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Video

Voiceover:
For the last year, Keith has been living with a curvature of his penis that occurs whenever he gets an erection.

Keith:
Can’t have sex now. It makes me a bit…inadequate.

Voiceover:
He’s come to Russells Hall Hospital to meet consultant urological surgeon Mr Paul Anderson. Because Keith’s condition only presents itself when the penis is erect, he’s given an injection to induce an erection, so that the extent of the curvature can be fully assessed.

Mr Anderson:
I’m looking at how curved it is, and I’m looking at how long it is, and I’m looking to see if the foreskin’s going to cause any problems…and you really have got an S-shaped curvature.

Voiceover:
Keith has two options for surgery…

Mr Anderson:
There is the shortening option. What we would do is we would make two incisions and remove some tissue from here, close that area up, so you are going to lose length with this operation, but there’s a very low risk of erectile dysfunction with this. An alternative would be to think about a grafting procedure, but rather than operating on the good side, we’d concentrate our efforts on the bad side, and I would open it up, and there would be a defect just there. And into that defect, I would place a graft. And this is often a graft taken from a vein from the top of your legs. It is a good option, but the problem is it does carry a much higher rate of impotence, problems with erections, afterwards.

Voiceover:
Keith’s got a tough decision to make: risk impotence or lose length.

Keith:
I’ve, uh, took the option of shortening, cutting the penis on one side to pull it over to the right. It might shorten it two or three centimetres, but that would be okay.

Voiceover:
It’s the day of Keith’s operation. He’s undergoing the Nesbitt’s procedure, where he will lose some length, but the risk of impotence is low.

Mr Anderson:
Now, he’s got a fairly healthy-looking foreskin, and we spoke about whether we should get rid of the foreskin or not, and he decided he wants to keep it. About one in ten men need a circumcision later. The first thing I need to do, really, is just get all the skin off here, and start to have a look at the problem underneath the skin.

Voiceover:
Mr Anderson makes a small incision just under the head of the penis, and then pulls back the skin.

Mr Anderson:
Right, this is the bit where we skin the penis. It comes off quite nicely, typically. And all these structures that you can see here, these are the nerves and arteries and some of the veins that we’ll be so careful to avoid during the operation. So the curvature will be all around the plaque there, so the correction that we want to do will be all along the opposite side of the penis.

Voiceover:
A tourniquet is placed around the base of the penis, so that an erection can be induced with saline solution.

Mr Anderson:
Okay, so now we’re going to induce an artificial erection. And we shall see how bad this curvature is. Now you can see here how curved he is, you can see that he’s straight to about that point there, so nothing needs to be done between there and there. So all the work is going to be done between here and here.

Voiceover:
It’s a delicate procedure as all of the nerve structures on the side of the penis need to be moved out of the way.

Mr Anderson:
All this tissue here contains all his nerves that supply sensation to his glans there, and I need to continue working in this plane here to get it out of the way, so I can operate on the white area.

Voiceover:
Mr Anderson uses clamps on the good side of the penis to work out where the incisions need to be made to correct the curvature.

Mr Anderson:
You can see that now I’ve got three corrections down the right side, to uh, to straighten his penis. But if you now come and have a look around at this side here, I’ve had to fully mobilise his new vascular bundle past the midline at the back, to put in a further correction. So now he’s got a slight…no, now this is straight, but there’s a slight curve upwards, but some men…and women…would regard that as an advantageous thing. So a slight degree of dorsal curvature is a good thing to have in a penis. Right, so the next step of the operation is for me to remove small defects within this corporal tissue and sew him up again.

Voiceover:
Two hours later, and Keith’s wonky willy is no longer.

Mr Anderson:
I think you’ll agree that he’s a lot, lot, lot straighter now. That won’t cause any problems whatsoever with uh, vaginal intercourse. Put the skin back up there again.

Voiceover:
Mr Anderson stitches and bandages Keith back up, and a catheter is put in place overnight.

