Implant + TEP procedure Journal - 34yr old Australian

[Bigdave]

Girth Comparison

Left pic is just few days before surgery, right pic is just recent pumped to about 95% I think.

J

Now I see why you had the TEP.
Looks like a great result. Congratulations.

[aussiePeyronies]

Girth Comparison

Left pic is just few days before surgery, right pic is just recent pumped to about 95% I think.

J

Now I see why you had the TEP.
Looks like a great result. Congratulations.

Thanks a lot brother, appreciate it.

[Jage64]

Girth

Measured close to 5.5 inches, first time I have ever measured girth in my entire life. I hope I have done it correctly.
J

Not to be too picky here, but that's 5 and 5/16. Much closer to 5.25 than 5.5. You're still early, the girth will improve, but logging the correct starting point will make it even more satisfying as the cylinders soften and girth increases.

[aussiePeyronies]

Girth

Measured close to 5.5 inches, first time I have ever measured girth in my entire life. I hope I have done it correctly.
J

Not to be too picky here, but that's 5 and 5/16. Much closer to 5.25 than 5.5. You're still early, the girth will improve, but logging the correct starting point will make it even more satisfying as the cylinders soften and girth increases.

Appreciate this, we use metric system in Australia, not familiar with measuring in inches. I will take note of what you said.

Thanks,
J

[aussiePeyronies]

Update 8 Weeks 4 days

I can't believe that it's April already. I remember, New Years 2023, waiting for my surgery on the 7th Feb 2023, wondering if this would be the year that Peyronies would be over for me. I haven't been able to enjoy a New Years or my birthday for the past 5 years, Peyronies just seemed to undermine everything. It was just like a dark cloud over me. There have been times where I have felt like giving up.

It's just over 2 months since my surgery, and although I still have pain from the operation, I can say that, the undermining dark cloud of Peyronies is almost fully gone.

Some updates below:

Squeak

The pump seems to have broken in, the squeak is no longer present, the pump is soft. The only time the pump squeaks is if I try really hard to get in extra pumps after 20m of cycling.

This is a really good improvement.

Girth/Length

As pointed out above in a previous post, I measured the girth in inches incorrectly, the correct measurement is 5.3 inches. It gets slightly narrower towards the base, although, this would probably be unnoticeable to anyone else. It does look really girthy in the pics, I am not sure if this is due to it being more oval/flat, but it is definitely girthier than ever. It does get a bit girthier and more of a round shape if I am naturally engorged, I have not measured while engorged.

Length is the same as my last post, 6 inches bone pressed. This does improve slightly when engorged, I have not measured while engorged. I don't have it in me atm to try and get engorged, measure and take a picture. But, considering it's 6 inch BP without engorgement, I would estimate that, length is very close to pre-op of 6.5 inch BP.

Cycling

It's been 3 weeks and 2 days since I started cycling. The pain has reduced significantly but is still there. I now try to do 2 x 40m sessions per day. In a week I will increase this to 2 x 60m sessions.

I noticed some pain post-cycling, this seems to vary each day.

Pain

I still get random sharp pains and a burning sensation throughout my shaft and glans. There have been times where something has triggered an episode leaving me in pain for about an hour. This has been after going to the bathroom, tucking my penis up towards my belly button to walk around, and sometimes from pushing down on the glans. When this happens, I usually wait it out, and the pain eventually subsides.

I have asked my GP what he thinks of this, he said he wasn't too familiar with this whole operation (TEP etc), and referred me to a urologist.

Dog ears

There is a dog ear on the right and left base, this is also where the dents are. It is a little painful and only present when flaccid. When erect/inflated the dog ears are not present at all.

Dents

If you look back at my original pics with peyronies, most of my dents were on the underside and the most prominent narrowing was at the base of the penis. Most of the dents are no longer present. However, when flaccid there are 2 dents at the base of the penis. When erect these are almost completely filled.

Flaccid

My flaccid points at 4 o clock, it is stiff, tender, and still sore. This has been a very big inconvenience for me, I am unable to point it up or down, both result in pain. I also don't want to have a negative impact on the erection angle by pointing it down.

