Plication Surgery

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LWillisjr

Quote from: not9inches on March 12, 2011, 03:05:13 PM
I think I posted already that I am scheduled for surgery on the 22nd of March.  
( pray for me fellows )

Will say a prayer next week, and hope all goes well. Good luck and keep us updated.
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

not9inches

Tomorrows the big day!  In surgery at 11:30.  some questions for those in the know here.
I'm having the Nesbit surgery. How long will this take? How long usually before I can leave afterwards?
Any special advice on caring for "mr happy"  afterwards?
How long before I can have sex!?  

LWillisjr

Your doctor will answer all these questions post-op
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

not9inches

Surgery went fine today. Got started right on time..11:30  left the hospital about 3. Im home now and so far there isnt any pain.
It's kinda hard to pee but seems to get easier as time goes by. Im assuming its because of the swelling.
Got to go back to the doctors tomorrow so he can show me how to change the bandage. I got ace bandage on it,
As far as losing any length...Im assuming you cannot tell how much you lost untill you have an erection because right now in my present state
(limp) i cannot tell any loss of length.  

not9inches

I am wondering if anyone else who has had surgey found it difficult to keep your dick wrapped up. ?  I try to keep from doing too much activity. But i find i have to re-wrap it about 3 times a day.  

not9inches

Hey everyone. It's been 5 days since my surgery with Dr. Lipshultz here in Houston and recovering fine.  Everyone in his office has been super. I can't say how pleased I am with
all they have done.  I've experienced some mild ( accidental / nocturnal ) erections...about 60 % erect....and judging from what I see, when I am able to experience a full erection I think I am going to be just fine.  I am doing all I can to keep from having a full on hard-on for now. I have to keep my girlfriend away...  : (  
I had an incision done length wise, about 3 inches on the underside of my dick...not the de-gloving kinda surgery.   Healing up just fine.  
Doc said I wouldn't be completely straight but so far what I'm seeing I'm a happy man!  

Brightdog

Congrats! We like a good success story - be sure to post in the success forum too (maybe after you've recovered enough to try it out!)

not9inches

Well its been a few weeks and Im about all healed up and I seem to be straighter than the what the doctor indicated I might expect. As i recalled he said I might expect about a 30 degree bend after surgery. My official bend measurement was 74 degrees before surgery.  It looks like maybe 20 degrees now if that. In other words...Im a happy camper!
Question for any who have had surgery. Can i pull out the one remaining stitch. its itching the crap out of me. My incision is all healed up but got one stitch stickin out.


Worried Guy

Hey, have you healed up enough to use your fella yet?  How are things going?

Tim468

Go back to your doc and ask him about the stitch - not us. We didn't put it in there - so don't trust us to know what to do with it!

Tim
52, Peyronies Disease for 30 years, upward curve and some new lesions.

GeeGee

Hi!

This is my first post here and just came to tell that I had successful nesbit surgery week ago. I had 30-40 degree congenital curve to left.
Surgery went well, I'm straight now and didn't loose any lenght. I've had noctural erections since first night after surgery.
What comes to pain there is little to none except when I wake up at night with wood :) Still little swollen but that is also getting better.

Doctor said to wait 3 weeks before having sex but I think I'll wait 4-6 weeks after reading stories from this forum.

Feel free to ask questions on private or on this thread and I'll try to update my progress here :)  

LWillisjr

GeeGee,
Thanks for posting. It's always good the hear positive stories of improvment.

Les
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

newguy

Really happy for you guys (not9inches and GeeGee). It sounds like surgery went great for both of you.  

reynell

congrats to both of you it is good to hear of some good things happening for a change. You will both be in my prayers.  Keep us up dated>

james1947

I am missing something? My pages are not updating?   :(

not9inches last post in this topic was at April 14, 2011 and he last visited our site at April 21, 2011  ???
GeeGee last post in this topic was at September 16, 2011 and he last visited our site at November 01, 2011  ???

So both will not see your answers

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

BrooksBro

After two series of six verapamil injections (12 total this year), I have not had any functional improvement.  I went to an appointment Monday, expecting another ultrasound measurement and to talk with Dr Lipshultz (Baylor, Houston TX) about an implant.  Neither happened.  

The discussion quickly turned to plication.  In June, my curve was measured at just over 85 degrees, upward, with some hour-glass and calcification.  The ultrasound shows I have excellent collateral blood flow (3X the minimum).  The doc is confident he can reduce my curve to something between 60 and 30 degrees.  I am scheduled for plication surgery on October 25.

