TOPIC: Dcpimpin's Tunica Lengthening surgery coming up with Dr. Robert Valenzuela

Hey DC, so what are your current stats now, and what is the expected gains from this? Maybe you or someone can detail what this surgury entails.

How many surgeries is this for you?

And, good luck!!

Good luck DC! You know what you're getting into, I have no doubt you are prepared for what lies ahead and wish you the best of outcomes. Your progress reporting will be an invaluable contribution to the forum, we will be rooting for you!

This would be a great topic for Miracle to chime in on. I am sure he would have some good insight on this.

DC my brother, I'm rooting for you! Wishing you much success with this surgery

Good luck DC. Wow I didn't know you had an implant for ED. Could you tell a little about it? is it an IPP?

can you describe what actually happens during the procedure? I couldn't find any info on this surgery from google search. and good luck

Good luck w/ the surgery. I knew about this w/ Peyronie's but it is not for every case. So, my doctor (or any I consulted) wouldn't do this for me unfortunately. Here's an excerpt from the Djordjevic article:
Penile lengthening procedures are reserved for patients with preserved erectile function and severe penile length loss followed by marked hourglass deformities. When erectile dysfunction is associated with Peyronie's disease, penile prosthesis implantation with or without plaque surgery is the standard of care.

I had ED but didn't want a prosthesis, and almost no doctor would put one in someone my age who could have decent erections with viagra. So, I had to have the other Peyronies surgery (plication). I am pretty sure your surgery is much safer for someone with an existing penile implant, because a graft that goes on both sides of the tunica would compromise the erectile bodies. They don't even like putting it on one side bc of ED risk, unless you have 100% strong erections going into the surgery, and most Peyronies patients have ED. Also, you can stay Erect after the surgery for a few days to stretch the graft which is important. Only an implant can do that really. In the article I quoted above - the guys only gained 2.1 cm on average (0.8") and it's a pretty invasive surgery. Those were all Peyronie's patients so it may be different though... in my case, my Dr. said some people gain nothing and some gain an Inch - just depends where the curve is. I've never heard of anyone doing this surgery w/o PD, but it makes sense to apply this approach if you can find a willing doctor and afford it (my surgery without insurance was 30k - and that was the 90 minute plication...not the 180 minute grafting). With insurance, I paid WAY less than that thankfully! Well, good luck. The healing process can be tough but if you already have an implant and have had a lig cut, you're probably used to it.

Wish you the best dc. I'll be following the thread for sure.

Good luck to you. I hope everything goes well for you. Keep us informed.

They cut into the tunica albuginea (top and bottom) and place a graft in between the incisions that makes a longer tunica. The graft is presumably from the saphenous vein (used for coronary bypass) or another source like processed tissue (cow pericardium is one source I think). So, that's how it works in a nutshell. The risk of ED is very high with this approach, but he has an inflatable prosthesis so he doesn't have to worry about that. Also, you can't expand the spongy tissue below the tunica (what fills up with blood to get hard), so that is why you can't really make the penis that much longer than it already is just by expanding the tunica...but again, his spongy tissue was removed with the inflatable implant. I don't think you can get much length from this without peyronies or an implant. The article said 0.8" was the avg with Peyronie's patients who had spongy tissue already in place (it was just being blocked by the scar tissue on the tunica above it)...and also the majority of those people received implants as well. Without expanding the spongy tissue, I doubt the penis can get any longer. There are a lot of caveats here.

Also, this is a lot more invasive than it sounds. I just had plications (permanent stitches) put in my tunica in december for peyronie's and I still have pain sometimes, particularly after orgasm. And that was the shortest, least risky surgery. There's no risk of ED from plication surgery. Minimal risk of sensation loss. With grafting ("tunical lengthening") there is a risk of both...and not a huge guarantee of regaining size - it really all depends on the situation. Conversely, there would probably be less chronic pain risk with tunical lengthening since no buried, permanent stitches are staying in place to counteract the curve.

I don't think this is for everyone... you really need to be a peyronie's patient without ED or have a penile implant already. Or, you'll just risk ED big time.

^ thank you for that, yes it was mainly the terminology used. Your description made it a lot easyet to understand. It will be good to hear what dcpimping says what the doctor said about for non-peyronies men. cheers

Good luck!!

Hi DC

Thanks for sharing your experience.

Did you not have the new lengthening procedure shown here? www.ncbi.nlm.nih.gov/pubmed/22429331

Image: www.valenzuelaurology.com/uploads/2/3/3/...7140/2111247.png?201

This technique looks totally revolutionary and awesome... it seems geared towards gaining length and its difficult to see how it couldn't create at least some new length because the body of the penis is literally being pulled apart!

Is this the technique your surgeon wanted to do next time but you declined? Did your existing implant prevent the surgeon from performing this lengthening procedure during your last surgery?

Thanks!

tom kat wrote:

BTBassist wrote:

tom kat wrote: can you describe what actually happens during the procedure? I couldn't find any info on this surgery from google search. and good luck

After a google search of about 10 seconds of my day, I found this:
www.ncbi.nlm.nih.gov/pubmed/22429331Sounds like a good place to start your reading on this procedure. The method described is pretty straight and to the point.

I read that page but didn't understand much of it, especially how it would work for someone without peryronies

what were some of the risks you were told about? he said you will get 7.5'', what are your current measurements? cheers

Oh, okay, now I have a better understanding of what it is you are asking. Is it the terminology used that makes it tough for you to understand?To put the abstract in the link above in more plain terms: ventro (or ventral), means abdomen or "the front of the body", dorsal means the back. Ventrodorsal means it involves both the front and the back of the body. So it sounds like the tunica is cut from the front and from the back (as to separate into two "halves" that are still connected at the ends: the "root" of the penis, and the glans area of the penis). This would be done after a "de-gloving" procedure, where the skin is pulled back from the coronal area, down to the base. A prosthetic is then inserted (I have no idea what the prosthetic is made of). To enclose the prosthetic, tissue grafts from pig intestines are grafted onto the front (ventral) and back (dorsal) sides of the tunica. This makes sense, because the implant has to have more total tissue to be covered.I'm not sure of the particulars of how Dr. Valenzuela performs the procedure, but from the abstract, this seems to be the general idea of what they do with this procedure.It is also unclear to me how it works in those without peyronies, as I thought they would be removing scar tissue, and that was one more reason the porcine intestine tissue was being used (to replace the patients tissue that is being removed).Hopefully dcpimpin can chime in with some more details on that.

tom kat wrote: can you describe what actually happens during the procedure? I couldn't find any info on this surgery from google search. and good luck

After a google search of about 10 seconds of my day, I found this:
www.ncbi.nlm.nih.gov/pubmed/22429331 Sounds like a good place to start your reading on this procedure. The method described is pretty straight and to the point.