Does any Urologist perform a needle aponeurotomy for Peyronies disease?

Needle aponeurotomy for the hand is all I see online. I am a Kaiser Permanente subscriber and even at that, I don't see anywhere online where needle aponeurotomy is performed on a penis…Got any suggestions? Do you know of any Urologist in my medical plan who does needle aponeurotomy for Peyronie?

Sincerely,

Martin Carroll, Jr.

Greetings Martin,

Well, you are certainly an adventurous person. Here you are a layperson and you are thinking outside the box about your Peyronie's treatment, but you are in a risky area. The problem is that this idea of using a needle to tear up the fibrous Peyronie's plaque without having to cut the penis shaft open has already been explored.

As you know, needle aponeurotomy is a type of surgery done on the palm of the hand to surgically reduce the cords that develop in Dupuytren's contracture. It is a less invasive hand surgery performed by inserting a needle under the skin of the palm, and then blindly slashing and tearing at the cords and contracted fascial tissue since the skin is never opened by the surgeon so he/she never actually sees the tissue that is being cut and torn. The purpose of this procedure is an attempt to weaken and reduce the cords that develop under the skin in Dupuytren contracture to the point that the surgeon can eventually break or snap the weakened Dupuytren cords. The recurrence rate of the Dupuytren nodules and cords returning after needle aponeurotomy is fairly high, about a year or two faster than conventional hand surgery. Even though they return after this kind of hand surgery, the real caution and reason many people do not get this surgery is that when the Dupuytrens comes back in that year or two it will come back worse than the first time around. This is common for many of these Dupuytren hand surgeries and a good reason to think long and hard about getting started with the first one.

There are many hand surgeons who are proponents of this technique, and others who are not. No surgical technique is perfect, and they all carry risks. You might want to read more about these drawbacks and apply that thinking to what might happen if that same kind of technique was done for Peyronie's disease.

This same technique in which the tip of a large gauge needle is used as a cutting tool to reduce the Peyronie's plaque while the actual slashing and tearing of the tissue is not directly observed by the doctor who is doing the penis surgery is called the Leriche technique for Peyronie's disease. But it is not called an aponeurotomy because there is no aponeurosis in the shaft of the penis; that is why you were not able to find any information using the terms you were searching. If this surgery for the penis was to be named in a way similar to what is being done in the hand, it might a name like Needle Tunicotomy. This term would be applicable because it is the tunica albuginea of the penis that would be surgically cut by the needle tip and left in place, just as it is the aponeurosis of the palm that is cut with the needle in Dupuytren's contracture. You will not find this term anywhere but here because I coined it. to read more about this procedure, click on “Leriche technique for Peyronie's surgery.”

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There are many more conservative ways of trying to correct your Peyronie's disease than having the internal scar blindly being cut to shreds. I suggest you consider avoiding that kind of risk and look at some of the less risky non-invasive Alternative Medicine options that are on the PDI website. TRH

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If I can't find a scar is it possible I have a condition other than Peyronie's disease?

Hi Dr. Herazy,

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I developed an upward curvature about 10 months ago, and upon recent self examination I cannot find any lumps or scars at all. Is it possible that I have a condition other than Peyronie's disease? Also could I benefit from the treatments available from your website to reduce the curvature since I cannot find the scar and if so which treatment plan do you suggest?

Thanks,

Alan

Greetings Alan,

It is rare for a man to have a recently acquired curved penis and for it to be caused by something other than Peyronie's disease. Even so, you should go to a urologist with some interest and experience with PD for a complete examination and diagnosis of your problem.

It would not be at all unusual for a layperson who has Peyronies to be unable to identify the characteristic Peyronie's plaque or scar that often but not always can be detected as a lump below the surface of the skin. Many times no Peyronie's scar or plaque is found, or found with great difficulty and uncertainty; many times the scar is very flat and thin and is missed simply because the shape and size does not fulfill expectations. TRH


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How should I do penis stretching with two different deformities?

I have Peyronie's disease with a downward curvature when erect. I have watched the PDI gentle massage video and it states that you should attack the biggest curvature first, ok. But here is a problem, when the penis is flaccid, ie not erect, I also have an hour-glass deformity figure. The hourglass figure is not there when fully erect at all, but it does make it harder to apply gentle massage technique when flaccid. So should I try to attack the hour-glass figure first or not?

Greetings,

If you are correctly applying the gentle manual PDI penis stretching technique to a flaccid penis that demonstrates a hourglass deformity you should not have any trouble holding or maintaining the correct contact. You are doing something wrong.

In your question you used the word “attack” twice.

In the one-hour video I know I did not use that word once, because the emphasis is always about how light and gentle the contact and minimal the traction is when applying this special penis stretching technique. I hope you are not being too aggressive with this method of treating Peyronie's disease, and that you are carefully applying the specific instructions just as they were carefully presented to you. For you to be having a problem holding a contact for an hourglass deformity tells me you are not doing the work correctly.

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In the video spent a lot time explaining the method will not work if you are too aggressive and heavy-handed when you use it, so please be careful how you apply it. Actually, I encourage you to sit down and watch the CD again to be sure you are doing it correctly.

Regardless how you might be using unnecessary and counter-productive force, I can advise you that you should be applying traction not to correct the hourglass deformity since you report that it is only present when you are flaccid, or non-erect. Your gentle penis traction should be applied to correct the downward bent penis carefully following the instructions given in hour long video for this kind of deformity.

Also, you do not mention doing any other form of Peyronie's treatment, such as vitamin E and C, systemic enzymes, PABA, DMSO, etc. If you are only using the PDI gentle manual penis stretching technique by itself you are making another mistake. Please contact me if you have any questions or need something explained in greater detail. I am concerned how you are working to correct your Peyronie's disease and want to assist you in any way I can. TRH

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How is DMSO applied in a Peyronie's disease treatment plan?

Hi doctor,

I just have a quick question regarding applying DMSO to my curved penis. Will it still be effective to the fibrous plague even my Peyronies disease condition started a long time ago. I had developed a curved penis since i was young and i am now 28. Looking to purchase your BETTER PLAN. How should one apply it? on erect state or not? Thank you and hope for your response.:)

Ollie

Greetings Ollie,

Are you sure you have Peyronie’s disease? Have you been formally diagnosed with PD? Perhaps you were born with a normally curved penis.