Obviously, this is much less invasive than an implant.



LWillisjr

You should first discuss with him about expectations of loss of length for this type of surgery. I realize Dr. Lipshultz has a good reputation, but I know that Dr. Levine would not recommend plication for curves greater than 40-50 degrees. I think this is why he is telling you that he can reduce your 85 degree curve to something to 30-60 degrees. My concern is that if he is only successful in reducing your curve to 60 degrees is that you are not going to be happy. My personl experience is that intercourse with a curve 40 degrees or greater is a challenge if not impossible.

I understand he can improve your curve, but is it going to be enough to be satisfactory?

I had a 70+ degree curve, and Levine performed "Excision and Grafting" surgery and correct my curve to a near perfect 0 degrees with only a 2 cm loss in length.

Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

james1947

lwillisjr

I have a question:
Why the excision is shortening the penis?
My logic says that it should lengthen the penis if the plaque is tacked out because the plaque restricting the length that an erection can stretch the penis. So if the plaque not there, why not longer? Why shorter?
The opposite side of the plaque should be longer than the plaque side. :(

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

Hawk

James, Since I am not a candidate for such surgery I am not well informed on this but I think the answer is that they cannot leave a gap in your tunica where the plaque was excised.  They either fill it with a graft and you gain some length or they close the void.  However in the last case it seemd you would be no better off than with the plaque still there.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

BrooksBro

I also discounted plication, following the conventional wisdom of it being limited to curves less than 50-60 degrees.  If the level of acceptance is zero curve and zero length loss, then I am not a candidate.  My threshold is an improvement sufficient to permit penetration.  If achieving that means a 1-2 cm (3/8-3/4 inch) length loss, so be it.

I will have to wait to find out if intercourse with a 30-60 degree bend is less impossible than it is right now with 85 degrees.  With the 16 or 24 dot technique, it seems possible to me for there to be a significant reduction in the curve.  Oh but were this possible without a corresponding loss in length.  For all practical matters, that length is already "lost" to me.

After the plication, I may well find that I am unable to penetrate.  I may also find that I am.  In my current condition, that is just as impossible today as it has been for the past year.

This may buy me some time until Xiaflex becomes commercially available, which will actually "dissolve" the plaque.  If I find the plication outcome is unacceptable, either from a curve or length standpoint, there is always the inflatable implant option remaining.

In all my reading of studies, there are not any "good" grafting materials, be they cadaver, animal, patient harvested, or synthetic.  They all have side effects and complications.  There is also a large percentage of those with grafts which have significant worsening of pre-existing ED, or who now have ED.

LWillisjr

Quote from: james1947 on October 10, 2012, 04:51:53 AM
lwillisjr

I have a question:
Why the excision is shortening the penis?

James

James,
Good question. I may have not stated it correctly. From the time I first contracted Peyronies until after the surgery, during this time frame I lost 2 cm. So it wasn't necessarily the surgery, but may have been simply due to the peyronies itself. I'm not a surgeon but I have spoken to many guys offline who have had the excision and grafting surgery. Some did not lose any length, and some did lose length. I understand the logic of if you remove the plaque and replace it with a graft material then one would think that you would have your original length back. But this isn't always the case and I ALWAYS point out to anyone considering surgery that this is a possibility.

In the case of plication, the longer side is shortened to match the already shorter side. So I think shortening due to plication is a given.

Les
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

james1947

lwillisjr

Thank you for the answer.
My uro don't come back to me yet to answer this question (email). :(
Maybe I need to go again to the hospital to talk with him personally. :(
I will post what he says when I will meat him.

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

BrooksBro

It is 24 hours until my plication surgery.  Any last minute suggestions or affirmations?

I am praying for minimum discomfort, satisfactory results, quick healing, and no complications.

Buckeye

BrooksBro, I'll be praying for you. Blessings, Buckeye

Hawk

Our thoughts and prayers are with you.  You will be fine.

We are anxious to hear from you after the surgery.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

james1947

BrooksBro

Will praying for you, wish good results and fast recovery.

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

AphexTwin

Do the sutures ever dissolve?  That's what my doctor told me, but they are clearly still there.

Hawk

My understanding is they never dissolve.  If they did, or if they break, the curve would return because it is a simple surgery where they just tuck the long side with a non-elastic suture to equal the effects of the plaque on the short side.  There is no incision and healing on the shaft to hold the penis straight if the sutures dissolved.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

AphexTwin

Must of been talking about the stitches then

Hawk

Aphex,

How much of a curve did you have before surgery?
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

AphexTwin

Quote from: Hawk on October 25, 2012, 09:49:48 AM
Aphex,

How much of a curve did you have before surgery?

