Still Curving After Implant for Peyronies

The final frontier. Deciding when, if and how.
Lost Sheep
Posts: 2120
Joined: Mon Jul 04, 2016 11:16 pm

About early activation/cycling and scar tissue formation - see also "Modeling"

Postby Lost Sheep » Wed Jan 30, 2019 1:49 pm

With respect to Peyronie's Disease, the technique of "Modeling" (bending the penis against the curve to break up or stretch scar tissue to shape the penis into an optimal configuration - or size) is (or should be) well known.

But "modeling" the penis size post-surgery by inflating the implant forcibly and early has been discussed before. So, a tiny bit off topic are the (below) references about early cycling and prevention of scar tissue encapsulization of the less-than-fully-inflated implant.

viewtopic.php?f=6&t=11269
wallyworld wrote:Found this 2014 interview with Dr. Eid on Yahoo Finance of all places:

https://finance.yahoo.com/news/size-mat ... 35263.html

"To ensure appropriate healing and prevent penile shortening, post-operative care is critical. If the implant cylinders are not inflated within the first two months, the retracted size becomes the permanent size of the erect penis. Dr. Eid routinely brings patients back to the office to cycle the device within the first four to eight weeks after surgery. Inexperienced doctors allow the patient to heal after a penile implant without having them inflate and deflate the device, which causes the penis to heal over deflated and retracted cylinders, causing decreased inflated length"

This seems to clearly state that the dreaded "coffin" effect happens at the 8th week without cycling. Taken together with the AMS Operating Room manual recommending cycling start 3-6 weeks after implantation would seem to indicate immediate cycling is not necessary.

I plan on discussing this topic with Jamie at AMS this week. I'll post the results of that discussion.

Mark

Lost Sheep wrote:In July, 2016 I found this article. I recommend anyone interested in this subject to read the full article thoroughly.

Most interesting is the high dropout rate (and the reason for it).

I also wonder how much pre-op stretching by application of a Vacuum Erection Device (V.E.D) would have reduced the dropout rate or increased the effectiveness of early activation.

Other studies have been done, experiencing a similar dropout problem. I guess it depends heavily on how much you want it and what you will endure to get it.

Pre-op prep as well as post-op treatment are both important, in my opinion.

This article refers to the differences that early activation vs no early activation of the inflatable prosthesis
Title" Pseudo-capsule “coffin” effect: How to prevent penile retraction after implant of three-piece inflatable prosthesis
Authors: Enrico Caraceni, Lilia Utizi, Giovanni Angelozzi; Department of Urology, Civitanova Marche Hospital, Italy.
Short Summary: http://www.ncbi.nlm.nih.gov/pubmed/25017596
Longer summary: http://www.ncbi.nlm.nih.gov/pubmed/25017596
with this sentence: "The result is a penis bigger in flaccid state but smaller in erect phase, when early activation is not performed"
Full article: https://www.researchgate.net/publicatio ... prosthesis

This article was obviously translated from the original Italian, so there may be some grammar issues to overlook.


See also this thread: "Coffin effect = shrink to fit"
viewtopic.php?f=6&t=11301&p=96618

And this one: "Over what timespan does Scar Tissue form post-op? (And can it be reversed)?"
viewtopic.php?f=6&t=11379&p=97430
Lost Sheep
Born 1948 AMS LGX 18+3 implant Nov 6, 2017 by Dr Tavis Shaw. Spent 14 months researching in effort to optimize outcome. After 30 yrs of progressive unrecognized ED I will do this RIGHT; no second chance with one's first.
Anchorage AK, USA


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