{"id":3303,"date":"2020-05-11T05:28:27","date_gmt":"2020-05-11T05:28:27","guid":{"rendered":"https:\/\/www.newyorkurologyspecialists.com\/peyronies\/?page_id=3303"},"modified":"2020-05-26T00:29:37","modified_gmt":"2020-05-26T00:29:37","slug":"63-year-old-curve-hourglass","status":"publish","type":"page","link":"https:\/\/www.newyorkurologyspecialists.com\/peyronies\/real-stories\/63-year-old-curve-hourglass\/","title":{"rendered":"63-year-old with Peyronie’s Disease and ED – Real Stories"},"content":{"rendered":"

63-year-old Man with Peyronie’s Disease and ED Treated at New York  Urology Specialists<\/h1>\n

by Alex Shteynshlyuger MD<\/a><\/strong><\/p>\n

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If you have any questions, to schedule a consultation<\/a>, please contact us<\/a> or call\/text: <\/strong>1-646-663-4050<\/span><\/a>.<\/strong><\/p>\n

We have excellent reviews from patients <\/a><\/strong>and their partners.  Information for out-of-state and international patients<\/a>.  <\/strong><\/span><\/p>\n

We offer affordable prices<\/a> with or without insurance.<\/strong><\/span><\/p>\n

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Real Stories. Real Patients.<\/u><\/h2>\n

Please note:<\/strong>  <\/u>Names and age have been changed to protect patient privacy.<\/u>  Treatment success varies. Not every patient experiences benefit from treatment.  Please talk to your doctor.  This is for informational\/educational purposes and is not intended to replace a patient-doctor relationship.<\/p>\n

Only your doctor can advise you on a course of treatment that is appropriate for your needs.<\/strong><\/p>\n

Peyronies Treatment: 63-year-old Man Treated at New York Urology Specialists<\/h2>\n

TN is a 63-year-old man<\/strong> with complaints of penile curvature<\/strong><\/a> for the past 2 years.  He noticed a narrowing and shortening of the penis<\/a><\/strong> starting 1.5 years ago.  The patient reports mild pain in the penis<\/a><\/strong> with a pain score of 2 out of 10 with erections.  The patient denies a history of penile trauma.  Patient reports worsening of erection quality<\/a><\/strong> since the onset of penile curvature. <\/p>\n

He describes difficulty with obtaining and maintaining erections<\/strong> for the past 7 years that has gotten worse in the past 2 years since the onset of Peyronie’s disease.  Patient reports that he takes Cialis 5 mg daily plus an additional 5 mg prior to intercourse<\/strong>.  Over the past 6 months, he is able to achieve erection hardness of only 50% with Cialis<\/a><\/strong>, which is occasionally sufficient for intercourse. The patient saw a urologist previously and has been using coenzyme Q for the past year without significant improvement in symptoms.  He is fairly healthy, has a history of elevated cholesterol<\/strong> which he is managing with diet.  <\/p>\n

Physical exam<\/strong> revealed a palpable diffuse plaque<\/a><\/strong> dorsally in midshaft of the penis.<\/p>\n

Peyronie’s Disease Questionnaire (PDQ)<\/a><\/strong> score = 9.  SHIM score of 15.  Erection Hardness score of 3. <\/p>\n

\"\"Follow-up Appointment – 1 month<\/h2>\n

The patient was evaluated. Blood work revealed normal testosterone<\/strong>, normal lipid profile, and pre-diabetes. <\/p>\n

Penile Doppler ultrasound<\/a><\/strong> revealed compensated vascular insufficiency<\/strong> and no evidence of veno-occlusive insufficiency.  Injection of Trimix<\/strong> resulted in >90% erection.  <\/p>\n

Measurements were performed with the penis fully erect<\/a><\/strong> (>90% erection): 60-degree dorsal curvature (up) and 30-degree left-lateral rotation at midshaft,<\/strong> 3.5 cm below the corona.  Moderate hourglass (waist) appearance<\/a><\/strong> was noted to be present at the left-lateral shaft.<\/p>\n

Because patient’s erections are inadequate for intercourse<\/strong>, finding an effective treatment for ED is a necessary first step before deciding on the treatment for Peyronie’s disease.  A straight penis is not all that useful unless it is erect.<\/p>\n

