VED's - Vacuum Erection Devices

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Mick

Old Man:

    What's the thinking about Augusta's not including the Soma protocol with the merchandise?  Seems to me it's a pretty useless piece of equipment without it.

Respy, Mick

Hawk

I cannot address whether the Soma Correct is currently shipped with or without the protocol.  If it is shipped without, the only reason would be that the FDA did not like some of their statements about VED and Peyronies Disease treatment since those statements were not supported by properly conducted clinical studies. Basically, if you cannot prove it, then you cannot say it to sell a medical product.  The issue may have been more with a few advertising statements rather than with the protocol, but I cannot answer that question.  

Having said that, Old Man provided me with a link to the Birmingham Urology Association which posts the Soma Correct protocol.  You have him to thank for finding and providing this link, I am just posting it on the forum.

http://www.vacuumtherapy.org/extras.html

PS: I recommend that those interested, copy the information.  Websites change and links often become useless for what they were intended.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Old Man

Note to all:

Will try to answer all the questions below in one posting. Yes, it is true that Augusta Medical no longer provides the protocol with the Soma Correct. For some reason, they were required to have more clinical evidence of its use for treating Peyronies Disease. Therefore, they removed the Peyronies Disease protocol from their packaging and will continue to do so until they have new approval for a medical quality VED. It is now marketed only for ED.

According to my source at Augusta Medical, the link that Hawk posted below lists the viable and correct protocol for use with a three cylinder VED unit. That link does not state the brand name of the VED used in the study done by the 1,000 patients. It simply says that a three cylinder or 3 stage unit must be used to use the protocol.

Now, about the differences between the Osbon Esteem manual model and the Soma Correct regimens:
We know that a 26 week protocol is available for use with the Soma. the Osbon Esteem, being develoled primarily for ED therapy, does not have a protocol in the package for Peyronies Disease therapy. The regimen that worked for me and others using the Esteem was developed by me under the supervision of my uro who had experience in a VA hospital with Peyronies Disease patients.

The Esteem regimen is usually developed for an interested party by me using the symptoms that he presents, i.e. amount of curve/bend and where it is located on the penis shaft, where plaque/nodules and other affected areas are located, loss of dimensions and any other item peculiar to that individual. The exercises must be varied to suit the individual's symptoms.

The Soma protocol and the Esteem regimen are basically the same. The Esteem has only one cylinder, but does have inserts that control the size of the opening. There are two of these available, the larger one comes with the VED when purchased, the smaller one if needed, must be purchased separately. They are still available from the Timm Medical Division of Endocare, Inc. in MN. Exercises with the Esteem are controlled by the individual as he uses the regimen over a period of time. They are diffferent for each case of Peyronies Disease.The Soma just uses the developed protocol, etc.

My usual caveat about using the VED for Peyronies Disease therapy is that it works for some and not for others. All I know, is that it worked great for me and has for others. I guess that it is like the old saw: "Nothing ventured, nothing gained." I firmly believe that it is a viable solution to Peyronies Disease for at least some.

Will be glad to field any further questions about the protocol and/or Esteem regimen. There is really no set of exercises that I have that would apply to all. However, I suppose that one could be developed with certain stipulations based on the different symptoms that have been presented by individuals.

Note to Steve:

Either of the VEDs would give you good therapy exercises for Peyronies Disease. The Soma is designed primarily for Peyronies Disease, but can work for ED. The Osbon Esteem is designed for ED, but can work for Peyronies Disease.

Regards to all, 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.

Steve

Old Man
 :) Thanks so much for the valuable inforation.
I got my Rx today for the Soma Correct VED, and am mailing it in with my insurance info.  I plan to follow the protocol in that was in the link unless you've got any 'personalized' modifications to it, like you do with the Osbon unit.  If so, let me know and I'll drop you a personal message, and we can set things up over email.

Thanks again, and I'll be posting my results.

Steve
Topical Verapamil,
12 Verapamil shots (ouch!),
Now VED - Too many Weeks,
Still 70 Degrees :(

flexor

Following Hawk's link to the Vacuumtherapy site, the protocol described there is the SomaCorrect protocol, but unless you know the equipment, it seems to me less clear than SomaCorrect's own literature.

The SomoCorrect has a hand vacuum pump, which fits on one end of a large cylinder. The other end seals with a rubber insert ring against the body, with the penis inside the tube, and this contains the vacuum. A loose medium diameter tube fits inside the larger tube, and a loose smaller diameter tube fits inside the medium tube. These two inserts change the effective inner diameter, but play no part in sealing or holding the vacuum.

SomaCorrect own literature calls these tubes A (smallest), B (medium) and C (largest) and says that for week 1 you would use Cylinders A-B-C. So when theVacuumtheray list says "Week 1 Small cylinder", it is giving the size of the inner insert (ie use A-B-C). When it says "Medium cylinder" it means using B-C. And when it says "Largest cylinder", it means using the Somacorrect (cylinder C) without any inserts.

Steve

;) flexor,

Thanks for the clarification.  Now that the protocol isn't included with the unit, I'll be depending on prior users for detailed information.

Steve
Topical Verapamil,
12 Verapamil shots (ouch!),
Now VED - Too many Weeks,
Still 70 Degrees :(

Old Man

Steve:

I have tried to attach a simplified version of the Soma Protocol to a reply on the forum. Sent it to Hawk who will try to get is on somehow.

The Birmingham Urology listing is very confusing unless you know the equipment as flexor said. His explanation below is very good and should be no problem to follow when applied to the Birmingham list. Maybe Hawk can get the other one listed soon.



Regards, Old Man


THE THERAPEUTIC TREATMENT PROTOCOL FOR SOMA Correct is attached to this post in MS Word format.  Click below. Hawk
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.

Old Man

Hawk:

Many thanks for listing the link to the Soma Protocol. I was never able to get it set up for some reason.
I am sure that it will be of value to many.

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.

Tim468

I have used a VED, though not following a protocol of any sort. Some questions and observations:

1) Why the graduated cylinder technique, using gradually larger tubes? Once a negative pressure is created, it doesn't seem to me to matter one way or the other if the tube is larger or smaller.

