can anyone recommend or at least point me in the right direction of finding a surgeon?  doesn't matter where he's located, i just want to find somebody really good.  i don't know even how to go about finding somebody like this, could anyone help me out?

QuoteI curve slightly under 15 degrees left and 20 degrees downward

Why would you even consider surgery?  

Quote from: Liam on August 11, 2007, 03:20:46 PM

QuoteI curve slightly under 15 degrees left and 20 degrees downward

Why would you even consider surgery?  

because i want it to be straight again

any docs?

Good answer.  Have you had a doctor express a willingness to do surgery?

QuoteI have between a 5 and 10 curvature to the left and about 20 degree slope downward.  it doesn't curve down, but it points in the direction of the floor.

It doesn't seem this would prevent you from having sex.  Sometimes the surgery leads to "big time" ED.  Why chance it?    I honestly don't think a surgeon would touch it.  Maybe I'm wrong.

Go see a good doctor like Lue (SF) or Levine (Chicago). We have discussed them before and they are said to be good.

They will probably not operate on you. There is a surgical axiom that you should know about. It says: The enemy of 'good', is "perfect". YOu could have a straight penis when you are done that has no feeling and does not get erect. Other than that, it would be a terrific operation. Oh, and it will be shorter too. Oh, one other thing. If you are like me (I was 21 when I got Peyronie's), it will intermittently get worse in tiny little bits over the next 30 years, so not only could or will you have new bends, but your penis will also (still) be shorter, without feeling and unable to get erect.

Sound good to you? Be ready for a dose of reality when you speak to a doctor (if you ever do).

Tim

Hello again. I promised to keep in touch. As I told you in an earlier post, I had curvature of about 45 degrees. I had plication surgery here in the UK on July 3rd 2007, not having been able to achieve penetration since about October 2004. Well I was sore and uncomfortable for weeks, but we decided to wait until everything was OK. Today I achieved penetration with mutual satisfaction for the first time in nearly three years. We're both very happy with the result. Bend is now about 5 degrees, which is probably within the limits of the normal.

bix

Bix,

That is great news.  Can you share with us who your surgeon was.  Do you know if he has done many of these surgeries.  Any further details would be helpful because we have men both in and out of the UK that are always looking for such information.

Hawk

Hi Hawk,

The surgeon's name is Richard Brough and he is based at Stepping Hill Hospital in Stockport, Cheshire, UK. I believe he also works at the private Alexandra Hospital at Cheadle, Cheshire. I don't know whether he's done many Peyronie's operations, but Stepping Hill's Urology Department has a very good reputation, and all the medical staff, including the nurses, seemed very familiar with the procedure.

bix

WTG Bix!

Thanks for posting the good news.

Thank you bix so much for this information.  This has the potential to be VERY helpful to guys in the EU who are DESPERATELY looking for a doctor with an interest in Peyronies and a skill set to match that interest.  This is yet another ray of light in what can, at times, be a very dark place.  I have one request of you, bix.  Please crosspost this information in the thread titled: Urologists and Other Doctors .  That will make it easier to find for those in the EU who are searching for a doctor.   - George

Hi everyone,

First let me say that after countless months of worry and doctor visits, I was stated to not have Peyronies Disease, but rather something more along the lines of a penile fracture.

       Short version first:  I had corporeal plication surgery earlier this month to correct my curvature.  I am lucky to have been born with an above average penis (7") so lenght loss up to about an inch will not upset me too much.  I am still recovering and erections are getting less painful every day.  I have not masturbated and will not for several more weeks, so actual length loss is not yet known, but I will report that later.  I have 4 permanent nylon sutures on the dorsal side of my penis (2 on each side), and I have developed two pea sized bumps near the head of the penis on either side (kind of a bummer).  Overall my experience has thus far been satisfactory.  I have a straight penis with all of the 30 degrees of sharp curvature resolved.  My doctor has said that this procedure is less applicable to those with Peyronies Disease as length loss is already such a big issue.  But it is common to see it done for those who are not as worried about length loss, whatever their condition may be.  My post today aside from telling my story is to ask about these sutures.  I am only 19, I have another hopefully 50 years of sex ahead of me.  I don't want to have to go through this type of surgery again.  What are my chances of these sutures breaking??  Having read the post below by I think Tree lump, I am really worried.  Any thoughts on this would be really really appreciative, and I would be happy to share any other infomation with anyone regarding my experience thus far.


Now the long version:

When I was about 12 I recall having a falling accident wherein my erect penis immediately lost its rigidity and consequently developed a 30 degree curve downwards.  This is how I remember my penis-- straight shaft at base with sharp 30 degree deviation midway along shaft.  I also have urethra damage (flattened section) and the S shaped penile skin- line on the ventral side.

Growing up I was the only one who knew about my condition.  I didn't even tell my parents about the accident when I was a child, although I recall there being much pain involved-- something I thought was like any other bruise that would heal up and resolve with no consequence.

Around 14 or 15 I realized that my penis was different than that of many others around me.  This was mainly due to-- you guessed it-- pornography.  Imagine a kid at 14 learning that his penis was different than the norm because of a porn flick.

Anyway, very long story a bit shorter, I stumbled upon links to Peyronies Disease when I searched google for curved penis etc.  I was sexually active at 16, and my g/f at the time was just as naive and uneducated in human anatomy.  She would often speak of uncomfortability and pain, etc.  Sexual positions were quite limited and uncomfortable.  All this made me believe I had Peyronies Disease, but shock of being plagued with such a disease at such a young age made me dismiss the idea.

When that relationship went sour, I decided to approach my doctor at Kaiser Permanente-- not as evil as Michael Moore claims-- I was 18 at the time and wanted to know what was going on.  After several observations by many doctors including the veteran urological surgeon (happened to be the guy who did my operation), I was diagnosed with having experienced some sort of penile injury, but for the purposes of my options, was referred to as a congenital case.  I had two options:  To have the penile plication like I did; or to have implants put in on the ventral side to try and straighten me out.