Voiceover:
A few weeks after the surgery, and Keith is back to update Dr Christian on his progress.

Dr Christian:
So how long has it been since the operation?

Keith:
It’s been six weeks tomorrow.

Dr Christian:
Okay, and how are you feeling?

Keith:
Oh, I’m feeling all right, back more or less to normal now, and it’s uh, it’s straight.

Dr Christian:
Have you used it yet?

Keith:
No, I haven’t.

Dr Christian:
You haven’t, you’re too scared.

Keith:
It’s still a virgin.

Dr Christian:
And are you peeing okay?

Keith:
Oh yeah, but instead of going straight into the pot, it comes out three different places, because there’s too much skin.

Dr Christian:
Because you’ve lost the length…

Keith:
Because I’ve lost an inch, I’ve got a lot of skin now.

Dr Christian:
I’d like to have a quick look, check that it has healed properly, and also maybe have a look at this foreskin issue, see what we can do about that if we need to, yeah? Come over to the couch with me.

Dr Christian:
Proud owner of a new willy.

Keith:
Yup, a new willy, no?

Dr Christian:
That’s a little bit of bumpiness in the middle, isn’t there?

Keith:
Yeah.

Dr Christian:
That’s going to settle. You are new…is it very sore or not too bad?

Keith:
No, no, not at all, it’s not sore now at all. It’s just it won’t come out there, that’s as far as it comes out, a bit tight, yeah?

Dr Christian:
Yeah. Well, because you’ve got all this tethering, all the skin is still a little bit stuck to the shaft. You need to leave this well alone for a little while, let it all heal. Eventually when the scarring settles down, things will loosen up a bit as well. The more you get erections, the more that’ll just help the skin to loosen up and shift around a bit. And only a good three, four months down the line do you then start to think ‘do I have too much foreskin, will I need a circumcision as well, because it’s affecting the way I pee’. But otherwise, are you pleased?

Keith:
Oh yeah, happy as a lark.

Dr Christian:
I think it’s a great result, so I’m pleased.

Keith:
I am too.

Read the video transcript

Dr Christian diagnoses Peyronie’s disease when Ambulance technician Keith comes to the clinic. Realising the severity of this particular case Dr Christian sees surgery as the only option, and refers Keith on to a urological surgeon who he hopes can straighten things out. Keith meets consultant urological surgeon Mr. Paul Anderson to discuss options. With advice from his surgeon Keith opts for a Nesbitt’s procedure which removes tissue from the unaffected side of the penis so that things balance out when sewn back up, even if slightly shorter. After a two-hour procedure Keith’s penis is corrected, with Dr Christian recommending that he waits a few months before seeking further treatment for his excess foreskin.

Patient Name: Keith Roberts
Condition: Peyronie’s Disease
Specialist: Mr. Paul Anderson, Consultant Urological Surgeon
Hospital: Russells Hall Hospital, Dudley
Length of operation: Approx 2 hours

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Comments and Questions

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Way to much self-diagnosis here which leads to a lot of paranoia and misunderstanding. Go to a good doctor and let him tell you what you have.





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Hi I am 15 and I have a bend in my penis going up at about a 30 degree angle from the middle of my penis to the tip do I have Peyronie's disease





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I've had peyronies for about a year. The penis is now so bent that sexual intercourse is almost impossible. I also have a distinct narrowing of the penis just behind the glans which is painful when erect (like an hourglass shape). What treatments are available? Is surgery the best option? And can anything be done about the narrowing? Any help and advice would be appreciated.





