Surgery for Peyronie's Disease

[Hawk]

JTL,

You need to listen to your doctor and not hope for something you will not get.  There are video clips on the internet of men pumping up a 3 piece penile prosthesis. They get no do not increase in length, only girth.  Maybe if someone locates a video clip they can post it. This usually mens your erect penis will be about an inch shorter than you can stretch your flaccid penis right before surgery.

Two notes:  There was a manufacture that made a prosthesis that expanded in length as well as girth but it is never referred to which leads me to believe it had problems.  Also, RZZ once asked, "if a VED can increase flaccid length, would increasing flaccid length in the months prior to surgery result in a longer implant being inserted during surgery.  That is a good question.  It would seem if the VED increased the  length the penis can be stretched by pulling it out from the body, that th answer is yes.  If it only increased the hang so that without increasing the potential stretch length the answer would be no.  I would consider a VED and Fastsize traction for a year prior to surgery if I were going to get an implant.  I would also research the all implants to see if there are and solutions under development implants that expand in length.  I should say that is what I would do unless I had a 10" flaccid penis

[Steve]

  Hawk,

I found this video on YouTube.  It shows an implant (that they claim also extends in length) in use, and it's implantation surgery  
http://www.youtube.com/watch?v=uCIf4Pw6gck
The video's not the highest quality, but it's certainly graphic enough!

Steve

[Old Man]

Note to implant wannabes:

There have been quite a few guys that I have worked with on prostate cancer therapy for ED, Peyronies Disease and other men's health problems.

Several of them had implants done. From this experience, I gained considerable knowledge about the implants and their problems, upsides and downsides. For the most part, all were basically satisfied with their surgeries and the model they chose to get implanted.

There are several good medical quality implants out there on the market. The three piece model made by one company was the best choice for those I am familiar with their use. It would only be fair to say that it does not increase the length beyond what is normal for a guy.  You can only get back what you "came with" in implant surgery. My father-in-law had one done at age 76 and it gave him what he had before ED set in and I don't remember that he had any Peyronies Disease problems. The surgeon doing the implant has to rely on the stretched flaccid dimensions to determine what length the implant is to be - one too long or too short causes problems, so he has only "one shot" to get it right.

It has been reported by several guys that their uros/surgeons suggested using the VED to bring the penis back to its original size/dimensions. It seemed to help with their flaccid length, but again remember, the VED will only give you back what is lost by whatever reason in most cases.

Hope the above gives a little insight about implants. One can do a web search for penile implants and there are many sites showing models, how they are implanted and in some cases Q&As.

Old Man

[jtl4661]

Thank you Guy's for all your input. I may be doing the implant after all I will ask if i should use a ved before the surgery. I really appreciate all of your input and questions  now will ask my Dr. thanks again

[Craze]

Thanks for all the good info.
I will be getting pump implant the 10th of May. I will post my experience of the whole thing.
Craze
5/11/07
Had the surgery yesterday and at home now.
I must say, it was and is more painful than I had anticipated.
Will write more tomorrow. Pain at about 6 right now.
05/12/07
Doc left it partially inflated. It sticks strait out and is hard to wear sweats.
I think I am having a allergic reaction to the antibiotics. I have hives and swelling. especially my balls and penis.
I can tell it is going to take at least 2 weeks before I am able to walk normal.
Very difficult sleeping too.
05/13/07
Hives and itching are better today. Still a lot of swelling though. Doc put me on a different antibiotic. With the partial inflate I have to use urinal or just go outside. He will deflate it all the way tue.
I will wait a few days to give update on recovery. Hopfully I will have some good news on the healing process.
Later, Craze

[JKC]

Hi Hopeful
Thanks for encouragement Liam.
Saw #3 uro last friday. My local, 1st, 2 yrs ago perscribed potaba. My 2nd got me in touch with Dr Lue. He looked at the inflammation/calcification on my hand and felt it was a precursor
for peyronies. Inquired if my father showed similar signs and warned that my son has a good chance of carrying the trait. After 10 minute ultrasound said I had "very large calcification" almost full length and more than half way around, and that removal is
only option. It may not increase but will not decrease with only pentox(and other drugs).
I asked about other "new drugs", he said pentox works with smaller inflammations but
is only drug he recommends. My ultrasound (#2 uro) was a waste of time.
From this board I understand he is one the best, does any else have much experience
with Dr Tom Lue UCSF.

