90 degree Peyronies + ED + Conflicting Doppler Results

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Allyn

I am hopeful that you all can help me.  I have a 90 degree bend to the left and have tried the Timms Pump with two rings and can still not hold an erection.  Had a Doppler Test today and a very experienced Peyronies Urologist (nationally renowned & retired surgeon) tells me that my flow rates and retention are fine.  His remark, "Everyone is suggesting an implant for you but you do not need one."  He suggests a Plication Nesbit and that I can manage the ED with pharmaceuticals and suggests sex therapy.  He does not know why I cannot hold an erection with 50 mg of Viagra and two Timms Rings.  "I think it is in your head", is his reply.  My local urologist says as he hears my symptoms, "You are leaking and need an implant."  My symptoms say that I am leaking but the tests say that I am not.  Go figure!  I also asked if the surgery would impact my length and he said, "No!"  Any thoughts or suggestions?  Thank you so much!

Allyn

I am hopeful that you all can help me.  I have a 90 degree bend to the left and have tried the Timms Pump with two rings and can still not hold an erection.  Had a Doppler Test today and a very experienced Peyronies Urologist (nationally renowned & retired surgeon) tells me that my flow rates and retention are fine.  His remark, "Everyone is suggesting an implant for you but you do not need one."  He suggests a Plication Nesbit and that I can manage the ED with pharmaceuticals and suggests sex therapy.  He does not know why I cannot hold an erection with 50 mg of Viagra and two Timms Rings.  "I think it is in your head", is his reply.  My local urologist says as he hears my symptoms, "You are leaking and need an implant."  My symptoms say that I am leaking but the tests say that I am not.  Go figure!  I also asked if the surgery would impact my length and he said, "No!"  Any thoughts or suggestions?  Thank you so much!

tmwstw

Hmm Strange!! Your symptoms do indicate an implant to me. An IPP is standard treatment for Peyronie + Venous Leak. Did that doctor give you a color doppler test on your erect penis? It has to be a color one, on an erection, to detect venous leak as far as i know. If he gave you the doppler test on your flaccid, that test is of no use at all. Good luck and keep us posted.

Old Man

Allyn:

Sorry that the VED therapy you have used so far has not worked for your ED, etc. I strongly urge you to locate the one cylinder VED therapy in the VED board of the main forum and proceed to follow the schedule therein.

It takes time and effort to help correct ED and/or Peyronies Disease with vacuum therapy. I had the same problem after my first bout with ED way back in the 1950s. It was not completely overcome until I started the VED therapy at the age of 65 plus.

It took several months to overcome the problem of not holding up erections. Since you have the Timm Medical VED, I know from personal experience that erections can be achieved by practice with that device. You may have to use more of the smaller rings to hold it up, so practice using the smallest ring with the most tension first and then add the next tension ring and see what develops there.

There are others on the forum who have had success using the one cylinder VED therapy. Bottom line, patience is the watchword with VED therapy. Keep us advised about your condition and any success or lack thereof. There can be light at the end of the tunnel.

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.

Allyn

Yes, they took readings before the injection and afterwards.  I am dealing with Gerald Jordan from Virginia.  The Doppler readings showed no leakage and adequate blood flows.  I was thinking that I should try Viagra again with intimate closeness with my wife to see if I can create an erection that mirrors those experienced in nocturnal erections or those felt during the Doppler Study.  I hate to have the surgery and find the ED still present.  Sex therapy now in combination with Viagra to see if I can develop an adequate erection even though bent at 90 degrees.  If that doesn't work then an implant is the only path forward.  Does this make sense?

Allyn

I have been using the Timm's Pump for over a year.  I have tried 50 mg of Viagra and two rings, the strongest rings recommended by the manufacturer.  Beige on first and then the Pink.  I put the beige on first and re-pump and then add the stronger pink ring.  My penis is erect but not strong enough for intercourse plus it is too bent.  It might be strong enough for a few minutes but then loses it's pressure.  Strange that the Doppler did not show this.

Ben

You should try a few months with traction because there is no urge for surgery (eventhough I guess you are in a very uncomfortable situation).
- If you choose nesbit or implant, stretching prior to surgery may prevent shortening and you may benefit a longer implant.
- you may react positively to stretching and reduce your curve to a point that you won't need surgery, it also help for erection.
- If your flow rate is normal it may be erectile nerve compression due to the scar tissue.

I don't knowhow old you are (because implant are not lifetime efficient) but a nesbit plicature is risky because if you have ED pre-op, after surgery it will be the same (maybe worse), also for penile lenght it's better to be implanted without Nesbit than to have Nesbit plicature then a implant.

Whatever will be your choice, give a chance to traction. Stretching prior to surgery for one year may be a great benefit for you.

wish the best for the future

Old Man

Allyn:

Just read your post about the way you are using the retainer rings when going for any erection with the VED.

Here is a tip that works for most guys that is better than applying one ring and the other. Try placing the pink small ring on the VED first, then adding the small beige ring on the VED. After pumping up to the best erection you can achieve, then slide both rings off the cylinder at the same time onto the base of the shaft as close to your body as is possible. Be sure that you plenty of lubricant in all cases when going for an erection.

By using both ring at the same time, you apply more tension than if you place one ring on, pump over it and then apply the second ring. You will will need to practice doing this several times to achieve the better erection. You owe it yourself to try this before embarking on a different approach like surgery of other means of achieving an erection.