2) Why the vacuum/release/recreate vacuum protocol? Is there some reason that that makes more sense than simply applying a vacuum and leaving it for a period of time (ie 10-20 minutes)?

3) If one uses a VED as an aid for erectile dysfunction (ED), then that is usually accompanied by placing a ligature around the base of the penis to trap the blood drawn in by the vaccum. Some devices (ie the "medical VED" device made by "ErecAid") have a rubber ring that can be slipped off of the base of the cylinder and onto the base of the penis. My concern is that tis will be traumatic to the Peyronies Disease penis, and can lead to further injury or placque formation. My "common-sense" recommendation is to simply apply a vacuum and to leave the cylinder on - though this is not going to be much help if you are using the VED to fix ED!

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

Tim468

Addendum:

In an article by Hunter Wessells (the urologist in Seattle that some have gone to), he said to use the VED as follows:

"Daily vacuum expansion of the penis using an ErecAid (Timm, Inc., Eden Prairie, Minnesota) was initiated 1 month after surgery for a minimum of 3 months. The men were instructed to use the vacuum erection device to expand the penis 10 times in succession to the most complete erection tolerated without applying the constriction band."

It did not say how long to leave the vacuum in place. This was from a surgical report by Wessels entitled: "EFFECT OF INCISION AND SAPHENOUS VEIN GRAFTING FOR PEYRONIE'S DISEASE ON PENILE LENGTH AND SEXUAL SATISFACTION".

Here is the abstract's conclusion:

"Conclusions: Incision and venous grafting of plaque leads to statistically and clinically significant increases in penile length in men with Peyronie's disease. Preoperative erectile dysfunction and cavernous arterial insufficiency were associated with a higher risk of postoperative erectile dysfunction. Nevertheless, patients reported a high degree of satisfaction with their overall sex life."

As we like to say on the net - YMMV (Your Mileage May Vary).

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

Old Man

tim468:
Hawk says that I am the resident VED guru, so I will try to answer some your questions. Have used the Osbon Esteem manual model VED for over 10 years, almost 11. My history is posted elsewhere on the forum, so I won't go into details of that here. Only to state that at present my Peyronies Disease is in remission with only a small indication of a nodule about midway of the shaft when erect. In flaccid state, hardly noticeable and have no curve/bend anywhere.

Now about your questions: The length of time that the vacuum should be held during each pumping cycle can vary from 10 seconds to not more than 20. The most efficency is seen by repeated cycles of pumping up, hold for the time you desire, release and pump again. This action causes more and more blood flow. Although it is venous as well as arterial blood, it causes more oxygen to be forced into the erectile tissue and hopefully in or around the tunica, etc. The total time of these repeated cycles is determined by how much time one has to do them and not to excess to cause more microtrauma. Each person must determine the length of time to do the exercises based on their best judgment. Pumping up and holding the vacuum for 10 to 20 minutes or more does not allow the penis to expand and contract like a nocturnal erection does, so that is the main reason for the shorter repeated cycles.

Question about the retainer ring(s) used to hold up erections: Each medical quality VED usually comes with retainers for erections and are different is size, shape and ability to hold an erection. It takes practice using them to determine the proper one that will hold up an erection long enough for sexual intercourse. They must not be left on longer than 30 minutes. Since they act similar to a tourniquet, they must be removed after 30 minutes to allow the blood to pass back into the system. Also, to allow the penis to reduce to a flaccid state as in a natural erection. Removing the retainers must be practiced so that one can remove them with the least amount of pressure so as not to cause any damage to the erectile tissue. Again, one must practice doing this until they become familiar with the process to avoid any further trauma.

Personal Note: I used the VED for about two weeks before it became second nature to achieve an erection so that sex was possible without losing the erection. It took about 6 months of Peyronies Disease therapy to get rid of my symptoms to the state that I am today. The exercise regimen that I used was developed under the supervision of my urologist and with my trial and error system. It is totally different that the 26 week protocol for the Soma Correct style of VED.

Why the graduated cylinder size: The three cylinders system was developed by Augusta Medical Systems based on their experience with the earlier models of the old Osbon system. Mr. Geddings Osbon who owned the Osbon Esteem and other VED models sold the rights to one company, who later sold it to the Timm Medical Div. of Endocare, Inc. in MN. His son, Julian Osbon, now owner and operator of the Augusta Medical Systems company designed the Soma Correct model VED for the purpose of treating Peyronies Disease. For some reason, it had to be pulled from the market for Peyronies Disease and is now under study to clear up that problem. The theory of the three cylinders is that the small cylinder holds the penis in a more straight position when first starting the therapy. As time progresses, the larger cylinders come into play to allow for more expansion of the penis during the exercise cycles. Toward the end of the 26 week protocol, the larger cylinder only is used. Usually, by this time, the penis has begun to straighten, if it is going to, and there is no need for the penis to be constricted, etc.

Please excuse the long explanation, but I needed to elaborate on each question enough to cover the details. If you have other questions that I can field, let me know and will try to address them.

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.

Tim468

Thanks for the explanations.

The above article by Wessells said in the discussion (uh.. I think, since I don't have it here) that the constrictor band was not to be used (in that protocol, which was done in conjuction with surgery) as it might cause more injury.

The VED has also been implicated in *causing* Peyronies Disease in a case report. "Patient 4: a 65-year-old man developed Peyronie's disease after 4 years of correct VED use. Patient 5: a 62-year-old man with neurogenic impotence following a radical prostatectomy developed penile ecchymoses acutely following placement of a smaller constriction ring. He subsequently developed a dorsal penile plaque with mild dorsal curvature."

The other case report I read was of a man trapping is testicle under the constrictor band by accident. His wife's attempts to cut the band off only cut the grip on it. What I like most about that report is that the old man recovered without problem, and most of all, that he was 85 years old!

Of course, the problem with case reports is that we do not really know if something is cause and effect. The case 3 report above eventually was treated with a penile implant. Who is to say that would not have happened if he hadn't been using the VED?

