Peyronies Society Forums

Peyronies Disease TREATMENT Discussion Boards => Surgery for Peyronie's Disease => Topic started by: Jonbinspain on September 15, 2015, 04:07:58 AM

Title: It looks like surgery is my only option left.
Post by: Jonbinspain on September 15, 2015, 04:07:58 AM
I've had this damn disease for around 4-5 years now. I've tried anything and everything. All the oral meds, including Pentox. Traction, VED, topical applications. If you've read about it here, there's a good chance I've tried it. Nothing, but nothing will get rid of this curvature.

I have improved my own, and my penile health substantially and at the age of 66, I have no ED problems and can get a good erection. And sensitivity has been much improved. Problem is it's so damn bent that it's only usable in certain positions.

So, surgery it will have to be. I've narrowed it down to two options. Dr Kuehaas, who I saw last week, with his Egydio technique, or Dr Pallantzas at The German Centre of Urology. If anybody has any experience of these two, differences in technique, opinions etc, please let me have them.
Title: Re: It looks like surgery is my only option left.
Post by: SunSeeker on September 16, 2015, 04:00:13 AM
Hi,

I was in the same dilemma. Went with Dr Kuehhas in International Andrology London. Best decision of my life.

I was contacted by a few more people who did the same. There was a relevant post, which I can't find now (I am really bad at using the functionalities of this forum).

Anyways, I didn't know pallatzas but there is so many patients in here that went to the London clinic with very positive experiences that I would not risk goin sowmhwr else.

If you need more info contact me.
Title: Re: It looks like surgery is my only option left.
Post by: Pfract on September 16, 2015, 07:12:12 AM
I would second that sunseeker. Sort of the more people go there, the more feedback we might have encouraging others which will also benefit from excellent care. Who knows if this forum will start a new trend?
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on September 17, 2015, 01:11:48 PM
SunSeeker;

I sent you a p.m.
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on November 20, 2015, 01:29:10 AM
Well, the time is almost upon me. My appointment for surgery with Dr Kuehhas is Tuesday 24th Nov.

I'm a little nervous about this, but excited about hopefully having my 'old' penis back.

I think and hope that I've made the right choice of Doctor and of technique. I'll report back after my surgery.
Title: Re: It looks like surgery is my only option left.
Post by: J-A on November 20, 2015, 07:47:43 AM
Good luck Jonbinspain


You are in good hands, please update us with your progress as you go.

I had my 4 month post op last sunday, very pleased all is going nicely.

Nerves are to be expected.


J-A
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on November 20, 2015, 06:10:47 PM
Cheers J-A

Tell me, did they use general anesthetic on you for your surgery?  It's been suggested to me, and I wondered why they thought it necessary?
Title: Re: It looks like surgery is my only option left.
Post by: LWillisjr on November 20, 2015, 09:24:42 PM
I don't think a local lasts long enough. If they are suggesting it I would take it.
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on November 21, 2015, 02:32:06 AM
Here, in Spain, they very rarely use general anesthetic for surgery below the waist. My wife had a hysterectomy under epidural, as did my friend for a hip replacement.
Title: Re: It looks like surgery is my only option left.
Post by: kuaka on November 21, 2015, 09:28:35 AM
local anesthesia is safer, as you are conscious and can communicate with the surgeon during the procedure.  Sometimes that feedback is important.

General anesthesia is a combination of paralytic, pain killer and knock out.  If you are paralyzed and not sufficiently pain killed you can experience significant pain while "under" and be unable to communicate such.  It is a balancing act. 

Local anesthesia avoids such issues.
Title: Re: It looks like surgery is my only option left.
Post by: J-A on November 22, 2015, 07:55:56 AM


Tell me, did they use general anesthetic on you for your surgery?  It's been suggested to me, and I wondered why they thought it necessary?
[/quote]

Oh yes most definately.

If you are having the grafting proceedure you WANT a GA.

I have a strong stomach but not sure how I would be with the de gloving bit let alone anything else.

Have a sleep wake up all fixed is my advice
Title: Re: It looks like surgery is my only option left.
Post by: kuaka on November 22, 2015, 08:20:26 AM
To each his own.  I've had my testicles worked on three times, all under local.  I went under for a right knee ligament reconstruction, but it was extremely important that I not move one little bit for that delicate operation.  Come to think of it, the same may be true of having my penis cut on.  :)
Title: Re: It looks like surgery is my only option left.
Post by: thepaul on November 22, 2015, 01:43:46 PM
Good god, the only way to go is general. Anyway, that's how they'll do it in London. You've made the right decision doing to Kuehhas. You'll be just fine and back to form soon.

