Warning-explicit photos.
https://www.peyroniesforum.net/index.php/topic,10616.msg100640.html#msg100640
Tony, the inflated looks like it narrows or step in on the right near the base.
Is that a change?
On the deflated are you saying that in the past you did not have any irregularities from relatively new deflated cylinders? I could almost believe that looks normal for very deflated new cylinders of a non-LGX
Also, what made you think and self-diagnose as a graft coming loose?
Did you have pain? Did you know the instant it happened?
Did you discover it after the fact?
The two pics in last post are both deflated. First now, second from last week. The narrower base is plaque that was not removed and hopefully will expand due to the capacity of the CX. There is no pain so the theory about the graft coming loose is hopefully incorrect. It's just the increased bulging happened after intercourse abc seems to be in the area where the lower graft was/is? Hopefully it's all normal and can be managed by slightly inflating the cylinders when not in use—but I wouldn't do that until after 3 months so as to not limit the capacity of the reservoir.
I am no doctor but 6 weeks in, I really think as long as you are super deflated during the night a little bit of fluid in the cylinders during the day is not going to be an issue. You are stretching the reservoir 8 - 10 hours a day. That is a lot more than you are stretching your penis.
I'm beginning to think since my edema and swelling has gone down I can now see the flattened cylinder, dog ear type effects when fully deflated when the edema was rounding things out before.
I think you just hit the bullseye and solved the mystery! I am almost certain that is correct since I had a similar situation as did Floppy only much sooner in the process since less swelling and maybe stiffer cylinders with a Titan.
It's a relief.
Then the dog ears are in the deflated state? I must have missed that. Dog ears should smooth out with just a few pumps. In reality, for a while adding enough to smooth them out when you can helps eliminate them for good at an earlier time. Would it help your graft to heal smoothly and evenly keeping enough fluid in the cylinders to be smooth rather than dog eared? Just a thought. Cheers man.
Yes, only prominent in deflated state. I think this is where the cylinders tend to fold (crease really) when walking around.
Quote from: TonySa on November 06, 2018, 03:05:22 PM
Yes, only prominent in deflated state. I think this is where the cylinders tend to fold (crease really) when walking around.
Dog ear then. A couple pumps should smooth it out. Cheers.
60 days out and finally managed an orgasm in less than 1/2 hr. Sensations from degloving returning, but sutures are a hassle—3 of 4 have not dissolved or created scar tissue. As they say, each week gets better!
And again today, feeling much better about the excision/grafting w implant. Guess the excision/grafting impact on the nerves is improving...feeling more pleasure able sensations. Also, beginning to feel a bit of slight discomfort/stretch when pumped to the max which I hope is a good sign of increasing size w time as I think I'm still less length and girth than originally.
Quote from: TonySa on November 17, 2018, 04:36:22 PM
Also, beginning to feel a bit of slight discomfort/stretch when pumped to the max which I hope is a good sign of increasing size w time as I think I'm still less length and girth than originally.
When you say "originally" do you mean immediatly pre-op? If so, when you say "you think" does that mean you did not take precise, objective, pre-op measurements?
Btw, I suspect the feeling will very slow.y improve for a full year at least.
I was thinking the bone pressed flaccid stretch was the measurement needed. I'll have to find any other measurements I made. The postop measurements (not bone pressed) matched the preop measurements the doc made.
I always measure between my ears as the perception how I feel about it is most important! ;D
Lol, of course!
10 weeks post surgery update:
Sensitivity slowly returning with orgasms very delayed and not always possible
3 (of 4) Internal stitches remain hard.
Thrombosis (see photo link) has grown in size. Doc didn't seem worried but I will follow up.
See: https://www.peyroniesforum.net/index.php/topic,11123.0.html
Circumcision scar from excision grafting very fifteens from silicone gel wraps.
Most likely due to excision/grafting rather than implant portion of operation.
Oh boy... That looks like a vein coming out. Similar to mine on the side. Does it hurt or anything? I've never seen this result as part of IPP placement. Did your doctor gave you any hint on what it might be because of?
