Monthly Archives: September 2012

Will this surgery work to correct my Peyronie’s disease?

Posted on by Dr.Herazy

I have peyronies a year and a half now with a 45 degree bend when erect.i have consulted my doctor.i have seen a surgeon and I am not satisfied with his straightening method.he just wants to put a slit in it and sew it back.i don't believe this would would work.i need a second opinion.i am on medical card and live in county roscommon in the west region of Ireland. i need a surgeon who is prepared to carry out the full and proper treatment I would be very thankful for your assistance doctor and advice.i am only 39 and this is ruining my relationships and I am depressed. please help me.


Greetings,

Are you sure you heard and understood everything that was told to you about this penis surgery?

I cannot directly comment about what your surgeon explained about the Peyronie's surgery he or she proposed because I was not there to hear the explanation you were given, and you were. However, as I understand penis surgery to correct a penile curvature caused by PD, the typical procedure is much more complex than simply putting a slit in the shaft and closing it up.  

If you are positive you were given this exact explanation, I suggest you contact another urology surgeon who will take your case more seriously for a second opinion.  Using the information that follows I propose that this next time around you be prepared to ask many questions and demand answers.  You should fully understand what is being proposed to you so you can make an intelligent and informed decision.  I also suggest that you spend some time on the Peyronie's Disease Institute website to learn about the possibility of using non-drug and non-surgical treatment to increase your ability to eliminate the Peyronie's plaque naturally.

I am sensitive to what you are asking and I understand your concern about penis surgery.  However, I have no way to know what is the full and proper surgical treatment for your particular problem, and frankly neither do you.  Something as vitally important and final as surgery requires a great deal of trust in the skill and competence of the surgeon in an area that a layperson does not have enough knowledge or skill to judge what needs to be done. Having said that, I think you might be correct to want to talk to another surgeon if only because it is not correct or proper that you were allowed to leave that office without a better understanding of the proposed surgery.  In my opinion, a half-hearted explanation is no explanation, and does not bode well for the kind of surgery that a doctor like that would provide.

There is always the possibility you misunderstood what was explained to you, but it is still the responsibility of the doctor to make sure you do fully understand so you can give informed consent to a surgical procedure.  There is also the possibility the doctor did not want to give you all the (somewhat gruesome) details of the surgery, since it might scare off someone with a squeamish stomach. Another possibility is that the doctor simply did not want to take the time from a busy office schedule to explain what would happen in the proposed surgery.  It has been my observation that many times a surgeon will greatly limit or modify the truth about some aspect of a proposed surgery (risks, chances for recurrence, changes for failure, degree or frequency of complications or side effects) so that the patient is more inclined to accept the idea of the surgery, and agree to have the surgery done.  It is somewhat of a "selling job" that is done.  It is not appropriate, it is not correct, and it is not legal, but it is done.  Perhaps something like this happened in your case.  Whatever was the reason that you thought the doctor was going to "put a slit in it and sew it back," it is the fault of the doctor for that notion and possible misunderstanding to remain.

More than likely, and I could be completely wrong since I was not there, the doctor proposed to do a Nesbit procedure for your curved penis.

For the most men the Nesbit procedure is the most common, easiest and most direct way that a surgeon can address the penile curvature of  Peyronie’s disease. However, it causes shortening of the erect penis by 2.5 to 6 cm (one to two and a half inches), and this is the greatest drawback of it.  The operation is performed under a general anesthetic and takes 40 to 60 minutes.  Men usually go home the day after surgery, or even the same day.

Basically, in the Nesbit operation the main idea is to make an elliptical incision to remove some of the shaft tissue and tunica albuginea from the long side of the bent penis (on the side opposite the inner curve of the bend), in an effort to straighten the curvature.  This tissue removal is responsible for the overall effect of penis shortening when the long side is reduced. The rule of thumb is that for every 25-30 degree of curvature that is present, a loss of approximately 1 to 1.5cm penis (about half to one inch) length at erection will occur.

An incision is made all the way around the shaft, a few millimeters behind the edge of the head (glans) of the penis.  The cut skin of the penis is rolled back down (like rolling or peeling your socks down off your leg), exposing the two corpora cavernosae so the one corpora cavernosa that is opposite the bend and the Peyronie's plaque can be shortened.  This is done by either removing tissue of the corpora with removal using an elliptical incision or simply by drawing it tighter with internal stitches.  After this is done the foreskin usually has to be shortened also so that it matches the new shorter length of the penis.  As in any operation, infection of the incision lines can be a problem and the foreskin, if left behind, sometimes becomes swollen after surgery; for this reason many surgeons will also perform a complete circumcision to prevent this complication. Otherwise direct surgical complications are not common, but occasional to infrequent side effects after surgery of erectile dysfunction, permanent numbness and penile pain can occur.