You can follow my whole experience there by reading my posts in this thread: My surgery experience at the London Andrology Clinic - Peyronies Society Forums (https://www.peyroniesforum.net/index.php/topic,6640.0.html)
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on November 24, 2015, 02:16:01 PM
Early update;

Surgery done today - it took 2hrs 20mins according to Dr Kuehhas

Apparently, using the geometric principles involved with the Egydio technique, I had an almost 90 degree dorsal curve. It didn't look quite that bad to me, but that's what they measured it at with an enforced erection.

The surgery was completed using a double Y incision on the tunica paraurethrally, to isolate the neurovascular bundle and a semi circular incision for the graft.

At the moment, I have virtually no pain.

After the graft was done, another erection was induced. Result, my penis  is is now straight again.

Now just for the recovery phase. Sorry if all this is a tad garbled, I'm still a bit woozy.

I'll post regular updates, but so far, I'm more than delighted.
Title: Re: It looks like surgery is my only option left.
Post by: J-A on November 25, 2015, 09:10:45 AM
Pleased it went well for you.

I too had a severe curve like you described, the surgery photos are on here.

Follow the instructions to the letter and all will be well.

As I have said I am 4 months post op and back to work so to speak. I still use the traction device, get a phallosan forte when you can, it is the most comfortable.

You will get the most comprehensive follow up you have ever experienced.

If I can be of any help PM me I am happy to share my journey with you, either via pm or on the phone

JA
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on November 25, 2015, 11:45:31 AM
Thanks J-A

I've already sent Franklin a couple of questions via whatsapp. I have to send him photos of the head for the next 4 days to check blood supply.
Title: Re: It looks like surgery is my only option left.
Post by: Stabler on November 25, 2015, 07:18:52 PM
Glad to hear surgery went well Jonbinspain. Please keep us updated on recovery.

Stabler67
Title: Re: It looks like surgery is my only option left.
Post by: buscador on December 03, 2015, 04:05:05 PM
Jonbinspain, I hope you can get the best possible improvement!
I have a question:
Do you know what is your graft made of?
thanks
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on December 04, 2015, 02:02:51 AM
Hola Buscador;

The graft is made from Bovine pericard, which I believe comes from the tissue surrounding a cow's heart. It has been widely used in human heart surgery for some time now.

After two weeks I must begin stretching this new graft. Firstly with my hands, and then 4 weeks after surgery I have to use  traction device for 1-3 hours a day for several months.
Title: Re: It looks like surgery is my only option left.
Post by: J-A on December 06, 2015, 05:47:57 AM
How s it going fella ?
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on December 06, 2015, 11:47:13 AM
Hi J-A;

Good, thanks man. Still in daily contact with Franklin. Bandages came off yesterday ( 3 days ahead of schedule) but I've healed quicker than expected.

Still pretty sore, especially around the head. But partial erections are starting to come back - which is a very good sign! 

Manual stretching and Cialis starts on Wednesday morning. Still a long way to go, but so far I'm very pleased, and the level of care and attention from Franklin is something I've never experienced before. He's even called me 3-4 times to give advice.
Title: Re: It looks like surgery is my only option left.
Post by: Pfract on December 06, 2015, 12:26:01 PM
Que bueno! :-D Hope all goes well with your recovery and i can't even imagine the piece of mind such an aftercare should provide. Keep us posted!
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on December 06, 2015, 02:49:43 PM
Gracias pfract;

De verdad, Dr Kuehhas has given me a level of aftercare and reassurance that is rare indeed. In my experience, anyway.
Title: Re: It looks like surgery is my only option left.
Post by: Frank55 on December 19, 2015, 08:06:19 AM
Jon,

They did use a general anesthetic, right? And the procedure was outpatient (you went home that night?)

Just curious. Based on your other posts, I think you did a smart job looking into the "softer" treatment options prior to taking this step, but it was time.

Hope your recovery continues to proceed smoothly. I'll bet the results are a huge relief after your long bout with this disease.

Best,
Frank
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on December 19, 2015, 10:18:05 AM
Frank;

Many thanks. Yes, like most of us I wanted to avoid surgery, if possible, and so tried everything else first. In my case, none of it worked in terms of eliminating, or even reducing the degree of curvature.