JKC newbee 52

[allj]

   
      
   
The Tunica-Albuginea-Patch-Technique: A new technique of an autologous grafting procedure for patients with Peyronie`s disease

Author Block: J. Ullrich Schwarzer*, Freising, Germany

Introduction and Objective: In Peyronie`s disease, any kind of plication technique for correcting penile deformities is associated with penile shortening in addition to the disease-related shrinkage. To minimize penile shortening we describe a new technique of an autologous grafting procedere using a free graft from the tunica albuginea of the proximal corpus cavernosum. This new technique is demonstrated in the present film. Methods: From 10/01 to 07/04 we treated 36 patients with the new technique. All patients had stable Peyronie's disease with relevant curvature and sufficient erectile rigidity without any signs of inflammatory disease. Penile corporoplasty was performed by incision of the plaques to produce straightening. The resulting gap was covered with a free graft of tunica albuginea removed from the crural segment of the corpora cavernosa. Results: In a follow-up of 31 patients, 26 penises were straight and 4 had a residual curvature less than 20°. Six patients needed PDE5-inhibitors for sufficient penile rigidity, 5/6 patients before the corporoplasty too. 29 of 31 patients were satisfactory with the result of penile straightening. No severe perioperative complication was noted. Conclusions: The technique of penile straightening using a free tunica albuginea graft is effective and avoids additional shortening of the penis. As the results are preliminary, the study is continued to gain experience with a larger number of patients.

Keywords: Peyronie's disease, Grafts

American Urological Association Annual Meeting
May 21 - 26, 2005
San Antonio, Texas, USA

OASIS - Online Abstract Submission and Invitation System™ ©1996-2004, Coe-Truman Technologies, Inc.

Close Window
   
      
   
© Copyright 2006 The Association of Peyronie's Disease Advocates

[Joanie]

Hello to all
My DH had the surgery in Boston 6/12/07 (Penile Plication) and went back to work today!! He says he feels fine and is not in pain although very bruised.  His Dr said things went well and after treatments with Trental at a different Dr's office and 6 consecutive injections of Verapamil to a very severely curved penis with no improvement, we are hoping that when the 2 -3 week recovery period is up, we'll finally see a difference.  I'm happy this is behind us and wish you all the best.  If anyone wants to email me, feel free please.
Blessings
Joan

[Hawk]

I hope the two of you will keep us updated.  This is VERY critical information for the thousands that come here for information.

Best of luck with the treatment

[Tim468]

http://www.refertilisieren.de/literatur/penilecorporoplastik.pdf

The grafting technique using tunica albuginea from deep in the body - as usual the surgical pictures are enough to make you wince.

Tim

[johndoe]

hello to all, well i went through most of the sections on this forum regarding surgery and didn't find any topics that talk about penile lengthening for curvature correction (suspensory ligament release). i'm asking if anyone HAS FIRST HAND KNOWLEDGE HIMSELF OR DIRECTLY THROUGH A FRIEND that shows if it is possible to improve a mild curvature using this method. we all know that curvature is caused because one side of the penis is shorter than the other. i've talked to former patients of the penile lengthening procedure who have seen reasonable results with this technique (about a 1 inch gain in the erect state, 2 inch gain in the flaccid state). i was wondering if anyone knew if you could just cut the suspensory ligament on the short side of the penis to improve about a 10-15 degree curve? i'm looking for a quick fix so to speak, i don't wish to be on injections, or oral medications forever and ever and end up spending more money that way than if i would've opted for surgery in the first place. if anyone knows for sure, please let me know, thanks.

[Hawk]

OK, I have not had and know no one that has had this procedure but I have read literature and seen videos.  I am sure I am giving you accurate info.

suspensory ligament release is for the appearance of increasing penis length by cutting the support and allowing some of the penis normally inside of your body to extend externally.  There is no way this can correct a curve in an erect shaft.  It is never considered as a treatment to correct a curve from either Peyronies Disease or a congenital curve.

The ligament is there for a very specific reason. You make no mention of the nature or origin of your curve but in any case cutting the ligament will make you more prone to injury during intercourse.  

[Liam]

Like Hawk said.

Also, the cut would be above the curve.

Read everything you can about the different surgeries and you will see why so many men here are on meds, shots, etc.  It aint because we like it .

[johndoe]

as i mentioned before i have talked to a few patients who have had the surgery and despite those "rumors" that it gives of the appearance of a longer penis it indeed does make it longer. the essential part of the surgery is the use of penile weights and pumps to make sure the ligament does not heal back to normal or even shorter than where it was before. when it heals, it heals like it was never cut, not functional lose or anything significant like that. the patient i talked to gained approximately 1 inch of length in the erect state and 2 inches in the flaccid state (saw photo evidence). he also did a widening procedure and achieved awesome results but that's a different story. as for me and the source of my problem, i've had peyronie's disease since a childhood injury when i was about 13. over the years i've seen dramatic improvement in the curvature but still have a slight bend about 10 to 15 degrees left that i wish to get rid of. i was in contact with that patient because i was going for the lengthening and widening procedure myself. i would have to pay 4K extra for a curvature correction procedure on top of the massive amount of the other two. through deductive reasoning i came up with the question that i posted earlier and thought i see if anyone out there had first hand knowledge. IF ANYONE OUT THERE HAS HAD A LENGTHENING PROCEDURE WITH A SLIGHT CURVATURE AND HAS SEEN IMPROVEMENT PLEASE LET ME KNOW. ALTHOUGH I DO APPRECIATE EVERYONE ELSE'S TWO CENTS I WOULD APPRECIATE REPUTABLE RESPONSES ONLY, THANKS.