After his advise, I went with plication.  Its been about two weeks since surgery, and pain has just about resolved..just about.  The major risks/outcomes that are unfavorable are, in order of likelihood, penile shortening, suture palpability (being able to feel the knots of the stitches), residual curvature or suture breakage, ED or something like it.  As addressed above, I am not too worried about penile length, although I do have a traction device and would not mind using it if that is ok to do with the permanent sutures in place.  Any thoughts?

The sutures are to embed into the skin and over time be unoticable.  I am getting morning wood, which actually has been an uncommon thing for me.  Now my worry is about the sutures and the likelihood of them breaking.  My doctor has said again and again that it is rare, but reading about Tree Lump I am worried that mine can break too, and I would need another surgery.

Is anyone else going through this?  Again, I did not have Peyronies Disease (no lumps) but did have urethra damage and a sharp downwards curve of the penis of about 30 degrees.

Sorry about such a long post, I have just never done anything like this before.  Forums are new to me.  I wish everyone well with there situations and look forward to responses.

Hey, newbie here.  Found this forum on Google while searching about curves.  Well I have a congenital curve, it's about 40 degrees down and slightly left.  It's slightly rotated too.  I've had a gf for some years and she is the only one I have done anything with, but I want to do things with other girls.  I don't want to discuss relationship issues, I just want to do things with others as well.  I'm hesitant to do things with others and show them my weird member, what about you guys?  It's such an important thing for a guy.  I wouldn't want a girl liking me in spite of that.  I figure if it can be modified then I may as well do it.  It's like if girls would like you in spite of having long hair, you should just cut it so they will like you even more.

It's only been in the last few months that I've realized this curve is really not normal and that something can be done about it.  Also I'm shifting off my family's health insurance plan, and this is a big deal as I don't want to announce I'm having this done.  I'd like to keep it pretty secret even to my gf, I will just surprise her one day.  It's not something we've talked about and she has not been with anyone else.  She is really into me so she doesn't make an issue of it.

How does paying for this work?  Will insurance cover it?  I'm about to go on some student health insurance plan, and I don't have much cash right now to pay for things.  In a few years I'll be working and can pay, but I want to get this done soon.  What's the recovery like too?  Can I make it on my own?  Basically I've been thinking about doing the "Nesbit".  Btw I'm in Ohio, please anyone let me know if you have advice as fixing this would increase my confidence a lot.  I'm a confident and capable person in general, but when it comes to this most would be self-conscious.

Whether you read all that or not, can someone tell me the first step?  Something a little more tangible than research, although I need to do lots of that as well.  Should I schedule a visit with any urologist here?  Or do I need to go through a general doc first?

Videogame,

A urologist is the one to visit.  Her/his office can look up exactly how much it will cost.  Anything anyone here would say about cost would be a guess without knowing exactly what your coverage is.

QuoteI don't want to discuss relationship issues

You said this, but proceeded to give details.  To be honest, your post made me a little sad for your girlfriend.  It seems (maybe i am misreading) you want the surgery so you can cheat on a girlfriend who loves you and is loyal to you.

QuoteI'd like to keep it pretty secret even to my gf, I will just surprise her one day.  It's not something we've talked about and she has not been with anyone else.  She is really into me so she doesn't make an issue of it.

I can't imagine this.  Would you want to be done this way?

Sometimes things don't come across right in print.  Maybe this is the case.  Just be honest with your girlfriend.  It will be good for both of you in the long run.

Good luck!

Dear Videogame,

If you want to do things with other women (nothing wrong with that) than you ought to break up with your girlfriend. Why expose her to risk of disease and the pain of being replaced? Than, you could go ahead and get the surgery without having to tell her either. "Surprising" her would be an understatement - when we lie to people it usually does not go too well.

In reviewing your post, it strikes me as showing a tendency to not think things through very well: cheating on your gf (let's not discuss that, you ask); ignoring the effects of operating on your penis on your relationship with this gf (it does not seem to occur to you that it might make things worse - but I would strongly suggest you consider that possibility); not telling anyone in your family (true - it is embarrassing) but wanting to get it done on your parent's health insurance (it might be a bit difficult to explain the large co-pay for an elective procedure); you have chosen the surgical procedure that is right for you (the Nesbit), but you have not asked yet for the opinion of a surgeon...

So, in answer to your request for a "first step": try honesty.

Try honestly speaking to your girlfriend about your thoughts of other women; be honest to your parents and reveal that you have a possibly deformed penis (though it might not be as deformed as you think, if your gf doesn't seem to even mind it); and try going to a urologist to ask for help.

If all works out, you may end up with a straighter penis that works. Good luck.

Tim

videogame:

Want to add my 2 cents to this discussion. The advice you have been given by the guys is sage in my book. You should consider any and all treatments/therapies before even considering surgery.

I am going to give you a website that you should bring up and go through it very carefully to decide if you have a "deformed penis" or not.

It is:   www.ejacu.com/

This site is not considered pornographic, but it does show some very graphic views of penises in all sizes, shapes and forms. After viewing them, you might decide that you do not have an much problem as you now think.

Good luck to and stop, think, evaluate and the proceed to find a solution. First, get a professional opinion from a Uro qualified in Peyronies Disease.

Old Man

Hello All.  I do wish to say thanks to the many regular contributors to this site. However, im on a quest for information that Im not really getting here. And im not sure if it is possible, but im trying to get a gauge for how often surgery is succesful. If anyone on this site has had a satisfactory ( better than before outcome) i would like to hear from them. Im trying to determine the actual success rate of surgery.

Also...it seems that going to a guy like www.penisdoctor.com  would be a safer bet because of his type of surgery he does.

The majority of urologist choose not to do some of these proceedures.  I think I would trust someone who had a good reputation in the Peyronies Disease field.  Thats just me.  

