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Author Topic: STAGE TECHNIQUE FOR CONGENITAL CURVATURE  (Read 13865 times)

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dokdealer

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STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« on: September 17, 2014, 12:07:59 PM »

Our novel STAGE technique, consisting of superficial tunica albuginea excisions according to geometric principles, leads to rapid and excellent results due to an objectivation of the underlying curved penis. It is a safe and valid alternative for the treatment of congenital ventral, dorsal, dorso-lateral or ventro-lateral bent penis .

People who are born with a bent or curved penis (diagnosed as 'congenital penile curvature' condition) experience a mis-development of the penis during the embryology stage, causing one side of the penis to be longer than the other side. This leads to a curvature of the penis during erection, causing personal stress, potentially psycho erectile dysfunction, and sometimes loss of self confidence.

There are many surgical procedures trying to solve this problem by making one side of the penis either longer or shorter than the other side. However, most of these techniques are based an old surgical concepts and may result in undesirable long-term side effects (complications), such as significant penile length loss, pain during erection, significant loss of sensation, bumps or lumps, and others.
The STAGE technique is a surgery primary focused on solving the congenital bent penis problem by relying on scientific geometric principles, leading to a very high success rate of the surgery without the mentioned complications above.

The four steps of the STAGE  technique surgery:


Step 1: Analysis of the Curved Penis based on Geometric principles



- Shortening the longer side of the penis
The most effective way to treat a congenital curved penis is to shorten the longer side of the penis via small excisions, without losing much penile length. As a first step, the point of maximum curvature must be determined.

- Determining the point of maximum curvature
To determine the point of maximum curvature of the penis, the STAGE technique relies on geometrical principles, unlike other techniques that rely on assumptions or guessing.

- What is the Geometrical principle?
The intersection of both penile axis (yellow lines) determine the point of maximum curvature (P) at the convex side of the bent penis. The point of maximum curvature determines the location where the excisions should occur.

Step 2: Superficial Elliptical Excisions



- The Tunica Albugina Layers
The tunica albuginea consists of an inner layer and outer layer and holds the blood during erection. Most surgical techniques will excise both layers of the tunica albugina to straighten a bent penis. The STAGE technique, only excises the outer layer of the tunica albuginea, to avoid complications seen in other techniques (e.g.,hematoma, excessive bleeding, major length loss, ...etc). In scientific terms, the STAGE excisions are superficial elliptical excision of the outer layer of the tunica albuginea avoiding potential side effects such as hematoma, excessive bleeding, indentations of the penile shaft, bulging defects ("dog ears") or significant penile length loss.

- Reaching the Tunica Albugina to perform the excisions
After we have determined the maximum point of curvature of the penis (Step 1), we need to perform the superficial elliptical excision of the outer layer of the tunica albuginea. To reach to the tunica albuginea however, we need to mobilize (put on the side) the layer holding the penile sensibility nerves (neurovascular bundle) which covers the tunica. Unlike other procedures, the STAGE technique ensures that the neurovascular bundle is not damaged, to avoid potential loss of penile sensibility.

- Superficial Elliptical Excisions
After the neurovascular bundle is carefully mobilized, the tunica albuginea is exposed. Then, small 3 milli-meter elliptical excisions are made in the outer layer of the tunica albuginea where the point of maximum curvature was marked previously.

Step 3: Closure of Excisions via Absorbable Sutures



- Closing the superficial excisions
The elliptical excision of the superficial layer of the tunica albuginea is followed by three absorbable sutures to close the newly generated tunical defect.

- Closing the superficial excisions
The elliptical excision of the superficial layer of the tunica albuginea is followed by three absorbable sutures to close the newly generated tunical defect.
The STAGE technique relies on the natural healing capability of the human body to assure desirable long-term effects and to avoid other complications of non-absorbable sutures (used in other techniques), such as persistent palpable knots, bulging defects ("dog ears"), or pain during erections.

Step 4: Repetitions of steps 1, 2, and 3 for complete curvature correction



- Complete correction of the curvature
Each step of the procedure (e.g., step 1, 2, and 3) has to be repeated until the complete correction of the axis of the curved penis is obtained.
Each step is based on the geometrical principles. This ensures an objective and reproducible surgery, that culminates into a very high patient satisfaction post-operatively.