Hopefully, this explanation of the Nesbit procedure is helpful.  Keep in mind that this is the simplest Peyronie's surgery.  You can see Peyronie's surgery is a lot more complex than what you thought.  TRH

I am wondering can my erectile dysfunction be fixed?

Posted on by Dr.Herazy

I have an erectile dysfunction that I have since teenager and now I am 46 years old. year of 2001 and I went to see the urologist in Framingham, Mass when I used to work in Framingham, Massachusetts and he got me on x-ray and ultrasounds he found that I have a very good blood flows in my penis, good blood vessels but the blood vessels do not hold the blood in and that is why i have problem of getting of erection, and that is why I have an impotence. also I noticed I have an inability keep an erection premature.

I am very healthy I do not smoke, good heart beat, and that does not make any difference. during that time the doctor suggest me to take Viagra. but it causes me headaches and it works. then years later to use Calais that is even better and no headaches. But they cost me lot of money. I am wondering can my erectile dysfunction can be fixed? I am tired of this problem. I am not in depression or anything so I hope you could make some suggestion of what I shall do to fix my an impotence problem.

I am frustrated because many women left me due of this problems and wondering if you could help me with this?
Now I live in Ontario, Canada. I am a Canadian. I worked in USA with NAFTA Visa at that time. Many thanks for your help.

 

Greetings,

Since this website is focused on Peyronie's disease, I only get involved in the erectile dysfunction that is related to Peyronie's disease; it is a very special and unusual kind of ED because of the way that the Peyronie's plaque or scar interferes with how an erection occurs.    It would appear that your erectile dysfunction is related to a blood vessel problem.  What I do would not help your kind of ED.

I suggest you contact a urologist either in Canada or the US who works specifically in this area as a specialty.  You would call the office you are interested in visiting, and ask to speak to the doctor's nurse.  Explain to her what you mentioned in your email about the blood vessels not holding the blood in to create an erection.  She will know if that doctor works with men with this kind of problem.  Don't be satisfied talking only to the receptionist who answers the phone; you want to talk to the nurse who works directly with the doctor.   If she says her doctor does not do this kind of work, then ask her for the name of someone who does do this kind of work, so you can get the kind of help you need.    

However, if I missed something and you also have Peyronies, we can discuss how you might want to try to help both problems.

Please let me know how it goes for you.  TRH

Can I get relief from fibrosis of the corpus spongiosum with Super CP Serum?

Posted on by Dr.Herazy

I've been diagnosed with fibrosis of the Corpus spongiosum. Have you heard of any relief of this with the topical Super CP Serum and/or Vitamin E spray? Any other possibilities?

Thanks,

Spencer G.

Greetings Spenser,

The corpus spongiosum is cylindrical mass of tissue in the penis through which the urethra passes, located in the bottom half of the penis below the two corpora cavernosae. There are irregular cases of Peyronie's disease that start as fibrosis in the corpus spongiosum and later extend toward and into the tunica albuginea layer that surrounds the corpora cavernosae. At this point the fibrosis becomes Peyronie's disease.

When you ask about using topical Super CP Serum and Vitamin E oil you are forgetting about the most important component of the topical applications, and that is PMD DMSO. Using Super CP Serum and Vitamin E oil by themselves is fairly useless since they lack the ability to penetrate the tissue to get down to where the fibrosis problem is located. So please be sure to include DMSO in this topical treatment, always applying the DMSO last. When you order from PDI you will be instructed how to use all of these products for greatest effectiveness.

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Why am I urinating more frequently since I started to take Nattokinase and Fibrozym?

Posted on by Dr.Herazy

For about a month and a half I have been taking 2 tabs of nattokinase 3xdaily and 3 tabs of fibrozym 3x daily. In this time I have to urinate more frequently including getting up 2x at night from sleeping.(not experienced before) Coincidence or do these pills cause more frequent urination? No extra liquid has been consumed. Thank you

Greetings,

This observation is made from time to time with men who use any of the systemic enzymes (Nattokinase, Fibrozym, Neprinol) when they have a large quantity of internal fibrosis.

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The explanation for the increased urination is that your body is pulling out additional fluid from your tissue to dilute the toxins that are being produced as the Nattokinase and Fibrozym breaks down the fibrous tissue in your system, especially the Peyronies scar. Some men have more fibrous tissue than others, hence they experience more frequent urination. This can be seen as a good thing since it shows you that the systemic enzymes you are taking are working for you.