He didn't say specifically. It is not painful, just a distraction (hard knit feel) when having sex.
Seems to be so similar... The vein I took picture of, seems to be the same with no improvement. Read that doctors recommend just anti inflammatory and it resolves with time. Do you feel any difference in the bulge on the vein, while lying down? Is it always like that? Are you taking any medication that might have helped to cause that?
The thrombosis has tripled in size from when I first noticed it after surgery. Bin already on anti-inflammatories. Will see doc Monday.
Oh damn... That sucks and I am sure you are worried. Good luck with this.please report back when you see your doctor. By the way, what dosage are you taking of anti inflammatory? Is it ibuprofen?
200 mg Celebrex a day and 3,000 mg Tylenol a day.
Wow. Keep us posted how it resolves. Thombosed veins can take a long time in legs. Dicks? I don't know. Kind of gives an idea what goes on with these boys that want to try the quack cheap schelerotherapy where they cork off veins although deeper veins. Be well soon.
3.5 months post surgery:
Thrombosis appears to have completely resolved.
Length (full bone pressed inflated) is up .25" to 6.25"
Intercourse is akward with some buckling where "dog ears" are on shaft.
Sensitivity seems to continue to incrementally improve overbtime-orgasm still difficult.
You don't have any dog ears or any trace of where they are when you are inflated do you?
They're gone when inflated but tends to bend there w the in and out motion. Going to see NP tomorrow.
I am very surprised that a non-LGX model would do that fully inflated.
Though known for better rigidity than the LGX and seemingly often preferred for syndromes of bent dicks, all AMS models are known to not be as rigid as Coloplast.
Hey Tony! very nice to read that your vein thrombosis has resolved itself. As for the implant buckling... that's a bit distressing. But can you describe a bit better what do you mean buy buckling? are you having difficulty inserting the penis for penetration?
User error...lol
So I went back to the doc and explained my problem of inserting penis during intercouse (resulting in bending or buckling). Turns out I have not been fully inflating...apparently slightly pushing deflate valve while pumping. I seem to have it now and will try again.
Man, I don't think you could ever accidentally hit a Coloplast deflate valve.
Almost four months and now penis working like a dream. Sensitivity keeps improving, can now orgasm, stitches slowly dissolving and no longer a distraction when jerking off. Now successfully fully pumping and therefore useable for intercourse.
8) That is so nice to read Tony!!! if it feels good to read another success story, i can only imagine how you must be feeling! enjoy it :D ;D
Same here Tony, I know you have been a member on the forum for some time and that the decision for surgery was a difficult one.
Great news!
I apologize in advance if I am not posting this question for the group in the appropriate section. Long story short is that I have had Peyronies Disease for just under 4 years and have tried all conventional/unconventional treatments (Xiaflex, VED, traction, PRP, stem cells, ESWT, orals, etc.). At one point through Xiaflex I had gotten my downward curve of 40 degrees to almost straight. Peyronies Disease returned approx 3-4 months later and I currently have upward curve of approx 35 degrees. I have significant plaque and am now trying to decide if I should go with penoscrotal plication or implant. I do not have significant ED but recognize that most will get ED at one point. I have lost approx 1 inch because of Peyronies and currently measure at 14 cm on the SPL measurement. I am using RestoreX at least 1x daily for 30 min. I am afraid to lose any more length but the surgeon recommending plication has indicated that he wouldn't expect me to lose more than 1-2mm. I have a phone call consult with Dr. Eid next week to get his perspective. Anyone have any advice/thoughts? While plication is less invasive there is potential for loss of length when I don't feel like I have much length to give up. There is also a chance that Peyronies Disease could come back (assuming I am one of the ones that attribute this to a genetic wound disorder). On the implant side I take care of this once and for all but recovery is a bit more difficult and of course you no longer have a naturally occurring erection. Thanks in advance for any thoughts.
With an implant you would have the added advantage of still getting an erect glans and spongiosum which men with total Ed do not get with an implant.