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Assuming you do have Peyronie’s disease, the medium plan is by far the most popular. DMSO is an important part of the overall therapy. All instructions you need for using every part of the medium plan are included when you receive your order; you will not have any questions about how to use the DMSO or any other part of the plan.

To answer your question, the DMSO is applied in the non-erect, or flaccid, state.

Let me know if I can help you in any way. TRH

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Is there anything I can do to help my husband recover from Peyronie’s disease?

Any woman can help and support his effort to reduce Peyronies disease in several ways

There obvious and not so obvious, direct and indirect, ways a woman can help the man in her life to deal with his problems of Peyronie’s disease not only on a personal treatment basis, but also by supporting and assisting with those personal matters that threaten their relationship as a social and sexual couple.

It goes without saying that the obvious physical problems of a curved penis, reduced length and girth, and erectile dysfunction that are part of Peyronie’s disease directly affect the man who has this condition.  But the woman in a relationship with such a man is in a critical position because of their personal relationship to help him deal with the many negative aspects of Peyronie’s disease, and so can provide an integral part of any solution he might need.  Her role begins by understanding and accepting that he is going through a strange and stressful event for which no man is ever prepared.  Throughout a woman’s life, even before her teen years, she is talked to and prepared for changes in her reproductive system; she discusses these events that affect her genital area with her mother and perhaps her sisters and girlfriends who also experience these changes; she even goes to a special kind of doctor, a gynecologist, who specializes just in the female reproductive system; each month she is reminded that her pelvic region does unusual things; if she becomes pregnant she soon overcomes her modesty and privacy about this area of her body.  A man does not ever experience anything remotely like that.  His genitals are his prized masculine region, but they are private.  For the most part his reproductive area is uneventful and is not discussed much – except if he develops Peyronie’s disease.

For these reasons he has been completely unprepared by his past experiences to deal with  suddenly learning that there is a problem he has never heard of before, called Peyronie’s disease, that jeopardizes his ability to engage in sexual intercourse and denies him the act that defines manhood to him.   For a man Peyronie’s disease is perhaps not so much experienced as a health problem in which fibrous plaque material develops internally within the penis, but more so it is felt to be a loss of what makes him a man.  The woman who must deal with her man’s Peyronies problem must see this condition as a great emotional issue for him and be prepared to forgive him if his temperament and mood suffers while he comes to grips with his curved penis that no longer works as it once did.

He will benefit greatly from his mate’s emotional support and patience, and her ability to forgive him while he wrestles with the fears that are connected to Peyronie’s disease. Probably his biggest fear is the losing you because of his reduced sexual ability; no longer being able to provide you the pleasure of sexual intercourse, that you will leave him for someone else. He fears that he will never experience regain the pleasure of traditional sexual satisfaction. He fears that if you do leave him he will never be able to develop a relationship with another woman, and he will be alone in life. He fears being pitied and ridiculed as the man with the deformed and shrunken penis. He fears feeling like less of a man.  It is not really the physical aspects of Peyronie’s disease that drives a man into despair, it is being unprepared for the emotional isolation he feels.  More than ever he needs you but he feels ashamed and embarrassed to be with you, adding to the torment he feels.

From the combination of physical, emotional and sexual problems related to Peyronie’s disease comes a list of common problems and pitfalls that happen to most couples. Since the man with Peyronie’s disease will often shut down emotionally and a state of denial, totally ignoring his problem, the burden to actively learn about and reach out for help will fall to the woman in that relationship. From this reason the Peyronie’s Disease Institute has developed  a special program in which our staff nurse can consult with and advise a woman who needs help dealing with any aspect of Peyronie’s disease.  During a friendly phone call our nurse will answer questions of any sort about Peyronie’s disease (male and female anatomy, sexual difficulties, personal relationship problems, treatment options, or anything else that is on her mind).

Here are a few ideas to consider to help him deal with his penile problems and to protect the bonds of your family:

  1. Continue your usual sex life if at all possible, limiting traditional intercourse only to the extent that his curved penis prevents it.  In case you believe that you cannot any longer engage in intercourse, please know that there are many techniques and ideas that can help you allow entry and increase your ability for traditional sexual intercourse. Few couples are as limited in their ability to engage in intercourse as they assume; usually all they need are some basic ideas and simple instruction. This is such an important topic; please refer to my second book that covers many aspects of this topic at great detail and length, “Peyronie’s Disease and Sex.”
  2. An important aspect of Alternative Medicine treatment of PD is the PDI diet to assist recovery from Peyronies.   This subject is covered in detail in chapter 5 of “Peyronie’s Disease Handbook.”  You can assist his recovery greatly if you can coach him through these dietary ideas, and make it easier to follow if you incorporate these principles into your lifestyle for the time being.
  3. Moral support at this time is crucial.  You will help him, and help yourself as well, if you can offer him encouragement and praise during these rough times.  You will prove your loyalty and earn his admiration and respect when you demonstrate you are not a fair weather friend.  Men commonly refer to their time dealing with Peyronie’s disease as the lowest point of their lives, feeling alone and depressed, offering them all the excuse needed to behave badly.  Just because a man is acting like a jerk does not mean he does not know he is acting like a jerk; he knows his behavior is bad; he just does not care to control his primitive emotions of the moment. This is the time a man needs a friend to offer support and a trusting heart.  Even though he might push you away out of embarrassment and self-consciousness for his reduced physical state, he will soon recognize your acts of steadfast friendship and tolerance as proof you are not going to reject him.  Once he is confident you are not going to run away because of his sexual problems, your man will come around to his old self (and probably better) because you will have proven your love for him to an even greater level than he knew before.  This is how your relationship will grow under the adversity of Peyronie’s disease, by showing your strength and loyalty to him no matter what happens.
  4. Be tolerant and understanding about his reduced sexual interest and flawed sexual ability.  Both of you are afraid of what will happen in the future regarding your sex life together.  The way to make our fears become a reality is to place a lot of pressure on his sexual performance.  Easy does it.  As discussed at length in “Peyronie’s Disease and Sex,” we find that most couples can actually engage in sexual intercourse for a far longer time than they imagine, but stop only because the do not know how to solve get around some of the difficulties of gaining entry with a bent penis; this book explains how to be successful with sex using a curved penis than you could imagine.  In the early stages of Peyronies it is most valuable to continue traditional intercourse for as long as possible.  It is not necessary to stop sexual activity as long as no pain occurs for either partner.  Engaging in sexual activity is good for the physical and emotional health of both partners, as well as beneficial for your personal relationship.  Sex can be the all-important emotional glue that keeps you together, so use sex liberally since PD is really all about sex when you think about it.  If you reduce sexual activity at this time it will only confirm his worse fear that you are no longer interested in him as a sexual person. If traditional sexual intercourse turns out to not be possible due to his curved penis it is necessary to explore, expand and use a greater variety non-intercourse sexual activities and techniques, with the hands, lips and whatever else is mutually agreeable to you as a couple.  Your previous thinking and attitude about sexual activity might have to change to satisfy your unfulfilled physical needs for intimacy.  With an open and honest dialogue you can work these things out.  Again, your helpful and willing approach to sexual problem solving and cooperation only proves your place in his heart as the best possible partner he can have.