The PenisDoctor.com may be a great surgeon.

Quote"The American Urological Association, Inc.® (AUA) considers injection of fat cells for increasing penile girth (width) to be a procedure which has not been shown to be safe or effective.

The AUA also considers the cutting of the suspensory ligament of the penis for increasing penile length in adults to be a procedure that has not been shown to be safe or effective."

The fact this warning is on his page tends to discourage me from seeking his services.

Mark this down, Liam and I agree that we would MUCH prefer and trust a renown surgeon of accepted penile surgical procedures that corrects problems that cannot be solved through other means over someone soliciting patients for non-accepted penis enlarging surgery.

Also, there are people that have had surgery that have posted in this topic.  All you have to do is read their accounts.  These are the accounts you have to go on from our membership.  They are what they are.  The vast majority opt to avoid surgery so we will likely never have a large thread of successful surgical stories.

Alright so I take it everyone has read my long account/question below and decided that a response was either not necessary or not available-- I am aware I am asking a rather difficult to answer question to answer as info on my question is not readily available.  Nonetheless, contrary to many of you reading this, I have had surgery, and feel my experience would go in vein if I couldnt at least help someone make an informed decision based on many others experiences, including mine.

Before I give VIDEOGAME my two cents, I want to ask my major question once again.  Its been 3 weeks since corporeal plication surgery.  I am still getting pain w/ erection (mostly nightly) especially at suture sites.  4 sutures to be exact.  Things are lookin good, I'm excited.  But, as of now, it seems I have lost over an inch.  about 1.5.  Yes, 1.5 inches.  But losing so much isn't even my concern.  My concern are these sutures and their durability.  Does anyone have any idea what my chances are for not having to have this type of surgery again due to a ruptured suture???  Also, when these things rupture, what exactly ruptures?  the suture itself?  or the skin it is attached to???

VIDEOGAME-- I am assuming you are young, like me.  I am 19 and had many of the same concerns you mention below.  I too had a long term g/f that loved me like yours seems to love you.  I loved her back.  But, I ended up breaking up with her when I realized that a big reason i was still with her is because I was too uncomfortable/self-conscious with showing myself to any other girls.  That is unfair to her, and I knew I had my own serious problems to resolve.  From what you wrote below, I'm guessing you don't intend to cheat on her.  You just want to be able to have sex with other girls, as in, you really like this girl but you are young like me and want to explore what the world has to offer.  I am assuming you are young-- not sure of this.

Anyway, listen.  Bottom line is you sound like you have had this penis forever-- which means you either were born with it due to an imbalance in size in your penis tissues- crude terminology - or you sustained an injury when you were young- too young to remember? maybe you remember something?.  Do you have any lumps under the skin of your penis?  Does it hurt when erect?  You should see a urologist as soon as possible, but I am guessing that if your answer is no to these two questions then he is going to tell you that this is congenital...  mine did.

I tried non-surgical approaches first.  Jes-extender (aka penis stretching torture devise)-- 4 months-- no results.  Gave up.  Which reminds me-- I have one and wouldn't mind selling it for shipping cost to anyone who wants it-- I know these things are kind of gross second hand, but the quality and precision means that cleaning it and owning one for the cost to ship it would be worth it.  Vitamin E is more intended for individuals with Peyronies Disease, but I was taking it with the best of em.  1200 blah blahs per day.  Exercise exercise exercise-- was alright but kind of hurt after a while, and I was worried I would hurt myself further curving my penis.  So I gave up on non-surgery......

I had surgery that is best described as a modified nesbit-- instead of cutting out ellipse shaped tissue pieces out and then sewing everything up with absorbable stitches (called sutures-- usually cat gut, etc) they don't cut anything out but instead tuck  your tissue together and stitch it up with sutures that don't absorb.  Im not so sure what mine are made of, I said nylon but I actually think it is braided polyester.  Either way, these things are made not to break and they are stategically put in to correct curvature.  You said, down curve and left.  You will be getting at least 3-- 2 on th etop and 1 for the right.  This is at least.  Could be more.  Advantage of this surgery-- it is easy to perform....if a doctor messes up and your penis isn't straight on the operating table, he can correct it before you are sewn back up.... they don't have to mess too much with your nerve bundle which helps to very much limit potential impotency issues.... and you recover relatively quickly with minimal risk of infection.  Disadvantages of this surgery (as compared to classic nesbit)-- you will have permanent sutures in your body which you are likely to at least be able to partly feel, especially at first.... these sutures can break and you may have to have the surgery again, which blows, and which is what my questions are about.

Either way bud, you will be losing length.  I did.  they said average length loss is 2 centimeters.  I lost what seems to be like 3.5-4 cm, which blows.  I have not been able to masturbate or have sex for what seems like forvever (3 weeks now).  This might be why I feel so much smaller, but I probaly have lost all this length... there is always room for hope right??

Anyway here is where I lay down some advice-- as far as not telling your g/f.  That would be idiotic.  You should tell her after reminding her how much you trust her and need her advice here.  I know that if there is one thing I regret its not talkign to my ex about my situation.. I never asked her what it felt like, whether she really disliked it, whether I should get this surgery done or not, etc etc etc... of course, it is hard to trust someone with some really heavy information.  I couldn't so I never did.  But then again im kind of a p~$$%.
As far as your insurance.  I feel you on not telling anyone, your parents too.  I ended up telling my dad at a very placid dinner setting.  I reminded him how important this was to me and that I did not want to involve my mother.  My mother has no idea, its not something I want her to know or really have to deal with.  I wish I didn't have to tell my father, but it would have been too hard to hide a semi-invasive surgery from everyone, and he was the one I felt that I could tell.  As far as insurance costs and stuff go.  i don't know about ohio, but in california, they covered it cept for $100, my parents very excellent co-payment.  What I'm saying is that if you can somehow manage up the confidence to tell your most confident confident, probably one of your parents, you could get away with having this surgery done at next to nothing.