Result: Initial and Final Appearance of the Corrected Penis




We conclude that our novel STAGE technique, consisting of superficial tunica albuginea excisions, leads to rapid and excellent results due to objectivation of the curvature. In our opinion, this is an optimal treatment for patients suffering from congenital penile curvature.
The excellent functional outcomes and lack of significant postoperative complications resulted in a high level of patient satisfaction, including improved self-esteem, relationships, libido and sexual intercourse.
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james1947

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #1 on: September 17, 2014, 04:33:56 PM »

dokdealer

I read this document on Dr. Kuehhas website, also watched the video.
I don't understand the difference between this technique and the Nesbit procedures. Seems the same to me.

James
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Stevew87

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #2 on: September 17, 2014, 04:44:34 PM »

The end result shows that the penis is bigger on the underside girth wise. Is that significant or is it just an example or something. My penis is bigger on top (girth goes out more) will this even out based on the idea that some of the penis is weighed down to the bottom side of the penis. Sorry if that didn't make sense.
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Johniscurved

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #3 on: September 18, 2014, 04:07:50 AM »

dokdealer

I read this document on Dr. Kuehhas website, also watched the video.
I don't understand the difference between this technique and the Nesbit procedures. Seems the same to me.

James

James,

If you a bit more research you'll find there are substantial differences. As far as my understanding goes, Nesbit relies on sheer force of the sutures holding the now "straightened" penis in place. Liable for the sutures to break, as well as reduced sensation in addition to discomfort and possible suture bulges.

STAGE uses absorbable sutures and use the geometric principles and as a result, the least length is lost, and the absorbable sutures actually help reshape the tunica, I think? By the time they have dissolved your penis seems to be reshaped internally so to speak, so that it is straight. Along with that, I think the two Doctors that perform STAGE are far more experienced than most offering a stock standard 'Nesbit' op, and ultimately, the end result seems infinitely better with STAGE.
There is more than a few testimonies appealing to STAGE's success even on this site alone.

To sum it up:

Nesbit:

-Lower success rate
-Reduced sensation
-Bulging sutures
-Possible re-occurance

STAGE:

-Absorbable sutures
-More 'permanent' results if you will, little to no chance for reoccurrence
-Significantly higher success rate
-Minimal length loss (average of half a cm or so)

It might sound like I'm really trying to sell STAGE here but I've done a lot of research, and questioned both former patients and the doctors for STAGE etc. and it honestly seems like the most efficient means to correct a penis with congenital curvature. Is it that hard to believe such a successful surgery for congenital curvature is available with today's scientific and medical advances?

But I'm not the expert here. Users such as keepitstraight have done countless hours of research and actually had the surgery (mine is to be, next year with luck)

John
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Johniscurved

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #4 on: September 18, 2014, 04:12:55 AM »

For those with Peyronies, the website for STAGE also offers a similar surgery but for Peyronies disease instead called the EGYDIO technique by Dr. Egydio, one of the developers of STAGE.

This surgery has an impressive success rate of 90% with no reoccurrence, so it's certainly worth a look. I think they use grafting techniques so you don't lose much size and even hopefully gain some back but it's probably best to take a look at the website and do some personal research :)

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james1947

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #5 on: September 18, 2014, 04:46:50 AM »

John

The differences you are stating are stated on Dr Kuehhas website.
I am not arguing with them. I just don't understand too much the differences.
I also know that we have a few very very satisfied members that have done surgery with Dr. Kuehhas and Dr. Egydio.
I sent an email to Dr. Kuehhas, got a prompt answer from his secretary, and yes, with Peyronies and Implant surgery I may get back around 3 cm, impressive.

James
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Johniscurved

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #6 on: September 18, 2014, 06:23:16 AM »

James,

Overall I guess you could say it is a lot more refined than your average Nesbit, but probably the two biggest differences are the specific geometric principles they measure, and the absorbable sutures. Although there are other curvature surgeries that make use of these sutures.

That's great news James, whatever option you end up choosing (If that is the path you intend on taking), I hope you get a satisfying result mate!

Cheers

John
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keepitstraight

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #7 on: September 18, 2014, 09:46:21 AM »

Hi people.