Many of the conflicts and stresses a couple goes through when Peyronie’s disease enters their lives are avoidable.  A little understanding, a few suggestions about altered sex techniques, the man having the woman’s side explained to him, the woman having the man’s side explained to her, reading the positive and informative books that are available from the Peyronie’s Disease Institute, and starting an aggressive Alternative Medicine treatment plan to increase his ability to heal and repair the Peyronies plaque can do wonders to reduce stress and misunderstanding between people dealing with Peyronie’s disease.

If the woman would keep in mind that her man with Peyronie’s disease is very much like a scared little boy who is behaving badly because he is scared of losing you, and treat him accordingly, things would improve greatly. With understanding, love and a little compassion you can help that little boy know you are not going to leave him and you will protect your relationship with him.

Is it better to divide or not divide dosage in a Peyronie’s treatment plan?

Dr. H.,

Is it better to take the pills that say 1-2 per day (PABA, Acetyl, Vitamin C and E) 1 in the morning and 1 at night or better to take 2 at one time?

Thanks,

Eli

 

Greetings Eli,

Most people take all dosages in a Peyronie’s treatment plan divided equally throughout the day, so a two/day dosage would be one in AM and PM.

However, taking a two/day dosage all at the same time could be a variation to experiment with to determine if your body responds differently to it than taking the same therapy product in a divided dosage. Experiment.

No matter what you and I think and can rationalize about what to take and how to take it, all aspects of your Peyronies treatment should be evaluated against actual response of your internal scar. No one knows what will work best for you; you must figure it out based on early changes in the size, shape, density and surface features of the Peyronie’s plaque. Even something that many people would take for granted like dividing or not dividing dosages can have an influence on your body’s ability to change the scar structure. I always advise to evaluate every change in your treatment plan by looking for small changes in the scar – after all, that is what your treatment is supposed to do.   TRH

Will items in a Peyronie's treatment plan cause drug interactions?

Dr. Herazy

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I take metoprolol ( betablocker) , trilipix and simastatin for cholesterol and lansoprazole for reduction of stomache acid. Will taking Nattokinase or serrapeptase, neprinol or any of the other listed treatment plans be a cause for concern for any drug interactions . I also take krill oil.

Greetings,

In over 10 years of doing this work I have never been told about any adverse drug reaction with any of the Peyronie's treatment items that are used. I would suggest, however, that you pose this same question to the doctor who is prescribing all this medication to you. You always want to inform the doctor of your Alternative Medicine intake.

You might also want to discuss with this doctor the very real possibility that the beta blocker and the cholesterol lowering drugs you are taking are the cause of your Peyronie's disease. Taking any one of these carries a risk of starting a drug reaction of its own that can cause Peyronie's disease, but when you take two different drugs that both carry a risk you are creating a very unfavorable situation for yourself. This should have been explained to you when you first started to take these drugs. TRH

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How can I fix my curved penis when I get erect?

Good day,

I have curve to the left and is causing me serious trouble when I got erected.

How do I fix my curved penis?

Regards

Pongo

Greetings Pongo,

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You can spend a little time and effort reading and learning about Alternative Medicine treatment of Peyronie's disease. I suggest you go to “Start Peyronies Treatment” found at the top of the PDI home page and get busy. You can also read any of the hundreds of answers I have already given to this same question that appears in this Question/Answer section. TRH

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After Nesbit Peyronie's surgery the curved penis came back – now what?

Hi Dr Herazy,

I was diagnosed with Peyronie's disease in Oct 2009. the urologist put me on potaba which did nothing. I then tried neprinol that did nothing. I saw the uro again and he put me oh high doses of oral Vitamin E and said I was to start VED therapy. My penis curve did not improve at all and in fact became worse. I was then also put on pentoxifylline which again did nothing. After no improvement and the curve to my penis being 40 degrees upward he told me the only solution was Nesbit surgery which I underwent out of desperation in May last year 2011. All was fine, my penis was very straight but shorter by about an inch but then in Sept.Oct the same year I began to notice my penis curving up again! Now in August 2012 it is really back to where I was in 2009 with an upward curve of 40 degrees. Very depressing as same curve just shorter penis!

What do you suggest in light of my previous drugs and treatment to try and cure this myself as I am beginning to give up on the uro's and certainly do not want more surgery after the first one failing me! What do you think about this if I order: DMSO, Super CD Serum, Vitamin E unique Oil, stretching video, Scar-X and Acetyl-L- Carnitine? I am in the UK. Hello, please help as I am now desperate and depressed.

Gary

Greetings Gary,

I commend you for your tenacity and strength to continue to work to help yourself in view of all that has happened to you.

It appears that you have now spent some time reading a few ideas presented on the PDI website about Alternative Medicine treatment of Peyronie's disease. It sounds like when you earlier used Neprinol by itself you did not receive any good advice and you wasted that opportunity to do something positive and helpful for your curved penis. That is always the problem when buying Neprinol from people who do not know how to use it correctly.

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Please do not evaluate Neprinol based on using it by itself. In my opinion that is not the best way to use Neprinol. It is a great therapy product but it must be combined within a well balanced Peyronies treatment plan that addresses other aspects of this complicated problem. You did the best you knew how to do, but you just did not receive good information. Neprinol cannot do it all by itself, but then again, no other therapy product can either; they all must be combined for greatest effectiveness.