Lastly, I want to address something you said which really reminded me of just how I felt as I was lying on that bed in the operating room right before I was put to sleep.  You said "I wouldn't want a girl liking me in spite of that".
Yea, I know, I didn't either, thats why I finally chose the only really proven working solution...surgery.

I have no experience related to the question you asked.  I do want to commend you for posting your story.  The kind of information you provided is so valuable.

Thanks,
Liam

Youngling,

You asked

QuoteDoes anyone have any idea what my chances are for not having to have this type of surgery again due to a ruptured suture???  Also, when these things rupture, what exactly ruptures?  the suture itself?  or the skin it is attached to???

I did not answer because I had no real information to base an answer on at the time you posted.  I still have no information on the second part of the question about what actually has the potential to fail, the suture or the tissue.  

I have since come across information in Dr. Levine's book "Understanding Peyronies Disease" published by Addicus Bookswhere, where he indicates:

that available follow-up suggests plication surgery is very reliable over 5 years with 90 -99% of patients.  The highest rate of failure is associated with Nesbit plication where tissue is excised from the long side of the penis. Plication surgery where no tissue was excised from the long side ie: Shortening was achieved solely from a tucks and sutures, recurrence rate is about 1% with up to 7 years follow-up.  I take this to mean that some patients have been followed for 1 year and some up to 7 years with the majority in between these numbers. This 1% statistic comes from his practice.   His opinion that plication surgery where there is only a tuck with no tissue removed from the long side of the penis.

You have decades to go and there are no statistics for that.  For the foreseeable future the odds look good.  Worse case scenario would probably require a redo of the very same tuck with no additional loss.

This is about the best answer you are going to get and it is always important for us to remember that statistics do little to tell an individual what their specific experience will be.  Statistically I have almost no chance of having Peyronies Disease but here I sit.  All of us have been on the low side of the statistical equation either for good or bad on several occasions in our lives.  At that point statistics seem to matter very little.

Hawk

I am now on my fourth week.

As of today I started using a product called Mederma on the circumcision like scarring that has resulted from the surgery.  I removed the "absorbable" sutures myself because I head that by the third week if they have not fallen out they create unnecessary and excessive scarring called tunnel holes or something.

I will post progress over the next few months and provide final results both functional and aesthetic.

And lastly, erections have now become nearly painless, suture sites are still very palpable and are to diminish slowly over time, and I have begun exercising again without pain or worry.

All is well for the time being
Good luck all

Dear all,

As usual, I have a few silly questions regarding what has been discussed:

- In case I get this plication operation in the future, (I understand it's a tuck and suture operation), so what happens if the stitches break? Does the curve comes back as before? Or can the "plicated" (not sure if this expression exists) part get, like, "resorbed", or absorbed" and the penis will stay straight even if the stitches break?
Is it like (sorry for the imagery), applying pressure on an accordion, or does the "plicated" part eventually get absored as if a Nesbit procedure was done?
Hope I made myself clear...

-Can we use the VED after a plicature was done? Is there a risk of stitches breaking? We could use it, like, for regaining some length after the penis curvature has been corrected by the plicature... Is it possible? Same question for penile extenders...

Youngling, I think you chose the less risky option available at the moment when going for surgery, so I think you're safe...
You did a good choice apparently. Keep us informed about your situation, your experience is really valuable.

Ninjagaiden,

Based on all the other posts regarding VED's here, and my personal opinion, a VED wouldn't help 'regain' lost length after a Nesbitt or 'nip-and-tuck'.  In those cases, you'd need to stretch normal tissue beyond it's normal condition, and I think most of us here agree that a VED isn't an enlargement device.  In fact, now that I think about it, you might end up with a reverse curve!
Here's my logic...the Nesbit gathered up 'normal' tissue to be as short as the plaque tissue.  Normally, when a VED is thought of as restoring lost length, it's by stretching the plaque tissue back to it's original size.  If this were to occur after a Nesbit, than the Nesbit tissue would now be the shorter side, resulting in a curve just opposite of the original!
Anyway, just my thoughts.

Steve

Ninja,

After six months of consistent VED usage from last september to February, there is no doubt the VED increased my flaccid size, and made my erections more full and slightly thicker. However, after stopping using it for about 3 weeks, I clearly lost what I had gained. I do believe it can stretch the tissue, the protocol calls for 10 second holds when pumping.  I was holding for 30 seconds to 1 minute, then releasing, and suffered no damage or injury at all.  I only did this after trying the VED for awhile and getting a really good feel for it.  I would recomend doing this first, once the VED is like second nature to you, then play around with the timing.  

Comeback

Thanks to steve and comebacKid for your replies,

I understand your point Steve, seems like the stretch would bring opposite results. Man, I didn't think about that  . So if I do a plicature (if the curve gets real bad), I'll forget about stretching devices...

One other question: With plicature, if another effective treatment comes up in the future, can a surgeon remove the plicature sutures, so that we come back to the start (I mean, with our curve), and we can use the new treatment (I'm thinking about new anti-fibrotic injections)??...
Is it possible? I don't want to make a "no way back" move (so: no Nesbit for me), even if the plicature is tempting me cause of the aggravating curve...

Bye!

I note that Dr Wessell of the University of Washington recommends plication for those with uncomplicated Peyronies versu more complicated disease (see below - he also uses the VED in post-operative patients after grafting):

*******************************
"Surgical reconstruction
Surgical therapy should be reserved for men with persistent severe symptoms that have not improved. The plaque and curvature should have stabilized for at least 6 months before surgery is recommended. For severe curvature of the penis, precluding sexual penetration and normal function, we recommend surgery. Click on Figure 1 to see our algorithm. For men with mild curvature, minimal shortening of the penis, and no hourglass narrowing of the shaft, we recommend penile plication. This involves taking a series of small tucks on the side of the penis opposite the plaque. The penis has already been foreshortened by the plaque, and this plication equalizes the length of the two sides of the penis and creates a straight penis. This is an outpatient procedure, which can be performed in less than an hour and has few side effects.