I think the decision is a tough one and very individualized. I had clear ED so my decion was much easier.
I trust Dr Eid will advise you well and give you some valuable info for your decision. BTW plication always results in size loss equal to the shorter side.
I returned to my PCP, a female PA for the first time since my surgery and she got to see an implant live for the first time. I thought she should know how life transforming they can be.
Quote from: TonySa on January 05, 2019, 11:16:38 AM
Almost four months and now penis working like a dream.
Absolutely fantastic! Thank you for sharing the good news. Made my evening better reading it. Cheers man.
was wondering if anyone had heard of the "Scratch" technique for management of Peyronies in conjunction with penile implant. Believe this is relatively new and is being done by Drs. Hakki (GA) and Perito (FL). Essentially they breakup/incise the plaque prior to implant to help with length and curvature reduction (this is done with an infrapubic incision). There is a video out on you tube on it. Then they use the "no touch" technique for the penile implant. There is no degloving involved. I know Dr. Eid believes the implant alone can straighten the penis quite a bit but was curious if others had any familiarity with either these docs or this technique? Thanks.
Found this summary of surgical decision options when correcting peyronies with implant. Thought i would pass along.https://surgery.duke.edu/sites/surgery.duke.edu/files/field/attachments/DUA17-Lentz-IPP-for-Peyronies Disease-REVISED.pdf
In order to scratch the plaque, how would they reach it without degloving?
Quote from: curved on February 04, 2019, 05:02:46 PM
I know Dr. Eid believes the implant alone can straighten the penis quite a bit but was curious if others had any familiarity with either these docs or this technique? Thanks.
Correction: Dr Eid does not believe the implant alone can straighten a curve, he does it on a very regular basis and documents the results. There is no debate or room for opinion on whether he straightens severe curves.
Many doctors (not all) claim to use the "No touch teqnique" but in fact use a very degraded imitation of that technique and have much higher infection rates.
Also keep in mind that Dr. Eid does routinely use incision and molding. It is in many surgical notes including mine and my curve was very minor. He can often do the incisions at the base through the scrotal incision and does not deglove.
From watching Dr Eid videos, he breaks up the scar tissue when he opens up the cavities for the implant.
Guessing its the same technique as Drs. Hakki, without degloving would think its the only way to do it.
Hawk--- just want to make sure I understand your point on this:
"Correction: Dr Eid does not believe the implant alone can straighten a curve, he does it on a very regular basis and documents the results. There is no debate or room for opinion on whether he straightens severe curves."
In conjunction with the implant Dr Eid will employ molding and or incisions to straighten the penis to an acceptable curve (e.g. <30 degrees)? I didn't realize he was also using molding/incisions. My bad for not having that critical clarification and appreciate the additional info. After I posted yesterday I did reach out to his office to ask about the scratch technique. As usual he was quick to reply and said he was familiar with it and would utilize it on me if necessary but didn't think it would be.
I did get finalization of scheduling for my surgery for late March and will provide detail in my implant journal as appropriate.
I think we are walking all over Tony's journal here. I will post this response to curved but this needs to be split off into its own topic.
Curved, here is an excerpt from Dr. Eid's surgical notes for my surgery:
e) CORRECTION OF PENILE ANGULATION:
Examination of the penis with the cylinders fully inflated revealed the presence of a mild curvature to the dorsum. The area of deformity was determined to be proximal near the base of the penis. Using a combination of superficial incisions and blunt remodeling of the tunica albuginea, the defect is corrected. Further dissection was done to expose the tunica albuginea on the side of the penile shaft near the base of the penis. A series of small parallel excisions were made at the level of the corporotomy, and the resulting defect was closed with a running 3-0 PDS suture. An erection was induced again to test the adequacy of the repair. Marked improvement of the shape of the penile shaft was noted. The cylinders were deflated and then reinflated and the patient's penis was reexamined. The correction of the angulation accomplished, we turned our attention to the next part of the procedure.
