ULTRASOUND, DOPPLER to confirm Peyronie's

[atlantis]

Hello,

I am still in the first months of the disease, I was made eco/doppler (in black&white) in flaccid and they saw nothing, but I was suggested to do eco/doppler in erection. For that they will do an injection.  Do you know if those injections for making erection can cause problems/secondary effects?

Is it possible that they can see something in erection that is not seen in flaccid?

[jackp]

atlantis

When I had my color doppler I was injected with a small amount of PGE1 to induce an erection. In my case I did not get much erection but the doppler showed my venous leakage.
The injection is not painful and done by a good doctor should not cause problems.
The problems come with multiple injections to the penis with PGE1 or trimix to get erections for sex. They caused corporal fibrosis in me and made my problems worse.

Jackp

[Woodman]

atlantis- I have had three duplex doppler scans. They scan first while you are flaccid and then give you the injection to induce an erection then scan you again. There is a diffrance in the scans from the flaccid to erect states. I never had any problems with the injections. The injections did not hurt its a very small needle. As stated below by Jackp I had mine done by a experianced Urologist who regularly treats men with Peyronies.

Woodman

[ComeBacKid]

JackP,

I've heard several men tell me that the trimex injections caused corporal fibrosis.  I don't like the idea of injecting anything, unless its xiaflex and even that makes me uncomfortable at the time being since it is not proven to work just yet.  I don't know why Dr. Levine seems to like the traction with verapamil injections, topical verapamil did nothing for me, and I've read no study to date yet that indicates verapamil helps peyronies in any way.  If someone knows of a study please post it, I have not read it yet.  

Comebackid

[jackp]

comebackid

I know I am not the only one that had corporal fibrosis from penile injections of trimix and/or PGE1 for ED. IMHO The only injection you should have is the PGE1 for a color doppler.

I have no experience with traction but I can tell you the VED therapy recommended by Old Man works.

Jackp

[atlantis]

Hello,

Thank for the responses about the question on echo-doppler.

Another doctor has just offered me to make CAVERNOGRAPHY.  This one is a experienced doctor in Peyronie and penile issues.  He told me they would use an injection of an erection producer and another injection of a contrast agent (radioactive iodine they told me).  Has anybody here been done cavernography?  From the few things I read it is used not very much used nowadays, and can make problems worse.  Any advice or experience on this?

[Thin Man]

I had a doppler done about 4 months ago. I'm concerned that my erections have declined since then. Here's why - I requested that I not have a second injection to bring down my erection after the test because I wanted to minimize the number of needle sticks (my original injury was caused by a needle stick for a test 14 years ago when a very large needle used to inflate my penis with saline solution). Dr. Wessells agreed, and afterwards I had to wait over 3 hours for my erection to subside. I waited in the office, and Dr. W came to check on me, he didn't seem concerned. From what I've read this is not in the danger zone for priapism. However, I've been having more difficulty reaching a full erection since then. I've managed it about a dozen times in 4 months - prior to this I could get erect much more easily without using Viagra etc. It's pretty hard to figure out what's psychological and what's not - I'm trying to be patient, but at this point I really do think my erection capability has declined.

Has anyone else had a similar experience?

To be clear - I don't believe I was injured from the recent needle stick. I can't detect any scar at the injection site as I have in the past for other tests. I'm glad they're using a thinner gauge needle for this than they used to. I retrospect I wish I had the second needle to bring down the erection.

In brief - my biggest problem is ED due to arterial insufficiency from a childhood injury. The test confirmed that I don't have any detectable plaque, calcification, or site specific venous leakage. For that matter I don't have a bend, but since my injury I've had shrinkage, hourglassing, and worsening ED.  

TM

[jackp]

Thin Man

I agree needle sticks to the penis do more damage than good. That was my case from trying PGE1 and Trimix injections for ED.

Your shrinkage and ED could be from corporal fibrosis and that does not show up on a doppler. Also have you had your testosterone checked and if so what are the numbers? Do and of the pills for ED help?

Jackp

[newguy]

ThinMan - I think that injections have the ability to do more harm than good. It likely depends on the individual but it definitely seems to inflame some mens condition, sometimes in rather dramatic ways. Having an erection for 3 hours too... well that length of time period is rather excessive. Harmful though? Who knows. The PAV cocktail probably has some use in such a scenario if damage was done. It may also help to reduce impede the progress of scar tissue. I notice that you're already taking l-arginine (do you currently take viagra and pentox too?).

As ED is the defining factor, it may serve you well to add Pycnogenol to the L-arginine. I did a search and I don't see any mention of it in your previous posts. The synergy between the two really seems to be something that can make the difference:

http://www.ncbi.nlm.nih.gov/pubmed/12851125?ordinalpos=6&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

If that doesn't help much after a couple of months, try adding viagra or similiar (if you haven't already). It's feasible that medium/long term use of the VED might help too.