"For patients with severe angulation, distinct narrowing of the girth of the penis, or profound shortening of penile length, we offer reconstructive surgery with grafting. This involves release of the scar either by incising or excising the plaque, and grafting in a substitute for the tunica albuginea to expand the length and girth of the penis. Our preferred substitution material is a graft made out of the patient's own saphenous vein. This vein is harvested from the ankle, trimmed and reconfigured into a flat patch-graft, like a patchwork quilt. This can be then sewn into the defect of the tunica albuginea, correcting girth and length discrepancies and rendering the penis straight. While penile length is improved modestly with this approach, over 90% of men can report a straight or nearly straight penis after surgery, and most can regain sexual activity. However, risks are associated with this approach including penile numbness (less than 10%), persistent angulation (less than 5%), and severe erectile dysfunction (less than 20%).

***********************

He also does grafting repairs and sues saphenous veins, and also uses the VED to help out after surgery. I think a large measure of operative failures could be avoided by cautious use of the VED after surgery to prevent post-op fibrotic shortening:

"PURPOSE: We determined the effect of incision and saphenous vein grafting on penile length, erectile function and overall sexual satisfaction in men with Peyronie's disease. MATERIALS AND METHODS: A total of 24 consecutive men underwent plaque incision and saphenous vein grafting with postoperative daily use of a vacuum erection device. Erect penile length, pain, curvature and erectile function were assessed before and after surgery, and overall sexual satisfaction was scored from 1 to 5 by a validated instrument. RESULTS: Of the 22 patients in whom adequate followup data were available mean penile length was increased 2.1 cm. as a result of surgery (p <0.001). Median score of overall satisfaction with sex life was 4 or moderately satisfied. Of the 86% of men who achieved sexual intercourse after surgery 54% used no erectile aids and 32% required sildenafil or intracavernous injection. Complete erectile dysfunction was present in 14% of cases. Patients who reported erectile difficulty preoperatively were significantly more likely to have erectile dysfunction postoperatively that required erectile aids. Arterial insufficiency on duplex Doppler ultrasound was associated with a higher likelihood of complete erectile dysfunction. Complications in 33% of patients included complete erectile dysfunction in 3 and significant persistent penile curvature in 1. CONCLUSIONS: Incision and venous grafting of plaque leads to statistically and clinically significant increases in penile length in men with Peyronie's disease. Preoperative erectile dysfunction and cavernous arterial insufficiency were associated with a higher risk of postoperative erectile dysfunction. Nevertheless, patients reported a high degree of satisfaction with their overall sex life.

**********************

Tim

I had surgery for penis straightening some 4 years ago, the straightening was successful, the overall results were as bad as you can get, the length was reduced from 17 centimetres to 10, the surgeon removed an excessive amount of foreskin, causing very painful erections, this was tried to fix with a second operation that alleviated the pain a bit, but still uncomfortable, I am interested in finding out the rate of success with the undoing this operation, I know that I would need plastic surgery to move scrotum skin to use as replacement to the no longer existing foreskin.
I have consulted 2 different urologist, they seem reluctant to comment about the original surgery, perhaps afraid of getting involved in a lawsuit.

My approach to the Australian Urologist Association, by e-mail was totally ignored.

At this moment my recommendation would be "Do not allow a surgeon to come closer than a mile to your penis"

Thanks Tim for your info about veinous graft...
I guess plicature is the safest option in my case, I just need to get my brain saying "ok for surgery". I try to avoid it at all cost as long as the sexual intercourse is possible (while being harder and harder (and more painful)because of the curve). I guess having a straight penis could confort me psychologically for a while, but the loss of length is also uncool for me (having 15cm (on, the unaffected side  ), I can't afford getting it shortened to 13 or worse...). My mind would alway go "what if it shortens even more cause of the Peyronies Disease?" and that would really mess up with my life in general.

So it's plicature if there's no other option, but in the 1st place I'll try stretching devices and whatever's necessary if the situation gets worse.I get the point of Georgem about the surgeons... BTW, you talk about a reduction of 17 to 10cm, and foreskin... I'm a foreigner so maybe I don't understand, but do you talk about "excessive circumcision" after the straightening surgery, or are you talking about erect length going from 17 to 10???

JeorgeM.... what kind of surgery did you have?  was it a nesbit procedure?

Im very interested in hearing about Youngling's current status.
when you say you have begun exercizing again...what exactly do you mean?
I just saw a surgeon yesterday about possibly having a plication operation done, he said that when the surgery was over i would be perfectly straight.  but that scarring may cause me to bend even worse depending on how it healed.  How straight are you after having this operation?
How much length did you use?
are you satisfied with the operation?

my story is kinda similar to yours.  Injury when i was 13 caused me to curve, didn't tell my folks until i was 19.  Tried all the non surgical stuff you did and then some.  Not as severe a curve but it still bothers the hell out of me (and unfortunately others..)  im 22 now.  I know the risks and that i will lose length from plication but im considering it.  
What is your current status???

   I am very glad that I found this website.  I had a nesbit tuck in 1993 for penile curvature.  It resulted in me losing feeling in my penis.  I am  happy I will now be able to discuss this with others.  I had a downward bend of about 35 degrees.  The doctor made  the incision about half  way down my penis and of course all the way around the penis.  After the surgery, I had no feeling in my penis from the incision site to the tip of my penis.  I could not even feel orgasm.  After about 4 months, the sensation of orgasm came back.  However, only VERY MINIMAL sensation came back to the left side of my penis.  Sensation did not come back anywhere else. The tip of my penis has almost no sensation at all.  I had surgery in Atlanta, GA .   The doctor actually had the guts to tell me that he does not see how the surgery would have caused the loss of sensation and tried to convince me that it did not.   I went to another urologist at at Augusta Medical college in Georgia.  The doctor told me that this unfortunately is a side effect of the surgery sometime and that nothing could be done.   I have not consulted a doctor about it in about 5 years.   Does anyone know of any procedure that might restore my sensation to my penis?     The nesbit tuck I had in 1993 did not straighten my penis either.  It was like I had the surgery for nothing and in return, got many negative consequences.  You can still feel the sutures and it is painful in that area.  The urologist I consulted several years back said that  he could "go in there "  and take out the old sutures.  He said it was too bad that I did not have the surgery several years later, because in the late 1990's they started using a technique on the nesbit tuck that does not alter penile width, actually you gain a little width, although you do still lose length.  He also said that today's nesbit tuck uses sutures that "go away" on there own.

