March 1, 2017 PDI Newsletter
Welcome to this March 2017 Peyronie’s Disease Institute newsletter.
This month we will review two recent email exchanges. One discusses Peyronie’s disease curvature development and progression, and the other Dupuytren’s contracture recurrence after surgery. Both of these topics can should be of interest to all our readers, no matter if you have PD or DC. Dupuytren’s contracture presents problems of fibrous tissue progression and development that alters the hand structure, just like in Peyronie’s disease. And in Peyronie’s disease recurrence can and does happen after surgery, just like in Dupuytren’s contracture. The point being: The more you read and learn about the other problem, the more you will know about what is going in with your problem.
These particular emails are selected from the many dozens of correspondence I get from PDI and DCI readers each month who have questions, primarily about treatment. Peyronie’s disease and Dupuytren’s contracture cause a similar fibrous lesion in the body, and we have repeatedly seen how successful Alternative Medicine treatment is almost identical for these two problems. For this reason it is beneficial for people with PD to read about DC treatment, and for people with DC to read about PD treatment; everyone on our mailing list should benefit from learning the treatment principles and ideas found in the two emails, below.
The first:
—-Original Message—–
From: PRXXXXX
Sent: Saturday, February 18, 2017 1:08 PM
To: Theodore Herazy <herazy@comcast.net>
Subject: Question
Hi Dr. Herazy, I was diagnosed with Peyronie’s disease 2 years ago, i took Pentoxifylline for about a year, i have a noticeable plaque that is fairly hard and stretches about 1.5 cm on the left side about 2 inches below the head, this has caused a minor curve of maybe 10-15 degrees, and i haven’t had erectile problems throughout this time. My question is: since it’s been 2 years and this hasn’t changed at all, might it be safe to say that my Peyronie’s disease/erectile function will just remain the same from now on and not worsen (since i’m past the active phase)? Thanks very much,
PRXXXXXX
On Saturday, Feb 18, 2017 at 9:09 PM, Theodore Herazy
<herazy@comcast.net> wrote:
Greetings Paul,
Happy to hear from someone who takes his Peyronie’s disease so seriously that he has taken the time to evaluate it well and learned about the problem; many men panic so deeply that they ignore the problem until it ruins their lives.
Your speculation for how your Peyronie’s disease might progress is fundamentally correct if nothing else changes within the confines of your shaft. However, as you have already learned, the events that affect the physical condition of your p—s are not at all in your control; this is why you developed Peyronie’s disease. There are three things that can occur that have the capacity to change your PD even after it matures, hence the degree of curvature and erectile dysfunction you develop — for the better or for the worse. The first is additional trauma to your p—s, either during intimacy or during the course of life (being hit in the groin, car accidents, wearing tight clothing, work related injury, etc.). Even minor p—s trauma on top of a case of pre-existing Peyronie’s disease can be disastrous; insult to injury. As with any kind of accident, additional injury to the p—s can happen as fast and unavoidably as slipping on the ice. Secondly, side effects from a prescription or non-prescription drug. Not much to say here, because so many MDs who prescribe the big offending PD-causing drugs (statins, and many others) seem to take a cavalier attitude about this issue. They say: “I am prescribing this drug anyway because it is important. You may or may not get Peyronie’s disease as a side effect, we will have to see. If you get PD we can always do surgery. You will be fine. Take the drug.” I hear this story a lot.
Lastly, as you might be surprised to learn, an improvement or reduction of the Peyronie’s disease scars can cause an alteration (less curvature or more curvature) of the balance that now exists that is creating your mild 10-15 degree bend. This is so because a small curve is not necessarily caused by a small scar, and a large curve is not necessarily caused by a large scar. The size of the p—s curvature (and also the degree of ED) in Peyronie’s disease, is caused as a result of the unique placement and interplay of the odd-shaped scars and how they impact the internal support structures of the shaft (resulting in curvature). Changes in the size and density of the internal scars can also influence how or if the valves of the p—s veins can close tightly to create an erection (erectile dysfunction). I have seen men with multiple significantly sized Peyronie’s disease scars that are so balanced and so placed within the shaft that the curvature and ED created is minimal; and I have seen relatively small but imbalanced or asymmetrically placed Peyronie’s disease scars that wreak havoc in terms of curvature and ED. Thus, it is possible that a favorable and desirable reduction of the size, thickness or density of the PD scar can cause a temporary imbalance to a previously balanced arrangement that will increase the curvature or initiate a partial or complete ED phenomenon to occur. It happens. When it does happen, as further scar reduction continues under an Alt Med treatment plan fewer, smaller and weaker scars eventually balance each other and result in a significant reduction of the curvature.