I still get flaccid pain, the pain/burning sensation I described above were all while flaccid.

Graft

I received my surgeons notes from my GP, it turns out that the incisions to the tunica were covered with a TachoSil graft. This may be what is delaying my recovery.

Deflating

Deflating has become significantly easier, I can locate the deflate valve very easily. I press the valve and squeeze gently on the penis, I found squeezing top and bottom of the penis or in an ok position to work best. Squeezing left/right seems to cause discomfort. It takes about 1-2 minutes to deflate. I then press the pump once to lock.

If I just squeeze the valve and hold it, the penis does seem to deflate a little on its own.

Important to note that, squeezing too hard can result in pain post-cycling.

Peeing

Peeing has definitely improved, I still have to either sit down or lean forward due to my flaccid angle, however, my stream is straight. There is also a lot less dribble after peeing. I believe this will improve as I continue to heal. Straight after surgery, peeing was difficult, stream was in different angles, sometimes it could be painful. This improves with time.

Sensitivity

My sensitivity is definitely returning. Each week, I feel my sensitivity is getting better. The procedure was long, complex, there was also grafting done. I have seen people on FT say that it took 6 months to fully recover from just implant surgery. I expect, with TEP/circumcision, it may take just over 6 months for sensitivity to return to normal

Engorgement

I can get engorged, it is a bit difficult considering I am still in pain and my body is adjusting. When engorged my penis looks and feels like a natural erection. The shape is more round, and it does increase in length/girth.

Interstate Procedure

I did this procedure interstate, mainly because, the most experienced high volume implant surgeon was interstate, and he is the only surgeon (I know of) that does TEP in Australia.

Something to consider is that, an interstate procedure means you do not have regular access to your surgeon. During the healing phase, this can be very important. Last week, I was in pain, I went to my GP, he did not feel that he was knowledgeable enough on the device to give me an accurate assessment on what may be going on. I then got a referral for a high volume implant surgeon in my state, and I also contacted a previous high volume implant surgeon in my state. One was booked out for 2 months, the other may get back to me in a week. Both these surgeons in my state may not be familiar with TEP either. Considering that, a local urologist may not even be familiar with IPP, or TEP, I do not have many options.

If I was in the same state as my surgeon, I am sure I could have gotten an appointment to see him within a week to confirm why I am still in pain. Even if it is unlikely something has gone wrong, reassurance and peace of mind at this stage can be very important. Going through 5 years of peyronies, then the complex procedure, the last thing you want, is to have endured that much only for something to have gone wrong.

It can be in your benefit to choose a surgeon in your state, the surgeon who performs the procedure is in the best position to give you advice/assessment if you feel something may be wrong or recovery is delayed. Something to consider when choosing a surgeon interstate.

Mental state

It has been tough being mostly immobile for 8 weeks, the constant flaccid pain, being stuck with my thoughts and just feeling like life isn't progressing. On the other hand, I am feeling positive about getting my sex life back, and feeling more like myself once again.

This procedure is tough, anyone considering it in the future, be prepared for a long healing journey. I estimate at 4 months, I will probably feel normal and active again. In saying that, the girth/length restoration does seem promising.

J

[aussiePeyronies]

I have experienced some improvement, so decided to do an update. I would also like to give a very honest, impartial review on everything.

I think I will make this my final update until I see some progress or I will try to do monthly updates now.

9 Weeks

Intermittent Pain Issue

The symptoms included, severe to moderate pain in the glans and shaft which lasted an hour or two. This usually occurred after the following:

- going to the bathroom;
- pressing down on the glans;
- tucking penis up or down; and
- random movements.

This would occur 1-3 times a day and was very uncomfortable. Imagine randomly moving or going to the bathroom then being in extreme pain for 1-2 hours.

This started about a week after being deflated (week 6/7). Prior to this, the pain had mostly subsided, I could tuck my penis up towards the belly button and walk around, albeit with some discomfort.

My thoughts on what may have contributed to this:

One evening, the deflate valve seemed to have been stuck and I could not deflate. I was fully inflated for about 2 hours, eventually I pressed the deflate valve extremely hard and that seemed to work. However, at times, while trying to deflate I would have squeezed the erect penis (expecting it to deflate) quite hard. I think this may have contributed to what left me having intermittent pain for the next week.