Yes, a general anesthetic was administered. The surgeon wants you completely immobile. It's very precise surgery and if you were to move even slightly whilst the surgery was taking place the consequences could be dire!  And yes, I was allowed to go back to my hotel that evening.

I'm still in the recovery stage and have many weeks of traction to go through, but at this stage everything seems to have gone to plan and I'm delighted! I'll post updates as I go along.
Title: Re: It looks like surgery is my only option left.
Post by: Frank55 on December 20, 2015, 11:48:09 AM
Jon,

Couple of other questions. Is the post-surgery traction solely to restore some/all of the length? Or is that also for straightening? How long will you have to use traction? It sounds like you found a very good doctor, by the way.

Also, to what extent did your health insurance cover this procedure? What was your out of pocket expense?

I'm asking because I may eventually be looking at surgery as well. I'm probably going to give Xiaflex a try (Dr. office is now "pinging" my insurance to see if they'll approve that), but that is obviously not a sure thing. The posted reviews for Xiaflex treatment range from rave to useless (no result.) So the results could go either way.

The good news is my ultrasound did not show calcification. As you pointed out in a previous post, that may be the key variable as to the "softer" treatment options actually working/not working.

Thanks,
Frank
Title: Re: It looks like surgery is my only option left.
Post by: gringoviajero on December 20, 2015, 11:54:27 AM
I neither have calcification, nor even hard plaque.  I had thought this to be an advantage.  20 days post first injection with no obvious improvement, I'm now doubtful.  It seems with some of these hard-plaque guys, the Xiaflex softened or even broke the plaque enough to show improvement.  My soft plaque covers nearly the entire side of my penis.  I'm becoming pesimistic that the drug can cover enough ground, i.e. penetrate enough tissue, to make a difference.
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on December 20, 2015, 12:42:06 PM
Frank;

The traction is to stretch the grafted tissue. My penis is already straight, but the new tissue needs stretching to get back my old size. Traction, usually, is daily for around 3 months. Dr Kuehhas informed me that eventually my own tunica will grow back over the grafted tissue.

There is such a thing as private health insurance here in Spain, and in the Uk. Although, for most general treatment we have an excellent public healthcare system, which is free apart from prescription costs. Because this was highly specialised surgery - Dr Kuehhas is one of only two or three surgeons in the world that I know of who is skilled in this technique - I had to pay from my own pocket. Not cheap, but if you want the best, you pay for it. I may be wrong, but the only surgeon I know of who can perform the technique in the U.S. May be Dr Levine in California. I may be mistaken on this, however.

I investigated Xiaflex with the Doctor as he also treats with it too. He informed me right from the start that there was no guarantee that Xialflex would work at all, and that if it did the max improvement I could expect was 30%. His view of Pentox is that it may be of help in the active stage, but that once you are in the chronic phase, that it will not be of much use. I can't argue with that assessment as I tried it myself for 2 years with no improvement in my curvature.
Title: Re: It looks like surgery is my only option left.
Post by: Frank55 on December 21, 2015, 06:35:23 AM
Thanks Jon. By the way, I think Dr. Levine is based in Chicago. Unless there is another Dr. Levine. Dr. Laurence Levine is the one often quoted on this forum regarding treatments (particularly traction.) But I did notice a Dr. Sari Levine in CA on a Google search result. Is that who you mean?

Xiaflex does seem to be a hit or miss proposition. Gringoviajero, I think you are correct that is the placement/length of the plaque in your case that is making the Xiaflex treatment less effective. It may be that Xiaflex is more effectual when the plaque is more concentrated in one spot. Just a guess. Like I said, reported Xiaflex results are all over the place.
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on December 21, 2015, 08:39:36 AM
Frank;

I think,you're probably right. It's Dr Levine in Chicago. If I'm mistaken and it's not him, I'm sure he would know of any surgeons in the US performing this type of surgery.
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on December 22, 2015, 11:02:37 AM
Well, 4 weeks today since my surgery. I'm healing nicely although under  the head is still somewhat sore from where the incision was made.

I start today with the Phallosan Forte, which I have to say isn't the easiest thing to set up,or to get used to using. It's also uncomfortable on my sore penis head. Anyway, I'll try to persevere with it. I'm also allowed to use my VED with caution. It's all about stretching the new, grafted tissue - but carefully, and bit by bit.

