I am scheduled for an penile ultrasound next week. Can anyone tell me what to expect? how long the procedure will last, etc?
Thanks
The penile doppler ultrasound: I had it done back in December at Rush Hospital in Chicago.
First they will explain the procedure. Then they will rub the ultrasound gel over your flaccid penis and use the wand over it for 5 minutes. Expect an injection into the side of your penis and you will then wait 5 minutes to see if your penis responds to the injection. You will not get fully erect, but they will measure a response. If you do not respond, they will inject again. They may at this point rub the wand over your penis again.
After this, they will leave you alone for 5 minutes to work up to a full erection. Then they use the wand again. Finally, they will leave you alone for your erection to subside. If it doesn't, then you get another shot to bring it down.
The entire process takes about an hour start to finish. The ultrasound will show your plaque and scar tissue, and measure your bloodflow.
This is really no big deal.
What cause of treatment is your doctor suggesting for you?
I've noted that many members of this forum including Old Man seem to have a strict "no injections/stabbing of sharp objects into the penis under any circumstances" policy because it caused additional Peyronies Disease scarring for them at the sites of their injections.
I'd therefore be curious to know if this informal policy applies to the injections required for the ultrasound as well? (i.e. are the as many as 3 injections required for the ultrasound somehow materially different from the injections made during VI treatment?)
The injections for a penile ultrasound are to cause an erection. These three drugs appear to be those most commonly used, and as the information says, sometimes two are mixed and given at the same time. It is injected into the side of the penis. Because everyone is different, more than one injection may be needed to achieve the required results for the ultrasound. They use a very small needle, 30 gauge (0.012 inches). Until viagra was marketed, injections were about the only chemical way to induce an erection. Long term, these injections resulted in scar tissue formation at the injection site.
Papaverine hydrochloride was initially the most often used medication. Papaverine injections relax the muscle cells present in the arterial wall, causing dilation and increased blood flow in the penis. Several researchers have also noted that a second Papaverine injection reduces the blood flow out of the penis, so that the blood is trapped and the erection is maintained.
Phentolamine blocks the nerves that signal the arterial muscle wall contraction. Thus, the muscle cells in the arterial wall relax and the artery dilates when the nerves are blocked. This action compliments the action of Papaverine, and the two drugs are usually mixed together prior to injection.
Prostaglandin E-1 is a chemical that occurs naturally in the human body. Discovered approximately 30 years ago, it as a very potent vasodilator. Similar to the effect of Papaverine, Prostaglandin E-1 causes the relaxation of the muscle cells of the arteries in the penis, resulting in an erection.
The injections to treat the plaque are given directly into the plaque itself, called intralesional injection. The medication most often used is verapamil hydrochloride. It is a calcium antagonist or slow-channel inhibitor that has been used since the 1980s to reduce scars caused by thermal burns to the skin.
Quote from: pdnoob on March 10, 2010, 11:53:01 PM
I'd therefore be curious to know if this informal policy applies to the injections required for the ultrasound as well? (i.e. are the as many as 3 injections required for the ultrasound somehow materially different from the injections made during VI treatment?)
pdnoob:
Brooksbro has covered the subject very well. Repeated injections into ones penile tissue will cause scar tissue buildup that can and will result in a nodule or plaque formation.
In my case, after 12 injections for Peyronies Disease therapy, the scar tissue caused a 45 degree bend downwards and 45 degrees to the right. It took almost a year of VED therapy to get rid of the curvature.
Others have experienced the same problem and I guess this is the reason that we who have had problems advise against penile injections. There may be extenuating circumstances where injections are necessary for medical procedures, however one must weigh the possibility of further trauma to their most prized possession!!
Old Man
My urologist wants me to do interferon injections after the doppler. He said he could do verapamil, but thought interferon would work better. But he left the choice up to me. Anyone with any experience with interferon injections?