After all, we placed leeches on people thinking that bleeding them was good for them - and often people got better! It only took about 400 years to figure out that bleeding wasn't really useful. OK, OK, except  for priapism...

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

Old Man

Tim:

Yes, you are right about certain restrictions in usage of the VED. As with any medicine, procedure or therapy there is always cases that bear the brunt of the negative side. However, in the VED usage, my caveat has always been to use extreme caution in its use and especially in using the retainers for erections. Improper removal of these after sex can and will cause more trauma. The instructions that come with the Osbon Esteem clearly indicate that caution must be observed. I have found that when removing the retainers that one should pull out on the "ears" of the ring(s) and hold for a few seconds to relieve the pressure of the blood in the penile shaft and then slowly pull it off towards the head, etc. Another caution is that plenty of lubricant must be used when doing any Peyronies Disease exercise or removing the ring(s).

The cases you talked about are interesting in that they occurred in older men. The VED usage could have caused the onset of Peyronies Disease, but, it could have been the result of other causes. Suppose that no one really knows for sure. If the VED can help the majority of the cases of Peyronies Disease, then it would be worth the risk of using one.

Once again, I would like to make it clear to any and all that the retainers:

ARE NOT BE BE USED AT ANY TIME DURING Peyronies Disease EXERCISES, WHETHER ONE IS USING THE OLD MAN'S REGIMEN, THE 26 WEEK PROTOCOL ORIGINALLY FURNISHED WITH THE SOMA CORRECT OR ANY OTHER PROTOCOL.

Using these retainers during the exercise will put excessive pressure on the erectile chambers, blood vessels and most definitely will cause more injury to them. I know from personal experience that this is the case.

I am very pleased that we now have physicians like yourself and totheleft posting here. You guys can keep us on the straight and narrow when it comes to medical precautions. Currently, I am in the process of getting my personal urologist to become a member here. Her background is very extensive in the ED and Peyronies Disease field. Her residency was done in a city where she worked in a VA and other hospitals in that area. Do hope that she can see fit to join us and we can have the benefit of a urologist on the forum. This is what it is all about, helping others with this crazy malady.

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.

Mick

     Today marks the end of the 2nd month of my use of the Soma correct according strictly to Augusta's protocal (See my first report, reply # 112, this thread).  Progress has been good but not quite so dramatic as it was in the first month.  Here are the figures:

                                Feb. 25                 Mar. 25                  Apr. 25

Length flaccid                  4"                      4 1/4"                     4 1/2"

Length erect              4 1/2"                      4 7/8"                           5"

Girth ecect                      5"                      5 1/2                      5 5/8"

Angle                     15 deg. dorsal           5 deg. dorsal              no bend

Placque                  3/8 " strip from base     no discernable       no discernable
                            of shaft (dorsal)                change             change
                            to base of glans

There was a brief temorary set-back: by day 45 (Apr. 10), the angle had been reduced to zero, but on day 54 (Apr. 19), a bend of approximately 10 degrees dorsal was observed.  Within a day or two, however, the bend again disappeared and has remained so to date.  These is no discernable change in placque, but it does seem somewhat more flexible; perhaps the thickness has been reduced (?).  

    My next report is scheluled for May 25.

                            Respy, Mick          

Steve

 :) Mick
Thank you so much for the status report.  I just started with my Soma Correct last week, and am looking forward to some similar results.  I didn't take 'before' size measurments, but my 'angulation' is starting at 70 degrees, and it's my main concern.  I too will be trying to post my progress.
Topical Verapamil,
12 Verapamil shots (ouch!),
Now VED - Too many Weeks,
Still 70 Degrees :(

Mick

Hi Steve:

    Glad you found some use for my progress report.  I am really only concerned with the angulation and the plaque, but decided it might be useful to monitor the other items.  I feel like a 74 year old junior high school kid
doing the measurements, but I guess it's for a good cause.  I have gotten so much out of this forum that it's worth it.  Besides, I doubt if I'll ever meet any of the members face to face.  Sounds like you have a long way to go; I hope and pray that you will do well with the VED.

    Respy, Mick

Old Man

Mick and Steve:
Glad to see that you guys are seeing some results of your therapy work. Just keep up the exercises under the protocol and you should see some gain on a monthly basis if not sooner. However, be patient and use extreme caution with the pressure. That is the watchword in VED Peyronies Disease and ED therapy.

Mick:
No one will fault you for feeling like a teenager again! I will be 77 soon and I don't look at keeping up with progress in therapy of this mess a frivilous business. You need to keep measurements to know for sure if you are gaining anything. It is very serious and I intend to help others all possible until my time here is up.

Best regards to you guys and all others working with some form of therapy for this disorder/disease!

Sincerely, 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.

Will

Hello all.  I am a 34 year-old man who has been impotent since age 18.  When Viagra was made available, this worked wonders for me each time i used it.  However, a few years ago my hip was crushed in a car wreck, and since then Viagra does not work well at all anymore.  One year after this hip injury, on one of the occaisions the Viagra did help, I noticed a large dent in the top of the shaft of my penis.  Went to see my urologist as quick as I could (he is a well-known specialist in Peyronies Disease) and he examined me and felt no lumps - he said i did not have Peyronies Disease, and too, that i was too young.  I could no longer get erections of any sort - not even viagra worked.  I then began getting a left bend of my penis and went back to the urologist.  He diagnosed me with Peyronies Disease but still could feel no lumps.  He ordered a duplex ultrasound and gave me a hot to induce an erection for the procedure - it produced a very floppy penis - no erection.  The outcome of the procedure shoed good blood inflow, but leaky veins, however, he said it was not an extreme leak problem.  He did find a very small lump of Peyronies Disease, and said it was not major - anyway, he diagnosed me with Peyronies Disease which are causing leaky veins.  He advised the Peyronies Disease was a result of having a catheter inserted in my penis for a prolonged period of time when my hip was crushed.  I now use the soma correct and have been for 1 year.  About 6 months ago, he prescribed trimix shots and it worked fantastic!!  But now, 6 months later, it does not produce an erection, even if I try 1cc at a time.  He told me to keep on trying this 1cc trimix and if continues not to work, he will prescribe a "super" trimix (stronger stuff I suppose).  Dealing with this since 18, you can imagine, I am getting pretty desperate.  He says the penile prosthesis is an option, but recommended that I have the penile ligation surgery before opting for the prosthesis.  What are some of your thoughts on these choices?  Thanks.