The only other thing I can think of that may have contributed, is that I started cycling a week earlier to this incident. As I had been inflated for 5 weeks, I rushed into a cycling routine and started aggressively cycling for 2 x 60m sessions, leaving myself in excruciating pain each session, to the point where it felt like the tips of the cylinders may burst out of the glans. I started to cycle for shorter periods with less intensity.

This became quite an issue for me, it stopped me from cycling as I was constantly in pain.

How it is now:

For the past 3-4 days, I noticed that this intermittent pain has subsided. I do still get some pain when squeezing the glans, even if I squeeze it lightly to wipe excess pee. However, it is nothing like before.

I am really not sure what happened, perhaps I aggravated something or had caused some inflammation. I am grateful that this has improved.

I think being cautious and gentle is important here. Also, gradually increasing cycling intensity.

Flaccid Movement

One great improvement I would like to report is my flaccid penis can move left to right! My peyronies penis would not move this way, it would have to kind of move in a circular motion, I would have to point it up and sway it to the right if I wanted it to point to the right. I would usually be in pain if I tried to just move my flaccid peyronies penis to the right. This use to make sleeping very uncomfortable for me. I would sleep to lean my penis to the left, if I wanted to move it to the right to turn around I would have to get up and sort of push my penis up then sway it to the right, then lean to my right and sleep. This could also make walking in tight clothes very uncomfortable, sometimes if I was walking or in the gym and my penis started to move to the right, it would cause some pain and discomfort. This was still the same up until a few days ago.

In the past 3 days, I noticed my penis will move left or right without any pain. I can roll over to the right while sleeping and my penis will just move without pain. There is still a dent to the right which causes some discomfort, I intend for this to improve as I continue cycling.

I am grateful that this has improved, I can actually walk around, and sleep in peace without being reminded of peyronies every day.


Scar

One thing I have not spoken about is the sub-coronal scar. This is due to the fact that, I have dark skin, so, the scar is very difficult to notice. There is clearly a vertical cut down the underside of my penis, it is sensitive at the moment, but not very noticeable. This causes no issues for me. However, if someone were to undertake this procedure and had very light skin, their scar may be more noticeable.

Orgasm

I don't think I could have sex at the moment, still a lot of healing to do. I decided to masturbate, my mind needed assurance that everything will work when the time comes. Orgasm is enjoyable, sensitivity is returning, behind the glans and shaft was much more numb a few weeks ago.

One thing which happened is that the semen seems to be clogged when coming out. I note that user Tortao who had TEP as well, noted this. My peyronies penis would usually dribble out the semen, although it did not seem clogged. My pre-peyronies penis would squirt out the semen during orgasm. I really don't know what caused the semen to go from squirting to dribbling out, one doctor theorized that it could be due to the erection being less strong due to peyronies. He advised that a strong erection results in strong ejaculation, and a weak erection results in weak ejaculation (causing semen to dribble out as opposed to squirt out). I know this isn't a big issue but it was always something that bothered me on top of peyronies.

I believe doing kegels and reverse kegels can improve the strength which semen comes out. I may try this once I am healed and report back.

Nonetheless, orgasm is possible, and is enjoyable. I do not have the worry of feeling like I would damage my penis more. This was a constant worry with peyronies and was one of the reasons why I stopped having sex. I can see myself having sex now and not worrying about causing any further damage, this does feel alleviating.

The other thing is, being completely hard after orgasm. I thought this would be strange, or uncomfortable. There wasn't really much discomfort, I can see how someone could orgasm during sex and still continue. I think this is one of the great benefits of having an implant.

Post-orgasm, I had a lot of pain. Clearly, a lot of healing left and the implant is not ready to be used yet.

How circumcision affects orgasm:

I do not notice a major difference. I am a bit less sensitive, at the same time, I am recovering from TEP as well. Obviously, masturbating/handjobs will now require lube. I don't think there is a major difference for me, I still feel pleasure, and the sensitivity is slowly returning. I will miss receiving handjobs during foreplay. While I would have preferred to keep my foreskin, it just takes some adjusting too. I think I would still choose the circumcised TEP if I had to do this procedure again as it is promising for girth/length restoration.

