Tag Archives: Peyronie’s scar

Could ultrasound treatment help with some of the ED that is part of Peyrnie's disease?

Posted on by Dr.Herazy

I think that I got some positive results from taking Neprinol. I will continue to take at least six pills/day.

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My question is for the ultrasound machine that you have. I was wondering if this could help with some of the ED possibly.

Thanks,

John

Greetings John,

Taking any therapy by itself as a solo treatment is not a very effective protocol; usually Neprinol must be combined with other therapies for maximum effectiveness.

Having some degree of erectile dysfunction (ED) with Peyronie's disease is not uncommon.  It is due to the presence of the Peyronies scar preventing full closure of the veins that trap blood to create increased hydraulic pressure needed for an erection to occur.  The answer for this kind of ED is to reduce the size of the PD scar material, or get rid of it altogether, so the veins can close again as they did before you developed Peyronies. 

Here is some additional information about this subject: Should I use Neprinol as part of my Peyronie’s disease treatment?

The ultrasound machine is proving to be a good therapy to add to a basic PDI style treatment plan, based on the reports I am getting back from men who are using it in combination with broad therapy plans. 

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Sex is better after PDI treatment, but still needs help to locate the Peyronie's scar

Posted on by Dr.Herazy

Dr. Herazy,

I began using your small treatment plan about 4 weeks ago with what I feel have been very good results. My upward curvature was most extreme at the end of the penis, but still not very extreme based on what I've read on your site. When I first noticed the problem, the pain was terrible during intercourse but has gotten much less over the course of treatment. I want to thank you for your website as it gave me hope without a sense of over confidence about getting healed. I read both booklets and with some adjustments sex is back to being very, very good although there is still some dull pain.

My question is about locating the scar. While I can definitely tell where painful areas are when erect, it's difficult for me to locate exactly where the scar is when applying PMD. Do you have any suggestions on what it should feel like or will there be any noticeable areas on the skin?  The only thing I can tell is that a good portion of the penis from head to about 3/4 of the way to the base is somewhat harder in the center (like along the urethra.)

Thank you again for your work, and any advice is appreciated.

Greetings,

Most men with Peyronie's disease need help to locate the Peyronies scar.

The painful areas you feel when erect might not exactly correlate to the location of the actual Peyronie's fibrous scar tissue.   You do not want to be treating painful areas; you want to be treating where the scars are located and this will in turn reduce your pain and assist in your overall recovery.

It is a rarity to be able to see an elevated area of the skin that is caused by the internal Peyronie's scar tissue; for the most part, it is a waste of time trying to actually see the Peyronie's scar from the exterior.  The best way to locate the scar material is when flaccid, meaning not erect.

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Do not be discouraged if the scar you have is large since it does not seem that the size has much to do with difficulty or time required to eliminate it.  Larger scars can take just as long as smaller scars to treat.

Try this:  forget about finding a “scar.”  Just try to find something – anything – within the mass of erectile tissue that feels unlike the other tissue.  Find something that is unlike the rest of your penis.  When you find it, mark its location with a marker pen or something that will stay on the tissue for a day or two.  Go back each day to that area and re-think what you are feeling.  You are trying to see if it becomes easier to make sense of it.  It could be that you have an unreasonable expectation of what a “scar” should feel like, and you are missing what is really rather obvious only because your expectation is wrong.  Really, how could you know what a PD scar feels like if you have never had to do this before?  Trouble locating the scar is a common problem.

PDI has much success with the methods we present to you.  Just because your doctor could not locate your scar does not mean it is not there.  And it definitely does not mean that you cannot find it just because he can’t.   As so many men with PD finally come to understand, you must take control of your situation and begin to get well on your own.  A large part of being in control of your treatment is to have a vivid image of the scar physical qualities in your mind.

If you need additional help to locate the offending Peyronie's scar, please contact me directly.  TRH

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What Peyronie's treatment plan would you recommend for me with an enlarged prostate?