I am not sure the exact angle.

It curved to the right a little. It was the dorsal curvature that was the worst.   Instead of going out perpendicular from the body, it goes almost parallel up to my belly button. The surgery didn't do much but make my erections weak and soft.  

BrooksBro

Thanks for the prayers guys.  

My Creator, The Great Physician, delivered on His promises.  He used my surgeon to achieve what I believe will be a satisfactory outcome.  A few months ago, my upward curve measured 85 degrees.  The doc said it was 15 degrees after he finished.  My hope was for 30-60 degrees residual.  I know, with 70 degrees of reduction, the shortening will be more than if there was less curve reduction.  As I told my wife, as long as it reaches from me and into her, I am good.   ;D

I am thinking, perhaps a few months after I am fully recovered, I may use traction or VED therapy again to stretch the side without the permanent sutures, and restore some length.

It was late when I got the Vicodin pain med filled.  I forgot how much that can disrupt sleep.  It kept me up a few hours later than usual, and I woke up every few hours during the night.  I skipped my nightly 25 mg Viagra, not wanting to induce uncomfortable erections while I slept.  It didn't work.  My morning wood was too uncomfortable to lay there or go back to sleep.

I tried to make it through the morning with just extra strength Tylenol.  It was inadequate to take the edge off.  I may try an ice pack later today.  Urinating really burns.  I hope that eases after I remove all the bandages later today.

I am most pleased that the restriction is no sex for two (2) weeks, meaning after my follow up appointment.  OK, he wrote at least two weeks.  No lifting more than 10 pounds for 4 weeks.  Having been about a year since our last successful intercourse, I expect the first weekend after my appointment could be a lot like a honeymoon.  I know there will be some relearning and adjusting.  I am looking forward to that!

After several years of dealing with this condition, I feel like I am seeing the light at the end of the tunnel.  And, that light is the bright shinning sun.  I believe the combination of pentoxifylline, nightly Viagra, and L-Arginine were effective in restoring my overall penile health.  Having restored that health before plication was the correct order.

Hawk

Quote from: BrooksBro on October 26, 2012, 11:56:33 AM
I am thinking, perhaps a few months after I am fully recovered, I may use traction or VED therapy again to stretch the side without the permanent sutures, and restore some length.

Great news!

One HUGE caution however, if you attempt to stretch you have the potential of ripping out the sutures with a resulting disaster.  Be sure to consult you doctor about this before attempting it.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

GS

BrooksBro,

I'm sure I speak for all of us..."best of luck to you and your wife"!!!

But, please don't overdo it when you get the chance to "do it".

GS

LWillisjr

BrooksBro,

What surgical procedure did you have done??
Developed peyronies 2007 - 70 degree dorsal curve
Traction/MEDs/Injections/Surgery 2008 16 years Peyronies free now
My History

BrooksBro

Modified Nesbit plication.  One incision along the bottom side to put sutures in the tunica.  With the bandage off this evening, it is very swollen and very black and blue.  I just started folding a gel ice pack over it for 20 minutes on, 20 minutes off, to help bring down the swelling.

Quote from: lwillisjr on October 26, 2012, 07:23:55 PM
BrooksBro,
What surgical procedure did you have done??

BrooksBro

Today is my 4th day since plication surgery.

I stopped taking Vicodin for pain after the second day.  Since then, two extra strength Tylenol every 6-hours have been all I needed for pain.  I am still swollen and ice packs do not seem to help with that.

In addition to being sore along the suture line, there are some other tender areas.  The discomfort is tolerable (with Tylenol).  The most trouble occurs when the skin level sutures rub against something, such as the inside of my underwear.

Spontaneous night time erections were a little more tolerable last night.  I stopped taking L-Arginine and 25 mg Viagra each night, but the erections still happen.  I have specifically avoided trying to get an erection, out of fear about the discomfort that would result.

I think I am beginning to see some of the discoloration going away.

james1947

Wish you fast recovery.
Erections without L-Arginine and Viagra after surgery are GOOD signs that no damage has done to the nerves.

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

BrooksBro

Today is one week since modified Nesbit plication surgery.  My understanding is the true Nesbit involves full de-gloving.  I only had a single incision along the bottom side, a little below the circumcision scar, and running in the same direction as it.