Please keep me informed of your progress. TRH

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What is the best way to get rid of Peyronie’s disease?

Posted on by Dr.Herazy

Hello Dr. H,

What is the best way to get rid of Peyronie's disease?

Wendell from Ohio


Greetings Wendell,

The very best way to eliminate your Peyronie's disease is to do it exactly the way that half the men with PD get over theirs.  It goes away by itself.  With the PDI method we attempt to increase your natural ability to heal and correct PD like it should have happened in the first place. Peyronies heals naturally and spontaneously in about half the cases, the same way that a broken bone or a throat infection heals. 

We tend to forget that the body can and does correct the problem of Peyronie's disease in a high percent of cases.   There is a very good reason that the standard medical approach to managing a case of Peyronie's disease is to do nothing for the first 12-18 months after the condition starts.  The idea to initially do nothing is based on the absence of any actual medical treatment that works to correct PD.  During this  waiting period the body is given time to heal or eliminate the problem naturally.  In this way the medical profession admits that a natural healing process for recovery from PD does exist and that it actively happens in a high percent of cases. 

When I developed Peyronie's disease in 2001 I immediately understood the great potential for my body to cure itself of this problem if I could determine what therapies might support or improve my natural healing ability. After doing considerable research I found a large group of natural therapy items (vitamin E, acetyl-L-carnitine, etc.) that were abandoned after initial getting positive research findings as a potential Peyronies treatment. I have always assumed that they were not subjected to additional research because the large pharmaceutical companies did not want to advance the idea that inexpensive and readily available nutritional products might be helpful against PD.  Regardless, I started to use all the vitamins, minerals and enzymes I read good things about, and started to take them together and in slowly greater and greater dosages. Eventually over time I began to see my four PD scars slowly get smaller, softer and more difficult to find.

There is much that medical science knows about the healing process of the body in general – what cells are involved, what hormones and chemical messengers are produced, the different chemical equations that must happen,  the minerals and enzymes that must be present for certain reactions to occur.  However, there there is still much that remains unknown about what the body does to recover from illness and disease.   This is especially true in the case of Peyronie's disease where far more remains unknown than known. However, it is still possible to work to improve the odds for recovery from Peyronie's disease.  All that must be done is to present to the body a wide list of known vitamins, minerals and enzymes that

Promoting the natural healing of Peyronie's disease is not a simple or even easy thing to do, but by taking this route to recovery it is possible to eliminate the Peyronie's plaque and the curved penis it causes without exposing yourself to the risk of drug side effects or surgical failure.

I suggest that anyone with Peyronie's disease should go to the Peyronie's Disease Institute website to learn more about what needs to be done to stimulate and support the natural healing process against Peyronie's disease.  TRH

Is my curved penis since 10 years of age a congenital curved penis?

Posted on by Dr.Herazy

Good Day! I really don't what to do with my problem I have a curved penis and it really embarrass me for myself. My penis started to curved when I was in grade 5(10 yrs old) and years passes by my penis curved so badly, it curved to the left side about 35 degrees. This causes me big problems. I lost my confidence to continue my life. I always think about it how am i suppose to do to solve this problem. I've read lots of comments from different blog sites about curved penis but not like them, the curve of their penis are upward and downward. I always exercise my penis hoping to make it straight but sadly nothing change.

Our family are not fortune to give me money for a checkup. They don't know about this. I really don't want them to know, no one knows that I have a curved penis except my 2 ex-girlfriend. It's so embarrassing. I don't want to be like this forever. I send this message to this website hoping for a help. I am dying for help if there someone could help me please I'm begging.

Thank you. I apologize for my English grammar, I'm not that good in English.

God bless.


Greetings,

You use very good English. You should be proud of your ability.

There is a good possibility that your penis curvature is how you were born, meaning it is normal and natural for you to have a curved penis. It could be the way you were made. The term for this natural development is that the problem is a congenital penis curvature, meaning it is from birth. I suggest that you should go to a doctor to learn if you have Peyronie's disease in case this is what is wrong with you. It is your decision. If it is a natural curve you were born with there could be limited ability to make any change. I have no way to know ahead of time how you might respond.
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However, I have heard from men who also had a congenital curve of the penis and were able to make small to medium changes in it using the PDI gentle manual penis stretching technique. This method was designed and researched as a way to assist reversal of different penis deformities associated with Peyronie's disease, and was not intended to be used to correct natural penis variations. Even so, it seems to work in some cases, depending on how it is done and if supporting therapy is used to stretch the soft tissue of the shaft.

