Should I change my Peyronies treatment because I am younger?

Hi,

www.howtoincreasepenisize.com

I am a young man in my thirties. My torture with Peyronie's started two years ago. Following masturbation I damaged myself at the tip of my penis.  I knew at the time is was a major event and one that would change my life irreversibly for the worse.  It was caused by pulling the foreskin back too far with force.

Following it, I had considerable pain for a year and a half. I went to casualty, multiple doctor's but no-one could tell me what it was. Surprisingly, the first doctor I saw guessed maybe Peyronie's because I had a bit of fibrosis at the tip but it was not a nodule – it was clearly calcification along what I thought was a nerve. It soon circled round the head as a thin band. The pain continued and intensified and after a few operations on the skin, a circumcision was suggested as the only cure.

I had that done and it removed the ring of tissue, but no I just had pain when I came to a climax. The original injury happened just before climax so I hypothesized that it was still the same problem. Gradually the pain turned into Peyronie's with a big nodule just behind the head, neither at the top, bottom, left or right but in the middle. Where I had the pain at the top left, scar tissue was forming. The pain was intense, day in, day out. I am a very fit young man and nothing seemed to stop it, sometimes its subsides but then it comes back to remind me and worse than before.

I have tried pentox with Cialis and also Tamoxifen having gone to a specialist. I am quite well studied and just can't understand this disease. I also tried using a stretching device but that was the worst advice in my opinion and stopped quickly afterwards. I have read studies, have read your book and am interested in what happens to younger men.  No one seems to know. I am 1% of a sample size of 1% of the population – aren't I lucky. I am not giving up, your book makes a lot of sense which is why I started off with your mid plan and have now bought everything I can get my hands on. I do take pentoxyfilline at the same time though as I feel it does help blood flow although it doesn't fix anything.To summarize therefore, at the moment, I have changed my diet (as much as I can), now just started taking everything on your list (although I am still nervous about DMSO but it is a calculated risk) and pentoxyfiline.

Having said that, it is all slowly getting worse. I have days with intense pain and all the time I have some pain. I think your point about digestion is valid as I do struggle with digestion and find it hard to go to the toilet.

I would really like your help. Currently I have a very fibrous penis all throughout. Sometimes it feels better than others but it isn't good. I am a positive guy but I am at my limit. I have a beautiful girlfriend who doesn't mind and I am great at sex, but I can't climax. I don't actually have pain during intercourse but erections are getting harder.

My personal hypothesis is that Peyronie's is caused by a chemical that is released through damage. In my case it is a nerve at the tip of the penis. This chemical went everywhere due to the great trauma and now the scar tissue is just finding where the chemical is. If I can find the inhibitor, I might get my life back.

What are your thoughts? I may be barking up the wrong tree but I need hope. In short, forget my hypothesis, is there anything I should do.  Should I change my treatment because I am younger? Should I take more of one thing and less of another? I am completely open to ideas. Like I say, I think it is beatable at any stage, you just have to find what works for you. I think there are many types of Peyronies caused by many types of things (which is why drug treatments are inconsistent).

Let me know what you think. I really appreciate your approach and thoughts.

Many thanks,

Steve

Greetings Steve,

Welcome to the large body of men who do not understand Peyronie's disease.  PD is a mass of contradictions and irregularities and this accounts for the ongoing difficulty not only in making a diagnosis, but also treatment.

You ask for my thoughts.  To begin with, several aspects of your story makes it sound like you have an extremely atypical, or not standard, case of Peyronie's disease.

Your 2nd and 3rd paragraphs are very interesting.  Bear with me, but based upon the scenario of the development and progression of your problem as you present it, I can make a different interpretation of your problem.  From a slightly different vantage point I interpret your report differently.  I can see it is possible that your penile problem was not originally Peyronies.  It is possible that you only developed later into Peyronies after the rigors of “a few operations on the skin, plus a circumcision. Starting a penis problem by pulling the foreskin tightly down tightly during masturbation, a superficial and circular pattern of fibrosis at the tip of penis, and constant severe pain for 18 months are not at all typical of PD; fundamentally, Peyronies is a problem of the tunica albuginea located in the shaft, not in the tip of the penis. Your problem is not even in the usual location for it to be Peyronie's disease.  Furthermore, you do not mention a deep nodule in the shaft and you do not mention penile distortion.  Very little of your initial complaints during the first 18 months of your ordeal sound at all like Peyronie's disease.  It is only later, after you were under medical care and had several penis surgeries for these unusual complaints, when you were probably catheterized several times or used Cialis several times, or were traumatized while using a mechanical penis stretcher, that you started to have complaints more consistent with Peyronies. 

