Just visited an urologist, could someone help?

[Sonic]

I visited an urologist today. He palpated and looked at 2 pics I had with me. I have a narrowing at the right side of the base which according to him causes a 20° curve to the right. At first he mentioned something about surgery which I assume was plication? Said something about shortening the other side but then he mentioned some other surgery where he does local anasthesia and don't have to gain access to the nerves and whatnot and apparently this surgery doesn't cause any shortening of the penis. What surgery did he talk about here? He also recommended I get a PMP.

Understanably I'm not to keen on surgery, Xiaflex is not available in my country. Problem with me is my curve isn't that bad but the narrowing causes instability which is a risk factor for further injury.

[FlatteningTheCurve]

Hey,

As far as I understand there are different kinds of surgery. I believe plication is the one that involves adjusting the tissue directly opposite to the point of maximum curvature, also called tunica shortening procedures.

It could be that he is referring to is what is known as tunica lengthening procedures but I am not entirely sure tbh. That does have a lower risk of penile shortening being a side effect but it also has a lot higher likelihood of leading to erectile dynsfunction.

Please see a breakdown of various surgery options and their effects under 'surgical treatment' here: https://uroweb.org/guideline/sexual-and-reproductive-health/#8

Like you, I am unable to get a Xiaflex treatment and have instead embarked on a series of Verapamil injections in London where I am currently based. While I have corrected my curvature through Restorex and VED, I have had similar problem as you - hinging and instability. I can say that at least this issue has been somewhat addressed so far through the Verapamil treatment. Both the stability and blood flow has improved so far so that may or may not be an option for you. Just thought I'd share!

[Sonic]

@FlatteningTheCurve

Thx for the response. I see you are originally from the same nation as me. Kinda blows that xiaflex isn't available here, the Dr I went to said that he had given this to patients in the past with similar issues with good results. I'm glad you have gotten help that worked. There was no mention from this doc about verapamil.

[FlatteningTheCurve]

Yep that is true, annoyingly I started looking at getting Xiaflex injections the same month as it was discontinued, bad timing...

I do not think Verapamil is available in Sweden, or at least I have not found anyone who can administer it there. Dr Wang in Eskilstuna had a private clinic that used to provide Xiaflex, maybe they have transitioned to something else now? My former doc at Karolinska said Dr Wang was well established.

That link I shared lists not only options for surgery but also different kinds of injection treatments and what studies have found their effect to be so have a look at that too.

[Caseyjones01]

My uro told me in Montreal Canada, that they r working on a generic version and it's maybe 2 years away. I went through 1 round and didn't make it so I am not a good example. In my opinion it's a gamble and you should look at underlying issues you might have in response to traction and how easily aggravated your scars get. My peyronies did not present with so much pain, traction brought on inflammation and pain for me and xiaflex reaggrevated the plaques it seems. If xiaflex is something you want to choose do your dodiligence, my last visit I can't remember the numbers cuz I was in pain and in shock, he told me he had a few guys with positive results and 1 guy that wasn't happy and ofcourse then there was me. Now something that uros should not be doing is being vague about numbers and what not happy really means cuz if it's say 3 happy one not happy with no change, it's different from not happy with more shortening and peyronies ahead. But he literally walked away while I was in shock and trying to fumble out questions. I could go on with alot of things, but I just want ppl to know xiaflex can help you, or it can hurt you.

[Sonic]

@Caseyjones01

Sorry it didn't help you. It's truly a horrific disease this. He said I would be a good candidate but I still have my reservations because when you read about it there's very mixed opinions. It's not even available here anyways, they took it off the market in 2019 so I'm stuck with pretty much no alternative. Even with a curve as mild as mine with 20° it still has ruined my sex life due to the instability that the narrowing has caused.

Also doesn't help that the narrowing is located on the base. I'm hesitant on spending that much money on a PMP because all the hassle and also the risk of worsening. And of course I don't want to perform surgery. Plication would make it straight but it would become shorter and it's not like I'm on the big size plus the narrowing would still remain. Scar removal and grafting comes with a risk of Erectile Dysfunction.

Pretty much I'm fked. I try not to stress about it but it's nearly impossible. Being genetically predisposed to this disease is a nightmare. I wish it never existed.

[GaussRifle]

You can get your narrowing fixed by extra tunical grafting, it is not a regular grafting and no cut is made in your tunica, rather it adds support and fills in the narrowing by adding a graft to stability . Henc it doesn't worsen erections.  It was recently introduced and just now the trend is catching up. Best solution would be to go for extra tunical grafting.

[Bud luck]

I'm going to do Extra Tunical Grafting, my left side is dented due to a Trimix injection trauma, causing worst erections and unestability. My Doctor is reluctant to do any surgery, he mentions that with any surgery there is always risks

[Sonic]

You can get your narrowing fixed by extra tunical grafting, it is not a regular grafting and no cut is made in your tunica, rather it adds support and fills in the narrowing by adding a graft to stability . Henc it doesn't worsen erections.  It was recently introduced and just now the trend is catching up. Best solution would be to go for extra tunical grafting.

Thx for the info. I suspect this is what he was referring to when he was talking about a relatively easy procedure that would go for around 550$. He said that he won't have to gain access to the nerves and other sensitive areas so I'm assuming based on what you say that he was referring to this extratunical grafting.

[GaussRifle]

I would highly doubt If he is talking about extra tunical grafting, this is a very recent procedure and doctors in the us have just started practicing it. Moreover , this doesn't fix curve, it only adds girth to the narrowed area to provide stability. To correct curve, doctor still can choose to do plication along with this.

Your doctor most likely was referring to plication, where you shorten the longer end to match the shorter side. Obviously, I could be mistaken , maybe doctor in your country is up to date. You would want to ask him again.

[Sonic]

I would highly doubt If he is talking about extra tunical grafting, this is a very recent procedure and doctors in the us have just started practicing it. Moreover , this doesn't fix curve, it only adds girth to the narrowed area to provide stability. To correct curve, doctor still can choose to do plication along with this.

Your doctor most likely was referring to plication, where you shorten the longer end to match the shorter side. Obviously, I could be mistaken , maybe doctor in your country is up to date. You would want to ask him again.

He did mention plication at first but then when I mentioned hesitancy due to the shortening he mentioned some other technique which I can only presume is extra tunical grafting because he mentioned with this technique he doesn't have to gain acess to the neurovascular bundle, only procedure which does this is ETG. Either way I am going to contact him in maybe 2 months for more info.