I am now getting around two thirds erections, and they're perfectly straight!  Obviously, the new tissue is going to require lots more stretching before I will be back to full erection size. But, I seem to be getting there.
Title: Re: It looks like surgery is my only option left.
Post by: kuaka on December 22, 2015, 11:10:16 AM
Thanks for the update.  It looks like you are on your way.  :)
Title: Re: It looks like surgery is my only option left.
Post by: J-A on December 22, 2015, 05:10:26 PM
Jonbinspain use the largest bell on the Phallosan Forte. You ll get used to it, im 5 months post op using it at least 1 hr a day and Im almost back to full length
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on December 22, 2015, 05:36:39 PM
Hi J-A

Thanks man. I already figured that one out. I tried the medium and it almost killed me!  However, I still feel that the device has major flaws and is unnecessarily complicated to use. Plus the vacuum in the bell doesn't hold very well, I have to top it up every 20-30 mins. I'm actually wondering whether my VED wouldn't do a better job!
Title: Re: It looks like surgery is my only option left.
Post by: J-A on December 24, 2015, 04:47:10 AM
Persevere with it. the way i do it is to pull the sleeve back over the bell, retract foreskin and push my penis right to the top of the bell. then give the plunger a couple of pumps to get the suction going then roll down the sleeve.

Your VED will not give you the correct stretch and also you cannot use it for as long. I found the VED quite uncomfortable when I tried it. The reason for stretching is to encourage your cells growing over the graft to give you back your length.

In the beginning the bell hurt the glands but you do get used to it, ive stopped using the funny little cap thing, plus in the early days remember that the nerves are growing back
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on December 24, 2015, 07:55:50 AM
I'm more getting the hang of it now. I'm quite big, especially girth wise and as the head is stil a bit swollen I sometimes have trouble fitting into the large bell. I have to be completely flaccid or it just won't go. Even then. It's a tight fit.

The other problems seems to be holding the mini vacuum. I have to top up every 20-30 mins. And the hook mechanism that fits on the bell quite often comes away. Then I have to take it off, try to relocate that piece and start all over again.

I think the VED is better in some aye as it stretched the penis in all directions, no just length ways. But yes, you obviously can't use it for as long. At the moment I'm just doing 10 mins a day. A very cautious ten minutes, at that!
Title: Re: It looks like surgery is my only option left.
Post by: Frank55 on December 27, 2015, 12:56:04 PM
Jon,

Pleased to hear of your continued progress. I think your doctor was right to bypass Xiaflex in your case. It seems there is mounting evidence that once calcification has taken place, that treatment is less effectual. Some of the urologist sites are mentioning that now, like this one:

Xiaflex - Patient Selection - Peyronie's Disease (http://www.newyorkurologyspecialists.com/peyronies/xiaflex/xiaflex-patient-selection/)

Of course, there is no guarantee Xiaflex will work even when calcification has not taken place. That is the "thought of concern" when one considers that treatment, as I am. That is one huge benefit of taking the surgical step - provided the procedure is done properly, there is a very high probability of success. Almost all the other approaches seem to be hit or miss.

Couple of other questions. What type of procedure did you have done? I've seen several different names/labels for penile surgery. Also, did your Doctor expect the procedure to have any permanent length impact? Or does he expect you to get it all back eventually (assuming you do the traction as requested?)

Let me know - thanks. Unfortunately, I don't have as much length to spare as it sounds like you do. Worries me a bit about the surgical option.
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on December 27, 2015, 03:50:44 PM
Frank;
Avoid plication, or Nesbitt procedure. IMO, it's surgery from the dark ages of Peyronies surgery.

The technique I underwent was called 'Stage' surgery. It was developed by Dr's Egydio & Kuehhas. There should be virtually no loss of length or size as the surgery works on geometric principles to straighten the penis by surgery to the affected area, not by shortening the unaffected area to achieve the same aim.
Title: Re: It looks like surgery is my only option left.
Post by: Justiciero on December 28, 2015, 01:05:34 PM
Hello thank Jon first time and clarify details in his surgery.

EP am 40 years old and over 'm thinking of going down the road of the implant. Here in Spain there are few surgeons with experience in this field and to travel to the US is expensive and tired.

Recommend this center and doctor for the implant procedure ? also mention that my level of English is very low. Thank you for the excellent work and posted the best recoveries . Cheers
Title: Re: It looks like surgery is my only option left.
Post by: Frank55 on December 29, 2015, 07:40:55 PM
Jon,

Thanks for the info. To where did you travel to have your surgery done? And how long did you stay there after the procedure was completed?