Would the individual then have stitches on the shaft where the tunica was exposed?
As I understand it the incisions on the tunica would not have stitches because that would defeat the purpose of the incisions which is to relax the scar tissue. In my case at least there were also no stitches in the skin other than the vertical scrotal incision which was large enough to give access to the base area if the penis that needed the incisions. I don't even have a slight trace of a scar at this point. I was however more sore on the one side of the base of my penis after surgery.
I will present a couple of questions to Dr. Eid about this issue and report back to the forum.
there are carvertomes specifically made for this purpose. I think they have merit in their use. I do not have a picture at hand but they look very much like a wood rasp. Next month will be 2 years in on my implant and I do not think that manual manipulation along with a Titan alone can handle the toughest scar tissue. Dr. Kramer told me he had considered inflating me to 100% after surgery but "thought the pain would be cruel". On afterthought now I think with a good roughing up of scar tissue, that would have made perfect sense for an exacting straight dick.
Figured out w cialis or viagra my glans has full engorgement and girth rounds out due to engourgement of corpus spongiosum. Now almost at original 6.75". Sensitivity has returned and now can usually easily orgasm. Someone asked for updated pics, so if interested see: https://www.peyroniesforum.net/index.php/topic,10616.msg100640.html#msg100640
Man... I've seen the pictures... Such a dramatic improvement! Congrats, I am stunned! I would never say you had surgery just by looking at the last picture!! :o amazing how you have no bulges or humps. Did you regained some length, or you basically maintained?
Before surgery I regained lost length from peyronies by VED, traction & supplements. Post surgery now—no lost length from presurgery.
Very nice Tony! glad I followed your success story. Here's hoping it lasts you a long time till your revision! 8)
Hey Tony! I was thinking the other day in your situation. Now that a good amount of time has passed and you are fully healed, what do you have to say about your penis? Pre peyronies VS implant? How about the bulge post full deflation vs how it used to be?
Hello pfract, I'm quite happy with my post surgery dick. It's close to my pre-peyronies state and 1000% better than with peyronies. The hang has lessened, and therefore the bulge but certainly a shower rather than grower. Pics here: https://www.peyroniesforum.net/index.php?topic=10616.msg107716#msg107716
PS, pics show deflated but also, with 1-2 pumps as that's where I tend to have it which minimizes the dog ears.
Nice!!! :)
Hey... I'm thinking... Would you have any issues tucking your penis sideways like at a 65/70 angle to the left on your boxers? Flaccid, I mean. Or it tries to stay straight on all the time unless you tug it to whatever side you feel like?
It looks perfect Tony. Give it a few more months and the dog ears will be no issue any more. I think a couple of pumps like you are doing helps condition your implant and weenie so they stay smooth over time. Cheers man. Great outcome and posts.
Thxs alibaba.
Pfract, I usually wear it to the left side at 10-11 O'clock or up at 12 O'clock.
New development.
Dr Karpman placed my tips nicely uniform and high in the glans. Now, after full healing one has shifted down lower than the other. Anyone ever heard of this happening? I'll give him a call tomorrow of course.
Hey Tony! You meant Dr Karpman?I only heard and read about erosion through the glans. Is it possible that with cycling you have regained some size and that caused the area at the perineum to become looser? Do you have any pain or discomfort? How do you feel about emailing Dr Kramer in Baltimore about this?
Oops, I incorrectly said kramer rather than Karpman. I'll call him tomorrow. Can't understand why the size may have changed only for one side.
I've read a little more and apparently this can happen if a bit of curve returns and can be remedied by adding a RTE.
Has it returned tho?
I have no real input on this but wish you the best and am very interested in your updates.
Does it seem problematic at all in either feel, sensation, pain, or aesthetics?
Not really, just a bit disconcerting...
Quote from: TonySa on April 21, 2019, 10:06:23 PM
I've read a little more and apparently this can happen if a bit of curve returns and can be remedied by adding a RTE.