Indeed the difference is bigger and more detailed. To understand the differences more precisely you must read the literature and articles about both techniques (to understand how they work in detail) and about general penile anatomy/ penile tissue dynamics. Actually the most important is explained below (in the first post).
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keepitstraight

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #8 on: September 18, 2014, 02:28:08 PM »

Ok i will copy/paste the keypoints in my point of view that are differences/improvments over Nesbitt:

- Objectivation of the curvature and correction based on geometric principles)
- Small superficial elliptical excisions
  "The tunica albuginea consists of an inner layer and outer layer and holds the blood during erection. Most surgical techniques will excise both layers of the tunica albugina to straighten a bent penis. The STAGE technique, only excises the outer layer of the tunica albuginea, to avoid complications seen in other techniques (e.g.,hematoma, excessive bleeding, major length loss, ...etc). In scientific terms, the STAGE excisions are superficial elliptical excision of the outer layer of the tunica albuginea avoiding potential side effects such as hematoma, excessive bleeding, indentations of the penile shaft, bulging defects ("dog ears") or significant penile length loss" (end quotation)

Commentary: For me this is one of the highlights of the technique both distributed small excisions coupled with only touching the outer layer. Dr. Levine uses a similar approach for congenital curvature with the TAP technique (at least thats what i discussed with Dr. Levine). The difference is that Dr. Levine does paralel incisions, then slightly "shaves" the outer layer and then approaches the previous incisions with sutures (i think he can use both absorbable and non absorbable material, but i think he routinely uses non absorbable).

Now there are other important points/tricks/approaches that comes with the doctor expertise and experience and should be also taken in account. Really i could go further... i think i shared much of my knowledge (about penile curvature in general and about the different techniques) over these years in some previous threads/posts.
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dokdealer

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #9 on: September 18, 2014, 04:26:08 PM »

james,

The differences are:

- the geometrical principles
- The small 3mm excisions (in Nesbit at least 7mm)
- Less trauma as only the outer layer will be cut
- absorbable sutures

All this will ensure less postoperative issues and more length.
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Stevew87

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #10 on: September 18, 2014, 05:24:11 PM »

dokdealer, do you know if they even out the girth while correcting the curve? My penis is bigger on top and i'm worried it may look a bit weird after the curve correction (even if it will i'm still going ahead 100%). Posted on this recently but just wondering on your opinion.
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dokdealer

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #11 on: September 19, 2014, 04:50:57 PM »

the girth will not be touched in any way.
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Stevew87

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #12 on: September 21, 2014, 06:52:19 AM »

Do you know why they measure the flaccid penis stretched?
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james1947

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #13 on: September 21, 2014, 07:45:45 AM »

Quote
Do you know why they measure the flaccid penis stretched?
To know the length of the erected penis.

James
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Stevew87

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #14 on: September 21, 2014, 02:27:00 PM »

Well mine stretched was 11cm... and when erect min is 7 inches. Then again it was hard to do because of my foreskin is very tight.
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Stevew87

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #15 on: September 25, 2014, 02:09:35 PM »

Can anyone explain this?
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LWillisjr

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #16 on: September 25, 2014, 06:00:57 PM »

No it does not make sense to me. Your bone pressed stretched flaccid length should be similar to our erect length.
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Stevew87

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #17 on: September 26, 2014, 01:48:23 PM »

I spoke to Dr Franklin during my preop. It's because of my tight foreskin you cant really stretch it. When i pull my foreskin and stretch it, it does go near to my erect.
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james1947

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #18 on: September 26, 2014, 05:46:18 PM »

Steve

What you are writing in your last post is exactly what we are saying:
The flaccid stretched penis size is the erected penis size.

James
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Jack1909

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #19 on: September 27, 2014, 06:22:49 PM »

I don not to seem stupid or more, but are you sure that this procedure gives a precise measure of erection length? My stretched penis is 14 cm (I think it did not change after the surgeries, it's not?) but it was, in origin, close to 23 cm.
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Jack1909

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #20 on: September 27, 2014, 06:27:01 PM »

..and before today (i got the surgery) was close to 20, as Kuehhas evaluated at the first consultation.
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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #21 on: September 28, 2014, 12:44:28 AM »

Leading world surgeons are telling you before surgery and implant that what you will get as erected after the surgery is what your bone pressed stretched flaccid length.

