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Welcome to Dr. Landon Trost - Directly answering member questions in the "Medical Professionals" section below the Treatment boards. https://www.peyroniesforum.net/index.php/topic,16512.0.html

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Author Topic: Minimally invasive plaque resection precedures?  (Read 4564 times)

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emasculated

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Minimally invasive plaque resection precedures?
« on: January 18, 2014, 04:26:22 PM »

I wanted to ask what kind of minimally invasive operative procedures are known to other members and / or practiced by doctors.
By this I mean operations with small incisions aimed at reducing plaque content without total removal (resection of plaque). Thereby making some improvements on the Peyronies Disease condition without the risk of a full surgery.

I had the idea that if we consider the case of a plaque which is located very close to the circumcision scar, the surgeon would make a tiny incision reopening the circumcision scar at one point (patient should be circumcised).
By this he gains access to the tunica albuginea and the plaque. Then resection of the plaque, removal of parts of it / surgical resection is performed. Afterwards the bleeding is stopped the skin moved back and the circumcision scar closed again.

As I'm not a medical doctor I don't know whether resection has ever been tried and whether there is risk of worsening the condition in the long run.
The point is also to avoid a total degloving of the penis which invariable always causes some degree of nerve damage. In the 16-dot plication procedure total degloving is also avoided. A tiny reopening of the circumcision scar is even less invasive.
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LWillisjr

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Re: Minimally invasive plaque resection precedures?
« Reply #1 on: January 20, 2014, 05:34:34 PM »

emasculated.

The procedure of making an incision on the circumcision scar and sliding the skin back is called degloving. But degloving alone has nothing to do with causing damage to the nerve bundle. Degloving exposes the tunica for various surgical procedures. Removing plaque and replacing it with other tissue (I think this is what you mean by resection?) is call excision and grafting. Various types of grafting tissue are used ranging from natural to synthetic.

I have heard of some doctors not using the degloving procedure when performing plication. There are not making a small incision in the skin directly over the spot on the Tunica where the plication sutures will be placed.

The potential for nerve damage is increased when any procedure on the Tunica is performed at or near the nerve bundle which is located dorsally along the top of the penile shaft.
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emasculated

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Re: Minimally invasive plaque resection precedures?
« Reply #2 on: January 20, 2014, 06:28:06 PM »

I was suggesting something much more minimal then total degloving. And by resection I meant reduce that plaque in size, not excise it completely. Therefore no grafting would be required. Aim of the surgery would be some improvement of the condition. One could also apply some anti inflammatory medication at the site of the plaque. But I guess since I'm not a doctor my own thoughts on this probably have some flaw in them.

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Forester

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Re: Minimally invasive plaque resection precedures?
« Reply #3 on: January 20, 2014, 07:06:59 PM »

Dr. Allan Morey has developed a minimally invasive surgical technique to fix peyronies.  See this link here:

Allen Morey: Q&A: UTSW, Dallas

Unfortunately I cannot find any details why don't you give his office a call.
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emasculated

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Re: Minimally invasive plaque resection precedures?
« Reply #4 on: January 20, 2014, 07:16:29 PM »

Thanks Forester. I'm pretty sure I found it: Penoscrotal plication as a uniform approach to recon... [BJU Int. 2010] - PubMed - NCBI

Not what I had in mind but could be interesting for others here.

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Norm

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Re: Minimally invasive plaque resection precedures?
« Reply #5 on: January 20, 2014, 08:53:44 PM »

I had penoscrotal plication by Dr. Morey in December. I am extremely pleased with my outcome. Check him out. I will be happy to answer any questions you have.
Norm
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Norm

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Re: Minimally invasive plaque resection precedures?
« Reply #6 on: January 21, 2014, 04:09:29 PM »

Em,
I am not aware of any surgery like you are describing. There is nothing "minimally invasive" about doing an excision and resection. That is degloving, whereby, they make a circumferential cut around the penis, shuck all the outer skin back to the pubis, perform their excision, and resection your penis back together. I cannot imagine they would go so far as to deglove you and NOT go ahead and remove ALL the plaque and insert a graft. There are videos on YouTube that show this procedure. It may sound like a simple procedure, but if you watch one of those videos, you will see that it is not. I had the least invasive surgery that I know to exist. I had one incision about 3/4" long on the opposite side of my plaque. Through that opening, they placed the plicating sutures to straighten me out. After one month, I am good to go. I think you are looking for a major correction inside your penis through a minor opening on the outside. I am just not aware of that existing. I really did lots of research before I committed and I never saw anything like what you are asking. If you find it, please let the guys here know because I am sure they would all be interested.
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Forester

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Re: Minimally invasive plaque resection precedures?
« Reply #7 on: January 21, 2014, 06:34:33 PM »

Also Emasculated check out this thread here were less invasive procedures are discussed such as the Leriche technique and a technique employed by Dr. Gerald Brock in London, Ontario, Canada:

Lariche technique - Treatment of Peyronies Disease in the Stable Phase - Peyronies Society Forums
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csm101

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Re: Minimally invasive plaque resection precedures?
« Reply #8 on: January 26, 2017, 08:44:50 PM »

I've seen Dr Brock 3 times now and I'm booked for the surgery on June 29th. I can post before and after pics if the moderator feels it will help. I can also say the Dr Brock is the only Uro I've seen that really wanted to help you. He spent as much time with my wife and I as we needed and answered all questions. What Dr Brock does is 'cut' the plaque about 100 times or more he doesn't do any grafting this allows your body to heal on its own and prevents rejection and possible swelling. Dr Brock said the surgery would be 60 to 80 mins in total. .

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james1947

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Re: Minimally invasive plaque resection precedures?
« Reply #9 on: January 26, 2017, 11:23:33 PM »

csm101

First, I wish you a very successful outcome
Second, I don't know what moderators feels, but it will be very helpful for other members if you will post pictures and your story

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

csm101

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Re: Minimally invasive plaque resection precedures?
« Reply #10 on: January 27, 2017, 04:16:17 PM »

Hey James, I will do that. If you look up my name you will find my story and "stuff" i'v done already, PAV, Vits, Phyiso, Verap Etc. As it gets closer the surgery date I will post pics before, and after. I hope this helps members out.

pain free all

Thanks

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james1947

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Re: Minimally invasive plaque resection precedures?
« Reply #11 on: January 28, 2017, 07:54:28 PM »

Be sure will help :)

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