I was awakened from sleep early this morning with a painful erection.  Most of the pain was along both sides and seemed to be most intense nearest to my body.  I can only presume this may be where the internal sutures are tied off.  To me, it felt like the strongest erection I have had in the last week.  My thought was, if this is how it is going to feel, having penetrative sex again is going to be very uncomfortable for me.

I noticed when even partially erect, it sticks straight out from my body much more than I ever remember.  Since the curve-limiting sutures are on the bottom, this makes sense to me.

Much of the lighter bruising is disappearing almost on a daily basis.  The swelling is also decreasing.  The swelling is down enough that I believe I can feel the sutures under the skin.  I am beginning to pick out bits of the surface sutures as they dissolve.

I think the fear of losing length got much more attention than it deserved.  I was not overly well endowed before.  What remains appears to be quite adequate to me.

The plaque is still there, and I expect it still causes some venous leakage.  That means I am likely to need to use the VED and constricting band.  At least I am straight enough that I am highly confident that I can penetrate again.

In retrospect, I should have done this at least a year ago.  There was nothing to be gained by waiting.

Hawk

If you are getting decent quality erections now you may not need a constriction VED & band.  If anything maybe viagra or even 1/2 a Viagra (cheaper than lower dose pill).

I would try with nothing, then if you need something add L-Arginine, if yu need more then add a 1/2 a viagra.  If that still does not work I would add a constriction ring.

Good luck
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

BrooksBro

Getting it and keeping it long enough are two different things.   ;D   You are right, and I am looking forward to finding out which works best for our mutual satisfaction.

Quote from: Hawk on November 01, 2012, 03:46:39 PM
If you are getting ecent quality erections now you may not need a constriction VED & band.  If anything maybe viagra or even 1/2 a Viagra (cheaper than lower dose pill).

I would try with nothing, then if you need something add L-Arginine, if yu need more then add a 1/2 a viagra.  If that still does not work I would add a constriction ring.

Good luck

BrooksBro

I wish I had read this study long ago.  In over 90% of the cases in it, the outcome was favorable.  The study shows the concerns about feeling the knots and shortening are over rated.

At a mean follow-up of 30 months (range 8–69), subjective result was good (straight penis, mild shortening, normal erection and penetration) in 92.5% cases, fair in 5%, due to permanent glans numbness in a case in which the neurovascular bundle was not mobilized, and psychogenic ED in a patient who expected the operation to improve his erectile function, poor in a patient (2.5%) who claimed signiŽcant penile shortening (which was objectively shown to be 1.2 cm). None of the patients had problems with the knots.

http://www.hawaii.edu/hivandaids/Tunica_Albuginea_Plication_for_the_Correction_of_Penile_Curvature.pdf


nebula2

Hi guys
Day 3 post op Nesbitts procedure. How do I feel? pretty good really apart from waking up at 3am with painful throb down below and after a quick check can say I`m mega pleased that it doesn`t look like I`ll have a problem with ED  ;D
Interesting to read others dealings on the forum with medication for Peyronies. I`ve never tried any medication for this condition. I remember reading once that vitamin E or a lack of it contributes to Peyronies Disease but thats as far as I got. I have always been of the opinion that surgery for me anyway was the only option.
In the UK we have a program broadcast on Channel 4 called `Embarrassing bodies` where members of the public go to the tv doctors surgery to discuss their problems and the next course of action. I watched one program about a guy called Keith and the nesbitt procedure he went through and found it a great help. You can see it here http://www.channel4embarrassingillnesses.com/video/in-detail/in-detail-peyronie-s-disease
Best
Steve

Hawk

Quote from: nebula2 on November 09, 2012, 06:15:40 PM
In the UK we have a program broadcast on Channel 4 called `Embarrassing bodies` where members of the public go to the tv doctors surgery to discuss their problems and the next course of action. I watched one program about a guy called Keith and the nesbitt procedure he went through and found it a great help. You can see it here http://www.channel4embarrassingillnesses.com/video/in-detail/in-detail-peyronie-s-disease

The producer of that show contacted me about possible volunteers from the forum about 3 years ago.  I posted his info incase anyone cared to contact him.  I think at least one did but I'm not sure if it progressed.
Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

lukewill

Quote from: BrooksBro on October 10, 2012, 04:14:11 PM

This may buy me some time until Xiaflex becomes commercially available, which will actually "dissolve" the plaque.  If I find the plication outcome is unacceptable, either from a curve or length standpoint, there is always the inflatable implant option remaining.