I doubt that you would be able to restore innervation of the end of the penis. It would require microsurgerical repair of the nerves, and then the good luck to get them to regenerate from the site of connection down to the tip, giving feeling back as they went. On the left side, the nerves reconnected on their own and gradually restored feeling.

It is possible that in the not so distant future that we will have nerve growth factors that can be added to the mix to increase chance of success.

The usual way to avoid this is to make the incision near the tip and to then "de-glove" the shaft of the penis, thus avoiding cutting through the skin. The nerves for the tip come in a bundle on the top side of the penis, which is why downward bends and repairs are harder to fix - the tuck is taken near this tissue.

If you are able to have intercourse and to orgasm and to have some feeling, I would leave it well enough alone. If the newer surgeon says he can remove old sutures that are uncomforatble, with minimal risk of worsening, then I might do that. Otherwise I would wait for better surgical techniques to arrive that can help restore damaged tissue, not just do nips and tucks.

Tim

dcycle,  about 10 years ago I had a hand surgery for Dupuytren's contracture (a similar and related condition) and the surgeon severed a nerve, causing complete loss of feeling in one side of one finger.  He realized what he'd done immediately and performed microsurgical repair  (then he phoned his lawyer, before I even woke up).  Over the next few years, something like half of the original sensation returned as the nerves slowly reconnected. I don't blame him for this outcome, because he warned me ahead of time of the possibility, and the surgery was successful overall.

I don't know if a repair like this can be attempted years later, but maybe it's possible. As tim468 correctly points out, surgery can always make things worse, too; we have to do our own risk/benefit calculations and not let a surgeon "sell" a surgery.

What's up, I posted a month or two ago and I'm back again.  This has been on my mind during that period and I'm still pondering the surgery.  I don't know how to even get the ball rolling--is it worthwhile to see a general physician first before consulting a urologist?  The problem is I dunno how to find which urologist will be a specialist in this area.  And I'm skeptical a general doc would know either.  How did you guys find docs who are experts in this?  I'm in ohio and don't plan on venturing far away.  I'm not lazy but I'm a student and on a short budget so traveling to see the world expert in this is impractical.  Of course I can wait until I'm more financially established, but meanwhile there are lots of girls I want to fool around with and am hesitant to.  So...it's not something I want to delay indefinitely.  

I mean, regardless of what consolation people give, chicks will definitely be expecting or hoping for a member that is similar to dirty movies, or anatomy pictures.  As far as girls and comparisons to dirty movies--well sure real girls may have tummies or small busts, but those are not as crucial to their identity as a guy's member, you know?  Like there is not much I can think of on a girl that compares to a strange member on a guy.

Also, the research papers I've skimmed online seem to portray great results of surgery for curves.  But when I look at personal accounts and forums I see a lot of horror stories that give me mixed feelings about taking action.  What do I do?  Sigh

I would start with a University hospital.  Get diagnosed and discuss it with the doctor.  Ask questions.  Write down any concerns you have and don't proceed with anything until you are satisfied with the answers.  Then, if surgery is recommended, get a second opinion.

VideoGame,

You post that you are considering surgery for your congenital curve and say you have no intention of traveling far from home to find a renown penile surgeon.  In all due respect, that statement blows me away, especially since you seem to have not only a concern over a functional penis but one that cosmetically makes a good presentation.  What will you do if you get a scared penis with a strange "S" curve, let someone else cut on it again until you lose sensation?

Keep in mind,  I am not saying that this is the likely outcome if you choose a "pretty good" surgeon, but you must face the risk and the question.  As a man that traveled a couple hundred miles to a major cancer center to have my prostate removed (a surgery performed in every hospital in the USA), I cannot imagine trusting my only penis at a young age to a doctor because he is close.  Maybe you have not had enough medical experiences to realize that the medical community has goofballs, incompetents, and money grabbers mixed in among the good and great doctors.  They all can run into things beyond their control, and they all can and do make mistakes.  Your job is to minimize the risk.

There is a very valuable axiom used by investors and calculating gamblers.  "Never risk that which you cannot afford, and are not prepared to lose"  I think that applies to penile surgery.

Welcome to the board, videogame. You've found a priceless board for information and education on Peyronies Disease.
I'd like to invite you to go over and read the Highlights child boards (if you haven't already done so) that feature selected posts from all the threads presented here. I'd specifically like to invite you to read the Highlights Of Women Speak Out About Peyronies Disease post. This post contains posts from women that show how they think about and approach men with Peyronies Disease, and if read slowly and carefully the thread can be an enlightening tool for men who want to learn how women are "wired" as it were, especially when it comes to attitudes and Peyronies Disease. After the highlights thread, you may want to read and digest the entire Women Speak Out thread. Women do not expect a "member" to resemble those found in porn. If a particular woman does expect this, consider not associating with her. If you present yourself as a man who is comparable to a porn star, then that is how you will be evaluated. Present yourself instead as a man. A man with values who would enjoy some good times get togethers, dates and so on. Present what is above the belt. What is below the belt will take care of itself in due time in a relationship. You're worrying more about what is percieved by women below the belt WAY more than you should.
 