The men how have used the PDI gentle manual penis stretching technique, also used Neprinol three times a day to assist this process. I would suggest you consider a brief trial of treatment for three months to see if you might respond. If you are interested in experimenting a bit in this way I can assist you. Please contact me again and I can give you the necessary information to get started. TRH

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Should I take Neprinol instead of Fibrozym, or with it, for my Peyronie's disease?

Posted on by Dr.Herazy

I ordered the medium package and in it was a sample for Neprinol. I noticed it has a lot of the same things Fibrozym has. Is this something that would be used instead of other products, or on top of? If in place of do you like it better and which products would it replace.

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Thanks a million.


Greetings,

Neprinol has many of the same ingredients as the Fibrozym and Nattokinase 1500 therapy products PDI sells, but Neprinol also has additional ingredients and all ingredients are in higher concentration.

Some men use Neprinol as a substitute for Fibrozym and Nattokinase 1500, meaning once they start taking Neprinol they do not use the other two enzymes products. And other men use all three enzyme therapy products, but they use more of the Neprinol and only lesser amounts of the Fibrozym or Nattokinase. Using these different combinations, and all the possible different dosages of each, provides a wide variety of treatment options to get the best possible response from your PD treatment plan.

The changes and modifications in how you take these different enzymes should be done while experimenting and watching for changes in the size, shape, density and as surface features of your Peyronie's scar. Taking Neprinol as the only enzyme or taking with the other two is not just a whim or something you THINK would be good to do, but it is something that you actively experiment with to see how the therapy change affects your scar structure. Any change in your therapy plan like this must be evaluated to determine if it causes a desirable and beneficial change in the scar you are monitoring. So you can ask me what I think you should do, but I will only answer, “Try doing several different combinations with the enzymes and see what happens to the scars. That is the best way to know exactly what needs to be done to get rid of your Peyronie's disease.” You will see that your scar will show you exactly what needs to be done to get the best response.

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How much total loss of size can happen as a result of Peyronie's disease?

Posted on by Dr.Herazy

HI Doc,

I think my injury was about 2 years ago. I did not notice anything right away except for black and blue on the lower part of my shaft. After about 1 and 1/2 years i noticed i was having a harder time getting and maintaining erections. I thought it was because i was a diabetic. About a month ago i noticed that i had a dent on the lower left side of my penis causing it to bend slightly to the left. I also have pain while erect and soft. my urologist appointment is not for 2 more months. I was wondering if this was early stages or later? I have also lost some length and girth. I am very scared and nervous. I want to start your best plan as soon as possible, i don't want to waist 2 months of your treatments if i don't have to. Do you know what the total loss of size could happen as a result of having Peyronie's disease? When i order your large plan should i add anything else to it to get the best results? Thank you in advance.

Scared 50 year old

Greetings Scared,

We are all scared when we first come to realize how bad Peyronie's disease can be. Try to take some of that energy you now waste on feeling scared and put it to positive use by reading and learning how to help yourself with this problem so you can instead feel confident and in control of yourself.

A dent (also called a ding, nick, divot or hinge deformity) such as you describe is common. Sometimes there is only one, and other times they are numerous. Sometimes these persist, and other times they slowly or rapidly evolve into other deformities such as a bottleneck, hourglass or simple curve or bend.

Pain can and does occur in Peyronie's disease while both erect and flaccid; however, some men experience pain only while erect, or only during sexual activity; I only had pain while flaccid. As you will soon learn there are very few things about Peyronies that are not variable.

A common and consistent finding of PD is loss of penis size. It seems that the larger the penis, the more size that can be lost. While most men speak in general terms of getting smaller, not too often will actual numbers be mentioned; just like you most men do not give a number. It seems like admitting to the actual reduced size is too embarrassing or uncomfortable to reveal that kind of detail. When the actual size loss is mentioned it seems that 1 to 1 3/4 inches of lost length, and about the same for lost girth or circumference is what I am told commonly. Occasionally I am told the loss will go up to 2 inches or more. One poor devil told me that his 8 inch erection was now just slightly more than 4 inches. I have never heard of anyone losing only length or only girth, but always both; I suppose it could happen, but I have not heard of it.

I always encourage men to start Peyronies treatment proactively when there is strong evidence of the diagnosis, as in your case. It seems logical that treatment should start the sooner the better, while the fibrous tissue changes are less well developed.

The large plan is a smart way to start. Do not add anything to it initially – although you could if you feel compelled to do so. A good therapy to consider adding, if that is your intention, is the gentle manual penis stretching program since it is so unique compared to the rest of the items in that plan. It is also comparatively inexpensive and it never has to be replenished, making it a good buy for a whole new range of treatment that you are able to use.