[Wintercookie]

I was given One solitary injection of 5mg Caverject in January 2009 in the Consultants treatment room with the complacent comment 'That should be enough for a man of your age.'  It didn't induce an erection only a mild swelling and tingling of my flaccid penis.  No explanation to that.  Worse still was the aching/pain at the injection site for the next 6/7 Months which based on past experience has probably caused more fibrosis and narrowing of my penis at the injection site although it is hard to tell since I already had diffuse scarring.

I will never allow anybody to puncture my Tunica Albuginea with a needle ever again except perhaps a surgeon implanting a penile prosthesis.

[newguy]

I was given One solitary injection of 5mg Caverject in January 2009 in the Consultants treatment room with the complacent comment 'That should be enough for a man of your age.'  It didn't induce an erection only a mild swelling and tingling of my flaccid penis.  No explanation to that.  Worse still was the aching/pain at the injection site for the next 6/7 Months which based on past experience has probably caused more fibrosis and narrowing of my penis at the injection site although it is hard to tell since I already had diffuse scarring.

I really feel for you. I do think injections are bad news, for some more than others. As many people seem to find their way to having peyronie's via various routes, I also feel that some people are VERY susceptible to further damage, and injections can be a bad idea for them.

[depressedpns]

I haven't gone to a urologist for a while now.  To be honest, they left me feeling pretty frustrated.  Maybe if I kept going I would have got much better results though, I don't know.

One of the things I wondered about was how useful it is to examine the penis while erect vs flacid.  Anyone have an idea?  I would guess it to be very important.  From what I remember, this was never brought up.  The one time my penis got erect at the Dr office was when I got the ultrasound for plaque.  I believe the ultrasound technician was the only one that saw it that way though.  I wonder what I may have going on besides plaque.

[jackp]

Call the doctors office that did the ultra sound and request a copy of the results. By federal law they must comply, it is your test and your record.  I get a copy of all test done in any doctors office and keep for my records.

Most likely they were checking for venous leakage and/or corporal fibrosis.

Jackp

[depressedpns]

Call the doctors office that did the ultra sound and request a copy of the results. By federal law they must comply, it is your test and your record.  I get a copy of all test done in any doctors office and keep for my records.

Most likely they were checking for venous leakage and/or corporal fibrosis.

Jackp

I should get another one done.  The last was a few years ago.

Maybe I remember wrong, but I don't remember ever having the dr review the erect penis besides the ultrasound results.  Not sure what that lacks showing.

[jackp]

If it has been several years it may be an advantage to have a color doppler (ultrasound) done again. It would be best done by a Male Sexual Function Specialist and not a general practice urologist. There are very few Male Sexual Function Doctors. Send me a PM with your area of the country, I may have a lead on one for you.

I would still get a copy of the last ultasound. That way you will have something to compare with.

Jackp

[quickguide90012]

I masturbated about 1 month ago and noticed my penis got very small flaccid and is turtled a lot.  I then noticed that my penis had this hourglass effect and didn't expand and this has never happened to me before ever when i try to get an erection.  It felt like constriction.  


I have went to a urologist last week and he examined my penis and tell me he sees no plague and feels no plague and thus no peyronie's disease.  He also did an ultrasound of my penis when it is flaccid and the test showed that nothing is wrong.  He said its pretty close to 100 percent i don't have it.


However, he did schedule for me to do an ultrasound of my penis when it is erect this week.  My question is, has anyone here done ultrasound of their penis while erect to confirm peyronie's disease?  The thing is i had venous leak surgery last year which is a surgery that is not even allowed in the USA because it has very poor success rate and just doesn't work but my surgeon who is the best in the world in Taiwan, did the surgery for me and cured me of venous leak.


My surgeon who did the venous leak surgery on me to who i speak to on SKYPE tells me that if i already had an ultrasound of my penis while flaccid, that is sufficient enough and that i have no peyronies disease.  And the people that i spoke to  here who has peyronies, tells me that a urologist confirmed they had it either by just examining them or ultrasound of the penis while flaccid which confirmed the plague and thus peyronies.


I wanted to know, has anyone had been told they didn't have peyronie's disease according to a physical examination or ultrasound of penis while flaccid, ONLY TO FIND OUTER LATER THEY HAVE PEYRONIE'S WHEN THEY DID ULTRASOUND OF THEIR PENIS WHILE IT WAS ERECT?


Because some others here tell me i do have it but the reason why they don't see it on those tests is because i'm in the earliest stage of the Acute stage which is why they can't confirm it.


So in order to test if someone has peyronie's disease,  the methods are only this right?

1.  Physical Examination
2.  Ultrasound of penis when flaccid
3.  Ultrasound of penis when erect?

Is there any other methods?  And does anyone know if the erect test shows a lot of things different than the flaccid test which i had already?