James
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Stevew87

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #22 on: September 28, 2014, 05:06:20 AM »

I don't think mine was stretched properly due to the foreskin. But the measurement was 11cm and my penis is a good 7 inches. Thing is he did it by going under the gland but it didn't really stretch i think due to the foreskin issue, but when i stretched the tip of my foreskin and pulled it would stretch quite alot.
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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #23 on: September 28, 2014, 02:17:38 PM »

Another thing to keep in mind is that some doctors measure bone pressed stretched flaccid length from the pubic bone to the BASE of the glans. Where often times men measure their erection to the TIP of the erection. So this can explain a little difference, but at most there would only 2-3 cm difference due to the size of the glans.
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Old Man

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #24 on: September 28, 2014, 03:01:36 PM »

FredJones:

Yes, you can fluctuate as much as an inch or more on different days of VED pump up sessions. It all seems to occur based on whether or not you have an inclination toward getting an erection.

Also, medications can and will affect the length of your erections. Anti histamines are the worst meds to do that. I was prescribed them to keep my erections down shortly after several surgeries (hernia, etc.). The surgeon did not want the old tool to just jump up and possibly harm his internal Goretex patch (6 inches wide across my lower abdomen for the hernia fix.)

There are mental blocks too that can affect erections while pumping with the VED. In my past 20 plus years of VED therapy and now maintenance of keeping my full length, I have experienced different sizes on different days.

Hope this helps. Regards, Old Man
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djordj

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #25 on: December 30, 2018, 06:20:54 AM »

the results of stage are the same as any other technique for curvature. The penis size after surgery is pre-op shorter size before surgery
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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #26 on: December 30, 2018, 09:45:00 AM »

This is not true. Why are you bumping an old thread to spread lies? Pretty soon I am going to start filling reports on your posts. Back up your posts with facts, studies or posts from members of this board who had surgery, with photos to prove it. Otherwise, think about stuff like this.

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #27 on: December 30, 2018, 10:04:45 AM »

This is not true. Why are you bumping an old thread to spread lies? Pretty soon I am going to start filling reports on your posts. Back up your posts with facts, studies or posts from members of this board who had surgery, with photos to prove it. Otherwise, think about stuff like this.
Well he has not told any lie, with stage technique your size will be less than your preop size
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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #28 on: December 30, 2018, 10:17:26 AM »

ask anyone who had STAGE surgery or any good doctor ( Dr. Gelman for example).

The final size of the penis after surgery is the shorter size before op. In case you have chordee also, than the penis is a bit larger than that, That is the fact.

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #29 on: December 30, 2018, 11:24:07 AM »

djord: http://www.peyroniesforum.net/index.php/topic,7734.0/topicseen.html

Clearly.... something is wrong with your rationale.

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #30 on: December 30, 2018, 11:44:58 AM »

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #31 on: December 30, 2018, 12:50:50 PM »

This isn't up for debate, if you have any surgery apart from a graft or the sliding technique your penis will be shorter.

Get a banana and try to get the shorter side to the same length as the longer side, without adding or leaving a gap.




 
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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #32 on: December 30, 2018, 08:26:55 PM »

Stage surgery can regain lost length (mine did) and plication alone cannot as shortens longer size with stitches to same length of shorter side.
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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #33 on: December 30, 2018, 09:58:05 PM »

Sorry but how is the stage surgery different than the plication in princeable. Both work in the same way as in shortening the long side to match the shorter side.

I've had both surgery's and there's no difference in the end result.

Did you do stretching exercises after your surgery?
As that might be the reason for any size gains.

To say the stage surgery can regain lost length is just down right wrong and irresponsible. It's a matter of physics, you can't add length by making the long side of the penis shorter.

Depending on your curve, it may seem longer now it's straight again. But with a curve it can be hard to get exact mesurments to compare the before and after.

Sorry if it seems I'm attacking, that's not my intent.
But I don't want men to have the Stage surgery thinking they going to get back any size, when it just can't do that.

Kind regards
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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #34 on: December 31, 2018, 02:58:13 AM »

Hi TonySa,

Can you clarify what surgery's you have had, as reading though your posts I can't find any information on you having had the Stage surgery?
Only excision, grafting and implant surgery, so unclear why you gave false evidence on a surgery you don't appear to have had.