Well, I am on track for Verapamil injections. Had Peyronies diagnosed in August (4 months after symptoms started). Been on Pentox ever since. Went back to Uro today, and we are scheduled to start series of six injections in January. I have scar tissue on both sides of the penis giving me slight indentation about 1 inch long on right side when erect, and a smaller indentation on left side. Actually looking forward to seeing if it improves the situation. Uro said worse case is nothing improves.
Will post after injections with any changes. I welcome anyone else's insight into results, experiences, etc...Thanks.
Thanks, Old Man, for the info. I believe I will stay with your learned method.
Mike
Quote from: charlie44 on November 23, 2011, 03:52:48 PM
Well, I am on track for Verapamil injections. Had Peyronies diagnosed in August (4 months after symptoms started). Been on Pentox ever since. Went back to Uro today, and we are scheduled to start series of six injections in January. I have scar tissue on both sides of the penis giving me slight indentation about 1 inch long on right side when erect, and a smaller indentation on left side. Actually looking forward to seeing if it improves the situation. Uro said worse case is nothing improves.
Will post after injections with any changes. I welcome anyone else's insight into results, experiences, etc...Thanks.
You will find mixed results. Some have posted of improvement while others have posted of problems with the injections themselves. I also had a series of 6 with no change at all. But I was to the point of trying anything to get some improvement.
Hey guys:
Based on my experience with verapamil injections my best quote of note would be this: "Any stick in your prick can and will cause more damage"! It may not affect everyone this way, but is that is what happened to me with 12 of the nasty feeling sticks!! Final result: nothing good, just more plaque, nodules, curve/bend and hourglass effects.
Old Man
Charlie44: I'm getting my second series of 6 shots. I've taken pictures over the months, so I have some indication that things are improving. I don't have any evidence that the shots have created more scar tissue. There was one shot last month that seemed to dissolve one of the nodes near the head. I kind of feel like my doctor and I are doing this together with some mixture of hope and consternation--not sure if it works, but not sure it doesn't. After my last shot in December, we plan to wait about 6 weeks, then look at pictures, and figure out whether to press on. I wish it were more clear cut than this, but considering how much I detest getting these shots (it's the embarrassment more than pain), I obviously have some hope that they are helping. Good luck with it all. KAC
KAC, thanks for the feedback and insight. It is very helpful and much appreciated. Like you, I am taking the shots with the hope that it helps, but not with the assumption that it will. As we all know, there is not a lot of "treatments" for this disease that guarantees results, so you do what you can with the info you have. My doctor is one of the leading Peyronies specialists in the country, and the first question I had for him was "can this make things worse?"....he said "No....either it helps or does nothing, but won't make it worse". So I am trusting his experience on this, as I know he has done it hundreds of times....He stated that since I came to him early in the disease, now is the time to try and mitigate progression as best we can (which of course I agree).
My plaque does not move, and it is very clear where the lumps are, so I should be able to tell if that shots are doing any good. The procedure won't bother me in terms of embarrassment or manipulation, etc....I just want to do what I can to try and get better. I also asked the doc about bruising and he said you apply pressure for about 5 minutes after the injection to minimize that.
I asked him for his "crystal ball" on where I would end up with Peyronies, and he said I would probably always be able to feel plaque, but that I should be able to have a normal sex life (which I pretty much have now). So we'll see....
I always hope for the best, and plan for the worst.
Charlie44: Glad to hear your thoughts. I feel like I've been very proactive about doing something about Peyronies Disease--and am glad about that. My one regret is that I waited on the shots. The first urologist I saw--about 2 weeks after noticing the lump--offered the shots that day. I said no. Over the course of the next 5 months I went from a small node and no noticeable curvature to over 70 degrees, difficulty with intercourse, pain, etc. I decided to consult the leading local Peyronies Disease specialist (meaning surgeon) and then started the shots. It seemed like if the disease progressed at the same rate, it would have been the end of my sex life. I now wonder if the shots are the most effective with new inflammation sites--so who knows what a difference getting the injection 2 weeks after first noticing a problem would have made. A new inflammation node started developing in the head of my penis soon after I started the second round of shots so he directed one injection there and it dissolved that week. With the others, and especially with the rope like older plaque running the dorsal length I've not noticed any change with the injections.