I have read the same. I have a left curve and my left cylinder tip withdraws down to glans level when deflated. It feels to me the withdrawal goes all the way down to tubing exit level. When I start pumping it back up, it feel like the crunching I feel and shift that starts to push the tip back is at the tubing exit from the cavernosa level. Do you feel a crunch when yours moves back in place?
It doesn't seem to move back in place, but I'll check again tonight.
What happened with this issue?
Well, one tip is lower than the other...it's not creating any problems so I'm ok w it.
Update 10 months post up.
Post surgery and after regular daily cycling my inflated BPE length is 6.5". I have definitely regained all my pre-peyronies length.
Another happy implantee! Very nice to know Tony. 8)
Great news Tony. You have an AMS CX right?
Yes, AMS CX due to peyronies (more rigid than LX).
Great news Tony. Glad you went to a reputable doctor. The CX was the right decision and sometimes on revision, people are able to go to the LGX if things remain straight and they need more girth.
For others wondering why the CX; it is more rigid and has limited expansion. The LGX expands in 2 directions but being so, imagine a balloon deflated. Wrap some tape or your hand around the middle of the deflated balloon, then inflate it. It will inflate on each side of the tape but the tape section will still be skinny. That is what the scar tissue does when you have a pinched penis section or Peyronies on one side. The CX has a more rigid and controlled inflation profile to deal with this situation. Cheers all and again Tony, I am thrilled you have regained your length. Nesbit and such procedures just add to the scar profile if you ever need an implant and shorten.
A bit of a set back. The pump is apparently somewhat defective. After 5 minutes or so of use I need to add 3-5 pumps to return to max inflation. Apparently with pressure there's some back flow. I'm looking of having it replaced w a Titan for a few reasons. It's more rigid and w intercourse I've always found it not quite stiff enough, a smaller pump, and cylinders that round out more. Will keep all posted.
Ah sorry to hear this, Tony. A hassle and inconvenience you could no doubt do without. When are you talking?
Tony, sorry to read about the problems you are having. I can't imagine what you are going through. I feel hopeful for you that options for you will give you a better life. So sorry, but at least their is an opportunity to improve things. Stay in touch and prayers are coming your way.
StepOne
Sorry to hear about the new developments. I hope you find a solution soon that suits you.
Thanks all, Dr Karpman is seeking insurance approval for the revision surgery. I'm quite hopeful and encouraged recovery will be much quicker as I will not need the degloving, excision and grafting as before. I'll keep you posted. Thank goddess for the miracles of modern medicine and that I have good insurance 😊
Good luck my friend. Since the actual implant has a life-time warranty for the device is there and issue with going with asking your insurance to pay for a different brand?
I hope not, but will let you know once I hear.
It's very sad to read the new updates on your story tony. Hopefully it goes much smoother now once you get your revision. You will also be like Alibaba, that had the two implants installed.
Is it out of the question to travel to see either Dr. Kramer or Dr. Eid? i know you are confident with your doctor, but i wondered for a little bit.
I'd go to Dr Eid if he was I my insurance plan but he's not. I view Dr Karpman and Dr Karpman as comparable.
He has no problems installing a Titan on you?
No, I explained I was disillusioned w AMS given pump problem. He'll do the Titan, but guys will essentially have to explain it's all their interested in. I understand Dr Kramer also prefers AMS.
Insurance denied the authorization for revision surgery, but after two weeks and a dozen phone calls to multiple people they overturned the denial. Always appeal all insurance denials vigorously, and reach out for help if needed 😎
Sounds like a great Christmas present Tony! Happy for you! 8)
Great news and you are correct ALWAYS appeal and fight for your coverage.
Stabler
Tony, so happy for you.
I know it's tough to appeal for help.
Some insurance companies aren't even familiar with penis implants.
If one of the major news stations posted a 3 minute segment on penis implants, not only would a lot of men that suffer because of poorly trained urologists find hope, but insurance companies might be forced to comply a little more.
Best wishes and stay in touch.
I will pray for you buddy.
StepOne