[quickguide90012]

I masturbated about 1 month ago and noticed my penis got very small flaccid and is turtled a lot.  I then noticed that my penis had this hourglass effect and didn't expand and this has never happened to me before ever when i try to get an erection.  It felt like constriction.


I have went to a urologist last week and he examined my penis and tell me he sees no plague and feels no plague and thus no peyronie's disease.  He also did an ultrasound of my penis when it is flaccid and the test showed that nothing is wrong.  He said its pretty close to 100 percent i don't have it.


However, he did schedule for me to do an ultrasound of my penis when it is erect this week.  My question is, has anyone here done ultrasound of their penis while erect to confirm peyronie's disease?  The thing is i had venous leak surgery last year which is a surgery that is not even allowed in the USA because it has very poor success rate and just doesn't work but my surgeon who is the best in the world in Taiwan, did the surgery for me and cured me of venous leak.


My surgeon who did the venous leak surgery on me to who i speak to on SKYPE tells me that if i already had an ultrasound of my penis while flaccid, that is sufficient enough and that i have no peyronies disease.  And the people that i spoke to  here who has peyronies, tells me that a urologist confirmed they had it either by just examining them or ultrasound of the penis while flaccid which confirmed the plague and thus peyronies.


I wanted to know, has anyone had been told they didn't have peyronie's disease according to a physical examination or ultrasound of penis while flaccid, ONLY TO FIND OUTER LATER THEY HAVE PEYRONIE'S WHEN THEY DID ULTRASOUND OF THEIR PENIS WHILE IT WAS ERECT?


Because some others here tell me i do have it but the reason why they don't see it on those tests is because i'm in the earliest stage of the Acute stage which is why they can't confirm it.


So in order to test if someone has peyronie's disease,  the methods are only this right?

1.  Physical Examination
2.  Ultrasound of penis when flaccid
3.  Ultrasound of penis when erect?

Is there any other methods?  And does anyone know if the erect test shows a lot of things different than the flaccid test which i had already?

[Luciano]

Your surgeon is right. I was diagnosed after ultrasound on flaccid penis.
If the plaque is there, you can see it with ultrasound no matter what state your penis is in.
I think (not sure) ultrasound on erect penis would only be done prior to surgery or any other intervention to mesure the degree of curvature.
If you are in early stage, and there is no visible plaque when flaccid, the plaque will not be visible when errect.
But maybe your doc is not looking for plaque but something else.
Luc

[quickguide90012]

hey luciano.  The urologist said he did not see any plague at all when he examined me and when he saw the test results of the ultrasound when my penis was flaccid.  He said nothing was wrong and said again its close to 100 percent i don't have it.

But i just wanted to know if anyone here had an ultrasound done while flaccid that showed no peyronies, only to have an ultrasound done of penis when erect that showed peyronies.

[quickguide90012]

Hey guys a member here tells me this

Your doctor sounds pretty typical of a lot of urologists, very arrogant and non-caring of patients' concerns. By all accounts from what you have told me its pretty obvious that
you have peyronies.

Indeed the hourglass shape takes place for most of us sufferers when we are half erect, like after we ejaculated. And the reason your penis is shrinking is because the scar tissue/plaque is preventing adequate bloodflow to it that you use to get. It's he reason why we are experiencing such severe ED, blood doesn't flow easily into our penis like it used to when we got aroused. I don't even wake up hard anymore.

I wouldn't get the injections. You already have peyronies, there's a chance you could make it worse. The reason the ultrasound didn't detect anything while you were flaccid is because you are in the acute stage of peyronies, that is at this point you don't have enough built up scar tissue or plaque that will show up in an ultrasound. But you do have enough scar tissue to cause all the problems that you are currently going through.



Can someone here comment on this?  It definitely sounds right and makes sense that could be the reason why the ultrasound of my penis when flaccid didn't detect anything.  But someone else tells me that even if you are in the acute stage, the ultrasound would show some type of plaque.  Is there a chance i'm in the earliest stage of acute stage if there is such a name for it which is why it didn't detect it for me?  Is it because its just been 1 month which is why the ultrasound didn't show anything?

Can someone tell me what is the earliest time from when they had or heard of someone who have had an injury or thought they had peyronies and then had a urologist confirm peyronie's disease even in the acute stage?  Is it not possible for me because its just been 1 month and it takes at least 2 months from injury till a urologist can confirm it?  Because that is what i really want to know now.  Has anyone heard of someone who thought they had peyronies and then went to a urologist and then had them confirm they had peyronies within 1 month after injury?

[quickguide90012]

Hey guys a member here tells me this

Your doctor sounds pretty typical of a lot of urologists, very arrogant and non-caring of patients' concerns. By all accounts from what you have told me its pretty obvious that
you have peyronies.