[Hawk]

JohnDoe,

The point is this.  If a pipe is bent and you then weld 2 inches to the base of the pipe it still has the original bend.  If you weld 2" inches bent in the opposite direction then it will tilt the pipe in that direction but the original bend will not be affected.

Also, I was not giving you rumor.  I was giving you "from the horses mouth" information from a leading surgeon in the performance of this surgery.  IT EXTERNALIZES A PORTION OF THE PENIS THAT WAS INTERNAL.  It does so by removing the support that suspends it within the body.  Any weights, traction, or Vacuum device, is just adjunct to the surgery.

You will not find one soul here that has had that particular surgery because it is totally inappropriate for correcting any bend.  If you prefer, contact any world renown doctor that treats Peyronies Disease or any renown penile surgeon that corrects congenital curve or other penile deformity and confirm this for yourself.

[Tim468]

I know someone who had a lengthening procedure and it didn't affect his penile curve. Of course, the legthening was of tight achilles tendons for spastic quadiplegia.

Lengthening the base of the penis will not straighten it - that is why they want to "charge extra" for doing it - it is a different procedure. As already stated, lengthening the base does not affect a curve further down the shaft.

The suspensory ligament is medially located, so one cannot loosen just one side to allow the penis to drift more midline. Rather, the ligament is cut and the base of the penis is freed up to allow for greater externalized length to be visible. It also no longer points up, or even out, any longer. That may be important cosmetically - something to think about.

If the "bend" in your penis is right at the base - that is, it just points off to the side when erect, then freeing up the suspensory ligament may allow it to point more midline. Remember, though, that once it is freed up from the suspensory ligament, it is less easy to control in terms of thrusting, and thus is going to be more prone to bending injuries. If you are "prone" to Peyronies (and you may be since you got it in response to an injury when you were 13), then that might place you at risk of greater injury later, or trauma.

Finally, you say it has gotten much better over the years. You don't say how many years that has been, but if it is between 5 and 10 years, then it is possible that it will continue to improve.

If you did not have a bend, would you be considering this surgery?

I don't know if I am "reputable" - if you define 'reputable' as meaning "had the surgery that I am interested in, even though no one else has ever had it", then I guess the answer is no. You might have trouble finding a "reputable" person to answer you - although it seems to me, that you are more interested (or at least hopeful) of hearing just what you want to hear. FWIW, I am a physician who has had Peyronie's for over 30 years now. But "reputable", well thet might bo going too far!  

Tim

[johndoe]

thanks Tim i really appreciate your reply, it sounds like to me you know what you're talking about especially the part about the suspensory ligament being "medial"... as for hawk the story about the pipe... that story doesn't hold water in this case because the penis is not one connected organ (pipe) it has two sides that inflate. i was simply just inquiring if it was possible to lengthening just one of the sides to make it the same length as the other. my next step was to ask a physician but i'm always cautious of asking stupid questions, i thought i'd try here first. as for what's been working for me, i have my own regime i made up after researching some of the basics about plaque etc. that consist of  vitamin e (orally and topically), cologense (topically), and my personal secret... ems (electric muscles stimulator) twice a day for 20 minutes. been using that for about a year now and have seen dramatic improvements went from a 30 degree bend to where i'm at now 15 degrees. the elasticity is the thing that's improved the most, i used to have a hour glass and that's pretty gone away.

[Liam]

When the suspensory ligament is cut, the penis may look longer because more of it hangs outside the body.

Source: http://www.mayoclinic.com/health/penis/MC00026

BTW, I understood Hawks analogy.  But, sometimes a picture is worth a thousand words.

[Treelump]

Hey all,

I'm new here and stumbled across this forum after my third, yes third surgery to fix my peyronies.  I am 21 and after several years mustered up the courage to talk to the family doctor about this 2 years ago (after having this seemingly all my life).  I thought it was a congenital curvature, but upon inspection, doctors found plaque, so he said it was peyronies, and it could only be fixed through surgery.  I had three opinions and booked a surgery date.  A stitch broke (I must have strong erections) and six months later, I had another surgery.  

