Post-op expectations for incision and grafting

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Itsallmyfault

This is my first official post here, so bear with me.  My husband had an incision and grafting procedure done 16 days ago.  The incision was made over his old circumcision scar, and his penis was degloved for the surgery.  His plaque is near the base of his penis, and he had significant waist-banding and the hinge effect as well.

Most of his dissolvable sutures are gone, but there a few areas that haven't healed together.  His doctor started him on 5mg daily of Cialis, gave him the go ahead to resume his VED routine (a 10 minute "burn" twice daily) and told him that those areas will heal from the inside.  He has some blood-tinged drainage from the unhealed areas, but the doctor doesn't seem concerned about that (he's still on antibiotics for another month).  

Having said all of that, he is extremely depressed and frustrated because he has lost length since the surgery.  His girth has increased, but is certainly shorter.  His doctor keeps assuring us that he shouldn't have any loss of length once he heals fully.  Does this sound normal?  erections are still uncomfortable, and I wonder if the pain isn't keeping him from achieving full length.  Please tell me to relax, that he's only 16 days post-op, and he's got a lot of healing and stretching to do.  This is what I'm telling him, but I'm afraid that I may be lying.   :-\

*Disclaimer:  I don't care if he has 2 inches of erect length left.  That is so far from being important to me it's unreal.  I just want him to be happy, and he is devastated right now.  Thanks!

LWillisjr


It took me 6 months to be 98% healed and a full year before I felt 100%.

So yes..... relax. 16 days post op is barely a scratch on the surface. My progress was slow, and in small increments. But I kept focusing on the fact that it was slowly getting better.

The best thing you can do is reassure your husband. Don't even comment about it being bigger or smaller. It is what it is. If you worry, he will see that and become more anxious.

16 days post op is too early. My doc told me no intercourse for 6 weeks. I know a few guys who "jumped the gun" and regretted it later.
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

Old Man

Itsallmyfault:

I don't really understand your husband's doctor telling him to resume the VED therapy so soon after surgery. If the incision is still not fully healed and still draining, he should not use the VED as this will cause much more pressure on the incision than a regular erection. IMHO more trauma will be caused by the added pressure on the incision area.

The added pressure could lead to improper healing and maybe other problems. Strongly urge you to have him check with his doctor again to make doubly certain that the VED therapy is to be resumed so early after surgery.

In my experience with patients after penile surgery, the VED therapy is resumed only after full healing has been accomplished. So, if he does the VED therapy, he should be extremely careful not to overpump the pressure. Less is much better than more in VED therapy anyway.

Regards, Old Man  
Age 92. Peyronies Disease at age 24, Peyronies Disease after
stage four radical prostatectomy in 1995, Heart surgery 2004 with three bypasses/three stents.
Three more stents in 2016. Hiatal hernia surgery 2017 with 1/3 stomach reduction. Many other surgeries too.

fubar

Itsallmyfault

I agree with old man on this one.But I would go one step further and give the wound time to heal from the surgery .Any wound we have does not want agrivation but time to mend.All surgery has an outcome and we have to wait and see.

Loss of size is expected in this type of surgery.The ved is definately an option to post operation procedure but in my opinion  and probably others, used after the healing.I do not know of the bond of healing tissue is well enough for a ved stretch after 16 days.Maybe another opinion by a doctor that knows about internal healing is in order.

Of my limited understanding about internal healing. I would not risk it knowing ved therapy helps well after an initial Peyronie's onset.Like old man says any pain leave it alone. I go by those words all the time in my therapy if I have an ache I just stop.Wait for a time that I feel no pain and begain therapy as usual.

I would just try to comfort him and try to think of ways to take his mind off the obvious struggle at this time.Basically a decision was made and an operation and all that takes time to sort out.The tissues are delicate once I thought invincible what a silly thought knowing what I know now.


The very best to you ,fubar

Itsallmyfault

Thank you for all your input!  He did double check with his doctor, and he is adamant that the VED should be used now.  He isn't draining at all anymore, so that is a good thing.  It does concern me that you guys say he should NOT be using the VED yet, but the doctor said that once the graft starts to "scar down" it's not reversible, and that scares him.  

I am not mentioning size at all.  When he asks me about, we discuss his concerns, but I try not be as impartial as possible.  It really doesn't matter to me if he's lost or gained size.  

Is it normal for him to have loss of sensation above the incision site?  His doctor seems to think that it is, but I would like your opinion/experience as well.  The doctor says that it can take 6 months for the sensation to return, and some patients take as long as a year.  Again, it's not an issue for me, but I know that it is a huge concern for him.  


Tim468

The best study I read about using the VED post op had them starting after week 6. I have heard of it being used by week two.

Tim
52, Peyronies Disease for 30 years, upward curve and some new lesions.

Old Man

Itsallmyfault:

I still maintain that if the doctor wants him to use the VED at this stage of recovery and the wound is healing properly, use the VED very cautiously.

Another tip that my uro recommended for scar reduction is to use cocoa butter and massage it into the scar tissue area on a mild basis. It is well known to help reduce scarring.