Indeed the hourglass shape takes place for most of us sufferers when we are half erect, like after we ejaculated. And the reason your penis is shrinking is because the scar tissue/plaque is preventing adequate bloodflow to it that you use to get. It's he reason why we are experiencing such severe ED, blood doesn't flow easily into our penis like it used to when we got aroused. I don't even wake up hard anymore.

I wouldn't get the injections. You already have peyronies, there's a chance you could make it worse. The reason the ultrasound didn't detect anything while you were flaccid is because you are in the acute stage of peyronies, that is at this point you don't have enough built up scar tissue or plaque that will show up in an ultrasound. But you do have enough scar tissue to cause all the problems that you are currently going through.



Can someone here comment on this?  It definitely sounds right and makes sense that could be the reason why the ultrasound of my penis when flaccid didn't detect anything.  But someone else tells me that even if you are in the acute stage, the ultrasound would show some type of plaque.  Is there a chance i'm in the earliest stage of acute stage if there is such a name for it which is why it didn't detect it for me?  Is it because its just been 1 month which is why the ultrasound didn't show anything?

Can someone tell me what is the earliest time from when they had or heard of someone who have had an injury or thought they had peyronies and then had a urologist confirm peyronie's disease even in the acute stage?  Is it not possible for me because its just been 1 month and it takes at least 2 months from injury till a urologist can confirm it?  Because that is what i really want to know now.  Has anyone heard of someone who thought they had peyronies and then went to a urologist and then had them confirm they had peyronies within 1 month after injury?

[quickguide90012]

I just checked for other doctors similar to John Mulhall who is a peyronies expert/sexual dysfunction online and i found this person named Ridwan Shabsigh using a search engine and it showed 3 sexual dysfunction doctors total in New York.

I called his office and one of the receptionist asked me some questions.  I said i think i have peyronies but a urologist examined me and did ultrasound of my penis when flaccid and it showed no peyronies.  She said based on that, she said most likely i don't have it.  However, i said i will go tomrorowo and do the ultrasound of my penis when erect but not sure 100 percent if i will do that or not.

The weird thing about this is after i said this, she said that the correct way to diagnose peyronies disease if Dr. Ridwan Shabsigh would examine me, is to only do an ultrasound of my penis while erect.  I said isn't the ultrasound while flaccid good enough and she said well Dr. Shabsigh only does it when erect because the test when flaccid won't show everything like blood flow etc.

I'm bit confused here because most people say the ultrasound while flaccid will show whether or not a person has peyronie's disease or not but this receptionist said that Dr. Shabsigh who is one of the only 3 sexual dysfunction doctors in NY i found online, would only do the ultrasound while penis is erect to confirm.

Does that sound a bit strange?  Because most people i spoke to here said ultrasound while flaccid is what is used and that the erect test is not necessary.  I'm now thinking that i should take a risk and do the injection tomorrow because of this.  But i find it weird because i don't see many people here mention they had ultrasound of penis while done erect is needed to show it...

[quickguide90012]

I just checked for other doctors similar to John Mulhall who is a peyronies expert/sexual dysfunction online and i found this person named Ridwan Shabsigh using a search engine and it showed 3 sexual dysfunction doctors total in New York.

I called his office and one of the receptionist asked me some questions.  I said i think i have peyronies but a urologist examined me and did ultrasound of my penis when flaccid and it showed no peyronies.  She said based on that, she said most likely i don't have it.  However, i said i will go tomrorowo and do the ultrasound of my penis when erect but not sure 100 percent if i will do that or not.

The weird thing about this is after i said this, she said that the correct way to diagnose peyronies disease if Dr. Ridwan Shabsigh would examine me, is to only do an ultrasound of my penis while erect.  I said isn't the ultrasound while flaccid good enough and she said well Dr. Shabsigh only does it when erect because the test when flaccid won't show everything like blood flow etc.

I'm bit confused here because most people say the ultrasound while flaccid will show whether or not a person has peyronie's disease or not but this receptionist said that Dr. Shabsigh who is one of the only 3 sexual dysfunction doctors in NY i found online, would only do the ultrasound while penis is erect to confirm.

Does that sound a bit strange?  Because most people i spoke to here said ultrasound while flaccid is what is used and that the erect test is not necessary.  I'm now thinking that i should take a risk and do the injection tomorrow because of this.  But i find it weird because i don't see many people here mention they had ultrasound of penis while done erect is needed to show it...

[Skjaldborg]

quickguide90012

Please try keeping your posts limited to one subforum. Placing the same post in multiple subforums is confusing to people who might be trying to help you. Also, this is the exact same post that you PMd to me earlier and this is not the first time that this has happened. While I am glad to answer your specific questions through PM, if you are looking for a broad range of opinions just post to the forum instead of sending PMs. We have limited PM space and posting the exact same message in the forum may give the impression, however unintentional, that you don't value the PM respondents time or opinion.

