31yo Severe Peyronie - Considering Implant

[ontheroad]

Hi guys,

After being a reader in the forum, I am presenting myself, looking for some advise from you guys as well as sharing my experience up to now.

I'm 31yo based in Europe and my Peyronie started like 15months ago. Regarding the curvature of my penis, I have had some left and upside congenital curvature (not a big deal) since I was born but in November, 2019 I realized that I had some pain during my erections but I did not pay any attention till February, 2020 where I realized that my penis was curving to the left side and after two months I had a 90 degree curvature to the left.

At the beginning I visited two different Urologists, the first Dr. told me that there was not too much to do and he just did ten EMDA/Iontophoresis with Verapamil and Dexamethasone with no improvements and prescribed Tadalafil 5mg but just a quarter of a pill every two days. The second Urologist (May, 2020) induced an artificial erection and performed a Duplex Sonography where his diagnostic was:
"No signs of a corporal fibrosis.
The tunica albuginea showed severe signs of calcification in the areas of the palpable plaques.
Normal vascular parameters."

He suggested me to wait for 3-6 months and to go under Grafting to correct the curvature but in August more plaques appeared in my penis and the 90 degree left curvature turn into a 45 degree curvature to the left and now a 90 degree distal curvature appeared. My penis has gone from around 18-19cm to 13cm and I have also some hourglass and indexations. I have plaques almost everywhere, it's crazy.

Currently I am taking Pentox 3xday and Tribulus Terrestris to generate erections, it works quite well. I am tired of taking pills and not seeing any results.

Regarding Doctors, I have been in a personal consultation with Dr. Kuehhas in Vienna, it was ok but after reading a lot of bad reviews about him, I have opted to look for another Dr. I also had a Skype call with Dr. Gelman in California but he just suggested a Nesbit surgery (I have good erections but I am not sure if they are 100% erections or just good erections) what I am not going to do because I want to have a reconstruction surgery to regain the lost length and also a penile implant to be fully functional again and not to start having erection problems after the reconstruction surgery. Dr. Gelman told me to stop taking cialis since he thinks that this would not help, he prescribed Pentox. Apart from them, I wrote to Dr. Paulo Egydio in Brazil 6-7 months ago, because I think that he and his new technique is the best solution to my penis but they have told me that Dr. Egydio is not taking care of patients younger than 45yo. They do not know when they are going to take care of young patients again but I am kind of desperate because I want to find a solution to this as soon as possible. This has taken almost all my energy already and I just want to get out of this depressing shit.

My questions to you guys:
1- I am waiting for Dr. Egydio but since I don't know when they are going to be back, I am considering consulting other Doctors. What other Doctors do you know that would make both surgeries (Reconstruction and Penile Implant placement)? Let's say money and geography are not a constrain.
2- What about Dr Rados Djinovic in Serbia?
3- Any other Dr. in the USA that would also do a reconstruction surgery? I know that Dr. Kramer and Dr. Eid are one of the best surgeons there but as far as I know, they do not do reconstruction.
4- Up to what I have read, length would be most likely regain with a reconstruction and the girth in most of the cases is enhanced by the penile implant, would you say this is correct? I have seen some pictures from Dr. Eid where patients with really severe hourglass deformities have been corrected with the implant and cycling of the implant.
5- I did some penis stretching back in May, even though I was really gently with it, some new plaques appeared so I stopped it. Do you think I should buy a Vacuum and start with that?

I hope you can help me guys. Let's be kind please, this shit is already too much to not be kind to each other.

Thank you all in advance.

[fade3W]

Like you, I’m in my 30’s with peyronies and highly considering an implant.

I can’t speak to any doctors outside the US, but in my research, the doctors that are best for peyronies seem to be Dr Lue in San Francisco and Dr Levine in Chicago. Levine is also a high volume implant doctor.

Other doctors that are high volume implant and also treat peyronies are Dr Hakky in Atlanta and Dr Clavell in Houston, TX.

I consulted with Dr Eid and he initially said he wouldn’t do anything to my plaque, just insert the implant, but after viewing me decided he wanted to do excision/grafting while inserting a malleable, then wait 3 months to “stage” my penis, then do another surgery to do the implant. This honestly scares me. I thought I could be cured by the implant alone.

And, perhaps I can be, just by another doctor. I know Eid doesn’t like to do any modeling, nor incising of the plaque from the corporotamies, but I know Hakky does (as does Dr Perito in Florida).

I’m sure there are other doctors as well, I just haven’t come across them yet in my research.

My problem is I can still get erections with enough Cialis, they’re just useless due to curvature. As the weeks have gone on my spontaneity with erections has slipped. As has my mental state. I realize that an implant would make my penis never have a natural erection again, but if I can’t do anything with it, what’s the point?

Anyway, those are some other doctors you can look up. I have a consult scheduled with Hakky soon

[fade3W]

Also, I tried a restorex traction device that’s highly recommended. However, after about a week of use, my plaque became aggravated and grew. I’ve tried VED but that also caused inflammation almost instantly. So I’m sticking to the medications so that I don’t injure things further.

I’ve heard VED helps a lot of guys though. I can see why it would, it just didn’t for me.

That’s what sucks about Peyronies: it’s not a one size fits all remedy. Even the studies backed by science can sometimes contradict each other. It’s tough to find the one thing that works for you. That’s why I’m considering an implant: because the other things haven’t worked.