The thought of travel just after such an event is not appealing. But I'd imagine you accounted for that.

Frank
Title: Re: It looks like surgery is my only option left.
Post by: LWillisjr on December 29, 2015, 07:44:11 PM
Frank55,
A lot depends on the surgeon and the specific procedure being used. Mine was outpatient surgery with Dr. Levine. Surgery in the morning, and home later that afternoon. But I personally know some of Levine's other patients who flew in for the surgery the night before, had the surgery the following morning, spent the night in recovery, and then flew home the following day.
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on December 30, 2015, 01:34:45 AM
Frank 55;

As with L Willis, my surgery was around 10.30 am. I was back in my hotel by 6 pm.

Justiciero;

My surgery was at The London Andrology Centre. My surgeon was Dr Franklin Kuehhas. I believe he also handles implant surgery, if there is no other option.

The doctor can speak Spanish, and his patient coordinator, Giulio Conte is Italian. I'm sure you can communicate with him also.
Title: Re: It looks like surgery is my only option left.
Post by: Frank55 on December 30, 2015, 05:41:20 AM
Thanks both Jon and LWillis. Interesting info as I consider my options.

LWillis, does Dr. Levine perform the type of surgery (Stage) that Jon is talking about? I looked at his web site and I'm not sure.

Jon, did you stick around London (to have access to the Doctor just in case) for a period after the procedure? Or did you go home the next day?

Thanks,
Frank
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on December 30, 2015, 08:22:02 AM
Frank;
Yes, I had to go back for a follow up appointment the next day. After that, the doctor and I were, and still are, in contact through whatsapp. I can ask him anything I'm concerned about, send pictures, etc. He always responds within hours. I have another follow up appointment at the clinic shortly.

I have to say that his aftercare service is second to none, IMO.
Title: Re: It looks like surgery is my only option left.
Post by: LWillisjr on December 30, 2015, 06:42:47 PM
I had excision and grafting which is different. I am not sure if in other scenarios that he would use the Stage procedure.
Title: Re: It looks like surgery is my only option left.
Post by: Frank55 on December 30, 2015, 07:51:11 PM
LWillis and Jon,

Thanks again for taking the time to answer all of these questions. I hope you'll be patient with me, as each answer seems to lead to another question.

Jon, did you have to get a referral of any sort to get the procedure done? What I mean is, the urologist web sites often say "surgery is only done for serious cases", or something along those lines. I think I'm still in the acute phase, and I don't know if they prefer to wait until the subsequent phase (what is it called - chronic?) prior to surgery.

So I'm wondering if it was only your call to proceed, or did you need another Doctor to say "we've tried the other procedures and they didn't work." I'm guessing it was your call, but wondering about that.

By the way, I'd be in the same boat regarding the procedure cost if it was done in the UK. I have US health insurance through United Healthcare, but seriously doubt they would contribute. Even if I had it done in the US I'd still have a substantial co-pay. But I may bite the bullet anyway. I'm lucky to have the means to do it.

Sorry to keep asking so many questions, but the more I learn about Xiaflex the more skeptical I become. I'm not interested in a partial solution. And that may very well be all that approach would deliver. I can envision getting six months into the time/expense/hassle associated with Xiaflex and having little to show for it in terms of improvement.

LWillis, I'm still wondering if Levine does the Stage procedure at all. It sounds like Egydio and Kuehhas may be in a very small group of physicians performing it. If it has less length impact, that is an important benefit in my case. I don't have a lot to spare.
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on December 31, 2015, 02:01:38 AM
Frank;

In my case I had calcified plaque and a curvature not far from 90 degrees, at its worst point. I tried everything. If you've read about it here, and it has any credibility, I probably tried it.

As I put earlier, I improved my own and my penile health substantially. However, the curvature remained unimproved.

I had read about Dr Kuehhas on the site and investigated him thoroughly. I couldn't find anybody with anything negative to say about him. I initially booked an exploratory appointment where an artificial erection was induced, ultrascan done etc. Again, as I posted earlier, his conclusion was that in my case Xiaflex would only give me a max 30% improvement in my curvature, if it worked at all ( there is always a risk that Xiaflex will not work in certain cases. And I had calcification)  He explained the surgical procedure and assured me that it had a more than 90% chance of being successful.