-Skjald

[quickguide90012]

hey man.  yes i understand.  I pay attention to a lot of you guys pm but the reason why i posted this in the forum is so others who i haven't PM'ed with can give me their opinion.  There are a number of people that i have PM here many times and i found you guys by searching your posts.  Thus, there is many others who have peyronies that i didn't pm because i didn't find their posts that were that related to my problems.

[LWillisjr]

I can only say for sure that Dr. Levine does the ultrasound both while flacid and with an erection.

[Luciano]

well as far as i understand, you can see plaque either on flacid or erect.
But on erect you can see blood flow and other stuff.
So if ultrasound on flacid shows plaque, there is no need on doing it on errect for diagnose.
But if not, ultrasound can show difficulties in blood flow etc..
L.

[Luciano]

hey man.  yes i understand.  I pay attention to a lot of you guys pm but the reason why i posted this in the forum is so others who i haven't PM'ed with can give me their opinion.  There are a number of people that i have PM here many times and i found you guys by searching your posts.  Thus, there is many others who have peyronies that i didn't pm because i didn't find their posts that were that related to my problems.

He was NOT talking about PM, but about the fact that you post the text in several public forums and not only in one.
example: here AND in Erectile Dysfunction
Luc

[BSSS]

hey man.  yes i understand.  I pay attention to a lot of you guys pm but the reason why i posted this in the forum is so others who i haven't PM'ed with can give me their opinion.  There are a number of people that i have PM here many times and i found you guys by searching your posts.  Thus, there is many others who have peyronies that i didn't pm because i didn't find their posts that were that related to my problems.

The thing that most occurs to me when I read your posts here/PM's is that you tend to minimize what a doctor is telling you and somehow equate what a poster here is telling you to the same level of credibility.
Common sense should tell you that the doctor is in a much better position to advise you, after all he examined you and did an ultrasound. Listen to a doctor who is telling you you don't have it, or to a poster that really had no idea other than the description you give him/her? I know doctors are sometimes wrong but......
Seems at the very least you could get pentox and use a VED if you're concerned you have Peyronies Disease and don't want to wait.  I'd try that (if it doesn't harm the surgery you had) and continue to go to the uro in the future; the disease symptoms do often change.

[Worried Guy]

I agree with BSSS and you should listen to your doctor.  He has done an ultrasound and it has come back negative.  If it comes back positive there is still nothing a Uro can really do at the moment anyway. He will not operate for at least 18 months. You cab try a VED device or pentox but if you have ED because of peyronie's the only real option is an implant.

[rontherube]

I had ultra sound done at Baylor, not sure if I ever had it not erect. They can detect plaque, leaks and blood flow and show you a video. Due to get another next week after 6 VI's. My plaque is very difficult to detect when not erect.
RDR

[samo]

I had an ultrasound done. The knots were clearly visible. Doctors still said it wasn't Peyronie's. That was a year ago and I have many more knots and greater deformity.

[agent0]

yeah im pretty sure i have peyronies too, because i can feel a hard lump in my shaft and i also have an hourglass figure on the onset of some erections due to a untreated penile fracture from 5 years ago. anyways, iv taken a ultrasound doppler and all the results came back fine, but we did the test flaccid. i asked my doctor if i needed to get a papervine injection, but he said it dosent matter if i do the test flaccid or hard. what do you guys think? I couldnt even get hard during the test since my penis is so numb due to the fracture.
should i redo the test with a papervine injection?

*test was done flaccid*
check-in#/Test: 9421552 US DPLX PENILE ARTERIAL FLOW
CHECK IN-IN DATE/TIME: 03/11/11 0945

DOPPLER ULTRASOUND OF THE PENIS - 03/11/11:

HISTORY: PENILE NUMBNESS AND PAIN. SUBJECTIVE SKIN THICKENING.

TECHNIQUE: GRAYSCALE COLOR AND SPECTRAL DOPPLER IMAGES OBTAINED THROUGH THE PENIS.

FINDINGS: GRAYSCALE APPEARANCE OF THE PENILE SHAFT APPEARS NORMAL.
THERE IS NO EVIDENCE OF CALCIFICATION OR SKIN THICKENING. CAVERNOSAL ARTERIES ARE WELL DEMONSTRATED WITH NORMAL COLOR AND SPECTRAL DOPPLER APPEARANCE. THE DORSAL VEIN OF THE PENIS CANNOT BE WELL EVALUATED ON THE EXAMINATION

IMPRESSION: NO GROSS EVIDENCE OF ABNORMALITY

-----------------------------------------------------------------------

Iv also done a mri that came back with normal results, the test was also done flaccid.

chk-in#        exam                  desc
9118511     45737      AIC MRI PELVIS W+W/O-CST

EXAM START:         6 OCT 10 1549

MRI OF THE PENIS WITH CONTRAST FROM 10/06/10

CLINICAL HISTORY: PENILE TRAUMA 4 YEARS AGO WITH CONTINUED PAIN AND SWELLING

TECHNIQUE: MULTIPHASE, MULTISEQUENCE IMAGES WERE OBTAINED THROUGH THE LOWER PELVIS BEFORE AND AFTER THE ADMINISTRATION OF 10 ML OF MULTIHANCE.