If you read about the Nesbit Peyronie's surgery procedure and outcomes on the PDI website you will learn that it is not uncommon for Peyronie's disease to return within a few years; sometimes sooner and sometime later, but it will always return. The surgeons do not like to discuss this aspect of their work because it does not do a lot for their business prospects. In this regard I strongly suggest that you consider putting yourself on an aggressive support plan to minimize the potential of fibrous tissue return. The outline that you suggest is not a bad one and could be helpful in your situation. If it makes sense to you, as apparently it does, I suggest you put yourself of this plan you designed and try it for a month to see if it makes a difference in the size, shape, density and surface features of your scars – no plan can be evaluated on paper; it is only by applying it and evaluating how it affects your PD scars will you know if it is actually effective for you.

Please let me know if I can be of help to your effort. TRH

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What do you think is the best route for Peyronie's treatment?

I am a 39 year old male that developed peyronie's about 1 year ago. Much of the curvature has gone away, but my erection still bends slightly down (compared to having a natural upward curve previously), and it has a dimple on the underside of the shaft. Most of the pain has gone away. At the recommendation of my urologist, I was taking oral Vitamin E of about 400 IU daily, and added Wobezym (6 pills daily), Serrapeptase (120,000 IU/2 daily), and bromelain (1000mg daily of 2,000 GDU/g).

I was considering ordering the medium plan along with the stretching DVD. Do you think this would be the best route to go? How long do you think it would take to see results?

Thanks.

Tony

Greetings Tony,

Judging your progress simply by noting good or bad changes in the penis curvature is not a good strategy.  Naturally it is the bent penis that gets your attention and it is what you most want to see improved, but it is a poor way to evaluate what is going on with the Peyronie's disease treatment you are doing.

The fact is that the curved penis is not the primary problem of Peyronie's disease; the primary problem of Peyronie's disease is the internal scar or Peyronie's plaque that causes the penile distortion.  The size, shape, density and surface features of the internal Peyronie's plaque this is what you need to measure and evaluate to determine if your effort is being truly successful or not.

Another fact is that your Peyronie's plaque can be worsening and your curved penis can become straighter at the same time this is happening.  This happens when the growing PD scar tissue balances out the internal stresses and tissue pulling that takes place because of scar material.  This is not a good thing.  I f you have a large and complex interplay of PD scar material that is so arranged that your penis is straight, is this really desirable? Is it a good thing? If you say, “What do I care if the scars are getting worse?  Just as long as the curve is getting better and I can continue to have sex.”    The answer to that attitude is to understand that Peyronie's disease is not a static problem and over time it will worsen.  You might eventually have the currently balanced scars become imbalanced and they can begin to pull the penis in a weird and abnormal way resulting in a worse curve than you had at the beginning of your problem. 

Of course, I have no way to know the condition of your internal scar tissue.  But then again, neither do you unless you understand this concept and are paying attention to what is really important.  Your internal scar material could be totally reversed, it is possible, but you will never know and will remain at a distinct disadvantage for as long as you ignore what is going on inside. 

Only you will know the best treatment route to take by noting the response of your scar in terms of changes of the size, shape, density and surface features of your internal Peyronie's plaque.  The medium plan is a good one to work with.  Take it as you are given suggestions when you receive your order and every 7-10 days evaluate your shaft for changes in the scar size, shape, density and surface features.  Increase the dosage of your plan until you see definite and clear reduction of the size, shape, density and surface features of the plaque material.   This is the very best way to know you are following the best plan of action for your recovery. 

When a man follows a very aggressive Peyronies plan and does so faithfully, and finally reaches the correct dosage by slow incremental increase of dosage while evaluating the size, shape, density and surface features of his fibrous Peyronie's plaque, he can expect to see changes as quickly as 7-10 days after he has reached his correct dosage level.  Notice, I did not say his PD would be gone, just that his scar would begin to be reabsorbed and start to get smaller as determined by these various measures.   After that point it is usually 2-6 months of care to have all the tissue changes occur that will take place. 

By the way, you might be getting better results with Neprinol.  I also recommend that a good treatment strategy includes a variety of Peyronies disease exercises along with using vitamins, minerals, enzymes and herbs to support your natural recovery. TRH

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Can Peyronie's treatment pills be crushed and taken with water?

DR. HERAZY, CAN ANY OF PILLS OF YOUR TREATMENT BE CRUSHED AND TAKEN WITH A LITTLE WATER?

Greetings,

Sounds like you have a problem swallowing pills, my friend.

None of the vitamin E products can be crushed because they are soft gelatin capsules, but I do not see why you could not crush any of the others.

When you consider the small size of all these therapy capsules, I am confident that these pills are smaller than most of the food that you swallow with no problem after chewing it for a very short time. Most of us do not chew or food enough, and this represents a large digestion problem to a lot of people who do not realize that poorly chewed food is a major problem for their digestion. I mention this as a way of telling you that you are probably swallowing big pieces of food all the time, and you are making a bigger deal of pill swallowing than you need to do.

It seems a good thing that we are programed to not swallow things whole; that we need to chew them up and make them smaller and softer. It’s sometimes difficult to swallow a solid substance without first chewing it; you feel like you are working against a protective instinct. This is made worse when there are many such solids to swallow when you are taking a lot of different therapies in a Peyronie's treatment plan. Nonetheless, it is often necessary to swallow 4-18 pills several times a day to assist your recovery over PD.

Frustration grows when you can’t easily take many pills in your Peyronie’s disease vitamin plan because you hesitate or gag. There are different useful strategies to get over this hurdle. I have never met anyone who cannot get over this problem if they work at it.

Since pill swallowing will likely remain a required skill until you correct your Peyronie’s disease, approach a pill swallowing problem from several angles using old and new tricks:

1. Practice with common food. Swallow mini candies, or small bites of food, without chewing them very much to simulate pill taking. Deliberately think about and feel the sensation of having chunks of solid food sliding down your throat; get comfortable with that feeling; focus on how easy it is to be relaxed when you swallow pieces of cooked vegetables or meat that are actually larger than the pills that make you feel so uncomfortable.

2. Put 1-4 pills in your mouth. Keep them there while you carefully go through a few small chewing motions – do not actually chew on the pills them to avoid a nasty taste. After you have satisfied the need to “chew before swallowing,” immediately drink some water as you swallow the pills already in your mouth. You will thus fool yourself into the idea that you have chewed what you want to swallow.

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3. Take pills one at a time to avoid overloading your gag reflex.

4. Drink a large glass of warm water BEFORE taking your Peyronie’s disease vitamin plan. This will relax your throat muscles and make taking the actual pills easier.