Tim468

Hi Will,

A couple of issues pop up (so to speak). First, Peyronies Disease is a clinical diagnosis (as is ED) and a doctor who hears a story of someone coming in with a new dent in his penis, and who says that you do not have Peyronies Disease because he cannot feel anything - well that worries me (as does his erroneous information that you are too young to have it). It implies someone who is not listening well enough, and that always makes me worry that they won't read enough either. Simialrly, pushing up on dose of a good drug can make a lot of sense, but if loss of effect of a drug is NOT a usually seen phenomenon, then that should lead to more of a workup, not more of the drug.

If blood doesn't stay in there, then it seems that you would be a good candidate for a VED. Alternatively, if blood flows in easily when you are aroused, then it might be that all you need is a constrictor (otherwise known as a cock-ring) to keep the blood in there after it goes there with arousal. I would definitely look into something like the ErecAid or Soma like devices.

Finally, I would not go first to surgery for a couple of reasons. Since you are young, it is possible (even likely) that your Peyronies Disease is not a more "normal" aging related problem with connective tissue and wound healing, but more likely to be due to a general *tendency* to have abnormal "wound healing" or inflammatory mechanisms. Thus, I see you as being at higher risk for getting a new or more lesions after surgery. Secondly, it still seems too early to go to surgery (disease may be still evolving), and finally, you have not yet tried much in the way of non-surgical therapy.

From where I stand, it seems that you have several problems that might be *very* treatable, and should lead to good functioning erections, and a good chance of straightening out you shape too. Good luck!

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

Will

Tim...thanks for responding with the valuable information.  I have been using the Soma Correct since last april and it seems to work some for me.  I am just a little discouraged with the soma due to the difficulty it is for me to use the largest tube.  To explain, I have trouble getting blood to the distal half of my penis - the base engorges fine.  It seems as if the blood travels well up to the middle of my penis, but at that point there is like a blockage (nothing i can feel with my fingers) because the blood will not pass through well at all, which results in the base getting too much blood to the point of pain therefore unable to pump anymore.  No matter how slow I pump, not enough blood will go through the last half of my penis.  Now the small and medium tube does well...itis just this large tube that gives me trouble therefore not able to complete the recommended regimen for the soma.  Could this be a ring of scar around my penis restricting the blood - if so I do not feel anything there?  In reference to your advice about using a ved for my ed, I cant get enough blood past the middle of the shaft to obtain a usuable erection.  I have considered using a low dosage of triplemix and inject it before trying the large tube to see if that would help bust through this area.  Any advice on this?  And...thanks a lot for replying to my message.

Tim468

Will, that all sounds pretty challenging. I'd suggest going back to the drawing board entirely, perhaps with a new doctor (perhaps not). It seems that you need more data. I would want to repeat the vascular studies to see if blood delivery is impaired. Second, if you were able to get a complete erection one way but not another, that is confusing - doesn't make sense to me.

So that is my advice - get more or better information about how your body works and see if that helps guide you to a more individualized plan of action.

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

Steve

Hopeful,

Look down about 15 posts to one from Old Man.  He's attached the protocol as a word document.  There is also a link somewhere below that to a site vacuumthearapy.org that has the protocol on the Extras page.

Good luck.
Topical Verapamil,
12 Verapamil shots (ouch!),
Now VED - Too many Weeks,
Still 70 Degrees :(

Mick

Hopeful:
    Steve answered your question re the protocol.  As to the others,  I am 74 years old, have had Peyronies Disease for 14 years, have never done anything about it til now, and am doing nothing now except the Soma Correct protocol, so that the improvement during the past two months and any to be realized over the next four, has been and will be attributed solely to the Soma Correct protocol.

Respy, Mick

zigwyth

Old Man, I thought I would post this question here instead of emailing you personally in case someone else had the same concerns. Regarding  Pudder135's post(187) in the subject of Verapamil. It was mentioned that the patient needed to have the Iontophoresis treatment performed first before using a VED because more possible plaque damage would result otherwise.Your thoughts on this? Also, how is everything going with the Somma Correct? I'm sure you have seen the post from the illiterate Zeus. Are you in the position to speak with reps about this imposter? Any info is appreciated as I am considering going to my Uro to see if I can get a Medical quality VED prescribed.Thanks

bob

Another topic entirely:
Does anyone out there have insurance through the Blue Cross network? A VED is considered durable medical equipment, and we get some sort of discount if we go 'in network.' Problem is, most of their network are these little mom-and-pop distributors of walkers and crutches. I can imagine calling lots and lots of them and having to explain what a VED is and does.

Timm Medical, which distributes the Osbon esteem, is out of network. I ordered a VED a couple of months ago through Timm Medical because one of the reps on the phone assured me that he would personally handle the order and knew a way to place it through one of my Blue Cross network providers.

That didn't happen. The item now appears as a $455 charge on my Discover bill. I have a $500 deductible for durable medical equipment, so I know I'm not going to get any coverage... but it would have been less costly out of pocket if it had come through the right channels.

The guy from Timm said some time ago that if I don't get this resolved to my satisfaction, they would give me a call tag and I could return it. (Even though I used it once or twice. I would run it through the dishwasher before returning it. By itself.)

Anybody have any input they can share? Calling Blue Cross is useless.

ComeBacKid

Old Man has stated to me you don't need the ionotophoresis, and that the Soma Correct has worked on him without this, and it has worked on others.  I believe him, however remember if you use these devices to be very careful, it takes time to produce results.  The IONO if it does drive the verapamil into the target tissue, and if it does soften the plaques or shrink them, it would seem that this would make the VED exercises even easier.  