COMPARISON: NO PRIOR

FINDINGS: THERE IS SYMMETRIC APPEARANCE TO THE CORPORA CAVERNOSA WHICH SHOW NORMAL SIGNAL INTENSITY ON T1 AND T2-WEIGHTED IMAGES. THE TUNICA ALBUGINEA IS WELL VISUALIZED AND INTACT, SURROUNDING THE CORPORA CAVERNOSA BILATERALLY. THERE IS NO EVIDENCE FOR DISRUPTION OF THE TUNICA ALBUGINEA. THERE IS NORMAL MORPHOLOGY AND SIGNAL WITHIN THE CORPORA SPONGIOSUM. THERE IS NO EVIDENCE FOR PENILE DISRUPTION OR ASSOCIATED HEMOTOMA

THE PROSTATIC APEX IS NO APPROPRIATELY ORIENTED. NOTE THAT THIS EXAMINATION WAS NOT TAILORED FOR ASSESSMENT OF THE URETHRA. THERE IS POOR VISUALIZATION OF THE ANTERIOR URETHRA WITHIN THE CORPUS SONGIOSUM. THERE IS NORMAL NARROWING OF THE POSTERIOR URETHRA AT THE LEVEL OF THE VERUMONTANUM

NO FOCAL TESTICULAR ABNORMALITIES ARE SEEN. THERE IS NO EVIDENCE FOR INGUINAL LYMPHADENOPATHY.. NOTE IS MADE OF PROMINENT PELVIC VASCULARITY BILATERALLY.

IMPRESSION:

THERE IS NO EVIDENCE FOR ACUTE PENILE FRACTURE OR ASSOCIATED HEMOTOMA.

NONSPECIFIC PROMINENT PELVIC VASCULATURE WHICH MAY BE RELATED TO UNDERLYING VARICOCELE.

AS MENTIONED ABOVE, THIS EXAMINATION WAS NOT TAILORED FOR ASSESSMENT OF THE URETHRAL STRUCTURES. IF THERE IS CONCERN FOR URETHRAL INJURY, CONSIDER FURTHER EVALUATION WITH RETROGADE URETHROGRAM.

[agent0]

im sure i fractured my penis in 2006, because now i have indents on my penis and a hard lump inside of my shaft. my doctor did a Doppler ultrasound and a MRI of me recently while flaccid, but everything came back fine. i asked him if i needed to get a induced erection for the MRI but he said that it dosent matter. He recently told me i had injured my penis back in 2006, but i guess the first ultrasound missed the fracture. apparently ultrasounds are bad at catching minor penile fractures. I needed to get a MRI at 2006, but we didn't take the test because my dad is a cheap a$$hole who didn't believe me, even though the uro told us to take the MRI. i was 19 at the age and couldn't afford to pay for MRI working at publix making 7.50 an hour. anyways when i last saw my uro he said the hard nodule inside of my penis is excess collagen from the fracture/injury. He said i didn't have "true" peyronies because i have no bend. but, one thing i don't understand is that, how come the MRI or the ultrasound didn't catch the collagen? do i need to get a Doppler ultrasound with a induced erection? because, i definitely can feel the hard collagen. but, then again my doctor said it dosent matter if i have a Doppler ultrasound with a induced erection. im sure this collagen is putting pressure on a nerve somewhere because iv lost almost all the sensitivity in my penis. its almost completely numb. i can barely feel the underside at all, and my penis used to be extremely sensitive pre injury. anyways im going to the neurologist on the 23 and gonna try to solve this numbness problem, and see if i can relieve the pressure so my nerves can communicate with each other again. i just don't understand why the Doppler ultrasound and mri i took recently cant find the excess collagen, is it because i took the test flaccid? Does it matter if i take the test flaccid or with a induced erection? is excess collagen plaque? is plaque calcified? because in the ultrasound results it says "there is no signs of calcification".

[Skjaldborg]

Agent0,

I had the ultrasound done while flaccid a few years back and the thin layer of plaque was clearly visible on the screen. Scar tissue is definitely visible in the flaccid state. Dr. Lue, who performed my ultrasound, usually only does them flaccid. Doppler ultrasound, or other tests done with a chemically-induced erection, are typically only done when there is a problem with erectile dysfunction, not just Peyronie's by itself. Such tests are intended to measure blood flow going into and out of the penis rather than evaluate the presence of scar tissue. Although I do believe that for very severe Peyronie's that they will do an induced erection to evaluate what kind of surgery is best and for that they need to see how bad the curvature is.

Anyhow, long story short, the flaccid ultrasound would definitely be able to see scar tissue and would definitely be able to see if that scar tissue had been calcified. Not all scar tissue is calcified, by the way. Calcification takes time and does not always occur.

