been through it.  What do you want to know.  How bad is your curve?  Is your scar tissue large and calcified?  I'm here to help you out man
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

redbullmaster

As you have good erections, a lot of surgeons don't like to do the excision and grafting as it can lead to full impotence.

But your between a rock and a hard place, as the normal plication will leave you with a penis too short for sex.
(If I read you right)

So may be worth asking your urologist how confidant he can be not to cause Erectile Dysfunction issues.
As in your case maybe an implant surgery with a excision is the way to go.

You could always do the excision and grafting and if it works great.
But if not, do the implant if needed at a later date.

It's something to talk though with your urologist and see what he recommends for you

Fltru

Thanks to those that have responded. Still searching for those that have been there, done this, and are willing to help adjust my expectations (my expectations are pretty low as anything would help)

In the three years with Dr. Mohit Khera they tell me my curve is greater than 45 degrees (see attached, never could figure out how to shrink a pictures size), depending on the day and the success of the injection (and what my nurse looks like) that causes erection. Worst I have heard is near 60 degrees when the injection was really working. The real problem is peeing over my shoulder and folding or buckling right where plaque is which doctors tell me is normal.

Dr. Mohit Khera with Baylor College of Medicine in the Houston Medical Center wants to go direct to an implant, one of his worker bees would do it. Mechanical devices fail, he is up front about that. IMO I have wasted 3 years jacking around with a "playboy" style Dr. Mohit Khera, he doesn't do anything that I can tell, his staff does it all, he jets around to fancy places and talks at really expensive gatherings, says how smart he is, and tell me there is no hope.)  

I have troubles coming to grips with the lack of organic response with his implant, "Hey wait a minute babe while I pump up"...hell that would even break the mood for me much less my partner  8)

Dr. John E. Bertini (with surgery occurring at St. Joseph's Hospital in Houston) will perform my surgery. He and others says why rush the implant as we can always do that later. Dr. Bertini indicates he has had lots of success with this surgery. Life is full of risks, it is already broken and doesn't work, might as well try something...

It may sound silly but when I told my dad that we would have to take his car keys await he said, "I'd rather die and join Jean in heaven." (my mom passed before my dad)
I have a similar response today when I think of an implant. Now maybe later I will embrace an implant.

Miracles happen every day in our medical community when the right doctor is on the team.  
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ghcash

I underwent excision and grafting surgery 6 weeks ago. PreOp had 80-90% angulation. Postop 10-15%. Insurance would not cover Xiaflex because of the severity of the bend.  The extent of my sexual dysfunction was similar to what you have described. Still recovering, probably another couple months, but I am optimistic about good recovery thus far.. I was initially offered the usual surgery, but I did not want have permanent loss of penile length at age 65.  I am glad that I underwent the surgery.

BlueRidgeBern

I am scheduled for PEG surgery on Monday December 7th.  Of course I am anxious /scared.  I have no real options.  I have an 80 degree dorsal bend.  Can anyone give me a sense of the recovery process and pain?   Will I be able to drive 5 hours to return home the day after surgery, or should I plan on an additional night in a hotel.  Of course, the surgeon's office does not recommend driving the day after the surgery, but I imagine this is mostly a risk-management policy on their part.  I do not want my wife traveling with me because of COVID concerns.

Can anyone provide insights?

Thank you
67, Peyronies Disease for one year due to discrete accident.  Traction, Pentox, Vitamin E.  Severe dorsal bend.  No longer painful.  PEG surgery December 2020.

sky43diver

I wouldn't drive that far after a general anaesthetic. Likely the pain blocker that you will be given during the operation will take care of the pain, however you don't know how your body will react to the anaesthetic the following day. When I had mine I felt very tired and lethargic for a few days afterwards. Do you have the option of taking the train?
55 years old 5 months post op LUE procedure with Prof Ralph in London to fix 90 degree bend to left. Currently doing Traction and VED to gain back 2 inches lost in length, which is going well. Taking daily Cialis and having great erections and sex.

BlueRidgeBern

Thanks Sky43Diver.  I took your advice.  I spent the first night in the hospital and after I was released I checked back into the hotel.  Spent that night sleeping it off, then drove home on the third day.  You were right -- I was not clear-headed the day after.  I have not needed any pain meds.

I am relieved the surgery is in the rear view mirror.  I had a 90-degree dorsal bend, but the plaque was very close to the pelvic bone, so -- close to the nerve bundle.  I am still bandaged up.  That comes off tomorrow.   There is massive bruising around the pelvic bone.

I think I am still numb from surgery.  Any idea when this will begin to regain sensitivity / feeling?
67, Peyronies Disease for one year due to discrete accident.  Traction, Pentox, Vitamin E.  Severe dorsal bend.  No longer painful.  PEG surgery December 2020.

TDix

After my excision and grafting it took a good 5 months to get back to "normal".  Give it some time
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

GaussRifle

Can you please update how your PEG went ? Do you have erection quality and sensation as before after months ?
26 year old
45-50 degree downward curve with an indentation on one side when erect.
Using RestoreX and Xiaflex injections
Taking coq10 with daily Cialis 5mg.