Distal Crossover

[DougAnd]

After I first joined this group, I came across 4 of us who had what my Doc Rafael Carrion called Distal Crossover. That simply means that your hydraulic cylinders are not perfectly centered inside of your inflation chambers. For me this became the IPP boogieman. Severe cases like mine cause the penis to twist. Mine also bent about 90 degrees when on my back. Additionally the right side of my glans lifted up about 3/4 on an inch higher on one side than on the other. Dr Carrion assured me that a simple revision would not fix the problem; That once the path is cut the skin around it binds together during healing making it impossible to find the correct opening. He suggested corrective surgery, a three step process that rebuilds your penis. One member of this group tried a revision and was in so much pain afterward that they immediately scheduled a rebuild. I can't remember his handle but he posted postop pictures of after surgery and after healing. Another member scheduled to try a simple revision but I never heard the outcome. Dr Carrion indicated that usually the doctor realizes it won't work and simply does the rebuild instead. Dr Carrion told me that until I had a complete rebuild my IPP was dangerous and I've read that it could easily lead to infection and amputation. It also shortens your penis about an inch. Dr Carrion assured me that this was a common problem that he fixed all the time. I read a study that said the same thing except that in most cases it wasn't noticed until a revision was done. The study didn't elaborate on how often a rebuild was automatically done. But I get the sense that Distal Crossover could be measured on a 1 to 10 scale and that only the 10's need to be fixed. Those of you who like me have peyronies disease and a hardening of soft tissue are prone to having a problematic dilation. If the doctor has to fight to make space for your cylinders you can bet the the opening will not be perfectly centured. But it really doesn't need to be. As long as it stays inside of your inflation chambers I don't think that matters. My two doctors both immediately went outside of both of my inflation chambers. The instant they passed into that part of my penis that protrudes they both went hard right. One tip is almost centured on top and the other is just beneath my skin on the bottom right hand side. Thus far I have chosen not to correct the problem. Instead when the tip feels like it is trying to come through, I use vacuum therapy to set it right again and to stretch out beyond it. I've had multiple opinions. Dr Licht told me that fixing it would give me a much worse result than I have now. Dr Mason told me that a revision using a maleable would not give me satisfactory results. I don't know if any of you are facing this problem but if so don't panic. I've seen, been examined by or contacted many doctors and have been given many many different opinions options etc. If you want to discuss it PM me or just reply.

[Cnidium]

This is extremely interesting. I have many of the same symptoms you have, including my one tip being centered and further out than the "constricted" side. I also have a bend, and I also had peyronie's before being implanted.

Did your post-op implant curve occur years after your surgery? My surgery corrected my curve completely, but it came back after ~2.5 years later after not having inflated for a 3-4 months.

Some users think that what I have is a kink. When I saw Eid recently he thought that the tunica around where my peyronie's was had weakened and was now constricting the implant. Eid said he could do a revision and he also recommended that I get a second opinion from Dr. Billy Cordon.

Maybe I don't have distal crossover, but the symptons of distal crossover / kinks / tunica weakening are very similar.

Tell me what you think of the pictures below and if you think this could be distal crossover. I would be more than happen to bring this up during my upcoming consultations with Hakky and Billy Cordon.

Towards the bottom left cylinder you can see where the indentation is that is causing the curvature, which is where my peyronie's scarring was pre-implant. As I stated above, this was all completely straight post-implant for the first ~2.5 years.

[DougAnd]

If dr Eid did your surgery I doubt that the curve is due to crossover. I was shorter but perfectly straight before surgery. I was sent home partially inflated. As soon as I deflated my penis bent. The cylinders caused my bend. Even today when deflated I'm bent and when inflated perfectly straight. Here's the thing. An implant does not cure peyronies it only masks it. Eid is right your peyronies is getting worse. Tissue is still dying. I think you should ask Eid if daily VED might keep your oxygen high enough to stop or slow it down. Good Luck

[Cnidium]

If dr Eid did your surgery I doubt that the curve is due to crossover. I was shorter but perfectly straight before surgery. I was sent home partially inflated. As soon as I deflated my penis bent. The cylinders caused my bend. Even today when deflated I'm bent and when inflated perfectly straight. Here's the thing. An implant does not cure peyronies it only masks it. Eid is right your peyronies is getting worse. Tissue is still dying. I think you should ask Eid if daily VED might keep your oxygen high enough to stop or slow it down. Good Luck

Interesting perspective. I think I would rather take the peyronies getting worse vs distal crossover.