After the second surgery, two stitches broke and one of the broken stitches lodged it's way inside, poking me (yes, it was very painful).  I just underwent my third Nesbitt plication.  Everything is looking as good and straight.  It's only a week out of surgery, and after waking up with morning wood, I looked down and was very displeased at the amount of length I lost.  I lost almost 2 inches (the previous two times, I only lost about a quarter of an inch to a half of an inch before the stitches popped).  

My question is, do you think everything is still healing and I will regain some length once all is said and done?  Or is this what everything will look like from now on (assuming another stitch doesn't pop)?  Am I worrying too much about this?  Thanks for your feedback and let me say it has been really great finding this forum and reading through it to know that there are others (especially my age) that are going through the same emotional and physical problems associated with this disease.  

-Treelump

[Liam]

Did the doc put your penis in traction?

[dahc]

You should definitely ask your doctor about using a traction device. You may be able to recover some length over time using one.

[EddyG]

I first noticed a problem about 3 years ago, my GP told me to lose weight. About a year later the curvature started. I returned to my GP who sent me to see a urology specialist. Before my first visit I had already diagnosed my self as having Peyronnes disease. I had to under go three sessions of ultra sound treatment, very uncomfortable and degrading, all to no avail. A year later it was decided I would have surgery, my curve was by now very severe, I had my procedure on 4 JUNE 07. I had the Nesbit procedure which also entailed having to be circumcised.
It is now three weeks since the operation, the only soreness I have had emanates from the stitches that I still have. I requested medication to alleviate involuntary erections, I took the tablets for two weeks they did not work but I had trouble keeping awake. I don't have a follow up until November I will update later.

[Steve]

Thanks so much for speaking up and offering to keep us updated.  There are many of us out here who have thoughts of getting the Nesbit, and first hand knowlege from someone who's taken that step is invaluable!  Definately please keep us all informed.

Steve

[Star_Base]

Let me start by saying hello to all and I hope I am posting this in the correct location. I am new to this site and have read many if not most of the post on here. In the first stages I started researching what was happening to me on the net, and found only about 5 good sources on Peyronie's. I took some digital photos as recommended, placed them on my PDA and was off to my primary care so he could have a look. I was diagnosed with Peyronie's by my PC June 1st, 2007 and confirmed by the Urologist a week later.

I am 44 yrs old and started seeing a depression occur about half way up my erect penis on the top side traveling my left to right in the first week or so in May. Initially it was on the left side causing my penis to hook to the left about 15 – 20 degrees and up maybe 10. By the time I saw the urologist it was all the way across left to right still a bit more prominent on the left. Having intercourse is still possible but not as enjoyable for my penis wants to bend in half if I am not careful.

Anyhow, my urologist felt my flaccid penis and said he could feel the formation of plaques. He knew I was coming in to see him for confirmation that I had Peyronie's. He   recommend that I consume 1600 IU of vitamin E per day and go back and see him in December.

I have not seen any improvement whatsoever and I now have a burning sensation in my penis that can get rather [and I do mean ouch] discomforting at times when flaccid. This can last a few minutes to a few hours. Has anyone else experienced that? The depression does not seem to be getting any worse but I could be wrong.

After all the reads on this forum and others it seems to me that the doctors are correct and time is the only cure. I don't think sticking a needle in my penis is going to help nor do I think stretching my penis with ten pounds of weight is going to help.

Looks like vitamin E and check in with the doc in 5 months is going to be my plan unless someone can produce some hard evidence of a cure. Maybe contacting the doc about the pain if it continues to climb.

Thanks to all who have posted their info and good luck.

[Old Man]

Star_Base:

Welcome to one of the best, if not the best forum on Peyronies Disease one can find. I know the feeling that you are having at time. My history with Peyronies Disease could fill a fairly good sized book since I have had the mess since the age of 24. My history is posted elsewhere on the forum and I will not repeat it here. However, I strongly urge you to browse through all the topic threads on this forum before charging off on any one course of action.

There is a vast array of knowledge about Peyronies Disease here, so one just has to browse through the posts by topic to glean much needed information about Peyronies Disease, with the whys and wherefores about it and many suggested treatment/therapies that have been tackled by the many members.

Having been through the vitamin E course of action, I would like to suggest that you be careful of taking so much E for any extended period of time. I took vast dosages too, but had blood tests done real often to preclude damage to my liver, so be careful there. In my case, the E therapy did absolute nothing.

A number of us on this forum have had good success using the vacuum therapy. There is a highlights topics that cover its usage with success stories posted there. You might want to read over this one too.

If there is any way any of us can help, just feel free to ask.

Old Man

[Treelump]

No traction.  Is this something that I should ask him about?  Are there any people on here who have used the device with any success?  Thanks again for the help.

Treelump

[Liam]

I have seen where some doctors have used it post surgery.  However, I can't seem to find the link now.

