Maybe an implant?

[anon1986]

I've been doing research on implants and it seems like a win win. I have a consult scheduled with a doctor that does implants but just wondering if there are any guys here that could answer my questions. I know there are a lot of threads and I've searched and read but I've done so much reading on this site my eyes hurt—no offense of course, I just read and read and read and I'm sure I've read it or missed it or whatever.

I have a ~45/50° curve to the right but no erectile dysfunction. I can get hard but can't penetrate. I'm youngish, so I'd rather do an implant so I don't have to eventually do one. Is this a good idea?
If I get an implant, will I get back to my original erect length pre-Peyronies?

Thanks  

[Hawk]

In combination with your age and if you really have ZERO ED and are only prevented from entry by the angle, I think you should at least consider excision of plaque and grafting by a known, skilled surgeon.  

Several men including LWillisJr have had very good results with such surgery.

[Bud luck]

Incision and grafting have high rates of ED, penis numbness..., is the wost thing he can do.

[Hawk]

Bad Luck, where do you get your statistics and data?  What is your expertise in knowing the worst thing he can do?  I think you have chosen the worst thing to do which is accept life with no sex or intimacy.  What could be worse than that?

Quote s from Bad Luck: "I will never do an implant, I find it barbaric".  "I'm scare to death to get an infection ".

You may have chosen to live in fear and as you said in a recent post "go through your life alone", but don't preach that nonsense on this forum.  You have no understanding of procedures, success rates, best surgeons, or anything else necessary before you start giving advice.  First, learn, get a mental handle on your own condition, then give advice.

[anon1986]

Met with Dr. Eid yesterday— he did an ultrasound and found out that my penis is about 50% scar tissue, which seems high, but he's the doc, so I believe him.

In his office before the procedure he said the implant only would be enough to straighten me out. Then after seeing what we're dealing with, he's stumped at what to do. Says he has to think about it. Could be a malleable to "stage" the penis to be straight enough for the 3-piece. Which would be 2 surgeries. Or the other option is to graft at the same time as putting in the 3-piece. Which is a longer surgery, so higher chance of infection

Honestly, I'm a little defeated. It hasn't even been a year since I got Peyronies and now I'm giving pause to one of the top doctors in the world? It sucks.


Scared, but trying to remain hopeful

[Hawk]

I cannot imagine he is stumped by the degree of the curve because he has corrected many curves far greater than that.

Is it the degree of scaring that he questions whether he can get a Titan implanted as things are now?

[LuisFernandez]

You might want to see Dr. Clavell. I believe he does some more invasive procedures than Dr. Eid does, he might be able to help.

[anon1986]

Yes, it's not the degree that's the issue. It's the amount of scar tissue. I gotta be honest, I feel my dick every day and it doesn't seem like half my penis is inflamed  

[Hawk]

Well, inflamed and scar tissue are different things.  After a section of plaque goes through the acute stage there is no inflammation.

[Tortão Pra Direita]

In his office before the procedure he said the implant only would be enough to straighten me out. Then after seeing what we're dealing with, he's stumped at what to do. Says he has to think about it. Could be a malleable to "stage" the penis to be straight enough for the 3-piece. Which would be 2 surgeries. Or the other option is to graft at the same time as putting in the 3-piece. Which is a longer surgery, so higher chance of infection

Do you have narrowing?

If your problem is just the bend, then I find it odd you need another surgery before the implant, but he's the doc so he has his reasons.

[Hawk]

I am guessing here, but I think that maybe Dr. Eid thinks he cannot get the Titan cylinders into the cavernousa because of scarring and narrowing. I think he might have to put an interim implant in to widen the space then put in a Titan, which will have the axil rigidity to straighten the curve.  

[anon1986]

I have a slight narrowing on the side of the scar tissue.

Since the appointment, it feels like my whole penis has a tough "cage" in it now. I guess it's close to what some guys describe as hard flaccid, though I haven't had it before. The doctor handled my penis much harder than I have since I developed Peyronies.

I hope this passes, I frankly don't know what to do. Doing two surgeries 3 months apart scares me. I'm back to being really depressed about this situation. I'd rather be castrated right now  

[Hawk]

No one wold be happy about two surgeries for reasons of expense, recovery, etc.  your recovery will not be like two full implant surgeries however.  The first surgery is simple.  With Dr Eid it is probably  a 15 minute surgery tops.  

The second surgery will be a little less trauma because the cylinder capsule is already formed in your penis.

Also, Dr Eid is known for preparing patients for all possible complication.  There is at least some chance that once on the table he will find he can in fact install a Titan. He told me he would probably have to make a second incision in my lower abdomen for the reservoir since I had previous abdominal surgery.  He did not make a second incision.

[anon1986]

I hope that would be the case.