Sorry if I missed a post, but confused why you would mislead on such an important issue?

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TonySa

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #35 on: December 31, 2018, 04:25:48 PM »

I understand excision and grafting is stage surgery.  Do I have that incorrect?  I believe Options are 1) plication or 2) incision/excision w grafting or 3) implant as far as surgeries go.  https://www.issm.info/sexual-health-qa/what-surgical-treatments-are-available-for-peyronies-disease/
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PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

suicidecomingsoon

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #36 on: December 31, 2018, 04:33:39 PM »

I understand excision and grafting is stage surgery.  Do I have that incorrect?  I believe Options are 1) plication or 2) incision/excision w grafting or 3) implant as far as surgeries go.  https://www.issm.info/sexual-health-qa/what-surgical-treatments-are-available-for-peyronies-disease/
Yes you are wrong
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TonySa

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #37 on: December 31, 2018, 06:54:39 PM »

Ok, I read a little more and stand corrected that Stage does not include excision and grafting.  Apparently only excision w sutures and only of the outer layer of the tunica.  So this is more like a refined plication where there will be some loss of length but reportedly not as much as plication due to the geometric principles applied for more precision and finer corrections.  Do folks agree?
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PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

redbullmaster

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #38 on: December 31, 2018, 08:04:09 PM »

Hi TonySa

The loss of length is the same between both the plication and Stage operation, the stage is supposed to cause less trauma than plication that is all.
The talk about geometric principles is just marketing talk, both surgery’s will give the same results when it comes to length.
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djordj

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #39 on: January 02, 2019, 01:53:24 PM »

redbullmaster you are 100% right.

But i think plication (dorsal plication) is the safest method.

Its funny because i spoke with Dr, Kuehas and he is also saying that after operation you dont loose so much in lenght as in other methods, but i dont understand why . Both sides have to be same lenght, so i have to shorten one.
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redbullmaster

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #40 on: January 03, 2019, 02:11:29 PM »

Had the plication on the NHS, bad experience with the aftercare and my curve came back.

Spoke to my NHS surgeon and said he could redo the surgery and correct the curve.

But at the time everyone on this forum was saying the Stage is the best surgery you can have.
So i made an educated decision, based on the posts i read here and had my second surgery with Mr Kuehas.
I got into debt for £7000, ended up with much worse Erectile Dysfunction and the curve came back yet again.

Had to get a implant on the NHS and wished I never had the Stage Surgery, as I couldn’t afford to go private for a second time.
Not happy with the result of the implant and now I can't afford to have it fixed, NHS say its fine.

Not blaming anyone on here, as i'm sure the men who posted did have good results and it wasn't till much later that the bad results started to turn up on this board.

Also it was my second surgery and if I had gone and had my first surgery with Mr Kuehas I may have had a different outcome.
I will say that the aftercare is second to none and Mr Kuehas was always ready to answer any of my questions and took a lot of the stress away from the operation.

Unfortunately as men we very caught up in our size of our penis's, so we grab onto any hope about not losing size and will believe anything because we want it to be true.
That's one of the reasons i'm so adamant about speaking up when the lie is told about you don’t loss as much length as you do in plication.
It was one of the big reasons why i went for that surgery in the first place, I got caught up in it.

I didn’t think it though, the only way of straightening the penis is by matching the long side to the shorter side.
Both surgery's give the same end result, if the plication made your penis shorter you would end up with a curve going the over way.

Much like when you watch a documentary's on faith healers for cancer, you sit there and can't believe how gullible people are.
But I even paid for £1000 for one Priapus shot in the hope that it would help me.

Now the new thing on this board is Ketogenic and fasting for a cure.
For heath reasons i might give it a try, but i don’t think its going to help much with anyone's penis curves.
For Erectile Dysfunction yes as it might improve blood flow/ stop diabetes etc.
But we desperate and we grab onto any little bit of hope we can find.
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TonySa

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Re: STAGE TECHNIQUE FOR CONGENITAL CURVATURE
« Reply #41 on: January 03, 2019, 10:09:29 PM »

Sorry to hear about your difficulties.  Did you get an implant, or considering now?
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PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.
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