Liam

[Star_Base]

Thanks for the comments Old MAN

[RiseNShine]

I know someone who had a lengthening procedure and it didn't affect his penile curve. Of course, the legthening was of tight achilles tendons for spastic quadiplegia.
Tim

This was actually something I had thought about after feeling the plaque..of course I'm female but I have known a few who have had the procedure you speak of on wrists and heels...cord releases.
Since the plaque in many is a continuous "cord" why couldn't the surgeon "notch" (V notches are cut into the length of the tendons to allow them to simulate a stretch ) it to release it also.
Too simplistic?

[Hawk]

I think Tim has been busy with other endeavors, but I will field a lay response to your question.

I believe you have put a significant amount of thought into this and posed a very good question as a result.
I actually think the surgery you suggest is not far removed from one type of surgery that is performed except that a graft is then added to the incisions where the plaque was relaxed with the series of cuts.  The problem is that with a penis you require nerve function for erection, separate nerve function for tactile function, vascular issues, and the problem of further episode of Peyronies Disease.  All this in addition to the typical issues associated with surgery.

After my knee surgery, the entire side of my knee was (and still is to some degree) numb.  It worked fine but it felt like it was not even my knee.  Obviously that is unacceptable with a penis.

PS: To some extent, the Lariche technique may do something similar on a micro scale (minimally invasive with a needle) without using grafts.  Unfortunately we hear little about this lately and our attempts to learn more have been unsuccessful.

[Joanie]

My DH is 67 years old and very youthful.  He was diagnosed with Peyronies Disease about a year and a half ago.  We've only been married 6 yrs. His first wife was very ill for 10 years and died of cancer so when he met me, all he wanted to do was -- well you know!  He has gone through the Vit E and Trental and Verapmil and this year changed Urologists to one in Boston. The man is a genius.  After my husband was treated more conservatively initially with 6 cosecutive shots to break up plaque, he then decided to have the Penle Plication which has worked a small miracle for us.  It was a day sugery with little discomfort and for the first time, he feels great inside me and the angle of the penis is the way nature intended. When I tell you that his curve was so severe it was almost impossible and with hardly any pleasure for either of us and more work than it was worth, I'm serious. If you'd like more info, feel free to email [email protected]
Joan

[Liam]

Most of the time we see the bad side posted here.  Maybe because the ones with successful outcomes don't post.  They're too busy  .

Thank you for your post and your being open to questions.  Your posts and responses may possibly influence many decisions.

[Tim468]

I agree with what Hawk said (in my original post I was being facetious and ironic).

The Lariche procedure is a relaxing incision. The problem with most such procedures is that they also affect the vascular integrity of the tunica, making it "leaky" - hence the need for patches and grafts.

I think that a lot could be done to learn better how to operate on this, especially using microsurgical techniques. Urology needs to make doing so a priority, IMHO.

Tim

[j]

A similar 'needle release' for Dupuytren's contractures has been performed in Europe for decades and is now available in the US.  American hand surgeons rejected and in fact ridiculed this technique for years: it won't work, it's unproven, it might damage a nerve, recurrence would be rapid. In fact, it appears to work extremely well in most cases, nerve damage is all but unheard of, recurrence is slightly worse than conventional surgery but it can be easily repeated.  Bottom line, American surgeon's weren't interested because it was unfamiliar, would replace what they already offer,  and was "not invented here".  Now a half-dozen American surgeons have learned the procedure and their waiting rooms are full.   Recovery time is essentially zero, vs. months for conventional surgery.  For most cases, the decision is a no-brainer.

I think this is relevant.  The needle procedure for Dupuytren's was developed by some French doctors who weren't surgeons, weren't dependent on surgeon's fees for their incomes, and were willing to try a creative solution in the interest of helping their patients, without being held hostage by corporate lawyers.  

[othello]

Did you see this article in today's NYT?

http://www.nytimes.com/2007/07/24/health/24hand.html?ref=health

Has anybody heard whether this method has been tried on Peyronie's?

[Tim468]

I believe that the French doctors who developed the needle technique were surgeons. I am not sure though. The term rheumatologist in America unifromly means non-surgeon. In Europe, doctors are more free to move across discipline IMO and are better cross-traineded between surgery and medicine.

I am glad that the technique is catching on. Rreluctance to use a technique does not mean just greed or laziness - many a new technique has not turned out to be that great a panacea as it looked like at first.

Tim

[flexor]

Ref the NYT article - I think that the procedure is the Leriche Technique.

The difference is that in France, some urologists have used this technique for the plaque of Peyronies.

Slow progress, but at least progress.

