Extra tunical grafting or straight to implant?

[IwillbeatPD]

Hey everyone,

Just looking for some wisdom and opinions on what route I should go here. Basically my situation is a slight 15 degree curve (which doesn't cause problems since I've always had it), and hourglassing mid shaft. The hourglassing is causing instability that would make sex way too risky and I thinks it's reducing blood flow which causes weakened erections-only making the instability worse. Read my bio for my current regimen.

After countless hours researching I've pretty much concluded that once you have hourglassing the outcome isn't usually good. Despite that, prior to me choosing to do anything I am waiting a full year trying less invasive methods like VED, traction, heat, pentox and tadalafil. If these don't work it sounds like my only two options are:


1. Extra Tunical Grafting with plication (If you don't know this procedure basically just adds a graft over the hourglass for stability without cutting like with excision and grafting. Much less risky, mostly cosmetic, but prob limited structural support). While I know this doesn't add tons of stability, I do believe the perfectly straight penis, and even a LITTLE added stability may be enough to make sex safer and possible. It would also make the penis look normal from a cosmetic perspective which is equally important to me. This route id imagine I'd have to stay on tadalafil for life to make sure I'm getting enough blood flow to have a strong enough erection. The only real hesitation I have here I guess is a potential loss in length, and the scar from degloving.

2. Implant route. The obvious hesitation I have with this is that I'm 36. Meaning, undoubtedly I'd have to have at least one revision done in an average scenario where it lasts 15 years. There's also no going back from that of course. This route the scar would be unnoticeable but I do have several questions that I'll probably post in another thread about implants.

Do you all think it's worth going the ETG route first, and seeing if im satisfied with those results first? I've heard such positive things about implants, just wondering if it would be worth it to just go straight to that. I'd hate to do the ETG, pay the money, have the risks, scar, and down time...only for that to not do much. Some of the gurus here like Hawk seems to favor going to implant much sooner than some people do. But I also realize he's much older and im 36, so maybe it's different for me. I really appreciate anyone's time who can weigh in on this.  

[LWillisjr]

Have you investigated which procedure might be covered by insurance?  

[Sonic]

This is something you should think hard and long about and make a decision based on whats best for yourself in accordance with your doctor. Don't make decisions based on others opninons.

The thing is most seasoned and expert urologists only recommend these standard surgeries if you have top notch erectile quality. I do not know too much about your case but if you have ED it's most likely best to avoid all standard surgeries and opt for an implant.

[PBerlin]

I think we are both in the same boat.
I suffer from almost the same symptoms. It's not the curve that bothers me but the indentation.

ETG does not always require degloving but may be done with the "window technique" - Depending on your case.

In any case let me know how things go. Would be interested in hearing about your further process.  

[cdub]

I consulted with Dr. Levine and Dr. Brian Christine in the last year about ETG for stability.  Both of them told me straight up that ETG will NOT provide added stability to your penis, it's merely cosmetic.  On top of that Dr. Christine told me that something like 30% of men that have the ETG procedure will end up with erectile dysfunction.  

[IwillbeatPD]

Hey C Dub-

Geez, even though that's a helpful answer, also discouraging. I've thought about ETG on and off, but aside from the downsides you already mentioned, I'm sure insurance doesn't cover it since it's a cosmetic procedure. And also, what good is it if your penis looks better but is still unstable.

I had an appointment booked with Brian Christine also but canceled to see dr Hakky as I thought if I do anything it would be an implant. If stability wasn't an issue for me and it was only cosmetic, I'd def spend the money on ETG before doing an implant. Then again, after your 30% statistic of ED- maybe not. Those are high odds.

[richestorags]

I developed hourglassing after a successful course of Xiaflex. Dr. Trost said there was a surgical procedure that could help (plication) bt that he did not recommend it. Everyone is different and your experience may vary. Surgery on the pen!$ is not something to be taken lightly. Dr. Trost offers free phone consults so perhaps that is a viable option to see what appropriate next steps might be.