5. Sip a cold, carbonated beverage (sparkling water, lemon-lime soda) straight from the bottle when swallowing a pill.

6. Spray or gargle with an over-the-counter topical anesthetic (normally used for sore throats) before swallowing.

7. Take a deep breath and hold the breath in your lungs before putting the tablet in your mouth; some say that this can suppress the gag reflex.

8. Place the pill on the back of your tongue, drink some water, tilt your chin down toward your chest, and swallow.

9. Put the pill on the tip of your tongue, drink some water, tilt your head back, and swallow.

Combining some of the above ideas could yield a remedy for you, but if none of them help you should really consider some larger issues.

The fact is your throat operates as part of a complex system. While it may seem you have an extraordinarily strong gag reflex or odd throat mannerisms, consider that it may actually be the power of your mind, not the power of your throat. Try to psych yourself out with this pill swallowing mantra — “I can swallow this…I can see the pill going down.”

Or, perhaps not being able to swallow pills has something to do with a past event. If you are unusually tense about pill swallowing from something that happened in your childhood, it makes sense for it to surface when you try to swallow a pill again. Did you choke on a raisin many years ago? Did a school nurse with dirty hands force you to take a pill? You may be subconsciously dealing with issues such as these every time you swallow an aspirin or vitamin. Fear of choking, fear of medicine, or general anxiety may be preventing you from swallowing pills. If you think these mental factors are to blame, you might consider talking with a counselor.

While it seems unlikely, the possibility of a greater medical issue does exist. The medical term for difficulty swallowing is dysphagia, and the term is often used with regard to a disorder of the esophagus. Keep in mind, though, that if you can swallow your food without trouble, your esophagus is probably fine.

This is an important issue to address because you cannot allow trouble swallowing your Peyronie’s treatment pills to prevent you from achieving success over your PD. TRH

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What do you think of a mechanical penis stretcher for treatment of Peyronie’s disease?

I'm so confused on what to do about my Peyronies.  On one site it says to use a stretcher, and on other web sites it says not to!

I was diagnosed with Peyronie's disease about about a year and a half ago I had a bend to the left and now about six months ago a bend about a inch away from the first bend I have a bend to the right and lost at least an inch of length to my penis.

Currently I'm taking PENTOXIFYLLIN  and using a vacuum device but not seeing much of a change. Not sure what to try or do next. What do you think of a mechanical stretcher? I would really appreciate any advice!!!!!!

Thanks

Ken

Greetings Ken,

I am sorry for the confusion you feel.  Maybe it will help you to know that you are not alone in that regard; everyone who first comes to the Internet is thrown around in different directions by the conflicting information and non-information about Peyronie's disease that abounds there.  

First, I suggest that you read as much as you can about all the different subjects and ideas about Peyronie's disease that you can.  But as you do, please try to make a deliberate effort to pick out the reasons that are offered and the explanations that are presented.  Do not just accept, "Do this…", but read with special interest those articles and discussions that say, "Do this because of these following reasons…"   Carefully read and try to see if the author makes any explanation why he says what he says.  Often many authors give no reason or rationale for what they say, or the reasons they offer just do not make sense.

Since  you mention your confusion about the use of mechanical penis stretchers, I will use that as an example.   You will notice that the discussions and promotions for these mechanical penis stretchers never explain how or why they work, they just say that they work.  That has always made me suspicious of all of them.  In my experience they do not work, and I have explained in great detail why I say they do not work; you can read it on the PDI website.

You should know that I think the mechanical penis stretchers are basically ineffective and often dangerous to the extent that many men have told me their Peyronie's disease started or got worse after using one of them.   I have written several posts on this subject.   Here are a few:  "Penis stretcher: Big problem as a Peyronie's treatment"  and  "Penis stretching for Peyronie's disease"  and   "Peyronies treatment and the penis stretcher."  

I suggest you spend some time on the PDI website to see if the ideas and explanations make sense to you.   TRH

What about these other systemic enzyme products for Peyronie's treatment?

What do you think of the products Serracor-NK and Serra RX? I have been taking them as well in my Peyronie's treatment plan. They are very expensive and I am wondering if I should reorder or not.

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Thanks so much for your feed back

Nick

Greetings Nick,

I have never used or had experience with anyone who was successful in using these products as a Peyronie's treatment. I just do not have any experience with them so I cannot speak with authority about them.

What I can comment on is that several years ago there were some terrible lawsuits that were initiated because of aggressive business practices by the manufacturer of Serracor and Serra RX, and they attempted to destroy the manufacturer of Neprinol. Eventually, the Neprinol folks won out, and I have always felt that this history did not speak well of the people who make Serracor and Serra RX. I just do not have confidence in them. It might be a great product, but I would just as well continue to use the older, larger and more experienced company that makes Neprinol.

I cannot work with you to answer any questions about using these two enzyme products since I have no practical experience with either of them; you are on your own if you have a question about them. TRH

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Which enzyme preparation is most effective for Peyronie's disease treatment?

What enzyme preparation do you feel is the most effective, and has the highest quality control in its manufacture, Neprinol, Fibrozym or Nattokinase?

What is the reason you don't recommend Serracor or Serra RX?

Greetings,

Effectiveness of Neprinol, Fibrozym or Nattokinase is never evaluated in a vacuum. Since I have never used them alone or recommended any of the PDI therapies to be used as a solo treatment, I cannot speculate in that way for you. Each product undergoes rigorous laboratory testing to prove each is effective in its ability to degrade and catabolyze fibrous protein molecules, so we know each is effective in that regard. The question you are asking has never been investigated because it is contradictory to the way these products are used and the philosophy of synergistic Peyronies treatment I promote on the PDI website.

The quality control issue is equal for the manufacturers of Neprinol, Fibrozym and Nattokinase since each fulfills the government standards for laboratory testing and manufacturing practices.

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I do not recommend Serracor or Serra RX because I was around before these products existed and I know some of the nasty history behind them, and the lawsuits that did not go in favor of the manufacturer of Serracor and Serra RX. Given that, I think it is more prudent to stay with an older, larger and more stable company. TRH

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How can you help my Peyronie's disease situation?

Hello,

I have, what I believe is the early stages of Peyroine's disease.

I have a very distinct and sudden narrowing of the base of the penis, on the left, but little angular distortion, and no palpable scar tissue. I do have have the pain associated with this condition.

I am fortunate that I found your site, and identified the condition before it becomes more established.

I would like to prevent this from escalating and of course return to normal ASAP.

How can you help in this situation?