Posted on by Dr.Herazy

I have used your basic plan in 2010 and after that I discontinued since I was able to get erections and intercourse was not painful. Later I have been diagnosed with an enlarged prostate but PSA is normal. Now I have irritating and burning pain after ejaculation for many hours and my penis appears to become short although the curvature is not significant. The amount of semen is also very little. I am 47 years old. Never used Viagra or any other enhancing drugs.

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I am deficient on Vitamin D and taking an Omega supplement which also has Vitamin E.   What plan you would recommend for me and can you provide me details of medication in each plan. It was listed in this site but could not find now.

R Venkat

Greetings R,

I suspect that you did not correctly or completely finish your course of initial care and that this is the reason some of your symptoms of small curvature has come back.  Since you discontinued care because your erections improved and intercourse was no longer painful, I suspect you made a fundamental mistake in understanding how the PDI treatment should be used.   It appears to me you did not monitor the condition of your scar in terms of reduction of the size, shape, density and surface features of your Peyronie's disease scar to know for a fact that your true problem was gone.  While it is good your pain improved and your erection quality improved, that is not a good way to determine success or failure in treatment.  I also suspect that you got a small reduction of your scar (enough to make intercourse less painful and erections stronger) but that there was more work left to be done to reduce the scar further that you did not do.

Many of your current complaints could be due to the prostate enlargement you mention; you should discuss this with your doctor.  For this I suggest that in addition to using the medication he has prescribed for you, that you consider using multiple vitamin supplement that will supply all the nutrients that you need for your general health, plus special nutrition and herbal support for the prostate gland; it is called Prosta-Support.   Additionally, it would be good for you to talk to your doctor about performing a simple and economical prostate massage on yourself a few times a week using the Aneros prostate massager.

You should consider using at least a medium Peyronies treatment plan, and even a large Peyronie's treatment plan if it is in your budget because it is larger and more diverse, to help your body completely eliminate the remainder of your Peyronie's scar.  TRH

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Can I cause more damage to my Peyronie’s disease due to difficult penetration during sex because of a partial erection?

Posted on by Dr.Herazy

Hi Dr. Herazy,

I started having some pain with erections about March 2012, seen family doctor, asked if penis was bent and when I self examined, and yes it was. He then told me I had Peyronie's Disease. I had about 30 degree bend to left and could still enjoy sex. Most pain has subsided, but about 2 weeks ago, found I could not make penetration with my wife. Upon self exam, I see I am not getting full erection, top of penis is soft while base is erect. I gather there must now be full blockage to the end of penis? I am thinking of trying your medium treatment plan. Also, can I do more damage if I try again with my wife? I was also thinking of trying CyberSkin Transformer, would that help? Like every other guy, this is a huge blow to me.

Thanks!

 

Greetings,

Your assumption that your poor erection quality is due to a "full blockage to the end of the penis" is not correct.  Actually, the opposite is probably true.

In Peyronie's disease the reduction of erection strength is typically due to the Peyronie plaque preventing the closure of valves in the penis veins.  When these valves cannot close the blood that is normally circulating within the penis simply is not trapped and collected to create the hydraulic effect known as a erection.  Imagine what would happen if you attempted to blow up a balloon that had the other end cut off.  Any amount of air you would blow into the balloon would not be trapped inside and the balloon would not swell and become firm with increased internal pressure caused by air being collected in an enclosed space.  To say it another way, if you try to warm up your bathroom in the winter you must close the door so the heated air can collect inside the enclosed space.  Opening the door allows the heated air to escape.  In the soft area of your penis the blood is not being trapped because the scar prevents closure of the valves that trap blood.  Your blood circulation in the penis is probably as good and uninterrupted as it has ever been, it is just not being collected to create the hydraulic pressure a good erection requires. 

What is probably happening in your situation is that the fibrous material related to your Peyronie's disease has advanced now to the point that the internal Peyronie's scar or plaque material is getting larger and reducing the ability of the valves to close to trap blood and create a complete and normal erection.  The solution involves reducing the size of scar, or even eliminating it.  That is where the PDI treatment plans come in to help you heal them as they normally are healed in about half of the cases.  The medium plan is a popular way to get started with Peyronies treatment.     