I'm confused about your doctor calling excess collagen not scar tissue, because scar tissue is basically disorganized collagen. But then again, I'm not urologist. If you can, go see a specialist male sexual health specialist urologist in your area. They should be able to provide more details.

If you do not have curvature or pain, you may have a mild case of peyronie's. I have a mild case and it was tough at first but everything has been ok for the last couple of years. I lost sensitivity as well but it came back in time, or I got used to it, I really can't tell which and it doesn't matter. You will get through this. This disease is one of the worst things short of cancer that the gods can throw at you and when you come out the other end of this tunnel, there isn't much else that will scare you.

-Skjald

[agent0]

thanks just the answer i needed

[0x5555]

I have been dealing with pain in my penis for quite a while now.  It's particularly painful right around the glans and there is a sharp pain inside the glans.  This is mostly when I am flaccid - when I have an erection it actually feels different - not painful but just very uncomfortable.

I have been to see a urologist who didn't have much for me - basically said 'well you're pretty young to have peyronies' and to take 3 aspirin a day for a week.  I also ended up getting a ultrasound where they were not able to see any plaque.

My question is, does this always show up in ultrasounds?  I've had this pain for about 4 months now and it's not getting better.  Likewise the deformity in my penis has only been getting worse.  Does this fit with what others on this forum have experienced?

I'm also having an incredibly hard time sleeping - basically I can only sleep for about 1-2 hours before I get woken with what can be described as a very uncomfortable erection.  It's been like this for a while now - I'm really having a hard time dealing with ordinary life as I am exhausted all the time.

Any advice / info would be really appreciated.

[George999]

You need to see a Peyronie's expert.  General urologists are NOT trained to deal with Peyronie's.  You need to be on medication NOW, and I'm not talking about aspirin.  If you would share with us your general geographical location, perhaps someone here could make a suggestion as to a Peyronie's doctor.  Often doctors who know very little about Peyronie's ASSUME that they know as much as any other doctor which is NOT the case.  They are often making decision based on medical training and/or texts that are several years old or worse.  This means you are not getting the latest and best treatments.  You need to see either a urologist who is a reputed Peyronie's expert (many describe themselves as Peyronie's experts and they are not, so beware).  OR you need to see a sexual medicine specialist who knows about things other than the basic plumbing which is the core of urology training.  A woman would not go to a urologist for these sorts of sexual health issues, she would go to a gynecologist.  That should tell you something.  Men should get the same quality of treatment.  - George

[0x5555]

I'm close to Toronto.  Planning to go to the Mt Sinai clinic - scheduled appointment with a Kirk Lo.  I also know that Dr. Gruber there has some experience w. Peyronies (I believe someone on this forum goes to him).

They were actually the ones who said I showed no sign of plaque or cavernosum rupture and I assume they are experts in this.  The radiologist mentioned that sometimes the scarring is too thin to be noticeable on ultrasound.  I'm just curious if anyone else has experience with that.  Still, my dick is REALLY painful/uncomfortable and I can feel nodules in there.  Note that I don't have curvature except for a very minor tapering right near the end.  I don't know for sure that it's peyronies (and I'm trying to get to a urologist who can tell me what it is or suggest a treatment).

I don't know if anyone else gets this but I pretty much can't sleep at this point - 1.5 hours in I am woken with an uncomfortable erection.  It's made the last 3 weeks a waking nightmare, I'm just constantly tired/sleepy.  The killer part is how long it will take to see a specialist - the wait times are likely going to be at least a month.  I'm not sure if I can make it that long....SOOOO SLEEPY.

If anyone knows a urologist in Toronto I should talk with it'd be much appreciated.

[richard wheeler]

hi, i'm new to this.always had had curve which never bothered me but back in June noticed an indentation where i am crooked or its like a weak point .still have no problems with erections but they are not as strong.(not sure if this is just me worrying now). have an appt with a urologist in early december,getting an ultrasound on tuesday.My MD put me on low dose Cialis.been reading about other meds like Xiaphil etc. Any input would be appreciated.Thinking is that this this is fairly recent and maybe the sooner the better. Also any input on Neprinal ,Potaba,Verpamil,Collagenese etc would be appreciated. Ilive in the Toronto area. tks,Rick    

[0x5555]

My only advice is to leave it alone and not engage in sexual activity for a while.  Which urologist are you seeing?

[richard wheeler]

i am seeing Dr Buckley.According to my GP he has experience with this{I HOPE} What is your reasoning for leaving it alone? Any thoughts on meds? Bad timing here,cause i just started dating a nice woman. lets just say the sex has been average by my standards at best and am afraid this will hurt the relationship. Anyway , we were adult enough to talk about it ,but it still sucks!!  