In my case, I elected for the surgery as I felt that I had very little left to lose. I'm delighted to say that it appears to have been successful. Your case may be entirely different.
Title: Re: It looks like surgery is my only option left.
Post by: J-A on December 31, 2015, 06:00:21 AM
I may be wrong but doesn t STAGE surgery shorten the long side ? The operation I had (I thought) was the excision and grafting proceedure known as the Edgyio technique. I though these were different. Be careful with acronyms!!!
Title: Re: It looks like surgery is my only option left.
Post by: Frank55 on December 31, 2015, 06:58:57 AM
Thanks Jon. Pleased to hear of your continued progress.

Regarding the post operative service, I think the old saying of you get what you pay for applies. The urologists I've seen here in the States are generally rushed and usually seem to be in a hurry to conclude an appointment. I can't imagine their post operative service would be much better. Even getting a message through to their nurses is a chore.
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on December 31, 2015, 10:51:42 AM
J-A

Yes, I think you're right. My mistake! 

The Stage technique, although very similar to the Egydio technique, is for congenital curvature. The two techniques are very similar, although as congenital curvature doesn't require any graft, it can involve a very minimal shortening.
Title: Re: It looks like surgery is my only option left.
Post by: LWillisjr on December 31, 2015, 11:11:08 AM
Quote from: J-A on December 31, 2015, 06:00:21 AM
I may be wrong but doesn t STAGE surgery shorten the long side ? The operation I had (I thought) was the excision and grafting proceedure known as the Edgyio technique. I though these were different. Be careful with acronyms!!!

Yes you must be absolutely careful with surgical procedures. Even surgeons have their own variations of these. And you are actually referring to 3 different procedures. When I get a chance I will update these descriptions on the surgery FAQ's section.

Quote from: Jonbinspain on December 31, 2015, 10:51:42 AM
The Stage technique, although very similar to the Egydio technique, is for congenital curvature. The two techniques are very similar, although as congenital curvature doesn't require any graft, it can involve a very minimal shortening.

Jonbinspain.....   Stage Technique is for Peyronies correction. See the link below.


Excision and grafting - Scar tissue on the short side is REMOVED and graft material put in its place. various graft materials  are used from synthetic to natural.

STAGE techinique - Similar to excision but multiple elliptical incisions are made only on the exterior of the Tunica on the short side. Grafting is not required. Their is a description in a post here....   https://www.peyroniesforum.net/index.php?topic=5444.0 (https://www.peyroniesforum.net/index.php?topic=5444.0)

Egydio Technique - I haven't researched this much yet. But there is a short descritpion on their web site. It sounds like a modification of the STAGE technique to me.   http://www.acpct.com/#!egydio-technique-peyronies/c1zre (http://www.acpct.com/#!egydio-technique-peyronies/c1zre)

But I do want to make a couple of points here.
1. There are different techniques for different reasons. Even the ACPCT states the the Egydio Technique is one of everal they offer. Some techniques are newer but it is incorrect to state that one single technique is better than the others. Each person's severity and direction of curvature must be considered for the proper technique.

2. No procedure guarantees restoration of length. I know of examples of all these procedures where none to partial length is restored. While all the above procedures address relieving the plaque/scarring on the short side, they tend to restore length but no surgeon can guarantee complete restoration.
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on December 31, 2015, 11:36:47 AM
L. Willis;

Not according to this. ACPCT Center - Treatment of Curved and Bent Penis (http://www.acpct.com/#)!stage-technique-curved-penis/c1qiu

It appears that they both involve micro incisions in the outer layer of the tunica based on geometric principles, but with the Egydio technique, which is specifically for the treatment of Peyronies, the incisions are made in the plaque and then covered with a graft before stitching.

Reading further, it seems that the difference is that The Stage technique involves incision in the long side to straighten the penis. The Egydio technique is incision of the short side ( sometimes with excision of plaque ) and grafting to cover the affected areas.

The Stage technique appears to be a much more advanced version of The Nesbitt technique.
Title: Re: It looks like surgery is my only option left.
Post by: LWillisjr on January 01, 2016, 02:10:47 PM
Quote from: Jonbinspain on December 31, 2015, 11:36:47 AM
The Stage technique appears to be a much more advanced version of The Nesbitt technique.

I agree, thanks.
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on January 01, 2016, 02:21:07 PM
So, going back to what J-A said earlier, and I agreed with, we both underwent the Egydio technique.

