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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: -Implant-Could anyone solve my doubts?  (Read 1633 times)

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lessor

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-Implant-Could anyone solve my doubts?
« on: April 16, 2017, 11:21:30 PM »

I am thinking I have two plaques and a new plaque developing now in my penis and I got this problem two years ago, with the time the things are going worse even I am using the treatments recommended. As everything is going to worse I can see as my penis is getting smaller, horuglassing is forming and increasingly, i have a letf curve (about 20 degrees) and I also have Erectile Dysfunction. Then I am valuing the implant and I have a questions:

1-If I get an implant now, will hourglassing, fibrosis be eliminated or they will continue developing even with the implant and will they affect it?
2- My condition with the implant will be corrected? is possible that the curve continue developing and bend my implant?
3-How the doctors straighten your penis in order to put an implant in the operation? Is similar to grafting,nesbit? Will I lose size? (I mean apart of the possible lost which can happen with a implant in a penis without peyronie)

I told all this because as I have bad Erectile Dysfunction, and my penis is getting smaller I think I must act soon, now, I dont want a tiny penis when I have to go for the implant which I am almost sure is my real and unique option, anyway I will visit Dr Kuehhas possibly and I ll listen his opinion before making any decision
Thanks
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james1947

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Re: -Implant-Could anyone solve my doubts?
« Reply #1 on: April 17, 2017, 04:02:12 AM »

lessor

Read JackP blog. He have answers to your questions, as someone who got implant

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

Jimbruski

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Re: -Implant-Could anyone solve my doubts?
« Reply #2 on: April 17, 2017, 10:16:57 PM »

Lessor,



MY SONOGRAM revealed long dorsal plague with two major locations at the base and distal seperately, with intracavernosal fibrosis

1-If I get an implant now, will hourglassing, fibrosis be eliminated or they will continue developing even with the implant and will they affect it?

It's best to consult with a doctor regarding this question.   I do however feel that both hourglassing and curve will not be an issue after the implant.  My curvature was 75 degrees and no longer curves at all.

2- My condition with the implant will be corrected? is possible that the curve continue developing and bend my implant?

The implant will correct the curvature and you should have no further curvature.


3-How the doctors straighten your penis in order to put an implant in the operation? Is similar to grafting,nesbit? Will I lose size? (I mean apart of the possible lost which can happen with a implant in a penis without peyronie)

Below is a copy of my surgical report so you can read how the doctor dealt with my curvature.  I lost no size!!

Description of Procedure:
After a discussion of the risks, benefits and alternatives to the procedure, the patient had an opportunity to ask questions and informed consent was obtained.
Then, after induction of Anes-General anesthesia, a timeout was performed and Zosyn was given. The patient was placed in the supine position with sequential compression devices and all pressure points well padded. The patient was then prepped with a 10 minute betadine scrub and draped in the usual sterile fashion. We prepared antibiotic irrigation with 80 mg of gentamicin in 500 ml of normal saline for irrigation throughout the case. We began by injecting papaverine to induce an erection and evaluate the curvature. It was 45 degree left lateral and 30 degree dorsal curvature with erection. We then placed 2-0 Tycron stitches, two on the right and four on the ventral aspect of the penis. We left these in place without tying.
A 5 cm longitudinal incision was made over the median raphe at the penoscrotal junction. We dissected through the dartos fascia with bovie electrocautery. We then sharply dissected to the tunica albuginea of the corpora cavernosa bilaterally. A 1cm longitudinal incision was made in the corpora cavernosa bilaterally, avoiding the urethra. 2--0 vicryl suture were place on either side of the corporal incision as stay sutures and in anticipation of closing the corpora. We used closed scissors to help sound the corpora bilaterally. There was a small amount of scarring fibrosis bilaterally. We then serially dilated. We then measured the corpora. The corpora were copiously irrigated with antibiotic Printed on 2/11/2017 12:46 PM Page 26
irrigation.
Next, we placed the reservoir. We advanced into the left inguinal ring and made an entry using sharp scissors. We then bluntly dissected into the space of Retzius and advanced the reservoir into this space. The 65ml reservoir was gently placed in this space, avoiding any air bubbles. Care was taken to ensure that the reservoir tubing exited the fascia without any kinks.
Next we used 18 cm inflatable cylinders and 3.5 cm rear tip extender on both sides, for total 18. + 3.5cm. We passed the distal sutures through the glans without incident. The proximal portion was dilated sufficiently to allow the cylinders to lay flat within the cavernosa. The wound was again irrigated copiously. We then tested the cylinders and they in good position but the curvature was visble and we went back and tied two right sided stitches and re-evaluated again. We then three of the ventral stitches and the penis appeared straight with the distal portion of the cylinders even. We removed the distal ventral left suture as it was unnecessary. The cylinders were deflated. We then closed the corporotomies with the preplaced tunica albugina 2-0 vicryl sutures and carefully added an extra interrupted a the proximal right corporal incision for excellent hemostasis. We then created a dartos pocket for the pump in the right dependent portion of the scrotum. We then connected the reservoir tubing to the pump, taking care avoid any air bubbles and ensure that that the tubing length was adjusted to minimize risk of kinking or tethering. The wound was again irrigated. The prosthesis was again tested with pump and it functioned well with excellent inflation and deflation. There was excellent hemostasis. The penoscrotal incision was closed with two layers of running 3-0 vicryl sutures for the dartos and then running locking 4-0 and 5-0 vicryls and histocryl surgical skin glue. The penoscrotal wound was dressed with xeroform, kerlex fluffs, and a scrotal support. Foley catheter was inserted and placed to a drainage bag.
The patient was then extubated, and taken to the recovery room in good condition. All sponge and needle counts were correct a the end of the case
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lessor

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Re: -Implant-Could anyone solve my doubts?
« Reply #3 on: April 17, 2017, 10:22:33 PM »

Thank u so much Jimbruski
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james1947

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Re: -Implant-Could anyone solve my doubts?
« Reply #4 on: April 18, 2017, 04:35:33 AM »

Thanks Jimbruski for the detailed report :)
It will help many understanding how an implant is done

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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