Length gain after surgery in book by Levine

Previous topic - Next topic

0 Members and 1 Guest are viewing this topic.

Luciano

I just read Dr.Levine's Book, Peyronie'S Disease a guide to clinical Management.
(for those that dont know it, its a compilation of treatment methods and of surgery methods)
Its not written totally by levine, he wrote parts of it. Its mainly a collection of Articles and Essay of Doctors describing how they treat and perform surgery. I suppose levine chose the articles.

There are also several chapters by Levine himself, one that drew my attention:

Chapter 20 / Penile Straightening With Plaque Incision or Partial Excision and Human Pericardial Grafting Technique by Laurence A. Levine

He there discribes the method, (with pics).

In the conclusion Levine writes:
QuoteIn a published review of our initial experience with the Tutoplast pericardial graft
repair for advanced Peyronie's deformity, we found that in 40 consecutive men with a
mean age of 50 yr who had a mean curvature of 69° (range 40–140°) and in whom 65%
had significant indentation, 98% were satisfactorily surgically straightened (defined as
curvature less than 20°) at a mean follow-up of 18 mo (range 2–40 mo) (5). Of these
individuals, all were sexually active, 70% required no pharmacological assistance, and
as noted, 15% of men had reduction of their erections when they had a grade 9–10 out
of 10 erection preoperatively, but 30% had reduction of rigidity when their rigidity was
graded as 7–8 out of 10. Objective evaluation of length change measured dorsally both
pre- and postoperatively revealed that 58% of patients had a mean increased penile length
of 1.4 cm, 33% had mean shortening of 1.7 cm, and 10% were unchanged.

What made me curious, was at the end:
Objective evaluation of length change measured dorsally both
pre- and postoperatively revealed that 58% of patients had a mean increased penile length
of 1.4 cm, 33% had mean shortening of 1.7 cm, and 10% were unchanged.

So if I understand correctly, 68% of the patients have an increase of penile length or stayed the same, and only one third had a loss in length.

btw, there are other methods described in that book by levine,
One method by american Dr. L. Dean Knoll from the Center for Urological Treatment and Research, Nashville, TN
Use of Porcine Small Intestinal Submucosal Graft in the Surgical Management of Peyronie's Disease  by L. Dean Knoll, MD

here the results table:


Penile straightness:     110 (90)
Recurrent curvature: 12 (10) (reoperation 4)
Penile length change:No change 54 (44)
Longer 68 (56)
Shorter 0 (0)

-he speaks of NO shortening
and
Brazilian Dr. Paulo H. Egydio, MD, PhD  Surgical Straightening With Tunica Incision and Grafting Technique Single Relaxing Incision Based on Geometrical Principles
he writes:
This single geometrically determined incision is a standardized procedure that may
be used for the correction of any penile curvature whether or not associated with tunical
constriction regardless of plaque characteristics, resulting in maximum penile length
gain.


Now here are my questions:

1. Is Dr. Levine still using this method????

2. He has selected the articles for his book, and as I think he is a serious doctor that knows what he is doing,
why are they all writing about length gain or at least no length loss in most cases, and why i have not read here of a single patient that did not have a shortening after surgery.
*confused*

L.

Brightdog

My guess is that we are measuring different things.

Example:
Let's say two men each started with 8".
And let's say the Peyronnie's caused one to have some shrinkage because of where the plaque was - and a dorsal curve. So before the surgery he actually measures 6", not the 8" he had at the start..
Let's say the other man has shrinkage only on one side, so they measure the short side at 3" and the long side at 7" and decide the average is then 5".
The surgeon does the surgery. Let's say it is successful in both cases, and they both have straight 7" erections.
The guys are going to feel like they have each lost 1", because they used to be straight and 8" and now they are straight and 7". But the doctors never saw them when they were straight and 8" - the doctors only saw them when they were 6" and 5" respectively. So according to the docs, the surgery has actually made the men longer than they were before by 1" and 2" respectively.

Luciano

You got a point there, that would explain lots of things,
But then that would meen, if someone has spontaneous healing, or if xiaflex dissolves the plaque and people are healed, that would meen they are back to (taking your example) 8" or 7?
(I am not that worried about length, just curious)
Luc