I will check this with Franklin Kuehhas, but I believe that this is the preferred method of treating Peyronies, not the Stage technique, which is primarily used for congenital penile curvature.
Title: Re: It looks like surgery is my only option left.
Post by: gayguy on January 03, 2016, 06:31:48 PM
Hello Jon, thank you for some great reporting.  I am going for the same egydio procedure as you but here in Amsterdam next week. No talk at all about stretching here. All my doctor says is that after the procedure i need start having sex asap and that will do. Well i am not so sure.The stretching after a month with the Phallosan i understand but could you please explain to me as graphically as possible what the manual stretching is all about or otherwise where i could read about it. I do want to have a  well informed talk with my doctor about it too.
Title: Re: It looks like surgery is my only option left.
Post by: itsme on January 03, 2016, 09:38:10 PM
I didnt do the surgery. Egydio told me to keep with pentox n vit e n add colchicine 2 mg. If u raise the colchicine slowly in two weeks u ll not have diarrea. Stratching it with hands five minutes six times in a day. But I never heard about stretching after Egydios procedure on his testimonials. Its a lot of them. Maybe thirty or more. But maybe he request that. I just said I never heard. My stratching is with hands. Pushing the dick head. It was hard to learn lol. I put something under my arm to not get tired n just push it. Being carefull to not strech it too much.
Title: Re: It looks like surgery is my only option left.
Post by: yyy on January 03, 2016, 10:26:43 PM
LW

Stage technique is made by EXCISIONS, small and elliptical. Not Incisions, which is typical of a plication surgery
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on January 04, 2016, 01:43:58 AM
Gay guy;

Good luck with trying to have sex after this surgery!  You're gonna be sore, man!  I was in bandages for almost 10 days. No sex for at least 6 weeks is what I was told.

Re the traction. Apparently it's to stretch the new grafted tissue. It can retract if no stretching is done. The gentle manual stretching I was told to start after 2 weeks. Traction after 4 weeks.
Title: Re: It looks like surgery is my only option left.
Post by: yyy on January 04, 2016, 10:24:45 AM
Gayguy

If I were you I would avoid to have a surgery with a physician advising sex asap.

It's really dangerous! but good luck
Title: Re: It looks like surgery is my only option left.
Post by: gayguy on January 05, 2016, 04:51:55 PM
Well to be fair to the physician sex asap means as soon as possible not immediately after the operation. So i guess as soon as most of the healing has taken place and most of the pain has gone. But the gentle manual stretching to be started after two weeks i can understand and it will continue for about two weeks until the other stretching with the mechanical machine starts. My question is: is there anything to be read on the internet explaining IN DETAIL how the gentle manual stretching phase is to be done or do i just use my imagination.
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on January 05, 2016, 05:24:43 PM
I was told to stretch until it felt uncomfortable but not painful, if that helps. But, be guided by your own surgeon.
Title: Re: It looks like surgery is my only option left.
Post by: Frank55 on January 06, 2016, 06:48:12 AM
Jon,

How are you finding the usage of the Phallosan device? I watched their video and it looks kind of awkward (though I suppose all the traction devices are to an extent.)

The feature that surprised me was the penile positioning when the device is being used. Looks like the stretch goes to the side. I thought a traction device always stretched to the front, if you know what I mean. Looks like that is an incorrect assumption.

Also, how many hours per day are you wearing it? How will you know when you can decrease/eliminate your usage?

Thanks,
Frank
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on January 06, 2016, 07:20:58 AM
Frank;

I'm using it. IMO, it's nowhere near as easy to locate or to wear as claimed. Having said that, it's advantage over the traditional loop or noose type systems is that it doesn't severely restrict blood flow.

At the moment my usage varies. I'm only 6 weeks post surgery and so there is still some pain from the grafted areas, especially when they're being stretched. Some days are easier than others. I usually try to do 5-6 hours a day, even if it's in 1.5-2 hour shifts.

Yes, it is located to the side (either)  it still stretches the tissue through tightening the belt.

It has gotten easier to locate now that I'm more used to it, but it's still uneccessarily fiddly, IMO.

To conclude, it's far from faultless, but for extended daily use its still probably the best bet as you can wear it 4 hrs+ without a break, which you can't do with the traditional devices.
Title: Re: It looks like surgery is my only option left.
Post by: Frank55 on January 07, 2016, 06:32:37 AM
Jon,

Is that how many hours (5-6) the Doctor suggested? I'm asking because I work full time, and probably could not do that many. I'd be more in the 2 - 3 hours per day range.

Despite the more discreet appearance, I doubt I could wear the Phallosan to work. Too distracting.