Have any of your heard of Dr. Anthony Atala.  He is currently at university of wake forest.  He specializes in tissue engineering.  And of course he is a urologist.  I read online earlier today that his team is able to cause nerves in the penis to regenerate to a degree.  I would be interested to hear if any of you that have lost sensation due to penile surgery, have seen Dr. Atala.  I am going to make an appointment to go and talk to him in December or January.  

Hey Man,
I have indeed heard of Dr. Atala.  I believe if anyone is going to cure this illness, it will be him or someone following in his research.  I read that he created "new" healthy penises for rabbits, and they were completely functional.  Someday, men will probably be able to have a new penis regrown in a lab, and attached using some kind of nanobots, to make sure all the nerves are connected perfectly.  Please let the forum know how your meeting goes with him.  Also, ask him about all possible future treatments, including gene therapy, and inquire about how far away he thinks all possible treatments are.  Good luck.

I had Peyronies about 12 years ago with an upward bent. Uro put me on 400IU Vitaman E 3 times a day and Potaba. In less than a year the bend was gone but ED started.
I tried V C and L with little success. Even tried Uprima on a trip to Mexico on the advise of my Uro Little to no help.
About 3 years ago I had a Doppler that showed a Venous Leak. Uro said try shots. He offered me Trimix from his office at $10.00 per unit and Cash only.
At 4 units little to no help. Asked for a Rx and went to a local Compounding Rx.
Still little to no help.
Changed Uro's. Offered Trimix after prostate exam and went to a large local Compounding Rx. Went to 10 units of the strongest they mix and little to no help.
Dr. recommended implant surgery a year ago. Had it scheduled and had to postpone because of my heart and hear stints. After a year Heart Dr said OK to continue with the implant. During the last year Uri recommended a VED and had a custom fit in his office. Some success but the bands were not comfortable for me of wife.
Rescheduled Implant for Tuesday of last week. Woke up feeling like someone stuck a tree trunk with the bark still on it up me. Wife came into recovery and told me they had to cancel the surgery. Uro came in and said that the instrument punctured the urethra and because of the risk of infection he stopped.
Last Friday at the Dr. office he explained that when he inserted the instrument into the Copra that it punctured the Urethra. He showed wife and I where we needed to go in 3 months.
Tuesday when I had the cath removed he said that he had talked with other Drs and next time he would use some special instruments.
All this to say. His opinion is that my penis was badly scared and that the scaring was because of the Peyronies and made worse by the injections.
I did not realise that I still had Peyronies because the curve went away. He explained that the Peyronies was also the cause of loss of penis size.
Looking at Peyronies info today and found this site. Any suggestions or info will be helpful.
Thanks
JackP

QuoteHe offered me Trimix from his office at $10.00 per unit and Cash only.

QuoteEven tried Uprima on a trip to Mexico on the advise of my Uro

QuoteLast Friday at the Dr. office he explained that when he inserted the instrument into the Copra that it punctured the Urethra

Quotenext time he would use some special instruments.

I think it is time to find another doctor!!!

Find someone who is considered the BEST at implants (even if you have to travel).  Sorry for all your trouble!

QuoteLast Friday at the Dr. office he explained that when he inserted the instrument into the Copra that it (HE) punctured the Urethra ...he said that he had talked with other Drs and next time he would use some special instruments.

Jack,

Welcome to the forum.  What a horror story.  I shudder that you went through that.  I would be very interested in just how many of these implants this doctor has done and how many he has screwed up.  Anyone can run into an unforeseen problem but your surgery seemed to evolve no real surprises or special challanges.  This sounds like a serious  lack of knowledge or dexterity failing with the surgeon.

I also doubt that the relatively few injections of trimix caused significant scar tissue.  I assume that since they did not  result in an erection that you were not doing them weekly for months. I am also assuming that you were trained to apply pressure after injection to prevent any bleeding and that you were not taking blood thinners at the time (like 1200 IU of vitamin E).

I am with Liam - Travel to a VERY accomplished surgeon.  This man would get no additional chances on my penis.  In fact, if there was indication that his puncture of my urethra was a surgical blunder, he would likely be paying for my surgery with another surgeon.

I am not so sure that I agree that the urologist showed anything like incompetence.

He aborted a surgery when something went wrong. He came forward immediately and told the patient exactly what happened and what he would do differently to make it better. He tried to minimize the damage by getting out while he was ahead. He asked his colleague for help and advice.

The message i got from Jacks post was that the doctor found extensive fibrosis going on and that the fibrosis made the operation more difficult than expected. One reason for an instrument to perforate the urethra is that it was densely adherent to the surrounding (normally) spongy tissue of the corpora spongiosum. That might not have been as easy to recognize pre-operatively as you all seem to think.

A doctor who can stop while he is somewhat ahead; who is honest; who is able to speak to his partners about an unusual complication and then share that with the patient - I would not be so fast to bail out on him.

I would be sure to speak to a second urologist for a second opinion. I would also sit down for an "extended" consultation (the scheduler needs to block off 45 minutes, not 15 minutes) with the urologist and ask what the best approach is to deal with your specific situation. If you have had contractile tissue scarring down so that your erect length would be much shorter than it ever used to be, then you may be a candidate for a more radical surgery. I previously posted on this with the following article:

RECONFIGURATION OF THE SEVERELY FIBROTIC PENIS WITH A PENILE IMPLANT
FRANCESCO MONTORSI, ANDREA SALONIA, TOMMASO MAGA, RENZO COLOMBO, ANDREA CESTARI, GIORGIO GUAZZONI AND PATRIZIO RIGATTI

These surgeons are in Italy from the Department of Urology, University "Vita e Salute-San Raffaele," Milan, Italy.

IN this surgery, the surgeon has to make "relaxing" incisions and then cover the open area with a graft to allow for a longer length to the erect penis. THis is a good surgery for the "ruined" penis following priapism and complete fibrosis.