Flexor

[Michael]

I posted last on Feb 7; things were really not going well. Dotty was heading toward a hysterectomy, so I anticipated no forward progress for some time (in my heart I was afraid that would be forever)... and then, bless his heart, I got a private message from Old Man encouraging me to try a VED. That gave me the kick I needed; I eventually went on-line and ordered a Vacurect. It took a couple weeks to get here; and I started using it in private. I found the ring that was not too tight but was tight enough, and started pumping up. It was immediately obvious that I COULD be the same size I was before surgery; I just wasn't getting enough blood in there to either approach that size, or maintain it. I approached this very slowly, since I knew it would be months before we would be attempting sex again-- the instructions say to pump up twice a day for a while, then to be regular about it after that. I only tried to ejaculate a couple of times while fully pumped:  for me, that was not a comfortable feeling. Several months later, we tried to have sex while pumped--  it was ok for her, but not so hot for me.  With the pump, I was uncomfortable; without it I couldn't maintain an erection. Now, I don't know what changed... but one morning about a month ago I woke up hard as could be, and it stayed there.  Every other morning erection I had had before that day was only semi, and temporary. Long story short, I have been getting regular morning erections that last; we have had successful sex a number of times in the last month, and one day to our complete surprise I actually got it up in mid afternoon and had sex with my wife like the old days.  I am not as long as I was, but I have gained back a good inch, so I have enough to penetrate and thrust--  and Dotty says she can't tell the difference from before the whole Peyronies nightmare began. I'm straight; my girth is back to normal; I don't have the orgasms of a 25 year old... but at nearly 56 I don't expect to.  They feel damn good considering what I've gone through to get them back.  I will keep working with the pump, and will let you know if things stay the same, improve more... or go south.  All I can say is that I have the best attitude I've had in a very long time...

[Steve]

Wow Michael,
That's some very good news you've posted.  With all the stories of our problems, it's refreshing to hear from someone who's had success with a treatment!  Best wishes to you both, and keep us up-to-date with your progress!

Steve

[Old Man]

Michael:

That is some real good news about you getting somewhat back to normal again. Glad that you tried the VED therapy. It has worked very well for so many patients after a radical prostatectomy as well as Peyronies Disease symptoms.

Using it after the surgery kept the old tool primed and in shape looks like. Keep up the good work and keep us posted in the future.

Old Man

[rcrj]

http://www.metro.co.uk/weird/article.html?in_article_id=33257&in_page_id=2

Hello,
This is somewhat similar to the procedure to correct a micropenis that was used in Russia, although in the case of this Romanian surgery the arm tissue was used for a patient who was butchered by a previous surgeon.  Has anyone seen any info on using arm tissue to replace scar tissue, or to "build up" an undersized penis to reach average or above average length or girth?

Robert

[rcrj]

http://www.metro.co.uk/metrosexual/article.html?in_article_id=19833&in_page_id=8

[bix]

Hi,

I'm 66 and I live in the UK. Late in 2003 I started having painful erections and about March 2004 I noticed that although I had no difficulty achieving an erection it was bent up about 40 or 45 degrees. By the summer intercourse was difficult and very uncomfortable for both of us and by the end of 2004 it had become virtually impossible. I consulted my GP who diagnosed Peyronie's and gave me Cialis (apparently Viagra isn't good for me - I have hypertension and type 2 diabetes) which gave me a splendid but very painful erection and the bend was no better. So he sent me to see a urologist who offered surgery (plication or corporoplasty) but I chickened out. He mentioned ultra-sound treatment but said it wasn't available on the National Health Service (we pay for it all our lives through National Insurance and it's free at the point of treatment) and would cost me £1,000 and often didn't work anyway.

In September 2006 I saw the urologist again to have my prostate checked (no problem, thankfully), but he was more interested in my Peyronie's, mentioning that ultra-sound treatment (lithotripsy) was now available on the NHS. So I had three sessions of lithotripsy over three months. I've been a nudist for 25 years so I didn't find it at all embarrassing. It feels rather like having your penis flicked quite hard with a rubber band for about 12 minutes. The first time it made my eyes water, the second time I could hardly feel anything, and the third time was like the first. I've no idea why. Perhaps the second time they were really hitting the plaque? After the first session my erections stopped being so painful, but even after the third session the bend was still just as pronounced. So he offered me surgery.

With the National Health Service you get first-class treatment, and the same surgeons as private patients, but you have to wait. So finally on July 3rd 2007 I had my corporoplasty. Apart from a little residual soreness I feel fine. It's now July 29th and I'm wondering how long I ought to wait before trying sex again. Any advice?

I'll keep you posted on future developments.

bix

P.S: Your spellcheck didn't recognise "Peyronie's" and for "lithotripsy" suggested "deathtraps"!

[Hawk]

Bix,

Welcome to the forum and thanks for the great post.  Since surgery is considered the last resort and since most men avoid that option, you can be a wealth of information for thousands if you will keep the forum updated on an weekly basis.

you asked

With the National Health Service you get first-class treatment, and the same surgeons as private patients, but you have to wait. So finally on July 3rd 2007 I had my corporoplasty. Apart from a little residual soreness I feel fine. It's now July 29th and I'm wondering how long I ought to wait before trying sex again. Any advice?