For the first two factors, trauma and drugs, there is certainly something you can do (at least to some extent). For the last factor, scar change over time, there is not as much that can be done to avoid that since the body always attempts to heal, repair and eliminate foreign scar tissue if it can. At PDI we work to promote those changes early for the benefit of the man with Peyronie’s disease.
These are the reasons why a mild and workable case of PD can suddenly become severe after 5-10 years of peaceful co-existence. Peyronie’s disease is a wicked problem. Some of the things that happen in PD do not always make intuitive sense. PRXXXX, be careful with how you manage yourself.
All I am saying here is that with Peyronie’s disease there always seems to be a hitch, and a mild case will not always stay mild. No one can confidently predict much about PD. You might consider looking at my book, “Peyronie’s Disease and Sex,” that goes into great detail how a man with PD can avoid further injury while being intimately active. TRH
The second:
—–Original Message—–
From: FFXXXXXXX
Sent: Wednesday, February 8, 2017 10:46 AM
To: Theodore Herazy <herazy@comcast.net>
Subject: Dupuytren’s contracture surgery recur
Dr. Herazy,
I have Dupuytren’s contracture on both hands. My doctor told me that at my age there is no recurrence possibility after open hand surgery. I am 66 now. What do you think about my chances for the DC coming back if I have hand surgery to get rid of the Dupuytren’s contracture?
On Wednesday, Feb 8, 2017 at 2:49 PM, Theodore Herazy
<herazy@comcast.net> wrote:
Greetings FFXXXXXXXX,
Let me give you my opinion about Dupuytren’s contracture recurrence. Your doctor has the advantage of knowing you directly and personally examining you. I do not have that advantage. It is impossible for me to address your specific situation; I can only speak in broad and general terms about how Dupuytren’s contracture responds to the kind of surgery that is done for most people. After thinking about my response you can make up your own mind.
Based on my work and my investigation in Dupuytren’s contracture since 2002 I find that approximately 50% of people who have open hand surgery will have some degree of recurrence (early or advanced) in three years. I believe most sources of Dupuytren’s contracture information will generally agree with that number. Further, I find there are extremes for the speed of Dupuytren’s contracture recurrence at both ends: At one end, 5-10% of people will have slow recurrence in 10-15 years, and at the other end, 5-10% of people will have fast recurrence in a year or so. Concerning these fast recurrences, I have communicated with loads of people whose Dupuytren’s contracture recurred in less than a year after their hand surgery. It is my observation that most people’s Dupuytren’s contracture will begin to recur after open hand surgery in 2-8 years.
Bear in mind that Dupuytren’s contracture recurrence after surgery will always be faster than the speed of development of Dupuytren’s contracture when it progressed prior to surgery. By this I mean that a first time case of Dupuytren’s contracture might take 3-10 years to be severe enough for surgery, while a recurrence of Dupuytren’s contracture to surgery will be faster than the 3-10 years of the original problem; if it took six years for the first episode of Dupuytren’s contracture to get bad enough for surgery, the recurrence of that Dupuytren’s contracture will be 1-5 years; if it took three years for the first episode of Dupuytren’s contracture to get bad enough for surgery, the recurrence of that Dupuytren’s contracture will be 1-2 years. And if you have that 2nd Dupuytren’s contracture surgery, the recurrence after it will be even faster than the 1st recurrence; it tends to continue accelerating and worsening until no more surgery can be done.
Dupuytren’s contracture recurrence rate or speed it returns after surgery is greatly influenced by the technique and skill of the surgeon. If the surgeon has the hands of an angel and the brain of Einstein the rate will be much lower than if the surgeon is lazy, clumsy and indifferent (they do exist). This is why it is so critically important that you do your homework to find the very best surgeon available to you. You must determine if the surgeon who spoke to you is a gifted genius who knows all his cases have exceptionally low Dupuytren’s contracture recurrence rates, or if he is not being honest with you. You said that your surgeon told you “there is no recurrence possible after open hand surgery.” That is interesting. Ask him to put that in writing.
I offer for your consideration that there is a way, in some cases, not all, to use Alt Med to assist the body to reduce the Dupuytren’s contracture tissue naturally. From my experience I have found that the harder a person works and the broader the treatment base that is applied, the better the results tend to be. Please review the information on this website to see if you might want to try to possibly avoid the need for hand surgery. TRH
OK, that does it for this month. Hopefully these two communications will give you a lot to think about, and help you to understand and work with your situation better.
See you next month when it should be warmer and greener than it is right now.
Stay focused to your plan and be successful. Please send any questions you have for me via the link on the PDI website. TRH
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