It might be worth talking to the doctor about going on Pentox, arginine and viagra (not for erections but for it's Nitric Oxide-enhancing effects on inflammation). This might be of even more help if you have a *tendency* towards inflammation that will get your newly operated penis in trouble as well.

Tim


Tim

Thanks for the support. A thousant what ifs run through my mind.
Just to clarify the 1st uro I went is the one that sold trimix out of his office for cash only and recommended Uprima. The cash only for trimix said to me get another Dr. I have known this Dr almost all my life (65 yrs.) and had been to him several times for BPH and even a prostate reduction.
About 2 years ago switched to new Uro and liked him. Seemed sincere and helpful and said to quit trimix when my heart Dr put me on Plavix.
He told me that the reason for stooping the surgery was because of the possibility of infection, and that some others would have continued but if I had an infection it could be real bad.
I support the fact that he quit when the urethra was penetrated. I don't know any way he could have foresaw what was going to happen. He even had the AMS rep present with the whole AMS line of products.
My heart says to give him another try because he has been there and knows what the problem is. My mind says go to the UT Medical School in Memphis for an evaluation (if they do that).
Keep me posted and I will do the same. I did not know that Peyronies could cause all this damage when the curve went away.
Thanks
Jackp

QuoteI did not know that Peyronies could cause all this damage when the curve went away.

Who knows?  I'm not sure what to make of it.  Can you feel any plaque?  Maybe plaque developed opposite the curve.  In this case, as the conditioned worsened, you had less of a curve.

If you don't feel any plaque (lumps or bumps), how could it be pervasive enough to cause problems inserting an implant?

I would use another surgeon who has enough experience to have recognized your situation before the "oops".

Jack,

There is critical information absent from this conversation.

1. How many of these procedures has this doctor done.  I would have no type of surgery ( and I have had a few) without knowing the frequency with which the Dr. has dealt with my problem and his rate of various outcomes (not national averages).  As my wife would say, "Many women have been to beautician school and seldom worked in the field.  There is a difference between just being trained and in being trained and doing it 8 hours a day for years."  I would want a doctor that does my needed penis surgery weekly.  I wonder if the rep being there was an indication he was new to the procedure?

2. Tim makes some excellent points about the doctor stopping, admitting the problem, and consulting colleagues. Again, what is missing however is an explanation on what caused the complication.  I have not heard that the doctor explained what went wrong in your case.  I have not heard that scaring can cause aborted prosthesis surgery, and I believe that a very experienced surgeon would have made a nonsurgical assessment that warned you that your surgery presented abnormal challenges if that were the case.

Remember, we all like nice doctors but if I want warm and fuzzy I will go to a priest or a counselor.  This guy may be very nice but that is just not good enough to get the job done.  Find out the specifics with frank questions without you suggesting the answers in advance.  In other words ask: what lead to this complication NOT: did I have excessive scarring that caused this problem.


I am anxious to hear back.

PS: These posts should be moved to the 'Surgery" topic.

Sorry to hear the trouble with your surgery.

I guess what happened happened. However, why not get a second opinion from a uro surgeon who does this kind of operation all the time before your second surgery. Dont feel under any pressure to use either and as a matter of fact go for even a third opinion if you are not satisfied. Then you may be able to make a better decision on how to proceed next.

Best of Luck

I heartily recommend reading "Complications" by Atul Gawande.

No surgeon, no matter how good, has a career without complications. The fact that something bad happened does not mean he is a poor surgeon - I have been objecting to what sounds like a rush to judgment that this is probably the case.

Tim

Tim,

I do not think there has been a negative judgment here about this surgeon.  At least I did not read or write any posts from that point of view.  I fully agree that every surgeon both runs into circumstances beyond their control and even makes mistakes.  A person cannot tie their shoe every day without making a mistake.  Having said that, surgeons also make more mistakes with surgery they are new at or that they perform infrequently.  Some surgeons like some gymnasts, accountants, and engineers, are just not very good even though they may be very nice.  We have no clue where this surgeon fits between world class and a clutz.

Concerning experience, everything I have read for instance about prostatectomy indicates you want a surgeon that at a minimum, performs at least one of these operations per week.  My surgeon performs between 5 to 10 of these every week and I was not without complications.

In fairness, all surgical blunders and complications are not all UNavoidable.  I think you would be hard pressed to point to one piece of unsound advice in these posts.  

Surely you would want:
a very experienced surgeon
You would ask his experience and outcomes prior to surgery
You would ask what led to a punctured urethra
You would educate yourself on whether it was reasonable for the Dr.to anticipate this complication and inform you.
You would seek a second opinion and maybe a third
You would find the BEST within your possible area of travel

Any patient that does not do these things with his penis on the line, is not doing his part of the job in my opinion.
I can find little else that has been said other than this sound advice.

"Tim,

I do not think there has been a negative judgment here about this surgeon. "

I disagree. I read the following from you and Liam:

"I think it is time to find another doctor!!!"

"Find someone who is considered the BEST at implants"

"I would be very interested in just how many of these implants this doctor has done and how many he has screwed up. "

"Anyone can run into an unforeseen problem but your surgery seemed to evolve no real surprises or special challanges.  This sounds like a serious  lack of knowledge or dexterity failing with the surgeon."

All of those comments are quite arguably negative judgments, and seem to be based on something bad happening. I read a different story. It may be that he is clumsy or incompetent. But the comments I read assumed he was - without nearly enough data to suggest that was true.

When I read: "His opinion is that my penis was badly scared and that the scaring was because of the Peyronies and made worse by the injections." that seemed to imply that the scarring was worse than expected or usual. It did not suggest to me that the surgeon was inexperienced - rather that he had found an unexpected finding in the OR.

Maybe not - but the posts were very quick to condemn without much to support that condemnation other than a complication. And a complication does not a bad surgeon make. That is my point. The posts were quite judgmental and suggested looking for the "best". That is all fine and dandy, but it does not really get at the question of why did this happen, and that is a far more important question.

Tim