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I've had the problem 7 years now and I'm 33. Mine wasn't improving with the pentoxifylline so I started verapamil injections. It recovered in great shape only to mess it up from trying cocaine a couple nights. It's been back and forth. Having my injection number 30 Monday. Doesn't seem to be working this cycle of 6. Do not want surgery. I started with 12 injections and it was great afterwards. Did cocaine over a weekend with a friend and had sex a couple times. Messed it right up again. Did 6 more injections and it was good again. Then I tried testoforce and xength and it became better then ever. I grew about half an inch. Not sure if it was the size I originally was, before peyronies started, but I don't think so. Got really drunk one night and did a small line of cocaine, at least that's what a friend told me the next day. It became messed up again. Not that I was a regular coke head. Only 3 occasions in my life. Smoked weed most of my life but stopped that 5 months ago. Did 6 more injections and it seemed ok. Now back to being sore again with a curve. I believe I may have been ok if I never touched cocaine. Now I'm seeking another alternative. Don't want surgery and loose size. I beat myself up over my stupidity all the time. I believe that anything that constricts blood vessels seem to affect it. Even maybe antiinflamatories. I drank coffee and had sex a couple times and I believe it affected it even though my doctor dissagrees. Anyway, verapamil injections did prove very effective for me once. I now try to eat very health, drink only occasionally now and just try to keep my immune system it's best to allow myself to heal better. I also have chronic tendonitis ( wrist/forearm extensor and tennis elbow), very painful, also possible brucitis in my shoulder and a painful SI joint that's been on going for almost two years. Trouble sleeping on my right side because of my shoulder, left side because of my SI joint, and try to avoid sleeping on my stomach sometimes because of my peyronies. Where's Jesus when you need him lol. Yet in time I'm sure all will be well again. Have to believe it. Wow I really rambled on.

Why was Xiaflex not mentioned? Surely non surgical interventions for this and dupuytrens is a much better way forward?





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is xiaflex available on nhs now !!!!!





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Not a good idea this surgery. The underlying condition is left untreated and likely to come back. Also long term studies have shown these surgeries to have bad side effects in the long run. Thirdly the condition very likely would have changed on it's own. That's the nature of Peyronies Disease. It might have straightened on it's own with some loss of length. It should be treated conservatively with the combination of oral pentoxifylline 3x400 mg daily (to lessen the amount of plaque causing curvature) and daily routine of vacuum erection device. This will gradually straighten the curve.





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Can I ask you Chris do yo have or have you had pyrones!! And are you medically trained !! Or have you come to this conclusion after doing your research on the net, I'm sorry if I sound a bit off but my experience so far after having had the operation and talking to the consultant is that most of what you are saying is wrong, as you can see from my recent posts I have recently had the operation so i will be updating to let sufferers from this dreadful condition know what the outcome can be after having gone through it, it's most important to be positive.

Well I have now had the operation, its been 24hours and I can honestly say I have had no pain at all, i was the first down at 9.30am and in the recovery room at 11.45 I'm black and blue as you would expect, I spent the night in hospital just to make sure I never had any problems and was discharged at 10.30am, time will tell what difference it will make but the actual proceedure was no problem. I would like to say a big thankyou to Mr Foster the surgeon and all the staff at Good Hope Hospital for the fantastic care given to me





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I am off for the operation tomorrow (14.1.14) never been to hospital, so to be honest to say I am a little worried would cover it, the way I am looking at it is it will give myself and wife years of pleasure once I'm fixed. I have about a 45 degree bend in the shaft which is not painfull, I have waited two years becaus I was told by my consultant the condition needs to stabilize before any operation, makes sense. Having read the other comments I can't say I am looking forward to the constant erections but the wife as told me no to worry she would give me a hand. I'll let you know I get on if anyone is interested.





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I was born with hypospadias I think as my parents never told me but have researched this. I am 44 years old now but have never but still suffer with a lot of issues. I would love to meet mr Anderson and ask him is there anything he can do to make my penis better than what it is . It just seems that when I was operated on this must have been a new technique .





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I believe I have the disease I'm 33 and I feel a limp in the shaft of my penis it have a slight bend but I've always had that but like I say I just got the lump and I only feel slight discomfort when erected will it heal its self if I don't seek help what will happen would it eventuly heal itsself





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There is a chance it will heal on its own. It often heals on its own. Just not for me





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It looks like no one else has asked this question, so please fill in the rest of your details below.





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