The above procedure works in most all cases. So, I highly recommend you try this tip.

Old Man

Edit: The first sentence of the original post should have read: Here is a tip that works for most guys that is better than placing one ring on, then pumping up again and placing the second one over the first one when going for an erection for sex with the VED. The remainder of the post remains the same.
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.

LWillisjr

Any surgery can impact length. Some guys don't lose any, others do. No surgeon can guarantee you that you won't lose length. So I'm not quite buying your renowned retired specialist.

Also Nesbit procedure is generally used for curvatures of 40 degrees or less. So I also question the suggestion the Nesbit procedure for a 90 degree curve.
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

LWillisjr

Quote from: Allyn on July 19, 2011, 10:34:08 AM
Yes, they took readings before the injection and afterwards.  I am dealing with Gerald Jordan from Virginia.  The Doppler readings showed no leakage and adequate blood flows.  I was thinking that I should try Viagra again with intimate closeness with my wife to see if I can create an erection that mirrors those experienced in nocturnal erections or those felt during the Doppler Study.  I hate to have the surgery and find the ED still present.  Sex therapy now in combination with Viagra to see if I can develop an adequate erection even though bent at 90 degrees.  If that doesn't work then an implant is the only path forward.  Does this make sense?

Did the injection help create a full erection? If so then I think I agree that this should be treatable with meds.  
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

Allyn

You guys are awesome.....  Thank you so much!  I am (65) this year.  I appreciate the additional thoughts on the VED Ring approaches which I will try.  I plan to purchase new rings as well (2) of each (beige & pink).  Traction was mentioned.  Any particular device that you recommend?  It is amazing how much thorough study is required to find the right solutions in medicine today.  One thing I forgot to mention.  When I was going through the Doppler Test the injection given to me was on the right side only not on the left.  My bend is 90 degrees to the left.  Is this a normal approach for the test or doesn't it matter where the injection is given?  I did notice that the doppler test did have color in the screen.  Yes, I did have a full erection that actually hurt after the injection.          

tmwstw

Your symptoms are very similar to mine!! I get as hard as a rock with injection and it wont go down for a while ... but the docs confirmed i had venous leak. My bend is not that bad, but i lost a lot of girth at the base. I'm 5.5 inches at the middle of the shaft and the base is only less than 4, with an indentation and a buckling effect. But only because i can still function on meds Dr.Milam at Vanderbilt didn't want to give me an implant right now, he told me to wait until meds stop working. I dont know why your doppler result doesnt show the leaks?

Old Man

Allyn:

Check out my edited post relative using two retainer rings to hold up erections using the VED. It better states what I really wanted to say about 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.

Allyn

Old Man....would you suggest even going to two pink (D) rings, being applied at the same time if necessary?  Or is that overkill?  Thank You!

Also, what Traction Device do you guys recommend?  I saw Xiaflex mentioned.  Is that best in class?

Old Man

Allyn:

You would have to practice using both pink rings in order to determine if they would hold up your erections. Two is not too much tension if that is what it takes to hold it up. However, as fubar has mentioned several times in other posts, observe the 30 minute time limit for any restriction ring use.

I think that you meant the small pink and large ring when you said using two pink rings. In the Timm Medical VED, the old Osbon Esteem manual/battery models, there were two pink and two beige rings that come with the package. The tension starts off with the small beige ring and works up to the small pink ring. The instruction booklet should have given a chart showing the rings and what they tension they exert.

You will need to practice pumping up and using the various rings to determine which one or two works the best for you. Three rings are not usually recommended due to the difficulty one might have in removing them.

Let us know if trying the above recommended works for you.

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.

Allyn


Allyn

Old Man:  Thanks for sticking with me on this.  I have used the small pink on first onto the VED Tube with the beige small on next onto the VED Tube but only with over pumping on the beige, which is on my penis first.  I will try putting both on at the same time as you suggest (pink & beige--same order).  However, if that doesn't work.  Can I try two small pinks at the same time or is that dangerous?  I really think I am leaking but this should be the final test.  I am puzzled as to why my Doppler Test showed adequate flows and no leakage.  My Doc says that when he gave me an injection for the Doppler Test he was taking my psychological head trip out of it.  My erection was firm and holding but very bent 90 degrees to the left after the injection.  I would think that the VED Pump also takes my psychological head trip out of it as well.  Right?  Using Viagra should help as well shouldn't it?  It helps improve blood flow.  Thanks again!      

Old Man

Allyn:

Assuming that you are using the Osbon Esteem manual VED, I see no reason why you cannot use both pink rings at one time. Apply both of them onto the mouth of the cylinder before you put the sizing insert into the cylinder. When you have pumped up to a good erection with the sizing insert in place, remove it and then pump up a good firm erection as before. Then while  holding the entire VED firmly against your body, slide both rings off onto the base of the shaft quick enough so as not to lose the firm erection you have pumped up.

Practice doing this several times and let the rings stay on long enough to determine if they are going to work as you want them to for a good erection. However, do not leave the ring(s) on longer than the recommended 30 minute time limit. Remember that they are acting like a tourniquet which has to be removed every 30 minutes to let a good oxygenated blood flow to a wound as taught in first aid courses.

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.