His idea if there was only one surgery would be a modified no-touch surgery with an incision along the side of the penis to graft the scarring. I've seen other doctors' videos online and they always incise the scar tissue through the incision for the surgery (some doctors call it the scratch technique).

I'm just freaking out now because I'm still inflamed after the appointment the other day and if I'm already 50% scar tissue, how long is too long to wait to get this done? I've called the doctors office and he hasn't gotten back to me

[anon1986]

Spoke with the doctor.

He wants to do the grafting surgery and at the same time add a malleable on one side, wait 3 months, then put in the 3 piece implant. Says because the grafting part could take up to 5 hours he doesn't want to add the extra time to do the full implant and risk infection.

Has anyone seen a penis with one malleable cylinder in it? I feel like that would be awkward  

[Hawk]

Is this Dr. Eid?


This certainly raises a lot of questions.  I am sure no one here has ever seen a penis with one cylinder implanted.  Most people here have never seen a penis with an implant except maybe their own.  I have seen a few.  

This raises lots of questions.  One not answered by your signature line is, do you have ED?  If not, does this mean the malleable implant would fill out one side and straighten your penis, and you could still get a natural erection in your other side as well as the glans and entire spongiosium?  

I was not even aware that Dr. Eid did Grafting.  How many of these does he do?

[anon1986]

Yes, it's dr. Eid

He told me he's done grafting before but not often. After looking at my case he talked to some other doctors to formulate a plan and that's what he came up with.

After viewing all of Kramer's videos I thought my Peyronies was going to be fixed with some scratching and modeling, now I don't know.

I have mild ED but continues to worsen, especially with all the uncertainty and stress  

[Hawk]

I can only tell you how I feel.  There simply is no greater fan of Dr. Eid than me.  He has a great personality and a deep, sincere desire to help men.  He makes himself so accessible to the degree that it is mind-blowing.  His skill with implants is unexcelled.

Having said that, I would have to seek a second opinion and probably a third.  I am not sure who that would be off the top of my head, but it would be someone else great with implants to see if they thought the implant could be done in one procure without a graft.  I would probably also seek a high volume graft surgeon.  I know this is probably like a gut punch to you, but it is just going along with life as you systematically do your homework.  Others would probably just go with it, but I am a guy who considers every option. You are young.  You have 6 months or a year to set this up, and you might come back to this option.  That's just one guy's opinion.

[anon1986]

I appreciate your thoughts Hawk, thank you.

Eid was my top choice because of his reputation and location. Now that it's up in the air, I'm contacting the other high volume guys, specifically the ones with Peyronies experience.

I have a consults lined up with Dr Blick (AZ), Dr Hakky (ATL), and definitely going to reach out to a couple others  

[postrocker]

Question: if you have an implant you need to redo the surgery x years after getting the implant? Or its just a one time procedure?

[anon1986]

You have to get "revision" surgeries every time the implant stops working, which is a replacement of the unit. I've read that most implants last between 8-15 years. The more you use it the lower life span you get

[postrocker]

Get it. Thanks for the info

[Dared]

Implant should be absolute last resort... I never would've gotten my implant if i could maintain erection. I was only able to get a semi hard erection with severe peyronies and that only once per week if I went four plus hours without eating food. Don't mean to discourage you but implant is for severe peyronies and or erectile dysfunction because you will lose sensation and the orgasm will be less pleasurable as well. My two cents. I've had an implant for three years.  

[RichardWilson99]

How bad is the loss of sensation? I can tell that I've lost some sensation in the area where there is scar tissue. I haven't gotten a full erection in 9 months so I'm most likely going to need the implant as well.

[anon1986]

I never would've gotten my implant if i could maintain erection.

But what if that erection is useless? I can get an erection with Cialis, but I can't penetrate. The narrowing, the curve, looking down at all of it is so discouraging and defeating. If some decreased sensation is what it takes to become straight and able to have sex then it's a no brainer for me.

I just want my life back

[Hawk]

Guys,  I get the real sense that you are not taking advantage of the great content and the intense work that organized the content so you could educate yourselves.

At the top of the Implant board, there are several highlighted "sticky topics".  Read them.  They directly address and answer your questions in detail.

For example, it is absolutely false that an implant should be a last resort much less "absolutely the last resort". This highlighted topic addresses all of this, including sensation and much more."
https://www.peyroniesforum.net/index.php?topic=10974.msg102275#msg102275

[anon1986]

Hawk, as always, thank you for chiming in. I had read most of the journals but had not seen that post which is a well-written and brilliant summary for those of us that are considering an implant.

My point in my post above was merely to comment that I think an implant is the right call for me. I've talked to 3 high volume surgeons. All of them suggested xiaflex with hesitation. One of them said because I can still get an erection it would be "immoral" for him to implant me. The other two surgeons said because of my deformity, an implant is the best route for me.