Hardness

At 100% inflated, the penis is unnaturally hard, you can feel the cylinders. At about 80%, I feel like the penis is still a bit too squishy, although, when engorged, at this level of inflation, it does seem to take more of a round shape. I think going from 80-90% there is some girth gain. 90-95% seems to mimic a strong erection, although, at this level of inflation the penis takes more of an oval shape, even when engorged.

It's difficult to know what would be the most comfortable for sex. 90-95% would seem best, but at 80-85% it's more round.

I think that, it is too early to comment on these features of the implant. I think there is still time for the cylinders to soften and healing to occur, and these may play a factor in the idea level of inflation and shape. I remember reading on FT that, for some people, it can take a few months for the penis to take more of a round shape. Others, seem to keep the oval shape.

I would be very interested to know other members experiences with level of hardness, shape, girth and partner preference. Also, whether the device became softer over time resulting in a more round shape erection. Or if the cylinders softening had any effect on the inflated erection used for sex (e.g could you pump up more without losing glans engorgement).

Cycling

Currently cycling 2 x 40m sessions a day, I will be increasing this soon to 2 x 60m sessions a day. As advised above, I think it is important to work your way up. When I first started cycling and would sit through excruciating pain, I think I was doing more harm to the penile tissue.

Cycling now is a lot easier and less painful. I feel like cycling does improve the feel of the penis, it may have contributed to my flaccid being more movable.

The pump also broke in about a week ago.

Dents

There are two prominent dents with dog ears on the left and right side while flaccid. Upon a good examination of my erect penis, the dents are still there when erect but much less prominent. They seem to be less noticeable the more inflated/erect I am. I intend for this to improve over the next few months. Some members on FT stated that it can take six months for dents to fill.

If they do not improve, the only issue I can see, is that when erect, part of the cylinder sticks out in front of the dent, almost like a kink. This could cause issues/pain for a woman when inside her vagina. The cylinders softening may improve this, I will be reporting back in a few months to see.

Girth

The girth looks impressive in the pics and I think that is because it is oval/flat. It may look girthier than it is. I do think it is girthier than my pre-pryoneis penis, but on the other hand, I never measured my pre-peyronies girth. My pre-peyronies penis was more round, so it is difficult to compare just from thinking back/looking/feeling.

Nonetheless, it is still a great improvement compared to my peyronies penis. I had significant narrowing/dents which have all improved. I am grateful for this. There is no hinge and the erection is strong.

Travelling to have your procedure

I would just like to reiterate that there are some disadvantages when travelling to have your procedure. I would firstly like to state that this mainly effects us in Australia as we are limited for high volume surgeons. Further, we do not have access to personal phone numbers etc where we can contact the surgeon post-surgery. I note, it is common for some high volume surgeons in America to give out personal phone numbers to their patients post-surgery.

When faced with issues, I have to wait in my state to see another high volume surgeon and this can take weeks. I could go to a general local urologist but the chances that they are knowledgeable on implants is slim, being knowledgeable on TEP is even less likely.

I think having access to your surgeon where you can send pictures and text symptoms is a great service and can really provide reassurance. It also helps to quickly identify any issues in the event that something does go wrong. I think it's important to take all the necessary precautions in the early stages. You don't want to have to endure the complications of surgery, after having to suffer through peyronies for years, only for something to go wrong. So, keep this in mind when choosing a surgeon.

Recovery (TEP, implant and circumcision)

Recovery has been long and tough. However, this could be due to the fact that I was inflated for 5 weeks. I also may have caused some damage from squeezing the inflated penis when I had a deflate issue, and also from aggressive cycling in the beginning.

I do miss my foreskin but it just takes some adjusting to.

I estimate another 2 months before things start to feel a bit normal. My flaccid is still very uncomfortable and difficult to conceal. For anyone else considering this, be prepared for a good 3 months recovery with an uncomfortable flaccid.