I've read online that many doctors and people claim that the VEd can't enlarge the penis, however it seems from legitimate posters here including old man, that men with Peyronies Disease can increase length and girth through the appropriate use of a medical quality VED.

ComeBackid

Old Man

ComeBackid:

Let me make one thing in your previous post clearer. I stated that the VED can and will return one to the original size they were before in most cases. There are, however, some cases that resists all attempts to eliminate the syptoms. It does not enlarge one's penis beyond its original size before Peyronies Disease. It does keep the penis healthier because of it since it somewhat replaces the natural nocturnal erections.

The VED draws venous blood as well as arterial blood into the penis, so it is not totally like a natural erection. It does provide one with the means to have sex almost in a natural way. I say almost because it does not replace the natural one, only gives an induced erection.

With regard to the ionto treatment, I stated that is was not necessary to use it, but if one desired to to use it, there was possibility that it could soften the plaque/nodules enough that it would further enchance the VED pressure. I have never used the ionto, so I have absolutely no experience with it use.

Please note that the above is only my considered opinion based solely on my personal experience and that gained through working with others using the VED and other means of exercises.

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.

ComeBacKid

Old Man,

Thats what I thought, the VED can in MOST cases return a Peyronies Disease sufferer to their size before they had Peyronies Disease, however it won't add increased size like say if you had no Peyronies Disease and you just started using it, some companies and many scam sites online claim this and they are wrong.  I'm just hoping to restore lost size caused from Peyronies Disease. I think the IONO would only help the VED process, however I probably won't start my VED usages until a few weeks after IONO.  I will keep everyone posted if I have any success, or if I don't.

ComeBackid

Angus


   The use of graduated tube sizes with a protocol very similar to the one attached by Old Man several posts below has worked well for me. The use of small and medium sized tubes has helped with a reduction of the original 45 degree left curve to the present 10 degrees. I also do believe that in most cases original size (or very close to it) can be attained with the graduated tube size protocol as it has for me. I am not overly concerned with the last 10 degrees of left curve as I had a small congenital left curve pre-Peyronies Disease as far back as I can remember, but for now I will continue to use the protocol. I had plaque and subsequent scarring only on the left side about midway down the shaft; the hard plaque has been gone for years. I do believe that gentle negative pressure or vacuum on a scheduled basis with graduated tube sizes does help to exercise erectile tissues and helps keep blood vessels in the penis healthier. I have not had ED as a result of Peyronies Disease and am thankful for that every day. Thanks guys for posting what results you have so far here.  

Tim468

Can those of you who have done this comment further on the logic of the graduated tube size thing?

My confusion is this: If the initial tube is smaller (I take that to mean of smaller diameter), doesn't that mean that the penis is more constrained as it fills with blood? Time for ASCI art:

|\   \  |
| \   \ |
|  \   \|
|  /   /|
| /   / |
|/   /  |

My conceptual problem is that it seems that as one brings in the edges of the wall, in the above crude art, it would help bring the angulation more straight. That would suggest that gradually narrowing the diameter would gradually apply greater straightening forces.

So what is the rationale for gradually using wider diameters over time?

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

Old Man

Tim:

Let me add my view of the different sizes of VED cylinders. In most cases of Peyronies Disease, the penile tissue has shrunken and/or curved by whatever caused the trauma to it. To put it in everyday words, it is best likened to beginning working out at a gym. There you start out with lessor exercises and/or time of duration known as cycles of workout, etc. since your body has been inactive for extended periods of time and the muscles have atrophied or shrunken.

Applying the same principle to "working out" the penile tissue with the VED, the same procedure should be followed. If one applies too much negative pressure to begin with in Peyronies Disease exercises, more trauma is most assuredly going to happen. So, with the graduated sized cylinders, one starts off with very low pressure in a small area to concentrate the pressure better. Over time using this cycle, the penis "gets used" to the negative pressure. Then moving on to a larger diameter cylinder lets the penis expand a bit more, again using the moderate pressure. After more time has gone by and the penile tissue gets more adapted to the larger amount of vacuum pressure, it can accept more and more blood flow. Then after the prescribed numbers of weeks have gone by, then the more advanced cycles are added, etc.

The above description applies to the three cylinder VED only. The one cylinder VEDs must use a different approach to the negative pessure and therefore require a different protocol. There are several approaches to this VED and there has been a number of guys having success with it as well as the three cylinder VEDs.

The above carries my usual caveat in that it is only my considered observations while using the VED for myself and counseling with others in my prostate cancer support work.

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.

Hawk

Tim,

I am glad you asked that because I have struggled with the whole concept of cylinder size trying to apply physics to the concept and always a bit unsure if I was making the common mistake of applying cartoon physics instead.  I also have to say i am impressed with your ascii art.

I wonder if the point of the smaller cylinders is to prevent the expansion of the normal more elastic tissue and transfer the stretch to the scar tissue.  Assuming the scar tissue does expand with time, might it fill out the small cylinder?  The diameter can then be increased to allow more expansion to the normal tissue and focus further stretching to the scar?  I also wonder if the diagram in a small cylinder would look more like the pathetic attachment below.  
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

Angus

 The penis is constrained in the smallest tube in the sense that it expands all the way to the tube inner wall. In my case, the area on the left side with scar tissue does not expand out like the healthy tissue and is seen through the tube as an indention. Gentle vacuum is expanding tissues the full length of the penis and is exercising the entire organ including the scarred area. Moving to the larger cylinders in the protocol lets the penis expand in width to its natural limits without the constraint of the smallest tube. Hawk, the indention has not stretched out to the wall of the small tube for me; the indention has appeared to get somewhat smaller during the last year however. FYI, your attachment is not pathetic  ;D, but a pretty good representation of what I experience with the small tube, but with a much smaller indention area. Here is my own feeble attempt to illustrate what I mean with the scarred area more to scale to the tube size. The penis is erect within the small tube and the indention is on the left.
____
ll     ll
ll     ll
ll     ll
l\    ll
l/    ll
ll     ll
ll     ll

  I do not know if the scarred area will ever stretch out completely, but I do know that some sort of re-modelling and straightening has taken place for me. I believe the physics of the protocol are longitudinal forces (lengthwise) applied by the smallest tube and lateral forces (width) applied by the larger tubes. These are my own observations and thoughts only.