I have to ask if your surgeon covered this vital point with you?  If he did not bring it up you should have covered it in your prepared list of questions.  If that opportunity was missed, then surely his nurse will accept a call and get a professional answer from the man who knows the exact status of your surgery.  Please don't chances with something this critical.

Best wishes

Hawk

PS: Our spell check is far from perfect but it sure beats having none.  It may have a prejudice against lithotripsy.  (hmmmmmmm,  it did not offer me that suggestion )

[bix]

Hi Hawk,

Good to hear from you. Hands across the sea.

Well yes, I did ask him, and he said a month. But a leaflet from the hospital said two months. And another website I looked at said five weeks. But I suppose we're all different. I'll just wait until I feel comfortable. What the surgeon stressed was, "Don't leave it too long - don't leave it for four or five months - use it or lose it."

I visited another GP recently, about a different problem, but all he wanted to know about was my Peyronie's operation. He said the condition is much more common than most people think, but he'd never met anyone else who'd had surgery. I originally told the surgeon that I thought it sounded pretty horrendous, but he said it was just a nip and a tuck. I'm rather inclined to think he was right. Most of the other patients on the ward were seriously ill, and I felt I was in for not much more than cosmetic surgery.

One thing I didn't understand - when I got home from hospital I found my glans was bruised and wondered why. Since then I've seen photographs on Dr Alter's website which show weird sharp-looking objects stuck into the glans. Is this how they create the artificial erection?

Spell-check - I clicked the button on your website, but what came up was Opera, which seems to try to over-ride anything else.

I'll keep in touch.

bix

[bostonlocal]

Does anyone have any recommendations for a urologist in Boston who has surgical expertise in Peyronie's?  I would be very grateful for any recommendations.

Thx!

[Hawk]

Boston,

Welcome to the forum.

I will be brief.  You have one penis.  Most problems encountered during penile surgery cannot be undone.  In my humble opinion, you are not looking for a "close" surgeon for penile surgery.  You are looking for the very best surgeon in the country.  Since the best may be debatable, you are certainly looking for one of the top dozen in the country.  That should be your question.

The only exception I can think of is if you are recommending a surgeon to some guy that stole an old girlfriend.  

[Liam]

Although not for Peyronies Disease, this should be of interest to some of the members and guest with a congenital curve.

Sexual Medicine

Congenital Penile Curvature: Dermal Grafting Procedure to Prevent Penile Shortening in Adults

Alchiede Simonatoa, , , Andrea Gregorib, Carlo Ambruosia, Gabriele Ruggieroa, Paolo Traversoa and Giorgio Carmignania
a"Luciano Giuliani" Department of Urology, University of Genoa, Genoa, Italy
bDepartment of Urologic Surgery, "Luigi Sacco" University Medical Center, Milan, Italy
Accepted 22 November 2006.  Available online 30 November 2006.


Source: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6X10-4MG1MP1-1&_user=10&_coverDate=05%2F31%2F2007&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=01e76ffdd49b7e7a839150f3ff6619f9


Abstract

Objectives

We report the results of a derma graft corporoplasty in a selected group of patients with congenital penile curvature (CPC) who refused a simple plication technique for the risk of penile shortening, even if minimal.

Methods

Between January 1995 and January 2004, 15 potent patients with CPC underwent corporoplasty with inguinal derma graft, with or without tunica albuginea plication. Mean age was 26.6 years (range 19–36). Six patients had a simple lateral left curvature, three had a simple lateral right curvature, four had a ventro-lateral left curvature, one patient had a ventro-lateral right curvature, and one patient had ventral curvature. In nine patients the preoperative mean IIEF-5 score was 22.55 (range 21–24). All the patients were evaluated after three, six and 12 months.

Results

One graft was placed in one patient (6.6%), seven (46.6%) received one graft and underwent a tunica albuginea plication, four (26.6%) received two grafts, three (20%) received two grafts and underwent tunica albuginea plication. A residual curvature after three, six and 12 months was present respectively in all (100%), seven (46.6%) and one (6.6%) patients. No patients had a decrease of penile length. The mean difference in the IIEF-5 score before and after the surgical procedure was not statistically significant.

Conclusions

Surgical correction of CPC with derma grafts in potent patients restores penile straightening with no postoperative shortening and preserves normal erectile capacity. Patient satisfaction indicates that the proposed technique may be used in selected cases.


Take Home Message

Surgical correction of congenital penile curvature with derma grafts in potent patients restores penile straightening with no postoperative shortening and preserves normal erectile capacity.