[George999]

I would URGE both of you to contact Mike67 directly via PM.  He is the guy on this forum who really knows the right doc in Toronto.  Beware that even docs in the same clinic will not have the expertise that Mike's doc does.  Mike put a lot of effort into finding this guy.  You both need to take advantage of that information so that you get the right stuff as soon as possible.

Richard,  Xiaflex is proving to be an excellent treatment for Peyronie's with some good results trickling in at this point, BUT it is still experimental and you would have to enroll in a trial in order to get access to it.  Low dose Ciallis IS helpful so you are on the right track with that.  Neprinol is useless for Peyronie's.  No one here has made a credible report indicating success with it.  Several of us were using it extensively and getting no results.  Potaba works but is hell to take for a number of reasons.  I would not recommend it.  Veripamil has seen mixed results.  The injection method works, but the injections themselves pose new risks.  The topical form has shown very little effectiveness for most guys.  Collagenase is actually just the generic name for Xiaflex.  The two best oral treatments at this point are Pentoxifylline and CoQ10/Ubiquinol.  Both have solid research demonstrating their effectiveness.  There is also some research supporting the use of Acetyl L Carnitine.  The ONLY other oral treatment with research behind it is Potaba mentioned above.  I really would encourage you to start on Pentox as soon as possible.  That is why you need to contact Mike67 now.

A lot of urologists think they are good at dealing with Peyronie's, but you guys need a urologist who SPECIALIZES in Peyronie's.  In other words a doc who mainly sees Peyronie's patients, not just SOME Peyronie's patients along with his general urology patients.  There are VERY few actual bona fide Peyronie's specialists.  You have one right in Toronto.  In my case my uro thought he knew all the latest on Peyronie's treatments.  He was wrong.  I had to demand to see a Peyronie's specialist in order to get access to these treatments.  Don't waste time on things that won't achieve the best possible results.  The earlier you start getting the right treatments, the better off you will be in the long run.  I wish I had put my foot down with my doc earlier on this.  I urge you guys not to make the same mistake.

 - George

[0x5555]

Yeah, a common theme seems to be 'boy I wish I hadn't waited'.  There seems to be a lot of denial for some us of when we first start getting symptoms as we're all so used to our penis 'just working'.  Also, I've had some injuries in the past and generally time just makes things better.  I was definitely in some denial and just sort of hoping/wishing this would all get better.

I'll PM him and get the info.  Thanks for the post.

[richard wheeler]

George, thank you for thorough and thoughtful reply. i did send Mike 67 a message back on Sept 27, but have not received a reply back.maybe on holidays. Any help to get the doctor contact you speak of what be awesome.Thanks again,Richard

[George999]

OK ... In the absence of Mike, your best bet is probably to call Bill at Peyronie's Canada.  His phone number is 416-988-6263.  The Peyronie's Canada website is at http://www.peyroniescanada.org.  I believe he is located in Hamilton.  He has direct contact with Dr Ethan Grober who is probably the top Peyronie's expert in Canada.  While Dr Grober may not be able to see you personally, there are other qualified docs who can.  Bill is the guy who can help you make that happen.  Bill is not a medical doctor, but neither is he a layperson.  He is a qualified medical professional who works out of a doctor's office.  I wish you guys all the best.  You are both fortunate to live in a place where you can get top quality care locally.  I had to travel a five hour bus trip to visit Dr Lue in SF.  - George

[mike67]

Ox5555
Iam finally back on the Forum. Thanks to George for sending me an email earlier today , I have been catching up on my inbox and responding . Several system restores have deleted my ID s all over the net .
Just going over your posts and will send you a PM soon this evening.
Sorry for the delay
Mike 67

[mike67]

Thanks George for this very thorough response to Ox555
You have pretty well covered it for him. And I see you have been in contact with Bill at Peyronies Canada.
I might add that he works in close proximity with another Peyronies Disease specialist located in Hamilton. His name came up at our August meeting.
He is Dr. Michael Greenspan at 905 529 0988.
I'll send Ox5555 Dr. Grober's contact info.
I apologize to everyone for not being here for several weeks. Looking through all these posts , I have missed out on a lot.
When WINDOWS crashes , it takes a while to get everything set up again and it was a huge distraction.
Thanks again George for pitching in as always.
Mike

[George999]

Mike,  Its all fine and normal.  It doesn't say "send this member a personal message" because it doesn't allow you to send a message to yourself.  When I bring up your profile, the option is there.  I will send you a message to test it out!  - George

[Old Man]

mike67:

Another thing to check is to see if you have the "talk balloon" icon in the left side of your posts. To send a PM all one has to do it click that balloon and can send a PM when the message window comes up.

As George says, you are not supposed to be able to send yourself a PM. However, for some reason, I have that option. Know this because I have accidentally sent myself a PM when it was intended for someone else.

Just play around with the options to see what works and does not work for you. If you still have problems, let one of the moderators know and they can possible fix any problem area with your account.

Old Man