Sexual penetration with a partial erection can be difficult and dangerous.  It is dangerous in the sense that a partial erection can suddenly bend and buckle during intercourse and this can result in further damage to the tunica albuginea and make your PD worse than it is now.  I suggest that you get the 2nd book I wrote, "Peyronie's Disease and Sex" that will explain in great detail how you can maintain your sexual activity in spite of having PD.  It is a great book that has helped many couples in this vital area of life.  

The Cyberskin Transformer series of products are effective in providing additional support to the penis to reduce – but not totally eliminate – the possibility of sudden bending during sexual activity that can further injure the penis.  There are other products as well that PDI has available for this purpose like the Girth Prosthetic Rings, Invisi-rider Enhancer and the Reversible Sleeve.  All of these can be found at the sex supports/aids section of the PDI store front.

Peyronie's disease can be a tremendous personal stress to everyone who is in a relationship who has to deal with the outlandish physical changes that can happen to a penis.   The important thing is that you work to do all you can to reduce those changes by increasing and supporting the natural ability of your body to eliminate the internal fibrous scar tissue that causes the curved penis and weak erections of Peyronie's disease. Please let me know if I can help you in any way to correct your problem to the greatest extent possible.   TRH   

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

Posted on by Dr.Herazy

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

What is cause of mild pain in penis and urge to urinate at night?

Posted on by Dr.Herazy

Hi Doc,

I've been experiencing a mild pain in the urethra when the penis is erect and also the opening (tip) of the penis seems to a little swollen or may be I am just thinking that way..I've undergone all the tests (HIV, Herpes,Vdrl, Hepatitis B) everything came back normal..The doctor said no need for the Gonorrhea and Chlamydia test as the urine routine didn't show anything..Also I've developed a bumpy scar on the line of circumcision to which the urologist said it's a hypertrophic scar.. I have an urge to urinate frequently at night please advise as to what I am going through..

Thanks in advance!!!!!!


Greetings,

None of what you describe sounds like it is related to Peyronie's disease, even the penis pain you describe is nt characteristic of Peyronies.   The Peyronie's scar or plaque is not external and cannot be seen from the surface of the shaft; it is internal and must be palpated.  I doubt you have Peyronie's disease.  Beyond that I could not venture a valid opinion about what is happening to you because I would need to examine you and get a lot more information than what you have provided here.

I suggest you get a second opinion at an institution that is not associated with the first you went to so that you will get a more candid and unbiased tendency to not just rubber-stamp what the first doctor told you.  Good luck.  TRH 

Would a Peyronie’s scar on the surface have the same affect as if it were underneath?

Posted on by Dr.Herazy

I have curvature to the left side and don't feel any bump or Peyronies plaque. I know this means the Peyronies scar can be too small or too large and flat and I've also read that it won't be on the surface of the skin. However, I do see a few little things that appear to be surface scars where my curve starts. Why wouldn't a scar on the surface of the skin have the same effect as if it were underneath?  Don't all scars share the same characteristic of not being flexible?

 

Greetings,

No, a Peyronie's scar on the surface would not have the same affect as if it were underneath.

Yes, all scar formation within the body shares the fact that a greater amount of collagen and fibrin fibers is present that is not as elastic and pliable as normal skin.

Even so, the location of the scar or plaque material does make a difference.  It is the hydraulic tension or over-filling with blood within the two corpora cavernosae of the shaft that creates the hardness and expansion of an erection.  Each corpora cavernosum is covered by the tunica albuginea (which is normally also elastic)  but will not expand as it should when the Peyronie's plaque is present within the tunica. The external skin layer does not participate in that response of creating the erection, even though it does to a degree also expand; even when erect the external layer of skin of the shaft is not especially tight or overly stretched. Only if these were extremely large in comparison to the overall size of the shaft would an external scar cause a distortion  of an erection.

I cannot comment on what you refer to as the few little things that appear to be scars on the surface of the shaft.   A scar on the surface of the shaft skin not have the same effect as if it were underneath because no blood is trapped in the skin; there is no anatomical mechanism for it to happen.  It is the trapping of blood that creates the hydraulic effect, and this takes place only in the corpora cavernosae and nowhere else.