I've come to the conclusion that I do not want to live with a deformed penis. Even though I haven't tried xiaflex, I've tried the other solutions to no avail. I'm young, so multiple revision are in my future. If that's what it takes to carry on with my life, I'm ready. I haven't been living well since I developed Peyronies. In your post you alluded to spending all your time fixated on your penis and that's what I've been dealing with, and it's honestly been torture.

I don't look at the implant as the last resort. I look at it as a permanent solution. Key word: solution

[anon1986]

Well, I have an implant surgery scheduled. Feeling nervous.

I've done my research. My erectile function has been slipping—maybe mostly in my head, but regardless, I take Cialis everyday and other vitamins and my scar tissue is growing. I want to be done with this nightmare and it seems no matter what, the implant is in my future.

I've been doing VED to help with size. The soma device I had gotten months ago never really worked. I got a cheap one from Walmart that seems to be helping get me a little bigger by the week. Still not straight, but the implant will help that.

I think I'll start a separate topic as an implant journal when it gets closer to my surgery date. They are a huge help and I'm hoping my story can be of value to the website and members

[Hawk]

Which surgeon did you settle on and when is your surgery?

[Tortão Pra Direita]

Says because the grafting part could take up to 5 hours he doesn't want to add the extra time to do the full implant and risk infection.

5 hours??  

Well, surgeons I've seen talking about penis surgery (implant or reconstruction) never said it could took up to 5 hours.

Look at this: https://pubmed.ncbi.nlm.nih.gov/30195564/
Penile Sensory Changes After Plaque Incision and Grafting Surgery for Peyronie's Disease
Results: 63 patients were analyzed. Mean age was 56 ± 10 years. Mean duration of Peyronies Disease at the time of PIG was 15 ± 7 (12-38) months. 75% had curvature alone, and 25% had hourglass/indentation deformities. Mean primary curvature was 64˚ ± 28˚. The mean operation duration was 3.5 ± 1.8 hours. 21% had some degree of sensation loss at 1 week, 21% at 1 month, 8% at 6 months, and 3% at 12 months. Only 1 patient (1.5%) at 2 years continued to have extensive sensation loss on the glans and distal shaft with a very elevated sensitivity threshold. Using multivariable analysis, the only predictor of penile sensation loss ≥6 months was a duration of operation >4 hours (odds ratio = 2.1; 95% confidence interval = 1.2-3.0; P < .01).

[anon1986]

Which surgeon did you settle on and when is your surgery?

First week of March with Dr Hakky in ATL

[Hawk]

Be sure to keep us updated.  Your journal is critical to men looking for answers.

[Tortão Pra Direita]

anon1986
Are you going to have a simple implant procedure? So no grafting or two surgeries?

Please, make an implant journal! I think soon I'm gonna do that too.

[anon1986]

No grafting. Just getting the implant installed, with some "scratching" of the plaque to flatten it out and make room for the cylinders  

[Hawk]

Anon, I am not sure your posts are complete.  You were going with Dr. Eid, considering a malleable implant and grafting, then a 3 piece inflatable.

Then you said you were going with Hakky.  I never read details of your consultation, how that differed from the consultation with Dr. Eid.  I never heard exactly what the surgical plan is, what made you choose Hakky.

I am sure these are all details that are very important if to others trying to follow your case.

[anon1986]

Administrator's Note: some of this post addresses a post that was split into its own topic and found here https://www.peyroniesforum.net/index.php/topic,15208.0.html

I'm not a fan of implants.

so I don't want to throw cold water on them summarily.

But you are throwing cold water on it. You started your long paragraph with "I'm not a fan of implants."

I started this topic on this specific board because I wanted to hear from guys with Peyronies that have implants. I gave the details of my case and wanted them to weigh in. Obviously this board is open to all members but because it's labeled penile implants, don't you think a certain type of guy is going to be looking here?

This is a huge decision for me. It's the most difficult decision I've ever had to make. Posts like yours take the wind out of my sails. Cold water? You just threw me in the Arctic Ocean.


I had a phone consult with dr Hakky weeks ago and told him what Eid said about my case. He thought that there has to be a better way to fix it. He suggested the scratch technique. I looked it up, liked what I saw, and came down to see him.
When he examined me, he said my plaque feels shaped like a "potato chip" so it should be easy to get the dilators through and deal with it that way (plus relief incisions). A Doppler revealed that my right cavernosa was damaged on the outside but pretty good on the inside, and the left chamber was the opposite. He compared it to sausages: on the right side, the casing is damaged but the meat is good, and on the left side, the casing is good but the meat is starting to lose strength.

[Old Man]

Hey anon:

Forget the criticism posted by some members on the forum. You just do your own homework and do much research. So. that you can make the best decision of YOUR OWN about YOUR implant. Do not let negative comments derail you, make your own research BEFORE you make a final decision.

Old Man