Hi Brooks

Since xiaflex looks like it may be less than a year away, I am wondering why you decided on such drastic measures such as surgery in the meanwhile?

BrooksBro

ALL the treatments I have tried (traction, VED, trental, ubiquinol, 12 verapamil injections, etc, etc, etc) were unable to resolve the plaque.  My overall penile health is greatly improved through these treatments, but the plaque remained.  The stronger my erections became, the worse the curve became.  At 85 degrees upward, I have been unable to have penetrative sex for more than a year.  

The plication surgery was only to correct the curve sufficient for penetration.  It is the least radical surgery for this disease.  I was unwilling to wait for what could be another 12-18 months for Xiaflex to become available before having penetrative sex again.  My name is on the Xiaflex candidate list at my doc's practice.  When it becomes available, I am going to seek treatment.  I did not make it into the study because I was taking trental.

For now, even after the plication (straightening) surgery, the plaque remains, and with it, venous leakage.  When the doc says I can resume sex, I expect to need a constricting band of some type to retain my erection long enough for satisfaction.  Blood inflow is fine, three times the minimum needed to produce an erection according to the ultrasound technician.  Collapsing the veins to retain the blood is where I am having difficulty; the plaque does not allow the veins near it to compress and close off.

At my 2-week follow up this past week, the single incision is healing well.  My next, and last, surgical follow up is December 6.  I can't wait for the go approval from the doc!


Quote from: lukewill on November 10, 2012, 08:00:51 AM
Quote from: BrooksBro on October 10, 2012, 04:14:11 PM

This may buy me some time until Xiaflex becomes commercially available, which will actually "dissolve" the plaque.  If I find the plication outcome is unacceptable, either from a curve or length standpoint, there is always the inflatable implant option remaining.


Hi Brooks

Since xiaflex looks like it may be less than a year away, I am wondering why you decided on such drastic measures such as surgery in the meanwhile?

BrooksBro

The bills are being processed by my insurance provider (Blue Cross Blue Shield PPO).


Anesthesia $ 2,772
Surgeon    $ 3,849
Hospital   $18,015

TOTAL      $24,636   

My share   $ 1,462

BrooksBro

Three days shy of five weeks after plication surgery, I simply could not wait any longer to try out my much straighter second brain (85 degrees reduced to 15).  The wife agreed.  100 mg Viagra with 2.5 G L-Arginine (powder), and it was as hard as ever.  I did not need to pump and use a constricting band, and it stayed hard long enough.  Foreplay, what's that?  ROFLOL  

There was some slight pain along one side, probably where the restraining sutures were placed.  It was very tolerable and hardly worth mentioning.

From what I can remember from the last time we had penetrative sex (more than a year ago), it felt slightly shorter, although a little fatter.  My wife did not mention anything about it feeling different to her, and she sure did not complain if it did.  We both had a happy ending.   ;D

I see my surgeon in another week for the last follow-up.  What do I tell him if he asks "did you have sex yet?"   :-\


I am about 8 weeks after my first testopel pellets, and I feel like my testosterone level is lower than it had been on weekly injections (150 mg test cyp).   My concerns about it not being high enough for the viagra to work turned out to be nothing at all.  100 mg was enough.  My labs just came back at 600.  It was closer to 1,000 on the weekly injections.  I expect at my next implant in mid-January I will get more pellets.


james1947

Just tell him yes, I had sex and it was very successfull ;D 8)

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

BrooksBro

My plication surgery was 6 weeks ago on 12/6/2012.  Both times in the last week that we had sex, everything worked just fine.  We both had a happy ending.  After not being able to have penetrative sex in more than a year, this is GREAT!

When I saw the surgeon a few days ago for my last follow-up, he was pleased to learn that we are both satisfied with the outcome.  Yes, it is noticeably (to me) a little shorter.  I don't see that there is anything to be gained by me putting a number on it, so I won't.  It is still plenty long enough to reach from my body into her's, to our mutual satisfaction. Some of the length loss seems to have resulted in greater girth.  I can feel the sutures under the skin, but only when flacid.  They are not what I would call painful.  The doc said the slight discomfort (very low pain level) when fully erect will diminish over time.  It is not enough that I take any OTC pain medications.  It is more like having a rock hard erection.

At 606, my testosterone level is lower than what I remembered when taking weekly injections.  My second round of Testopel pellets is in mid-January, when I hope to raise that level a little bit more, perhaps closer to 800.