October 1, 2014
Dear Dr. Reed,
Have bad case of Peyronies’s. A nearly 90 degree bend to the left and if that’s not bad enough lost 3 inches of length.
Really don’t know how it happened but have had this condition for 3 years. Fortunately am still able to penetrate, but not a happy camper.
How do you think this happened?
My local urologist wants to do suture plication which will shorten me even further.
The most common cause of Peyronies’s that I know of is female above trauma or generally speaking sexual trauma. It hurts, you may have a bruise, and you remember the event. Another siltation is rolling over on a nocturnal erection. You may not recall that.
If your rigidity is good, then maybe a trial of Xiaflex injections, very costly (thousands) if you don’t have insurance. Auxilium the manufacture describes a successful result as an improvement and that may not be satisfactory to you. There are also the unfortunate complications of penile rupture less than 1%, and hemorrhage maybe 3 to 4%.
Xiaflex (Collagenase) will “melt” the tensing collagen scar tissue fibers.
Another option is traction, a vacuum erection device, perhaps 5 PDE inhibitors such as Cialis, Viagra. If your erections are weak, surely consideration can be given to a penile implants and simultaneous repair of the constricted area,. Another option is to repair the scar now with a graft. Graft success is less than plication which is almost uniformly successful. But certainly a worthwhile option to consider. If the corporal tissue (spongy erectile tissue) inside has been injured also, the erections may be somewhat hinged, as a good outer tire without a good inner tire is not going to provide the rigidity you desire.
Hoping this is of help,
Harold M. Reed, M.D. FICS
Senior Member of the American Urological Association
Member Society of Genito-Urinary Reconstructive Surgeons
Founding Member and Treasurer of American Academy of Phalloplasty Surgeons
Founding Member Sexual Society of North America