The best results come from two separate factors: 1. Being faithful and aggressively applying whatever plan you select to start with. 2. Spending the time and effort to learn the exact size, shape, density and surface features of each of the internal scars that are present in the shaft. This information is critical to use as a valuable referencer point to determine if your plan is or is not working. If you cannot accurately and in detail the physical structure of your internal scars you will not know if and when change occurs. Without this valuable knowledge you are forced to guess about your plan, and this is obviously to be avoided. Go to different parts of the PDI website to learn more about how to do this. You can also read about it in chapter 4 of the “Peyronie's Disease Handbook.”

Let me know if I can help you in any way as you work toward your eventual recovery. TRH

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Am I using my Peyronie’s treatment plan properly? – Continued

Posted on by Dr.Herazy

Hi.  This is a continuation and answer to an earlier I sent when I asked if I was using the things I using to build me up so I can get rid of my Peyronie's disease.

I take the Neprinol when I first get up and between meals. I take the vitamin E and C and Bromelain supplements just before or just after a light meal. As instructed I put a few.drops of Co serum,then a few drops of the DMSO to the scar area right after showering(morning and night).

The scar is approximately 3/8 in. wide and 1in long. Its on top and I have about a 35 degree bend to the left and down. It seems to have a substantial 'dent's on the bottom. at times the scar seems smaller and not as hard but then seems to get harder again. I hope this helps as I really want this therapy to work and need to know if I am doing it properly.

 

Greetings again,

OK, now we are getting somewhere.

You are doing alright with everything you are doing in your Peyronies treatment except the Bromelain 5000 which should be taken with the Neprinol, on an empty stomach, not with meals.  You are doing alright with the DMSO and Super CP Serum.

Overall I think your plan might be a little small and restricted.  The real test if your plan is being done correctly and effectively is when you begin to see positive changes in your PD scar.  What you or I think is a good plan or a plan large enough to help you will only be known for sure when you can definitely see desirable scar changes that are permanent.   Anything before that point is speculation and testing to see what your scar requires to respond in a way that is favorable.

You must define your scar better.   When you write your scar is approximately 3/8 X 1 inch and that it is sometimes hard and sometimes small you show you do not have a good idea of the scar structure.

  1. When it is soft, it is soft like what?
  2. When it is hard, it is hard like what?
  3. What is the shape of your scar?
  4. How does it feel when you slide your finger along the 1 inch length of it?  What does it remind you of when you slide your finger back and forth over it?

You must know how to answer these questions so that when the day comes that you think there is a difference in one or more of the structural qualities you will know it for sure, and not be guessing.  

Every 10-14 days you should increase some element of your current plan by either taking a greater quantity of what you are now taking or adding a new therapy item.  You should consider doing this until you notice a definite change (smaller, softer, weaker, more ragged feeling when you slide your finger along the scar) in your scar and at that time you maintain your plan unchanged until either the scar is gone or the positive changes stop.

You see, you need to know your scar better than you do right now so that you will be positive how to respond to your scar behavior.  If your scar is a stranger to you, you will never have confidence to know how to manage your self-directed treatment. 

By the way, you have one or more scars than you are aware, located on the bottom of shaft.  You need to examine yourself and isolate them, identify their characteristics and monitor them like you do the others. Watch them all. 

Please keep me informed of your progress.  TRH    

Am I using my Peyronie's treatment plan properly?

Posted on by Dr.Herazy

I recently started treating my Peyronies. I currently take 3 Neprinol 3x a day. In the morning I take 4 Unique E, 3000mg of vitamin C and 1 Bromelain 5000. I also use DMSO and Super CP Serum. Am I taking the supplements properly and am I on the right track? There has been little or no change in the 2 weeks since I started treatment.

Greetings,

First of all, you did not give me a lot of detail about how you are using your plan. For example, you did not mention if you are taking the Neprinol with your meals or between meals. And you did not mention if you are taking the vitamin E and vitamin C with your meals or between meals. Saying that you “use” DMSO and Super CP Serum does not give me any idea how you are applying it. Lastly, you did not mention if are taking the Bromelain 5000 with your meals or between meals. All of these details are very important to know if you are actually using your therapies correctly and what kind of results you will earn as a consequence.

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Also, when you write that in two weeks “(t)here has been little to no change” I would like to know what it is that you are basing that statement on. No change in curvature of your penis, or no change in the size, shape, density and surface features of your PD plaque? What you are using to gauge your success and the effectiveness of your treatment plan is of critical importance. Please let me know the answers to the above questions and I will be able to reply with a much more helpful response to you. TRH

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