It worked great for my Dupuytren's Contracture surgery two years ago. Have had supplemental surgery since that time on the same hand and the therapist I am seeing uses it each and every time I go for a session. The latest scar is hardly visible as a result of it.

Old Man
Age 92. Peyronies Disease at age 24, Peyronies Disease after
stage four radical prostatectomy in 1995, Heart surgery 2004 with three bypasses/three stents.
Three more stents in 2016. Hiatal hernia surgery 2017 with 1/3 stomach reduction. Many other surgeries too.

Itsallmyfault

I did more research on post-op VED use, and also found that week 6-8 is the optimal time to start.  We are going to hold off on the VED until he's healed.  We certainly don't want to do more harm than good.  Thanks again for your input.

Does anyone have any experience with the numbness/loss of sensation issues?  Above the incision, he is completely numb.  Will that area always be numb, or should he regain some feeling with time?

LWillisjr

Quote from: Itsallmyfault on July 07, 2011, 01:58:38 AM

Is it normal for him to have loss of sensation above the incision site?  His doctor seems to think that it is, but I would like your opinion/experience as well.  The doctor says that it can take 6 months for the sensation to return, and some patients take as long as a year.  Again, it's not an issue for me, but I know that it is a huge concern for him.  

Yes it can take  several months to heal and sensatoin to return. My best suggestion is for him to be aware of size, sensation, etc. The key is that he should track and notice slow small improvments.  
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

Laddie

I'm not sure if this is the right spot for me to be posting or if I should start a new thread, but I had an incision and grafting about six weeks ago. Tomorrow, I will start VED therapy. Not sure if I should follow the VED protocol I tried using when I had the curve or go with my doctor's suggestion of 5-10 every couple of days. Any suggestions?

As for details, I'm still in the healing stage. I felt this grafting was my only option, as I had a 70% curvature that made sex difficult and painful. I also had hourglassing in two places and a secondary plaque that developed toward the base due to pressure being put on there while having sex with the big curvature. The secondary plaque was a year old, but still seemed to be developing a bit. The doctor said that was fine and did grafting on that spot as well as on the curvature. I had extreme pain for 7-10 days after surgery, mainly in the spot where the secondary plaque was. I still have some pain there and some indentation appears to be returning. I'm hoping the VED will help balance that.

I must be 2 inches shorter than I was prior to surgery, but my erections feel tight. The doctor says that length should return in the coming months. Even if it doesn't, I'm happy that I am much straighter. Maybe a 5% curve compared to 70%. I just hope scar tissue doesn't form and put me back where I started.

I would like to give progress updates in the coming weeks and months. I don't know if this is the right thread for that or not, but I want to be a resource for people considering the same surgery.

james1947

Laddie

I don't know if this is the place to post, this maybe the board moderator will tell you.

I wanted to thank you for the update, is very important that people that had solved they Peyronies problem will write to the forum and update the outcome. Some just disappear.
Wish you successfull healling and good future sex life.
Continue to update us.

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

mike67

Best wishes to you post op. I had the same surgery Feb. 2 this year. You can read all about my story on the My History thread on the main page.
Please don't hesitate to contact me by PM or otherwise , if you want to discuss our mutual situations and how I have delt with it.
Mike
Mikey

Laddie

Thank you mike67 and james1947 for your thoughts. I will check out your history thread, Mike, as I definitely would like to see how our recoveries compare. There were several shocking moments post-op that I wasn't prepared for, like the extreme shortening (and the biggest shock - the amount of bleeding when I first changed my bandages). I appreciate you and others taking time to share your post-op experiences, and I'm looking forward to sharing mine.  

Noway

Its like any surgery it takes time too heal and listen too the doctor. Dont overdue anything let it take its time too heal.

2Oldfords

   Thanks for posting your experience. I'm having the surgery in about 3 wks and reading the outcomes is helping my anxious mind. I can't help but notice the loss of length is mentioned several times. Is this something that is mostly post-op and will correct itself with proper physical therapy? I trust the real life experiences of members posting more than all the literature I can find.
  I also have read this surgery should be a last resort. This is the only treatment I could find that could provide a quick turn around from this disease. Desperation kind of drove me in this direction so I hope I have made the right decision. I really thought I found a good surgeon but some Things I"ve read in this forum makes me wonder. My surgeon said the ultrasounds never helped him so he quit having them done. Also He has never seen the bend in my penis only palpate it flaccid. Should I be concerned? He does about 120 of these procedures a year.
   I can't help but worry about what is about to happen as there is a lot at stake.
Age - 65
Peyronies of unknown length of time
70 Deg curve 10-11 o'clock
first 2 uro's offer for xiaflex and referral
incision/grafting 12/18/18, Implant 9/11/20

TonySa

Regarding loss of sensation above the scar line, I had the same and 10 weeks out it's slowly returning.

Regarding the shortening, I'm wondering if that was because plication was also used in their surgeries?  Excision and grafting should release the shorter side and gain length to the longer size length.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.