gollam121 wrote:Hi Echegollen and the other guys on this thread,
Firstly sorry for my absenteeism over the last few weeks, I was waiting for my appointment so thought I would hold off until I had something tangible to report back. So then I’ve had my first consultation with Dr Franklin Kuehhas at the International Andrology Institute in London last week and can say it was an interesting day out to say the least! Firstly we discussed my history with ED and he asked many questions in terms of my ligation surgery in 1997 whilst he got a better understanding of the drugs I use and their success rates.
After the initial chat had finished I was asked to undertake an ultrasound which involved a caverject injection to force an erection! Well it sort of worked but I was extremely nervous I did lose it a few times so he came back into the room on 4 occasions in order to complete the scan. After we had finished he told me that my inflow results were good, however and as expected the outflow was not great hence venous leak present (again no surprise).
We left this room and went back to his office where he drew a graphic of a penis, pretty standard stuff at first in terms of blood flow in, however and everyday being a school day and all that I learned that the veins that allow blood to drain out from the penis actually go into the prostate and this is the case for over 90% of the male population with less than 10% elsewhere into the abdomen which as I will explain is unlucky for the ones who have a venous leak because it’s impossible to track the vein and hence close it down, however this potential quirk of fate doesn't show up on a scan so will only present to the surgeon when you are opened up on the table and this appears to be the only risk with regards to an improved situation post opp.
So to summarise I was deemed a good candidate for Sclerothreapy and because I no longer have a deep dorsal vein after the '97 opp the leak has clearly presented elsewhere, so the next steps, success rates, risks and cost as follows:
Next steps: Operation performed only in Vienna where Dr Kuehhas works half the week. 2 day stay with cavonosagram performed on day 1, this takes about 30 mins and involves an induced erection with a tracer fluid pumped into to target the source of the venous leak. Day two is the operation which about 20-30 mins under a local anaesthetic. A 1.5 – 2cm cut is made with fluid injected into the offending vein to collapse the structure to close it off. The operation is minimally invasive and you can fly back the next day. You will then be given daily Cialis for 1 month which I suspect is to get the blood pumping around. No intercourse for 3 to 4 weeks.
Success rates: A total success is a sustainable erection good enough to penetrate and perform / complete intercourse without the aid of PD5 drugs. This is about 65%. Partial success is the above but lower dose PD5’s still required, this is about 15% so I’m assuming that 20% see no betterment post pop but I was assured by the doctor no one receive a worse outcome after surgery.
Cost & availability: £4,000 (UK) which includes flights and hotel in Vienna for one. This is organised by the clinic. Being a private medical service you could have this performed with 2-3 weeks if you have the money and free time.
Risks: You are the unlucky 10% whose veins don’t travel to the prostate so its cost you £4k and you are still back at square 1!
I hope this helps and picking on Echegollen question regarding to why other surgeons don’t offer this treatment? Well I can’t speak for other countries but here in the UK the NHS really puts little focus into research so they rely on trusted methods such as PD5’s, injections etc… and they remain reluctant to test so we all end up being just put into a generalised ED bracket rather looking at our individual needs.
As for me I believe this could be a good option, however because of the high cost of surgery and the fact Viagra still hits the spot 75% of the time I’m going to take the summer to consider things so won’t rush in yet, however if my erections start to wain I could go for this before year end.
That’s enough for now but if you have any questions please ask whilst I would be happy to talk to any of you on the phone if you wanted to? Just let me know and I would message my number.
In the meantime take care and remain strong.
Gollam.
Thank you very much Gollam for sharing your experience with the rest of us. It is really generous of you.
The total success rate (95%) is incredible compared to the success rate of the ligation surgery. In fact, I haven’t heard yet of a single success story of ligation surgery. Having this said, who knows where they picked up those success rates. Again, if this surgery was so effective, how come it is only performed by them? This makes no sense.
You are lucky viagra still hits the spot 75% of the time. In my case, pills aren’t effective. The only thing that is working for me right now is caverject. However, not only injections are very impracticale, but I am only 31 years old and I am worried of the side effects of such a long usage of injections.
From what I understand, since you no longer have a deep dorsal vein because of your ligation surgery in 1997, you need a cavonosagram. I assume the cost of the surgery would probably be cheaper for someone who didn’t have a ligation surgery and still have a deep dorsal vein.
What I am wondering though is if you still have leak after having removed your deep dorsal vein, I don’t see why another leak wouldn’t be created after a sclerothearpy treatment…
If you do decide to get the operation, I pray God that you will be again very generous by sharing your experience.
Good luck.