I would be reluctant to advise anyone on shots given the mix of stories on this site. But I do wonder if people who have just developed the disease and are noticing rapid progression could benefit from it.
Glad to hear the suggestion on bruising. I will try that on my next shot.
KAC
I agree....I would never recommend a procedure...just relay whatever experience I had with it. My Uro is like "the sooner the better" which coincides with your experience and thoughts. I agree that if it comes a lot later after the disease has progressed, it very well could lessen the chances of any benefit. I will post my results after shots (1st ones are Jan. 17th). Thanks again for your insight.
I'm scheduled for verapamil injections in 8 weeks, I'm very nervous due to the mixed reviews Ive read, my plaques under the tip are very easy to feel you can even see them through the skin now its almost like a tendon or cord sticking out. I pray it will eliminate the bottle necking and improve blood flow to the glans. I would really appreciate some advice...I'm wondering if Its less risky since its just under the helmet rather than say at the base or mid shaft?
Trevor
Trevor,
I'm sure you have seen the mixed reviews on the VI's. Some of the guys don't recommend them, others have tried them with mixed results. I personally don't think the risk is any less or any greater a the base or under the glans. Bottom line is you are doing some invasive treatment by using a needle to break into and inject Verapamil into the plaque. Expect some soreness and bruising. I got to where I would take an ice pack some sort with me to the procedure. And then on the way home in the car I would drive home with the ice pack on my lap. You will have some soreness a few hours after the procedure once the pain drug wears off.
ok so my injections are in one week and I'm very stressed over whats the best pre injection protocol that will lead to the best potential results. Should I stay on all the supplements and pentox? Lots of stretching? lots of sex? no sex? What do you guys think would give me the best chance for ideal results.
Thanks.
One week ago today (4/5/2012) I had my first verapamil injection. To me, it was no big deal. There was very little pain or discomfort and that was very tiny when they have the lidocaine injection for pain. After that, nothing. After a week, the superficial "bruising" has nearly gone away. It was never painful, like after a real bruise, this was just darkened skin.
I had previously read all I could about the injections and questioned the PA giving them about the urologist's post injection protocol. I asked specifically about using traction. He cited what I read in the Levine study that at least 3-hours per day is needed for the best results. He said to wait at least 24-hours after the injection before engaging in sex.
http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2011.02519.x/pdf
Quote from: trevorrr on April 05, 2012, 04:15:03 AM
ok so my injections are in one week and I'm very stressed over whats the best pre injection protocol that will lead to the best potential results. Should I stay on all the supplements and pentox? Lots of stretching? lots of sex? no sex? What do you guys think would give me the best chance for ideal results.
Thanks.
Stay on your supplements and regular regimen.
Quote from: BrooksBro on April 05, 2012, 05:53:19 AM
One week ago today (4/5/2012) I had my first verapamil injection. To me, it was no big deal. There was very little pain or discomfort and that was very tiny when they have the lidocaine injection for pain. After that, nothing. After a week, the superficial "bruising" has nearly gone away. It was never painful, like after a real bruise, this was just darkened skin.
I had previously read all I could about the injections and questioned the PA giving them about the urologist's post injection protocol. I asked specifically about using traction. He cited what I read in the Levine study that at least 3-hours per day is needed for the best results. He said to wait at least 24-hours after the injection before engaging in sex.
http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2011.02519.x/pdf
Please please please! could you post this study in ressources? i was looking for it and even posted the abstract in the traction section.
https://www.peyroniesforum.net/index.php/topic,2345.0.html
IMHO its is also important for people using traction only, as it says that there was only effect for users using traction for more than 3 hours.
Luc