Thank you.

Greetings,

You ask perhaps the most common question that is presented to me in a thousand different ways: “I have Peyronie’s disease, how can you help me?”

You are correct in wanting to get Peyronies treatment started early before the usual tissue changes become entrenched and more difficult to reverse; it can be done later, but is usually faster and easier to help in the early stages.

I enjoy the sense of knowing that I can assist someone like you toward recovery from Peyronie's disease, so I also feel fortunate that you found this website. In fact, maybe because it is early on a Sunday morning that I am writing this response, I will approach my reply to you in a slightly different way. You see, I have received hundreds and hundreds of emails exactly like yours – and I have answered each of them and yet I never know the best way to answer your most fundamental and sincere question.

I spend from 50-60 hours a week talking to men from around the world, answering emails, writing various articles and posts for the PDI website, and tending to the business of helping the shocked and discouraged men who have Peyronies. After doing this for a little over 10 years, the PDI website is monstrously large and loaded with unique content about all aspects of natural Peyronie’s disease treatment.

It has been estimated that if someone were to print out the PDI website it would be well over 1,500 pages of information – how to treat PD, how to get started, how to handle various questions and problems along the way, technical information and every day practical stuff. All of that free information is available for your use and education, right now, 24 hours a day.

And yet, after all that, men like you write a simple email asking, “How can you help this situation?”

With all that I have written and presented to you that you can have right now at your immediate disposal for the mere cost of clicking on your cursor button, I do not know what else I can say or do to get that information to you that I have not already done a hundred times before. All you really have to do is look and read what is in front of you.

All you have to do is spend some time reading and learning the concepts and philosophy involved in helping your body heal the Peyronie’s plaque like it should have happened in the first place. If half the men who develop Peyronie’s disease are fortunate to have their problem spontaneously and naturally heal all on its own, then there exists the possibility that your natural healing ability can be increased and strengthened if you supply a high quantity of high quality nutrients and enzymes to assist that natural recovery process that failed to occur in you and me when I developed my Peyronie’s disease many years ago.

When i developed my Peyronie's disease I worked hard to plow through a mountain of information about this crazy problem to understand what was known and not known about it; I worked hard to sort out a large amount of technical information, facts, opinions, and what I came to know was simply lazy medical thinking; I worked hard to apply the information that made sense to me; I worked hard to put together the first Alternative Medicine treatment strategy that could actually make a difference in the recovery from PD and it actually worked for me; I worked hard to understand what was going on when the Peyronie’s plaque started to get reabsorbed and disappear; and I worked hard to keep that recovery going until all the plaque disappeared and the distortion finally straightened out.

And now I am answering your question to make it easy for you, but you still must spend a little time reading the PDI website. Go to “Start Peyronie’s Treatment” that is found toward the top of the home page, and read.

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And as I always conclude when I finish a response, if you have any questions please let me know and I will be happy to assist you. TRH

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Can I use DMSO gel and Fibrozym together for my Peyronies disease?

Can I use DMSO gel and Fibrozym together for my Peyronies disease? what are the risks if there are any? I read on the internet that DMSO absorbs plastic and they recommend not to use DMSO that is in a plastic bottle… thanks

 

Greetings,

It is a rare man who treats his Peyronie's disease using the PDI concepts of natural treatment who does not combine PMD DMSO gel and Fibrozym – plus many other systemic enzymes as well as therapies like PABA, acetyl-L-carnitine, vitamin E, etc.  The use of topical DMSO while taking all other forms of our therapy lineup has never caused any complaints or problems in over 10 years of doing this work with Peyronies treatment.   I just do not get any complaints or notification of side effects or problems. 

The PDI DMSO products – PMD DMSO and Dusa Sal DMSO – are both made by the laboratory that is still owned and operated by the medical doctor who did the original  research and investigation of dimethyl sulfoxide (DMSO) for use on human tissue, Dr. Stanley Jacob.  He is in his mid-90s and still teaches at the University of Washington School of Medicine.   He has thoroughly researched the subject of storage containers for transporting and keeping DMSO and has found that only one form of plastic is safe, and that is a rather expensive laboratory grade polyethelene.  Otherwise, if not using this particular for of plastic then DMSO must be kept in a glass container.  Anyone who gave you the advice you mentioned does not know or understand the subject of DMSO.   TRH

What Peyronies treatment would you suggest for a “waist” in the penis?

Dr. Herazy,

What treatment plan would you suggest in treating a waist in the penis? And also, does the penis waist happen because of lack of blood flow to that area?

Thanks

 

Greetings,

When you mention a "waist in the penis" I assume you refer to what is commonly referred to as an hourglass deformity of the penis associated with Peyronie's disease in which there is a narrowed portion of the penis in a small or large part of the circumference of the shaft.   

Treatment for this type of distortion is not much different for this distortion or for any other distortion that is caused by the presence of the internal Peyronies plaque or scar tissue – except in one small aspect I will explain a bit further down.  The very important point I want to make now is that good Peyronies treatment is not directed to the distorted (bent, curved, hourglass, waisted, limp or shrunken) penis, but to the scar itself.   What is wrong with you is not that your penis has a waist formation, but that you have a Peyronie's plaque or internal scar in the shaft that is causing a waist formation.  Do you understand the critical point I am trying to make?  Your problem is not the waist, but what is causing the waist to form.  That is why it is pointless to try to stretch a curved penis with a mechanical penis stretcher because it cannot do anything to remove or reduce the Peyronies plaque.   A case of Peyronie's disease is not a curved penis that will be corrected by forced stretching, like a bent paperclip.  A case of Peyronies disease is one in which internal scar tissue can cause the penis to bend or distort in some way.  For this reason treatment is not so much directed to the kind of distortion but to the reason for the distortion. 

Having explained that, I will say that the gentle manual penis stretching technique developed in a PDI research project a few years back can be modified to suit the type of distortion displayed because with this particular local technique it is possible to focus subtle traction vectors into the specific location and direction of the plaque formation.  We developed unique techniques for bends, twists or rotation, hourglass, bottleneck and combinations of deformities to isolate the fibers that cause those patterns in an effort to stimulate their reabsorption.

This waist or hourglass type of distortion is caused by a circular or collar-like Peyronie's plaque formation that either prevents or restricts the full expansion of the shaft during an erection or allows blood to not collect in a particular area and therefore not expand completely.