I can email Eid about VED, I'm not sure if he would respond. I am, however, hesitant to try VED again because, during the times that I had, I experienced really alarming pain in my dick afterwards - and I only used it moderately. But I would give it another go if a top doc recommended it.

I think Hakky and Cordon (especially Cordon, as he is the penile reconstruction doc recommended by Eid), will have a better idea of whats going on here.

I suspect that any one of these issues (distal crossover, kinks, peyronie's getting worse), will have similar end results when looking at a dick from the outside.

What I am confident in is that it is likely smart for me to cycle regularly (especially after I get a revision). I was cycling very regulary for the first few years due to being freshly implanted and because I was extremely active sexually. And then, there was a 3-4 month span where I didnt inflate at all, and thats when the problems showed up. My guess is that either a kink developed in the implant or the peyeronie scarring took over again because the implant was not inflating regularly to keep it stretched out.

Another option i need to consider is if there is no possible smart revision. I think this is unlikely. However, there may be a strong use case for the girth injections then to even out the curving/dent (Even though it wont fix the cylinders being slightly uneven). So whatever the case may be, there is an option to address it.

I should have an answer by August, at which time I will have met with Hakky and Cordon. I can't wait to learn what it is.

[DougAnd]

Good luck, I know how problems can grow on you

[nuance]

Newbie here, doesn't the impact of inserting artificial cylinders itself cause damage and lead to PD?

[DougAnd]

I suppose that by definition, yes destroying tissue would cause scarring ie PD. But the dying tissue that causes PD curving and deformation is much more than what an IPP causes.

[newbie443]

The only thing I can add to this is about the cylinder tip location in the glans. I had trouble with activation where only my left cylinder would inflate. The right would so slowly inflate that I would have to wait for almost an hour for it to move up close to my glans. This caused my left tip to move to the outside and then down. Then after weeks of this and a fix by an AMS rep the right cylinder inflated faster than the left. Not as bad though. With max cycling the right tip moved to the center as that was the direction it was going in those first weeks when the left cylinder was fully inflated and pushing to the right under my right cylinder. A few times the right tip crossed the center line in my glans. What I ended up doing was when inflating I would pull my glans away from me off the cylinder tips and then guide the glans back into the cylinder tips where I thought they should be or as close as I could. The right tip still gives me trouble with urination and the spray at times like right after surgery. My research has me to believe this is called Glans Hypermobility. Most common is floppy head but that is only one example of this and there are others. This is why I wanted a full replacement for my repair of my proximal perforation. I told the doctor about this and ask he to address it as well as the perforation. My left tip was so low and to the left that with the pointing left of my penis caused another source of pain with PIV sex. After the sling repair both of these improved by about 50%. The repair doctor said when he saw me again 6 weeks post op that getting the tip placement in the glans was like standing a pole in a bucket and was difficult. I do remember seeing something about in some cases where a patch of material is used over the top of the cylinder tip when putting it back up into the glans. This is to protect the areas where perforation is foreseeable or maybe had occured. This material looks the same as used to make a sail repair of a proximal perforation. I would have preferred to have that with the full replacement but it seems Insurance had a different idea.

I have seen some different approaches to problems in the shaft od the penis. 2 different deglove ones I can remember were the circumcision approach with a full 360 degree incision and then sliding the skin down to access the area that is damaged. Another is a horizonal incision at the base of the penis where it connects to the scrotum. Then the skin is pulled up over the glans exposing the shaft. Some men have a circumcision with implant and in that case no other incision is needed unless a drain is used. Then where maybe some different types of vertical incisions. My repair doctor said that I might have a perineal incision and I took that to mean that if it were possible that the perforation would be repaired and the cylinder placed back in. My research showed that this was rare as the cylinder usually flattens the empty corporal body and it heals together. Seems this is what happened.

Did you have imagery to show exactly where and the extent of the problem? My Gastro doc had a CT scan done as the RTE was causing pain in my large intestine. All I could see with it was the misaligned cylinder tips indicating the perforation. My repair doctor said that he thought he could see the location of the perforation but was not certain.

I would also not rule this out just because of the doctor is well known. All doctors have mistakes. Just the really good ones have way less of them. That being said the well known doctor from NY does do imagery prior for IIP surgery where many like my original doctor does not. The NY doctor has had men on here with problems in the past and last I knew posted every case of infection on his site.

Take care and keep us updated on this.