Tim468

Thinking about it - I don't buy it. At least not yet... (s)

There are two different issues here. First is stretching of tissue that is somewhat fibrotic. One could argue it lots of different ways. For instance, one could argue that the penis is inlfated in the smaller tube in a sort of "sub-maximal" way, such that it fills out to the diamter of the tube, leaving the defect as a dent (as described below). The problem I have with that, is that I do not see how a vacuum pressure would then be effectively transferred to the targetted area of induration or plaque. If the penis cannot completely fill out, because it is constrained by the tube diameter, then how can we argue that a stretch is being applied to the affected area?

If the penis occludes the end of the tube, then the only direction for it to grow is length-wise, not in girth. Yet it will be both length and girth stretching that is required for a real stretch (or so it seems to me). and if we end up by applying greater vacuum forces gradually, those will only be applied to the tip, and not to the area of "defect" in the drawing... (marked with > signs)

    ||     ||
 > | \    ||
 > |/     ||
    ||     ||

I see that as a longitudinal stretch, not a locally applied vaccum force.

On the other hand, if one uses a large tube - say a real Bell Jar with room for anyone to rattle around in, no matter how angulated, I could see that while stretch might be applied, it would never be a "corrective" stretch.

So this boils down to a fundamental discussion of what the VED is actually doing. If the VED is to improve blood flow to the tissue, them it shouldn't much matter whether or not the tube is small or big. What may matter is how long one allows the vacuum to remain applied, or whether it should be repeatedly done for brief periods of time. If the purpose is to stretch, and the blood flow issue is less vital, then using a tube in which you fit, but cannot bend too much, and applying a vacuum for a longer period of time would make sense.

Sorry to muddy that waters, but I think that the rationale for using VED's is all over the place in the medical literature (such as it is) and that application of it makes sense for a variety of potential therapeutic reasons that have not been studied very well.

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

Angus

Some thoughts...
Assuming that unrestricted erection size is limited by the tunica membrane which contains the Corpora Cavernosa erectile tissue, and assuming that the small ved tube inside diameter is slightly smaller than an individuals natural erection width, the vacuum erection would expand laterally only to the width of the small tube; the tunica would not be stretched to its natural erection width limit and blood pressure stretching from within upon the healthy tunica would be effectively negated (except for longitudinal forces towards the tip). The indenture or scar area appearing as an indentation however would not be constricted by the tube width and not be touching the inner sides of the tube. The scar or indenture would be getting the same outward force (blood pressure) as the restricted but expanded-to-tube-size healthy tunica which may be allowing some stretching or re-modeling of the scar in relation to the healthy tunica tissue beside it. All this is assuming that Peyronies Disease scar tissue has some degree of stretch potential, and I don't think anyone in the medical community or laymen have any clue on this potential at present.
I don't think you muddy the waters at all Tim. Sharing thoughts, notes and observations here on the board is a good thing and encourages thinking. Hopefully we'll get enough data someday to draw some conclusions about the physics of forces on erectile tissues and how they relate to Peyronies Disease and VED usage. Until then we've got to keep plugging away at this and further our understanding of the mechanics.

Old Man

Guys:

I am about to make a profound statement about the VED usage and hereafter will not address the subject again in the vein that we are now using. We seem to be straining to swallow a gnat and then gulp down a camel as we used to say back in the country.

It is my firm belief that we are trying to place too much emphasis on the subject of cylinder size and how it works or why it does not work. The main purpose of the three cylinder VED is to place restriction around the shaft to preclude lateral expansion of the shaft while applying vacuum pressure during the early stages of the protocol. This is designed so that the vacuum being applied will pull the blood flow toward the glans area. Then, holding the applied pressure for a definite period of time and as the pressure drops off adding more to keep the penis totally engorged with blood. Therefore, the constant pressure at varying levels does a stretching and relaxing action per the protocol. It is the same principle as a muscle being stretched and relaxed in any exercise of the body in a gym. The ever changing pressure allows the smooth muscle of the penis to recover from any trauma it has encountered. The main difference in the VED exercises and those used in a gym is that the penis contains smooth muscles and the body contain striated muscles. Smooth muscles take longer to develop and remain in a stretched condition than the striated ones.

All, I know is this, that after over 50 years of Peyronies Disease coming and receding 4 or 5 times, I have tried just about any and everything that came my way up to and including 45 3 minutes bombardment sessions of radiation. None of the treatments that I used, Colchicine, Potabo (took over 13,000 of them) Yohimbine, the ED drugs and some I can't even remember, did nothing. The Osbon Esteem manual VED has been the only treatment of any kind that gave me back my original size, shape and the ability to perform sexually. (Non nerve sparing radical prostatectomy saw to my being totally impotent.) The three cylinder VED can and will perform the same purpose only in a different way.  The VED does provide a very safe and viable means for erections when used properly and with extreme caution. As with all things, common sense should be the rule of the day.

The above is my considered opinion through the many years of experience with this crazy mess called Peyronies Disease. It is only fair to say that each and every case of Peyronies Disease is totally different from any other and will require special treatment and/or exercise therapy to get any relief.

Good luck to any and all who will venture to use the VED and hope that you have success in getting some relief. If anyone desires to ask me questions by PM, I will be more than happy to address them. I have no desire to cause any problems for anyone with regard to use of the VED in any way, shape, form or fashion. To each his own.

Sincerely, 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.

j

First, I have to say that in 25 years of working with computers, this is the greatest appplication of ASCII art I've ever seen.  :D

After reading the preceding discussion I would agree that the smaller tube has its purpose. I see two factors to consider: elasticity and stretchability.  Elasticity means temporary lengthening during an erection; stretchability implies permanent lengthening of the tissue.