My suggestion is that you do a bit of reading at start Peyronie's treatment to see if this makes sense to you, and to begin working to increase your ability to heal the Peyronies scar in the best way possible.  In my opinion the best Peyronie's treatment is the largest and most aggressive you can sustain for a few months to assist natural healing.  Read the PDI website to learn if you agree.  TRH

How should I improve my success of Peyronies treatment using vitamin E?

Sir i am 28 years old and i have bp from last 10 years taking olmat am (atagonist +amophline) tab sir my penis is bend towards left and upwards also for curing this i took vitamin e 400 capsule for 1 month yes results were OK means when i take my penis becomes straight and slight improvement as well but when i stopped taking vitamin e it started bending again for how long should i take vitamin e 400 and will it increase bp please guide sir as i will get married within 6 months please please please please

Greetings, 

From the limited information you provide I do not have a good idea how you should proceed since I do not know anything about the kind of vitamin E you used.   So I cannot comment on that element of what you have done to receive limited and temporary success. 

However, based on my 10 years of experience treating Peyronie’s disease I suggest that you expand and deepen your plan to include more therapy than using a solo therapy of just vitamin E.    My suggestion is to investigate how to improve your results by increasing your Peyronies treatment after reading how to start Peyronie’s treatment on the PDI website and using any of the plans you see available that make sense to you.

If you a specific question about treatment of Peyronie’s disease I would be pleased to assist you.  TRH

 

 

Unique urinary symptoms during Peyronies treatment

Is it possible that serraptease or the nattokinase of yours I just began using yesterday could cause some discomfort urinating? I do know that in trying to be more healthy I experimented for 3 months adding a forkful of natural unprocessed sauerkraut to my evening salad which seemed to have caused me to urinate frequently at night. When I stopped eating the fermented sauerkraut, I slept thru the night.

Do you think either of these products mights be causing me the same problem?Also, I just installed a new sink top water filter so I'm still trying to sort out the source of the problem. I don't have a prostate issue. Any thoughts?

Thanks,  Dr Herazy
Jim

 

Greetings Jim,

I do not see a clinical connection between intake of serrapeptase or nattokinase and urinary frequency or discomfort.  Having mentioned that, anything is possible since we are learning things daily about Peyronies treatment.  If there is such a connection, you are the first person in over 10 years to report it.  For this reason, I suggest you experiment a bit by stopping all intake of serrapeptase and nattokinase to see how your body responds.  We can create a theory to explain such a unique response if it happens it is associated with the systemic enzymes.  Let me know how you respond, please.  I would like to know.  TRH

Why is Neprinol not incldued in the three PDI Peyronie’s treatment plans?

I have been taking Neprinol for the passed few months, mainly because of your endorsement on the Fibromedica Health Solutions website.

In looking over the products in the Treatment Plans on your peyronie's website, http://peyronies-disease-help.com/product/peyronies-disease-treatment-plan-large-best/, I was surprised to find that Neprinol was not even listed as one of the products included in the Large or Medium Plans. Why is that? If Neprinol is so good in treating Peyronie's Disease why wouldn't it be included.

I did see where you can purchase Neprinol from your website, but why isn't it part of the overall plan? What role does it play?

John

Greetings John,

Not including Neprinol in the three basic treatment plans for PD is not a reflection of effectiveness in treatment of Peyronie's disease, but a matter of timing and long term planning.  Using Neprinol effectively for maximum removal of fibrous tissue elements from the body, and especially the tunica albuginea of the penile shaft, is more than taking a lot of Neprinol.

Neprinol is not included in the PDI Small, Medium or Large Plans for two reasons:

     1.  Neprinol is considerably more potent and concentrated than our other systemic enzyme products, Fibrozym and Nattokinase 1500.   Neprinol contains the same enzymes as Fibrozym and Nattokinase 1500 – at perhaps 10-12 times greater bioactivity.  It also contains different kinds of enzymes that are not found in Fibrozym and Nattokinase 1500.  So, Neprinol is more concentrated and has a greater variety of enzymes than these other products.  Therefore, based on seven years experience with men who are treating their PD, we have learned it is better to start treatment with the less intense and concentrated enzymes of Fibrozym and Nattokinase 1500 to get accustomed to the action of these enzymes; it is easier on the body and men have less diarrhea this way.   When you re-order the 1st or 2nd time you can then slowly introduce Neprinol into your treatment plan.

     2.  Cost.  Because the bottle of Neprinol contains 300 capsules of more powerful and concentrated enzymes, as compared to 100 capsules in the other products, Neprinol costs more.  Therefore, after almost seven years experience working with men who are treating their PD, we have found that men feel more comfortable keeping costs down when getting started.  The first order is the most expensive, and this is appreciated by men just starting who want to see how the suggested PDI plans work.

I suggest after being on your plan perhaps for a few weeks or few months, or whenever you are comfortable adding Neprinol to your plan, that you do so.  Many men will later use Neprinol as the primary source of systemic enzymes in their plan, but also keep a few Nattokinase 1500 and Fibrozym in their plans as secondary or minor sources of systemic enzymes. 

Recently I created an Alternative Large plan that does contain Neprinol.  It is intended for those individuals who have had previous experience using this product and know how their body will react to it. 

When I was actively treating my PD I took all three products, but with a greater emphasis on the Neprinol.  I do not think you must necessarily do it this way for you to be successful; I did it just to cover my bases and to keep my tissue as saturated as possible with the enzymes.

PD is a tough and terrible thing to happen to a man.  It takes dedication and persistence to overcome it.   I have worked with men who have had their problem longer than yours, and have done quite well.  It is never easy to overcome, but always worthwhile.  

The biggest advantage in ordering your therapy products from PDI is that we provide a high level of service and background information specific to the problem of PD that you will not receive from anyone else.  Each product you order from PDI comes with all the information you will need to you it correctly to treat your PD. You cannot expect that kind of vital information from any other source.  

Let me know if I can help you with your Peyronies treatment plan in any way.  TRH

 

 

 

 


How do I find the Peyronie’s scar?

I was diagnosed with peyronies about 10 years ago. I had the classic lump and my penis had a bend to it. It isnt super bad but enough that I want it gone as much as possible. I took potaba and vitamin E for several months with no real progress. I cannot feel any scars or lumps at this time but it seems that my curve may be worsening all of the sudden. I do not have pain and can have intercourse but would really like to have as close to a normal penis as possible. Is there a way to treat my condition after so many years? How do I find the Peyronie's scar and what would be the best action to take on an extremely tight budget? I am now 41 years old and in good health other then some problems with my discs in my upper back.