I mention this observation because it is important for you to explore the possibility that you are dealing with a complex problem that could actually be two or more different problems that are superimposed on top of each other.  Perhaps I am incorrect in this regard, but based on what you have reported in your statement I think the case could be made that you initially had a superficial tissue abrasion or tearing that later developed into fibrosis, and only after receiving drug injections into the shaft during surgery or from catheterization after surgery did you develop PD.  Something to think about. 

You ask if you should change your plan because you are in your thirties, which you apparently consider to be younger than average to develop PD.  Based on many years of experience, you are not young to have PD; many men I would with are in their 30s, and 20s; I deal with many sad cases of teenage boys with PD.

Regardless, whatever your age might be, age is not the reason to change your plan. You should change your plan because whatever you are doing is not working; if your current Peyronies treatment plan is not providing benefit or improvement, and you have not changed it by now, then you definitely should change what you are doing.  You did not mention how you are using your medium size plan, or what your individual dosages are, so there is no way for me to suggest how to best modify your plan since I do not know what you are currently doing for yourself.   

The best way to handle this is by working together in direct discussion during a telephone call.  We can get a lot done in just 30 minutes or so if we put our heads together.   Please go to the PDI website to arrange for a telephone call together so you and I can directly discuss your situation in detail.  TRH

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What are your thoughts about Peyronie’s disease after second prostate biopsy?

I never had a problem with my penis til the last year. I am 63 yo, WM who has had two prostate biopsies over the last 6 yrs…each biopsy came back negative. After this second biopsy I notice my cock bends towards my tummy when erect and that it has lost about 3/4 of a inch…this is substantiated by my wife. Also, I have trouble obtaining and maintaining a erection even with the use of ED drugs.  Please help with your thoughts.

Thank you,

Peter Martin

Greetings Peter,

Your upward distortion and lost of penile length suggest the possibility of Peyronie's disease.  I suggest you have yourself examined to see if that is true or not.  I also suggest you go to a urologist different than the one who did the biopsies to assure a more non-biased and straightforward discussion.

Many men with Peyronie's disease develop it as a result of repeated catheterization associated with prostate surgery and biopsy.  Please refer to "Possible Peyronie's Cause:  Catheter and Cystoscopic Trauma."   Much abuse to the shaft and urethra can and does take place during these procedures and this could lead to Peyronies disease developing; since this traumatic effects tend to accumulate, all the more so.  

Further, repeated use of ED drugs (PDE5 inhibitors like Viagra, Cialis and Levitra) can also lead to a curved penis.  For more information you should read "Peyronies and Viagra" and "Peyronie's Disease Plaque, Viagra, Cialis, Levitra and Blood Supply."

There are some good things that Alternative Medicine can offer you in the way of Peyronie's treatment.  Please read the PDI website for information on a way out of using more drugs and procedures that can make your problem worse than it is now.   TRH  

Possible Peyronie’s Cause: Catheter and Cystoscope Trauma

Unrelated cancer surgery possible cause of Peyronie’s disease

Debate and confusion persist about a Peyronie’s cause, no matter how much time passes.

We who deal with Peyronies on a daily basis know that not much research effort is given to this problem we share.  Medical research into the cause of Peyronie’s disease is often directed toward a genetic quirk or biochemical flaw within the cellular structure – that can be treated with drugs.  In spite of a hundred years of failure looking for a pharmacologically treatable Peyronie’s disease cause, one obvious area has not received much interest: trauma.