Final thoughts

I am quite happy that I could probably perform very well during sex. This has not been possible for almost 5 years. It is a huge burden off my shoulders. Yes, I would have to pump discreetly or disclose the implant to my partner, but I think in the grand scheme of things, that's a small price to pay to have your sex life back. Especially since, I was not able to have sex at all with my peyronies penis.

I do have some thoughts which I believe are just things that will take some getting used to. The device at the moment feels very unnatural. It is still a mechanical device, and having a mechanical penis can take some time to accept. I do think this can be harder to accept for younger guys (no disrespect to the older members out there). We are just less accustomed to Erectile Dysfunction, our age group, the women we interact with, friends etc are all less familiar with Erectile Dysfunction. Nonetheless, the key here is acceptance. Also have to remember that, I may need 5+ revisions in my lifetime. That's 5 more surgeries and 5 risks of infection. These factors can make a difference for someone in their early 30s who can still have sex with their peyronies penis. In my case, I could not have sex at all with my peyronies penis, so, an implant was the only option.

One thing I keep doing is comparing my current penis to my pre-peyronies penis. I think it's important to accept that, nothing is ever going to give you your pre-peyronies penis. I have to remember that, going from a narrowed, dented, curved penis which was not functional for sex, to the current penis I have, is a great improvement.

I have to say, I am grateful for this forum. The first few doctors I saw told me it was "all in my head" and one even told me I had body dysmorphia. We really need to spread more awareness for peyronies and Erectile Dysfunction, especially in younger guys.

I would like to leave with a quote from a book by Napolean Hill called 'Outwitting the Devil', the quote is:

“Within every adversity is an equal or greater benefit.
Within every problem is an opportunity.
Even in the knocks of life, we can find great gifts."



J

[aussiePeyronies]

Update -- Fluid leak issue

Just got off the phone with my GP, there was no infection. All tests came back as clear.

Really appreciate all the support from you guys. We don't get access to our surgeons private number or anything like that here. This forum is sometimes the only source of knowledge and comfort. Really helps, especially during distressful times.

Other Updates

Pain seems to be improving. I feel like the more I cycle, the better everything gets. I now cycle for 50 mins each session. I will pump to max then do 20m, after that 20m I can get in about 2-3 more pumps, then after another 20m, I will get in an extra 2-3 more pumps and do 10m. 50m total. By that final 10m, the penis is really stretched to it's limit, it is quite painful.

The squeak issue now is almost totally irrelevant. The pump is very quiet, and I think discreet pumping would be quite easy. This makes me very happy.

Getting the device to the right level of inflation can be tricky. Pumping to 80% provides good glans engorgement and a nice round shape. However, could be a little harder. At 90%, it seems really hard, almost to the point where, if you press the sides of the penis, it feels like a hard stick, but at this level there is extra girth and lots of rigidity. Perhaps, over time, as the cylinders soften and engorgement improves, it will be easier to find an ideal level of inflation.


Really have to thank all you guys, and this forum for all the support. Our greatest fear with an implant, is getting an infection. It feels great to be cleared, and feels great to have the support of members of the forum.

I may only do monthly updates now, but I will check in regularly to help and support other members.

J

[aussiePeyronies]

Clarification on Squeak

I think I need to clarify, today when pumping, if I pump quickly, the pump squeaks quite loudly. If I pump slowly, it does not squeak. This is a little disheartening, if one were trying to discreetly sneak in a few pumps. Perhaps it will change over time. Nonetheless, if you pump slowly but with force it does not squeak.

Other than that, I can say that sensitivity it slowly returning.

Will update in a month or so.

[Jage64]

Update -- Fluid leak issue

Just got off the phone with my GP, there was no infection. All tests came back as clear.

This is the best news of the day. I think that many don't realize how terrible an infection can be and why it's so important to MAKE SURE you and your surgeon do everything possible to lower the chance to as close to zero as possible.

We don't hear about infections much on FT, but don't ever let your guard down while your incisions are still healing. The penalty is too great.

[googly3]

Just want to say thanks for all the updates. You might not get replies to each update but some of us are reading and appreciate the insights. Hope for your full recovery and usage (and more updates ).