Keywords: Congenital penile curvature; Dermal graft; Penile corporoplasty



Corresponding author. Ospedale San Martino, Clinica Urologica "L. Giuliani", pad. 12, Università degli Studi di Genova, L.go Rosanna Benzi, 12, 16132 Genova, Italy. Tel. +393356444088; Fax: +39010354004.

European Urology
Volume 51, Issue 5, May 2007, Pages 1420-1428  

[Tim468]

Here is the editorial comment accompanying the text. Also, one should look at the PDF version (full text) - the repaired penis doesn't look better to me. It went from having a gentle curve, to having a couple of dents and bulges that make it look lumpy.:

Editorial Comment
Drogo K. Montague,
Section of Prosthetic Surgery and Genitourethral
Reconstruction, Glickman Urological Institute,
Cleveland Clinic Foundation, Cleveland, OH, USA
[email protected]

In normal men erect penile length correlates fairly well with the length of the stretched flaccid penis [1]. In men with erectile curvature as the result of Peyronie's disease, scar limits the stretch of the flaccid penis and also determines the length of the erection on the short side of the penis. In men with congenital penile curvature, there is a relative tissue volume deficiency on the concave side of the curvature. In these men, this deficiency limits stretched penile length and dictates length of the erection on the concave (short) side.

Plication procedures shorten the convex (long) side of the penis to match the shortening produced by scar (Peyronie's disease) or volume deficiency (congenital curvature) on the short side. Thus, with plication procedures stretched penile length before the procedure should match the length of the erection after plication. In this sense plication surgeries do not further shorten the short (concave) side of the penis. Grafting procedures as carried out in this report by Simonato et al do have the potential
for lengthening the short, concave side. However, in 4 of the 15 cases in this series no lengthening occurred despite the graft. In 11 of the 15 cases, lengthening of the short side did occur and ranged from 0.5 to 3 cm.

The most significant potential adverse event associated with grafting procedures is new-onset erectile
dysfunction (ED) presumably as the result of venoocclusive dysfunction through the bed of the graft.
Although ED did not occur in this series, it is the potential price men might pay for a length gain ranging from zero in 4 cases to 0.5–3 cm in 11 cases. In addition, as the authors have noted, healing takes significantly longer with a grafting procedure than it does with plication. These factors (possible new onset ED, longer healing, and possible failure to gain length) with grafting procedures should be discussed
with men who are considering plication versus grafting for congenital penile curvature.

***************

Tim  ::sigh::

[not9inches]

Hello Everyone. I haven't visited the forum for awhile as I had just resolved to live with my peyronies for awhile and of course...treat it from advice given on this forum. .

Some background: In about June of 2006 I noticed a change. It seemed that I was becomeing more cuved....so I googled "curved penis" thats what brought me here.  I grew progressivly worse...changing and becoming more noticeable. I've experienced the "Pain" talked about. Ive gone for long periods with no pain...now its back again to a lesser degree. But only when erect.   And it seems the curve has gotten worse in the last 6 mos. I was curved about 30 degrees to the left...now it seems its about 45 degrees. I posted pictures on my web link so that others could compare thier unit and provide encouragement as to my severity.  Im funtioning normally in all respects still. Ive been in a dating relationship that has been very supportive and understanding for the last 6 mos. But i feel it will become an issue and have resolved to become more proactive. However, the more you learn and read...the more disheartening and usless it seems.


Ive just now come back to the forum and something dawned on me. I saw two Uros last year and both said take a wait and see approach. One Uro was an old school, older man(who is now retired) and the other doc was a younger(about 39) guy. the yournger Urologist didnt even LOOK at my unit when i went to see him. We just talked. ( actually...the younger doctor wanted me to send him a picture of it...and i suppose he was going to look at the change from over time) He stated that the only cure for peyronies was surgery.

My approach has been simply to take the advice from this forum in regards to vitamins and such. (i never did stick with the VED) I feel like I need to find yet another urologist...one who will at least examine me and suggest SOMETHING...other than lets do surgery. I can still have intercouse ok and have no ED whatsoever. But it AINT the same. In fact...it sucks.  

First of all...can anyone direct me to others who have posted here and had sucessful outcomes on surgery....and who thier doctor was. Any Eurologist in Houston(where I live) would be great.  And secondly...can someone suggest a laundry list of what they think is the best items to use..i.e. Vitamins.,..etc.  I've been taking 800 MG of Vitamin E religiuosly...and vitamin B as well as fish oil piils. Ive even been rubbing 100% extra virgin olive oil on the area (close to the base) where the dent is. Can you Marinate this away??!!  LOL  I cannot stick with the regiment of the VED because i travel for a living and carrying that device around in my bag would get me searched everytime I go thru security!!  Talk about embarrasing!!  Thanks for reading my post.