Help with choosing type of surgery

[MiddleAgedMan]

Hi,

I have had Peyronies for over 2 years now and it's stabilized with a 60+ degree dorsal curvature. I'm still trying traction (with little evidence of any improvement) but more and more resigning myself to having surgery at some point. The question is whether to go for plication or incision and grafting? In the UK where I'm located they recommend the former for less than 60 deg curvature and the latter for 60 deg, so I'm right in the middle. My concern with plication is the stitches being uncomfortable and the loss of length (about 4cm predicted, I'm currently about 15 cm so would be left with a fairly short penis and I'm also not very girthy so that is something I'm concerned about). Grafting on the other hand seems to have a lot more risk, although the main one, ED, is probably slightly lower in my case as I have good erections and no heart disease issues (which apparently are associated with worse outcomes). Would love to hear from others with similar curvatures and what you did and why. For those of you who lost a lot of length, did it affect your sex life significantly? What about circumcision (which seems to be expected, I'm currently uncircumcised and would rather stay that way)? Those who did grafting, were you happy with the results?

[bustedchubb]

I had the same dilemma.  Had a stable dorsal curve around 50 degrees.  After much research and actually talking to several surgeons, plication was the right choice for me.  I had one frankly tell me that Excision and Grafting has much more likelihood of post surgical ED and doesn't recommend it unless you have significant narrowing that could not be addressed with extra tunical grafting.  I am nearing the end of my recovery period now 71 days later and after doing 6-8 months of excessive traction and VED without further results, I am very glad I pulled the trigger and got plication.

[Ascend]

Thanks for info. Following this thread because I'm also getting an operation IF the traction doesn't work. Do you mind if I ask what the shortening was in your case?

[bustedchubb]

I lost about 1/2 of an inch post surgery.  I lost a total of 1 3/4 inches between Peyronies Disease effects and surgery combined.  Went from 6" to about 4 1/4".  Lost girth from about inch up to the head as well.  

[LWillisjr]

I had grafting and very happy with the outcome. I went from an original length of 6.25 inches to about 5.75 post surgery. So is hard to say how much was due to just peyronies and how much was due to the surgery. But I think grafting minimized my loss of length. Happy to discuss further.

[MiddleAgedMan]

I had grafting and very happy with the outcome. I went from an original length of 6.25 inches to about 5.75 post surgery. So is hard to say how much was due to just peyronies and how much was due to the surgery. But I think grafting minimized my loss of length. Happy to discuss further.

Thanks - did you experience any side effects? Reduced sensation, ED? What made you opt for grafting rather than plication? How large was your curve before surgery and how much is it now?

[MiddleAgedMan]

I had the same dilemma.  Had a stable dorsal curve around 50 degrees.  After much research and actually talking to several surgeons, plication was the right choice for me.  I had one frankly tell me that Excision and Grafting has much more likelihood of post surgical Erectile Dysfunction and doesn't recommend it unless you have significant narrowing that could not be addressed with extra tunical grafting.  I am nearing the end of my recovery period now 71 days later and after doing 6-8 months of excessive traction and VED without further results, I am very glad I pulled the trigger and got plication.

Thanks - did the surgery work as you had hoped? What about the stitches, can you feel them and do they bother you at all?  

[LWillisjr]

Thanks - did you experience any side effects? Reduced sensation, Erectile Dysfunction? What made you opt for grafting rather than plication? How large was your curve before surgery and how much is it now?

I had some reduced sensation at first, but pretty much back to 100% 6 months post op.
I didn't opt for it, it was the clear recommendation of my surgeon, Dr. Levine. Whom I trust with no reservations.
70+ degrees dorsal before surgery....  13 years later around 10 degrees or so still dorsal. But no issues.

Details are in my link below in signature line.

[Alex83]

I lost about 1/2 of an inch post surgery.  I lost a total of 1 3/4 inches between Peyronies Disease effects and surgery combined.  Went from 6" to about 4 1/4".  Lost girth from about inch up to the head as well.

Is the loss of girth only due to Peyronies? Or did the plicature make you lose girth too?

[mst]

I do not know how you measure your lenght.
You will never be shorter than your shorter side. You just lose from the longer side but that must be done in order to make penis straight.

"When our patients who are contemplating plication ask how much their penis will be shortened, it should be understood that nothing is chopped off!  The answer is that the longer side is made fairly equal to the shorter side. ":

https://www.centerforreconstructiveurology.org/wp-content/uploads/2019/10/Illustration-demonstrating-to-what-extent-plication-is-needed-to-correct-penil-curvature-800x400.jpg

[MiddleAgedMan]

I had some reduced sensation at first, but pretty much back to 100% 6 months post op.
I didn't opt for it, it was the clear recommendation of my surgeon, Dr. Levine. Whom I trust with no reservations.
70+ degrees dorsal before surgery....  13 years later around 10 degrees or so still dorsal. But no issues.

Details are in my link below in signature line.

Many thanks, very helpful. Good to know that your surgery went so well - most of the stories on the forum seem to focus on the ones who had problems, for obvious reasons.