The problem with the reconstruction surgery on the penis while implanting is the length of the procedure. You’ll get your penis length back (or very close to it), but the surgery could be 5-7 hours. That’s long, which raises the possibility of infection. That’s why picking the right surgeon is the utmost importance.

And now that I’m thinking of it—Dr Brian Christine in Alabama is another peyronies/implant doctor that comes highly recommended

[LuisFernandez]

You should reach out to Dr. Clavell. He does Dr. Egydio's technique here in the states, if that's what you're interested in: https://dl.uswr.ac.ir/bitstream/Hannan/ ... 812%29.pdf

Other than that there's Brian Christine, who does extra tunical grafting and Dr. Perrito who does the scratch technique. There's also Dr. Levine and Dr. Hakky that does partial excision and grafting technique.

I think it all depends on your situation and preference. I for sure would not want plication. To me grafting + 3-piece implant seems the most reasonable.

[shrunken_dick]

I was wondering if the sliding technique is done only for peronies or in general, to restore lost penile length due to ED? I have read somewhere that the chance of glans necrosis is very high after the sliding maneuver. Nowadays Dr. Egydio is working on a New study called Tunica Expansion Procedure ( TEP ). Therefore I think he will not take young patients because these are experimental surgeries.

[ontheroad]

So guys, I am back with some of information but f%1k I am really lost.

In the last month I have had several consultations with the following doctors:

1- Dr. Rados Djinovic in Serbia: I flew there, met him at the clinic and we had a chat. I went there because he suggested me via e-mail to have corporoplasty + implant (Titan), I would regain my pre peyronies length and my girth would be same or a bit more than before peyronies. I have talked with two different guys that had this surgery with Dr. Djinovic and they are really satisfied, I saw the results and they have had really good outcomes. But when Dr. Djinovic saw me there he was kind of surprised because of my age and he suggested me to try something just reconstruction before going for the implant since my erections are still good (I'm not sure how good because my libido is on the floor and it's really hard to know how good they are). He did a physical examination just with his hands, no ultrasound or anything like that. I also showed him the pictures I have. (I have documented the whole progress of my peyronies). He also told me that if this fails, then we can go for the corporoplasty + implant to have a nice and big penis.

2- Dr. Georgios Hatzichristodoulou in Germany: I visited him in the hospital, he did an ultrasound (no erection induced) and he told me that I should not consider an implant now. He just saw the pictures and said that my erections looked really good that I should not think about an implant for now. He suggested grafting and told me that I would end up with a functional penis but from what I understood, nothing perfectly straight.

3- Dr. Levine in USA: I had a call with him some days ago, showed him the pictures and he recommended PEG surgery. Again he told me some of the side effects could be severe ED not responding to pills but if I have strong erections pre op this risk would be really low. Still some room for mild ED should be considered in my opinion. I have talked with two guys that had this surgery with him and they are quite satisfied but they had a single plaque. He also told me that I should not think about an implant yet. Hopefully I will visit him soon and do a doppler ultrasound to see the amount of plaques I have.

4- Dr. Marco Tulio in Brazil: he is doing the new Egydio technique (TEP) and he suggested me doing this technique together with an implant. He is quite young but he seems to be really knowledgeable.

5- Dr. Osmonov in Germany: I will have a consultation with him next month. He has been doing a lot of trainings with Dr. Wilson who is known for having placed more than 11.000 implants in his career.

So my concerns up to now. none of the doctors that suggested me grafting have done a doppler ultrasound to see how much scar tissue I have and I have several plaques in different places of my penis. I think I have lost some girth all over my penis with a 70°dorsal curvature just below the glans with narrowing. I also have another curvature to the left but more in the base of the penis of about 35° with some narrowing as well. I have also some fibrosis in the corpus cavernosa behind the glans. I have a severe case of peyronies but doctors keep offering me to do grafting instead of an implant. My biggest concern is to go out of the operating room with a half functioning penis (residual curvature, some sort of ED, skinny penis due to the girth/lenght loss, you have to be careful in future intercourse to not provoco more damage) and being stuck with this problem for some more years which is already hitting me really hard phytologically. I have also had some sort of PE before the peyronies developed and this makes me think that the implant is the right way to go, the implant would also tackle the curvatures, girth/lenth loss but then I have to think about having several revisions and I am not sure how comfortable the implant is when it comes to everyday life, ride a motorbike, bike or doing some other sports.

Honestly, Idk what to do. One Dr (not any of the above mentioned) also told me that we have to accept that we have to live with a dick that is not going to be what it used to be, he told me just to do some plication and live with it. All this concerns you have are in your head, your penis will be more than 10cm after plication, it more than enough to live with it. If you think you have to go for an implant, first go to a psyquiatric clinic. Haha. It seems that some urologist does not care about self steem or the phycological side effects about living with a not functioning penis.

[shrunken_dick]

Whatever you do but don't go to the last doctor that you mentioned. Btw what is corporoplasty?


Best Wishes!

[ontheroad]

Corporoplasty is the grafting, TEP or plication techniques.

[Flavio]

[...] I have plaques almost everywhere, it's crazy.[...]

What is causing this?

I thought these plaques were only caused by injuries to the penis.

[Fran4524]

Hi, mediterranean brother!

I am from Spain and here there is a very good andrologist called Mariano Rosselló. Nowadays he are doing a doctorate about peyronies and is one of the surgeon who has placed more implant in Europe. I know some people who had the surgery with him and all of them are satisfied with it.

https://www.haysoluciones.com/patologia ... eyronie-2/

this is his webpage, if you want to call him.