It might be helpful to you to review some basic penile anatomy on the PDI website at "Peyronie's anatomy of the penis and related areas"  and  "Tunica albuginea and Peyronie's disease."

If you are unable to find the Peyronie's plaque that is causing your distortion, I suggest that you arrange for a telephone discussion and I will work with you to help you locate it.  It is essential to good treatment results that you know about the size, location, density and surface features of the scar that is causing your bent penis.   TRH

Location of Peyronies scar in relation to prepuce, and circumcision

Posted on by Dr.Herazy

Dr. Herazy,
I have received my first shipment of treatment supplies and am beginning my treatment, thank you. My wife had an observation about my scar that prompted us to ask you this question. I was circumcised as a baby (it was common practice in the 40’s) and have always thought they did a lousy job of it. I have always had an excess of skin on one side if my penis, and thought it looked gross. It just so happens that my Peyronies scar is in the same area. Also my herpes out breaks would take place in this same area. The question is: have all men with PD been circumcised, and could this be a possible cause of this terrible disease?
Thank you for your insight on this question.
Sincerely,
Lou

Greetings Lou, 

There is no statistical differentiation or predetermining factor for location of the Peyronie’s disease scar in regard to circumcision.   Men with an intact prepuce or foreskin  (uncircumcised) are just as likely to develop PD as those who have the prepuce removed (circumcised).  

Actually, on a purely theoretical and philosophical level, I would suppose that men who are uncircumcised (with a foreskin) have a slight advantage to not develop Peyronie’s disease.  I conjecture that an uncircumcised man is slightly less likely to develop PD because he has a certain level of protection against injury working for him during intercourse that his circumcised counterpart does not have.  The presence of the foreskin acts during intercourse to prevent evaporation and “leakage” of normal sexual lubricating fluids that are produced by both the man and woman.  In this way the uncircumcised man is more likely on a theoretically level to not have a “sex accident” in which the penis is suddenly bent when it rubs or presses against an area where the vagina is dry.   In actual practice I have no idea if this would actually show up as a statistically significant factor, but who knows? 

Is it possible to have a penile curvature without having a Peyronie’s scar?

Posted on by Dr.Herazy

Dr. Herazy,

Is it possible to have an extreme curvature in one or both of the blood-filled columns in the inside of the penis without having a scar? I can't find a scar at all. Also, I only have pain (a slight twinge) in the base of the penis and in the curvature?

 

Greetings,

The only way you could have an extreme penile curvature without having a scar would be to have a congenital curvature (born with a normal curvature) or to develop some other health problem that would cause additional penile symptoms. 

If you have been diagnosed with Peyronie's disease and you have a bent penis you must realize the penile curvature is being caused by something that was not present before you developed PD.  There must be a reason for the distortion, correct?  In your case, the distortion is being caused by extra fibrous buildup that is very difficult to locate.  This is common in Peyronie's disease; I guess that at least half of men with PD have difficulty finding their scar(s).   In fact, it is so common that I wrote a blog post titled, "Can't find Peyronie's plaque or scar."   You could also read another question and answer, "How do I find my Peyronie's scar?" 

It is typical for someone who has been medically diagnosed with PD to still feel uncertain if this diagnosis is accurate and correct.   It is part of a denial response.  If this is true, you must either make up your mind you will either accept the diagnosis or go to another urologist for another opinion to either confirm or deny your Peyronie's disease diagnosis.  I sense that you are beating yourself up with doubts and endless questions.  At some point you must stop fighting the idea you have PD. You need to eventually take that energy you are wasting on endless worry and use it to do something about your problem.  Some men have a difficult time dealing emotionally with severe penile curvature.  If that is true for you, please contact me for a few EFT sessions and I think I can do something to help you in this way, as I have done for so many other men.   

The pain of Peyronie's disease is quite variable in terms of degree and location. Having a slight twinge at the base of the penis, and within the curvature, is consistent with this problem.  But then, having a great amount of pain at the base or toward the top of the penis would also be consistent since the pain of PD is wildly variable. TRH