The bend is caused by the unequal elasticity of the fibrotic and normal tissue. But besides being more elastic, normal tissue is also more stretchable. So if the vacuum were applied in an unrestricted space, you'd see the maximum bend and - I think -  the normal tissue would stretch more readily than the fibrotic tissue - so the bend could actually get worse.  In other words, you could make the 'good' side longer without a corresponding increase of the 'bad' side.

The smaller tube lets the vacuum produce a longitudinal stretching which would exert force on the fibrotic tissue because it's what's holding you back as the vacuum tries to pull you forward into the tube. It could not cause the normal tissue to stretch further than the fibrotic tissue.

Which brings me back to the idea of traction and those oh-so-hokey sounding stretching devices. Were it not for the obvious inconvience and discomfort, I think they might be part of the answer.

I hope I made my point clearly enough that some of you can respond to it.

ComeBacKid

Without my VED and not totally understanding how you actually control the negative pressure, its hard for me to picture how this works.  But what I notice about my own penis is that when its flaccid and I'm walking around it shrinks up and becomes hard.  However when I sit down more blood flows in and it grows probably to something like the normal size it should be when its flaccid.  The tissue seems to be durable, and even the fibrous tissue for me seems to be able to stretch.  When I get an erection it is shrinking, but if I put a finger at the base of my penis my penis kind of gets bigger, also if I use my ass muscles to push more blood into my penis.

The real question is can calcified tissue expand at all?

ComeBackid

Tim468

Quick response to different thoghts:

A penis may shrink up when it is cold (for instance). It may also shrink up when it is under "stress". That is, adrenaline will make you "up tight and outta sight" (That is sort of what Stevie Wonder was singing about - he was referring to the balls when one is aroused...but I digress).

Dive into cold water, or have someone jump out and scare you and you will shrink right up. That is not a function of "less bloss" flow. It is a contraction of smooth muscles that are arrayed around the wall of the penis, and by conracting, the penis retracts. These are NOT the smooth muscles that do not work right when one is impotent - those are usualy the smooth muuscles that line vascular structures and allow the release, or trapping of blood in the erectile tissue.

So "shrinkage" refers to a function of different smooth muscles than those usually of importance in erection.

However...  the fibrotic changes in Peyronies Disease are often (but not always) due to the *transformation* of myocytes (smooth muscle cells) into "myofibrocytes" - which are transformed muscles cells that have become fibrotic.

To me - based on my reading and personal experience - this means that the activity of the smooth muscles that pull me uptight and cause shrinkage, are associated *causally* with the changes of Peyronies Disease. Therefore, for my personal experience (having held Peyronies Disease successfully at bay for over 30 years), *stretching*, and relaxing are two important aspects of preventing changes.

To do that, I have tried to get daily erections - and better yet to use them. Secondly, I have applied stretching forces - enough to look like a third base umpire in situations where I might have thought twice about doing that - hohum... I tug a lot whenever I can. I think that by resisting contraction, one might be able to prevent the permanent shortening of the fibrotic area.

In addition to stretching, i have worked to promote "not shrinking". Since adrenaline causes this to happen, I have worked - HARD - on learning to relax and to not be a 'responder" with high blood pressure and stress responses. I take hot baths to relax my penis. Trying to be as "hang loose" (if'n ya know what I mean) has been a good thing for me (I am thinking of you ComeBackid - as hard as it is to imagine - i think panicking less will ultimately help you more).

Largely, this has worked for me. But as I have aged,and the frequency of erections and intercourse have slowed down, it has stopped working. So, now the verapamil and VED use. And the Iontophoresis I am doing is also loaded with decadron and I am also taking carnitine. We shall see.

Tim

One other thought: if we agree that a VED cannot make you bigger than you were originally (or make someone without Peyronies Disease larger), then it doesn't make sense to me that one might "overstretch" the normal part of a penis and thus lead to a greater curvature.
52, Peyronies Disease for 30 years, upward curve and some new lesions.

Angus

  Old Man, I see your point... swallowing camels (understanding graduated cylinder and regular VED physics) can be almost overwhelming to the layman. I think it's part of human nature to endeavor to understand the workings of everything of a mechanical or physical nature and this may be exacerbating stress levels here.  
 My own thought: Use of a VED of any type is a frightening prospect to men who are considering its use... I believe questions are being asked by men who are searching for assurance that nothing dangerous or damaging will happen to them in addition to just being curious as to how the physics works out. Another thought Tim... calming down and not being a "responder" with high blood pressure and stress responses might be a good step One before VED therapy and it might calm mens fears induced by the anticipation of inserting ones penis into an array of acrylic cylinders. Worrying less about the physics at this point and resting assured that there is nothing in the properly used protocol that would induce further damage may be a good thing for prospective VED users.
 And Tim, your analogy, Stevie Wonder lyrics "Up tight and outta sight" re: aroused balls has forever changed the way I shall listen to that Stevie Wonder song (I'm suppressing a stress response as we speak  ;D). Perhaps Stevie was referring to relaxation therapy when he wrote "Come Let Me Make Your Love Come Down", but alas, I don't want to drift off topic...
 Bottom line: Prospective VED users, fear not: no harm will be done by a properly used high quality VED and recommended protocol.

flexor

Just to iadd a little factual information, in the light of penises (penes?) expanding to fill Somacorrect cylinders, the actual internal cylinder dimensions are:

Small: 1 1/4 ins
Med: 1 1/2 ins
Large 1 7/8 Ins.

Outer cylinder length: 8 ins.


j

RE: VEDs and 'stretching':  I think many of us have always found the whole idea of "penis enlargement" so laughable that we assume it can't be done.  But tendons can be stretched, as can skin. (To prove this to yourself, get your weight up to about 350 and keep it there for 10 years, then drop 200 pounds and stand naked in front of a mirror.)  I believe even bones can be lengthened by traction.  

I don't know what sorts of tissue the penis includes, I know it's a complex structure, but it doesn't seem unreasonable to me that it could be expanded or lengthened by persistent application of the right forces.