Think I'm going to book a preliminary consultation (through Skype) with Kuehhas' office, by the way. Just trying to think through the details.
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on January 07, 2016, 07:29:11 AM
Frank;

Supposedly, you can wear it while you sleep. Personally, I wouldn't feel comfortable with that right now. The most I've managed without a break is 3.5 hours. Maybe I'll be able to do more as my healing progresses.

I think they would recommend a minimum of 3 hours daily. Maybe an hour in the morning, two at night?  But, discuss it with Kuehhas if you see him. He's quite open to answer any questions or doubts before you commit to surgery.
Title: Re: It looks like surgery is my only option left.
Post by: LWillisjr on January 08, 2016, 07:10:36 PM
Let's be clear that we are only talking about the Phallosan device. The traditional traction devices should not be worn more than 2 hours at a time.
Title: Re: It looks like surgery is my only option left.
Post by: kuaka on January 10, 2016, 10:52:31 AM
Absolutely.  Any hard physical traction device which anchors with a strap and saddle should NOT be worn more than 2 hours without a break.  Sleeping in such a device is extremely risky too...
Title: Re: It looks like surgery is my only option left.
Post by: Frank55 on January 11, 2016, 07:35:44 PM
Jon,

What were your first few days after the procedure like? Level of discomfort/pain?

Also, when were you able to get back to your regular level of activity? And do you continue to be pleased with the outcome (at least thus far)?

Lot of questions, I know. Thanks again for your patient answers.

Frank
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on January 12, 2016, 01:53:35 AM
Frank;
Pain was minimal. There is discomfort as you're in bandages. I was prescribed strong  painkillers but didn't need them. I just took 500mg paracetamol. The anesthetic stays with you for a few days and I slept quite a bit.

Thus far still pretty pleased. It's taking time to heal and I'm still a bit sore around the head. Aesthetically, you can still see the surgical wound. I will be asking Franklin about these things when I see him in about 10 days. Erections are still dead straight. I haven't got my old size back yet, but I'm getting there.

I haven't taken him for a 'test drive' yet, although I feel as if I could. But then it's still only 7 weeks since surgery, so I'll be a little more patient.

As a postscript, I had a good look underneath the head this morning. There are still tiny scabs on the suture holes, so I guess it's going to still be a bit sensitive.
Title: Re: It looks like surgery is my only option left.
Post by: gayguy on January 13, 2016, 02:04:26 PM
So today was Day 1, the day i had the egydio procedure done here in Amsterdam with prof Meuleman. I first noticed a pea shaped painless nodule in my dick in the summer/august of 2014 which had grown to be larger painful/ and nasty 'shape shifting' 75 degree alien by January 2015 and a painless but none the less stable awkward thing by the end of May 2015 . The crew in the hospital was ever so sweet. The procedure started at 10 am and was finished by 12.30pm. I was the second one to be done that day and I think a third person was due after me. Woke up from a relaxed deep sleep all bandaged up with a catheter a warm electric blanket, a cheese sandwich and orange juice feeling great.  Shortly afterwards the doctor came by for a visit and answered my questions which weren't many. At 3pm feeling fine, i was discharged and i left with my brother, the bandages and the catheter to go back home. Tomorrow at 11am i will walk to my GP's office and the GP will permanently remove all of the bandages and the catheter and then i will get my first view. No pain as of yet: 7pm and i haven't touched the pain meds: celecoxib and the paracetamol. Monday i have a talk again with the prof/dr Meuleman to evaluate how things are going. Cheers to you all. I am off to my Brussels sprout dinner.
Title: Re: It looks like surgery is my only option left.
Post by: gayguy on January 14, 2016, 02:38:46 PM
Day 2 Didn't sleep much last night because of the bandage and catheter discomfort. The GP took them off today and now i am free of it all. Early morning erections were very painful for a few minutes but that is all with no further discomfort. My manhood looks very small today not in any way to which i am accustomed. No pain meds for the moment as i prepare to go to bed for the night.
Title: Re: It looks like surgery is my only option left.
Post by: Jonbinspain on January 15, 2016, 02:18:34 AM
Gay guy;

Som pain will come. Mine was tolerable, but you will be feeling the effects of the anasthetic for a few days too.

I was told no exercise for 2 weeks. Bandages stayed on ( these are to prevent post operative swelling) for 10-11 days in my case. Manual stretching when you went to the toilet - to the point of discomfort, but not pain! Stretch 10 times. Traction via Phallosan Forte after 4 weeks. I was also prescribed 5mg of Cialis daily.