Thank you so much,

Phil

Greetings Phil,

POTABA and vitamin E do not make much of impact on Peyronie's disease; what you were given was a desperation prescription just to give you something to do and get you out of the office.

It is not at all uncommon for an older case of Peyronie's disease to continue to deteriorate and develop an increased penis curvature.  I have worked over the years with many men whose PD is in the 5-15 year range and they are still able to make improvement based on the concept that the Peyronie's plaque is still capable of change – for bad and for good.

Order "Peyronie's Disease Handbook" to learn how to find and define the PD scar since it is essential that you know all the physical features of it since you will use that information to determine how to manage your treatment program.

On a limited budget I would suggest starting with the small plan and working it aggressively against frequently monitoring your condition for making changes in the size, shape, density and surface features of your scars.  TRH

Do I need to consider seeing a urologist after penile trauma?

Doctor,

I read the PDI article and i'm very sure i have Broken Penile Syndrome…or Penile Fracture. i had rough sex, she came down on top of me and hit the head of the penis hard. no problem initially. about 5 days later woke up early morning with an erection and head of my penis was throbbing slightly.

didn't think much, but when another week later was having sex with my girlfriend and when i got really hard my penis head hurt pretty good…i still had sex but it the pain was noticeable.

another night time erection a few days later and head of my penis hurts slight.

2 weeks after having sex with my girlfriend  we have sex again and when i was hard it ached but the worst part was as i was entering her, and she was wet….the head of my penis really hurt. it hurt to have sex so i stopped. now i'm really concerned.

i've been checked for std's 2 weeks ago…i'm clean…the only thing here is the trauma i had over a month ago. will this heal on it's own, if i leave it alone? how long will it take? or do i need to consider seeing a urologist?

thank you,

John

 

Greetings John,

You may or may not have a penile fracture, but you could be on your way to Peyronie's disease.  I suggest you go to a urologist to have a complete examination to know what is going on.  Please advise me of your diagnosis and the treatment you are advised.  TRH  

Can we discuss my Peyronie’s disease on the phone, as l live in Australia?

Hi Dr Herazy,

I have noticed you now have Peyronies consulting by phone on the web site.

Can this be done as l live in Australia?  As l would like to discuss my Peyronies with you before l make my next purchase.

Looking forward to hear from you

Cheers

Marcus

 

Greetings Marcus,

Yes, I take calls from all over the world about Peyronie's treatment.  All we have to do is coordinate our time so you do not wake me up in the middle of the night.  Looking forward to hearing from you.   TRH 

How long should I follow my large Peyronie's treatment plan before making a change in it?

Dr Herazy,

I purchased your Peyronies Large Treatment Plan late last year and recently purchased your two books.

My first question is – When looking for Natural ED treatments that have a similar effect as Viagra – which supplements or combination would you recommend trying first?

The second question is – I have been using the DMSO/Topical Vitamin E since the beginning of April but have not noticed any change. Is that long enough or should I continue for a while longer?

Thank you in advance for your answers

Lee

Greetings Lee,

First, all the male sex booster and enhancer products are located near the bottom of the PDI shopping cart where are treatment products are found.

Start your ED treatment plan by taking Stimulin by itself. Take four per day, meaning two in the AM and two in the PM (closer to bedtime) Once in the blood, Stimulin helps increase the production of nitric oxide that stimulates blood flow in all parts of the body, especially the penis. More blood flow means improved libido and more powerful, long-lasting erections. Stimulin is superior to other herbal remedies for sexual vitality because it stimulates blood flow naturally. Nothing is forced, so the erections more like your previous ability.

You see, Stimulin provides nitric oxide (NO) a chemical messenger that is used in and a part of many normal body functions. For this reason, Stimulin is not taken right before sexual activity. Stimulin is taken like a supplement to assure your body works better in many areas – only one of which is the sexual function you are presently having trouble with. Stimulin is especially helpful for heart, blood pressure and gastrointestinal function – plus sexual function.

If you are satisfied with the way Stimulin helps you sexually, there is no need to go further. However, we are all different. Your results might not be all that you had hoped for; if that is so, then we recommend the use of one of several herbal products PDI has available that are useful to increase sexual ability. While continuing to take Stimulin© daily, we suggest you consider Step 2. This group of products is related to direct sexual stimulation and stamina, and these are used only right before sexual activity.

If after using Stimulin for several weeks you find you need a further boost with an an herbal sexual stimulant you should look at the products available in the PDI store. Unlike your daily dose of Stimulin, these herbal stimulants are taken only when sexual activity will take place.

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I suggest you experiment a but with the product lineup in this sequence, since this is the order of popularity of these products and I assume reflects the effectiveness of them, although you might easily respond differently:

Male X Booster
ITI Man
Libido-M
BetterMAN
Herbal V

Any of these products, when taken with Stimulin©, should provide sufficient diversification for sexual support and stimulus. Once again, it comes down to synergy and approaching your problem (along with 3 out of 5 other men in America) with a broad based ED therapeutic approach.

Begin taking the product you select according to label directions. The big advantage with the herbal sexual products is that they are far less overpowering than a drug. This is critical for you because of your PD. To knock you off your feet I can either hit you with a baseball bat (Viagra) or gently tap you at a strategic point (herbal product). Either way the job is done, but one is more preferable; herbal products do not run the risk of damaging the tunica by out-of-control and powerful erections that erection drugs can cause.

Second, I recommend that you should demand of yourself change in the size, shape, density and surface features of your scars after you find you correct variety and dosage of Peyronies treatment. This means that if you have followed whatever plan of care you committed to you do not see a structural change in your Peyronie's plaque NOT a change in your penis curvature – you should change your plan until such time that your scar changes. Keep checking and revising your plan every 10-14 days until your scar begins to make structural changes. At that point when internal Peyronies scar begins to get reabsorbed and starts reducing, do not make any additional changes in your plan; just ride it out until the scar either is gone or changes stop occurring. If your scar reduction plateaus out, you will then need to increase your plan again in some way to re-stimulate absorption of the fibrous plaque.

You have followed a static plan for approximately three months, so if your scar is no different it is time to increase some element of the plan to boost the intensity of care. If you need help with the specifics of this process I will need to know the details of your plan and then I can make suggestions to you. Please advise. TRH

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