a-)PEYRONIE (Congenital Penile Curvature) Treatment By ESWT or P-Shot :
Peyronie is a disease when ascar tissue, known as plaque, forms under the skin of the penis, the male organ used for urination and sexual intercourse. Plaque accumulates inside the penis, on the thick elastic membrane known as the tunica albuginea. The tunica albuginea helps keep the penis rigid during an erection. Plaque can develop anywhere on the penis. The penis begins to curve , and can hurt even without an erection. Erections could become painful when scarring develops.
As it develops, the plaque pulls on the surrounding tissues, causing the penis to bend or bend, usually during an erection. Curvatures in the penis can make erections painful or sexual intercourse painful, difficult, or impossible. The development of these plaques is caused by an injury to the penis or by an autoimmune disease, not the same plaque that can develop in the arteries. It is benign, which means not cancerous or a tumor.
Congenital penile curvature, or “chordee,” is a condition where the penile shaft is bent or curved due to abnormal development of either side of the erectile chambers.
The main difference between the Peyronie and congenital penile curve is penile curve starts in the early stages of childhood. It’s typically first noticed by the patient during puberty when they first get an erection. There is no plaque development like in Peyronie.
There are two different types of treatment for Peyronie and Congenital Penis Curvature:
· ESWT (Extracorporeal Shock Wave Therapy)
· Priapus Shot (P-Shot).
ESWT is a new technique where a small probe is placed against the penis and/or pelvic area and sound waves are applied for approximately 5-20 minutes. The treatment is performed in the office without the need for anesthesia. Treatment typically involves 3-5 sessions that last between 5-7days and aim to stimulate neovascularization, improving penile blood flow and cellular function. After 4-6 weeks the pain disappears. We obtain a success rate
80-90% in permanent treatment.
P-SHOT is a PRP(Platelet Rich Therapy) treatment that is not a surgical treatment. The Platelet Rich Plasma(PRP)Treatment is an in-office treatment that takes no longer than an hour to complete. A medical professional draws blood from the patient’s body and places the matter into a centrifuge that will isolate growth factors and stimulate stem cells. Obtained plasma consisting of growth factors, rich thrombosis, and stem cells injected into the penis. The plasma
restores blood flow and repairs damaged penile tissue. It should be performed in 3 sessions at regular intervals. Depending on your age and lifestyle, you may see results in 3-4 weeks.
P-SHOT treatment helps:
- Penis size increasing
- Penile shape straightening
- Pain reduction
- Boost in psychological wellbeing
- Increasing sexual performance
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b- PENIS PROTHESES
There are two types of penile prostheses available in the market.Malleable( One-piece ), and Inflatable (3 pieces). Malleable prostheses are less expensive, easier, and less likely to break mechanically to use compared to inflatable implants. Both implants allow the patient to have an erection satisfactory for intercourse. The main difference is that the Malleable(One Piece) penile implants are semi-rigid implants that consist of 2 bendable rods that are placed in the corpora cavernosa. The patient only needs to hold the penis and move it into the desired position to have an erection. And when the intercourse finishes the patient may change the penis to the previous position by himself.
On the other hand, the inflatable implant has 3 parts consisting of a pair of a cylinder, a pump, and a fluid-filled reservoir. With Inflatable penile prostheses, the patient inflates the cylinders by pressing the pump bulb in the scrotum. The patient can control the firmness by pumping until he is satisfied with the erection to deflate just needed to press the button. The physician decides which types of prothese are more convenient for the patient by considering ;
On the other hand, the inflatable implant has 3 parts consisting of a pair of a cylinder, a pump, and a fluid-filled reservoir. With Inflatable penile prostheses, the patient inflates the cylinders by pressing the pump bulb in the scrotum. The patient can control the firmness by pumping until he is satisfied with the erection to deflate just needed to press the button. The physician decides which types of prothese are more convenient for the patient by considering ;
- Age of the patient and his partner
- The body type of the patient
- The preference of the patient
- The sleight of the patient
- Penis size
- The proportion between penile length and scrotum size
- Scrotum size
- Glans penis size
- Penile prothese record history.
- Peyronie or congenital penile curvature problems
- Previous lower abdominal surgery records like bladder, prostate, colonic, kidney donation, and leg vascular surgery
- The previous operation type, such as a laparoscopy or robotic
- Significant supra-pubic fat existence
Duration time for malleable (one piece) prothese surgery is 30-45 minutes, and for inflatable (3 pieces) prothese surgery is 1-1,5 hours. The surgical small cut is opened either in the abdominal part or in between the testicles and penis to place the implants into the body. The hospital stay 1-2 nights
are then the patients return to their daily life in a short time. During the postoperation time, the patients should take medicines and antibiotics prescribed by the physician. After the first week of penile implant surgery, from 8 to 10 days, lighter exercises such as walking, or upper body exercises. and calves are allowed. Riding a motorcycle, horseback riding, and cycling are allowed after 60 days from the operation.
Penile prostheses surgery is not suggested for patients who have:
- Advanced neurological problems
- Uncontrolled chronic diseases like cardiovascular, diabetics, kidney, and liver problems
- Aktive urinary system infections
- Problems with permission from his partner.
c- Penis enlargement
Each penis over 6 cm can perform its sexual function and is considered sufficient in terms of sexual satisfaction on both sides.
Except for organic and hormonal disorders, any penis size can be considered normal. In recent years, many men who are not satisfied with their penis size have applied for penis enlargement due to the negative affect on both their psychological and sexual life
Although these patients are told that their penis size is normal, it has been observed that it is very difficult to treat the psychological disorders of the patients. For this reason, visually satisfying treatments that have no side effects and aim to fulfill the self-confidence of the patient have come to the fore.
The first-line treatment in these treatments is the happiness vaccine treatment. Satisfactory results are obtained after 3 sessions of happiness vaccine treatment with the injection of cells obtained from the patient`s blood into the penis.
Penile Fat Injection is the most effective surgical treatment for penis enlargement and has the lowest complication rate. Under general anesthesia, the fat tissue is taken from the belly area by liposuction and is injected around the penis. The patient is discharged on the same day with a penile bandage. After 4 weeks of the surgery, sexual intercourse is allowed.
There are temporal methods for penis enlargements and the penis can be extended max up to 3 cm-4. should be repeated with specific interval times. For permanent treatment, it should be performed penis prostheses if the patient is a good candidate.