No one denies that trauma is at least a common secondary cause of Peyronie’s disease, if not the primary cause.  Yet, there is nothing in the medical literature that addresses the great amount of totally preventable trauma delivered while under medical care.  It is my opinion that doctors can be a Peyronie’s cause during the sometimes brutal and hidden trauma of male catheterization and cystoscopic examination that occurs before, during or after many types of surgery, like bladder or penis surgery.

Since 2002 when I started the Peyronie’s Disease Institute I have communicated with a host of surgical nurses.  They advise me that during surgery, while a man is under general anesthesia and is catheterized or given a urethral scope examination for any reason the process is often rushed and aggressive since the patient is not awake or aware.

To understand the potential problem, consider that the male urinary opening at the tip of the penis is a slit that averages 0.15 to 0.20 inches (4-5 mm) in length, compared to a 9 mm catheter or cystoscope that is put into that slit.  .

The potential for abuse that can lead to Peyronie’s disease exists because the size of the cystoscope used for men ranges from between the thickness of a pencil up to approximately 9mm.  In addition, many cystoscopes have extra tubes to guide other instruments for surgical procedures to treat urinary problems.  That is a lot of material that goes up that little passage way.  Sometimes twists and narrowed areas of the male urethra are encountered that prevent passage, when the catheter or cystoscope will be forced deeper by a surgeon who encounters difficulty.  This, I have been told, is a common problem that is not much talked about.

Nurses get into big trouble, and jeopardize job security, for revealing what they see and hear in the operating room.

It is my speculation that unnecessary injury related to forceful and rushed catheterization or cystoscope insertion is the reason many men develop PD that they cannot otherwise explain.  This opinion is based on the number of men I speak to who tell me they cannot account for their PD based on penile trauma.  Of these men who recall no direct penile trauma, when I ask about any kind of surgery that took place within a year or so before developing PD, at least 95% tell me they were either catheterized or received a cystoscopic examination for one reason or another.

For this reason I speculate these men were traumatized during their catheterization or cystoscopic procedure sufficiently to injure their tunica albuginea enough to cause Peyronie’s disease.

One example within Peyronie’s disease research to support this theory of an association between surgical catheterization and cystoscopic examination and PD, comes from the Urology Service of the Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, in June of 2010 published an article in Urology Times titled, “Peyronie’s Disease Following Radical Prostatectomy:  Incidence and Predictors.”

This search for a cause of Peyronie's disease must consider that for men in their 50s, both prostate cancer and Peyronie's disease are fairly common.  The purpose of this project was to determine if there was an actual link between those men who had a radical prostatectomy (RP) operation for prostate cancer and Peyronie’s disease.

They reviewed their sexual medicine database from 2002 to 2008.  They isolated men who received a RP as the only form of treatment for a well-defined and localized prostate cancer, looking for those who developed Peyronies within three years after their RP surgery and compared this group to those men who did not develop Peyronies.  They studied 1,011 such men, of whom 15.9% PD – a number higher than the general population.   They found that the average time for a man to develop PD after his RP was 14 months, give or take a month.   The average curvature was determined to be 31 degrees, +/- 17 degrees.   They further found that younger men (average of 59 years) who had a RP operation were more likely to develop PD afterward, than older men (average of 60 years), and that white race men (18%) were more likely to develop PD than non-white rave men (7%).    Also, they discovered that erectile function after RP surgery did not predict the later development of PD.

Because men who experienced sexual dysfunction after RP were found to develop Peyronie’s disease more frequently than the general population, the study suggested that this group should be routinely evaluated for PD.

This study, written by R. Tal, M. Heck and others, speculates that the Peyronie’s cause for these men might be somehow related to their prostate cancer.

Because it is common for the medical community to primarily delve deeply and intently into the biochemical and hereditary factors for a cause of Peyronie's disease,  without consideration of more simple and obvious reasons, they do not much evaluate for trauma.   Surgical trauma is a possible Peyronie’s disease cause for those with a history of prior radical prostatectomy (because of the cystoscopic and catheterization procedures they receive), but apparently is not investigated since this would cause a medicolegal problem for the medical community and little reason to use medication.