Old Man

flexor:

Looks like that you measured the cylinder diameter from the end that goes on to the pump.

The Soma that I have measures as follows:

Cyl. A End that insert fits into: approx. 1 - 9/16 inches I.D.
Cyl. B End that insert fits into: approx. 1 -11/16 inches I.D.
Cyl. C End that insert fits into: approx. 2 - 1/8 inches I.D.

These measurements are without the insert in place.
Note that this is approx. since the cylinders are likely to be in metric measurement. (Don't have metric rule.)

The inserts measure: Small - 1 - 3/8 inches I.D.
                            Laarge - 1 - 3/4 inches I.D.

Again, approx. since they are likely metric also.

Usable length of the cylinder is 7 inches from the outside of the inserts to a safe distance from the pump itself.

Careful examination of the cylinders show that they are tapered from the dimensions that I list above to the ones that you gave in your post below.

Another note about the cylinders, if the stock ones are not large enough, larger ones are available by special order only and are made of glass rather than the lexan or whatever the material.

Thanks for giving this information as it will give some perspective as to the actual sizing of the VED, etc.,

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.

flexor

Old Man.

You are correct. The cylinders do not appear to be as tapered as they actually are.

Old Man

Note to all:

In view of several requests that I have received by PM, the location of the protocol is listed as shown below.

The simplified version of the three cylinder Peyronies Disease protocol is listed in a link on post #157 below. It is in Microsoft Word Version stored using Microsoft Works Version 4.0.

There should be no problem in connecting with that link.

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.

Tim468

Here is what I do not understand:

***********
1         A-B-C         Daily         10 cycles
2         A-B-C         Daily         10 cycles
3         B-C         Daily         10 cycles

******** etc...

Does this mean that you do ten cycles with A, followed by ten with B, folowed by 10 with C (on day one), and that on day 3, you are going to do that with only the B and then C cylinder?

Other than my continued confusion about the applicability of the process to different lesions (I do not have a large curvature at all), it seems to give quite a variable amount of daily suction (so to speak) over time.

Thanks if you can un-confuse my mind!

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

Steve

Tim,
If I can weigh in, I take the protocol to mean that you use all 3 cylinders (A, B, and C) at the same time for the 10 cycles.  This is because C (the largest) is the only cylinder that connects with the vacuum pump, and the others 'nest' inside it.  To put A (the smallest) inside C alone would let it move around inside too much and I think could conceivably pinch  :o sensitive parts.

Old Man,
One quick question about the Soma protocol...the cycle consists of holding the vacuum for 10-20 seconds and then releasing it.  The instructions are to repeat 10 times.  I'm curious how long you should 'rest' after releasing the vacuum before pumping up again.

Steve
Topical Verapamil,
12 Verapamil shots (ouch!),
Now VED - Too many Weeks,
Still 70 Degrees :(

Old Man

This will answer the two preceeding posts as Steve's came in while I was typing the first answer.

Tim:

No, it does not mean use A B and C separately for 10 cycles each day. It is a bit confusing, but what it means is this: Use all three cylinders, A,B, and C mated together for the required 10 cycles per each session. In other words, assemble all three cylinders in their nested position, place either one or two inserts to size the opening to one's penis for a good tight fit and then proceed to do Week 1 exercises. Then, after Week 1, do Week 2 with the prescribed lettered cylinders and so on down the schedule until all 26 week sessions are completed. It is best to follow the required schedule daily to obtain the desired results. If you miss a day, do not do two sessions on one day as a makeup because it could cause irritation or edema of the tissue if you pump too much, etc. Should you get any edema or irritation, stop the sessions until it heals before starting up again and then use less vacuum, etc.

Again, a word of caution about using all three cylinders: When you first start using them, it will appear that the opening is too small for your glans/penis to fit into the cylinder and work well. Be patient, use plenty lubricant on the penis and in the small cylinder, then work slowly until you are familiar with the exercise. It will be helpful to apply some vacuum pressure to help move the head portion into the cylinder. If one is not circumcised, the foreskin may need a little positioning by moving the cylinder around to allow it to flow into the cylinder and stretch out. Don't place too much emphasis on it if the whole penis does go all the way in on the first sessions. The small cylinder is so designed to keep the penis in a very confined area and very straight when starting with the overall therapy. So, it make take several days to get used to the fit and allow the penis to penetrate further into the cylinder, etc.

The protocol is really not complicated, but does require practice to get used to the procedure and the feel of the penis being confined in the cylinder(s). After a week or two, it should become second nature for it to feel OK and you are comfortable with doing the process.

Will be glad to work with you or anyone who may experience problems using any model of the VEDs.

Regards, Old Man

PS: Almost forgot, there are 26 lines on the protocol and each numbered line represents one week, i.e. 1 = week, 2 = week 2 and so on down the listing. The letters in each line indicated the cylinder(s) to be used during that week's exercise session cycle.

Note to Steve:

Again, the protocol is lacking in stating the time between each pumping cycle. Use your own judgment as to the time, but do not wait too long as the vacuum seal might be broken and it it best to hold the seal, etc. What I do is slowly ease off the pressure for a few seconds to almost a flaccid state, but, keep the seal and begin the cycle again.

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.

Tim468

I am 51 and have had Peyronies Disease since I was 21.

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

bob

I'm hoping Old Man will be online today at some point to read this. I need his expertise...

After a long period, I learned that my Blue Cross/Blue Shield plan will not cover the Osbon Esteem VED that I ordered from Timm Medical. It is out of network. Basically, that means I have a $500 deductible for durable med equipment, which means I have to pay the full $445 cost.

I'm in the process of trying to get them to take it back, because they did assure me that there was a way they could place the order in-network. A DME supplier near where I live, which is in network, has a machine called the Encore Manual VED. Is this comparable to the Osbon Esteem Manual, in your experience? I notice from pix of it that it is not a slanted design like the Osbon. In addition, when I discussed this with the rep, he had no idea about the availability of a smaller-sized adaptor.

Please advise ASAP. Thanks!