His dose and frequency of tadalafil were increased.<\/strong><\/p>\n

Follow-up Appointment – 2 month<\/h2>\n

At the follow-up visit 1 month later<\/strong>, RF reports that his erection quality is greatly improved; he is able to achieve erections that are 80% hard sufficient for penetration. However, he is now complaining of difficulty with intercourse due to curvature<\/strong>. While he is able to obtain good erections and can maintain the erection, the curvature and hourglass make it difficult to penetrate<\/strong>.<\/p>\n

He is satisfied with the treatment for ED but dissatisfied by his Peyronie’s symptoms<\/strong><\/a>. <\/p>\n

The patient was advised of the following treatment options for Peyronies disease<\/a><\/strong> available to him:  observation, penile traction therapy<\/a>, injections with Xiaflex<\/a><\/strong>, verapamil<\/a><\/strong>, or interferon<\/a><\/strong>.  Surgical treatment options including penile plication<\/a><\/strong>, and a penile implant<\/a> <\/strong>was discussed.  Relative risks and benefits of each treatment approach were discussed. <\/p>\n

The patient chose to start treatment with Xiaflex and penile traction therapy. He is a good candidate for Xiaflex<\/a><\/strong> given that (1) there is a palpable scar (plaque) into which Xiaflex can be injected, and (2) his curvature is greater than 30 degrees.  Insurance reauthorization was obtained based on these facts, and (3) his erections are adequate for penetration when he uses tadalafil as prescribed.<\/p>\n

Follow-up Appointment – 3 months<\/h2>\n

The patient started using a penile traction device<\/strong>. He received 1 cycle of Xiaflex injections<\/a><\/strong> with penile block. He experienced some swelling and bruising after injections but that resolved.  He has not noticed any change in his curvature.  He was advised that most men do not experience a significant change in symptoms after the first cycle of Xiaflex. He was advised to continue using penile traction and continue with Xiaflex injections<\/strong>.<\/p>\n

Follow-up Appointment – 4 months<\/h2>\n

Two injections of Xiaflex<\/strong> were administered 10 days apart.  The injections were spaced apart due to swelling after the first injection. The patient was advised not to engage in sexual activity for a month.  The patient was advised to continue using a penile traction device.<\/p>\n

Follow-up Appointment – 6 months<\/h2>\n

The patient had received 4 cycles of Xiaflex (8 injections).  He feels that there is a significant improvement in the curvature<\/strong><\/a>, having significantly less difficulty with penetration<\/strong> during intercourse.<\/p>\n

Artificial erection was performed and measurements were obtained. His dorsal curvature has improved from 60-degrees to 40-degrees<\/strong>.  His left lateral curvature has improved from 30-degrees to 20-degrees<\/strong>.<\/p>\n

Treatment options were discussed again including interferon injections, penile plication, and penile implant. The patient is satisfied with the results of Xiaflex<\/strong> and does not want to proceed with additional treatment at this time.<\/p>\n

Where to Get Peyronie’s Treatment in NYC?<\/h2>\n

At New York Urology Specialists, we offer treatment for men with Peyronie’s disease.<\/strong> <\/p>\n

Call\/text today: 1-646-663-4050<\/span><\/a><\/span><\/strong> or <\/span>make an appointment<\/span><\/a> online.  <\/span><\/span><\/strong><\/p>\n

We treat sexual and erection problems<\/a><\/strong> and Peyronie’s disease.  We offer comprehensive STD testing<\/a><\/strong> for infections.  We treat penile problems in men<\/a><\/strong>, including phimosis, balanitis, penile irritation, and penile redness. We perform a no-scalpel vasectomy<\/strong>, vasectomy reversal, cosmetic circumcision<\/strong><\/a>, circumcision revision<\/a><\/strong>, penile frenuloplasty. We offer confidential<\/strong> appointments.<\/p>\n

Our appointment costs<\/a> are affordable with or without insurance<\/strong>.  Low-cost<\/strong> Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.  We offer free insurance verification<\/strong>.<\/p>\n

Read Real Stories of Men who Underwent Treatment for Peyronie’s Disease at New York Urology Specialists.<\/a><\/h2>\n

Read RealStories<\/strong>: 67-year-old man with dorsal curvature<\/a> <\/strong>and ED after the use of Trimix injections.<\/p>\n

Read RealStories<\/strong>: 58-year-old man with penile shortening and narrowing<\/a><\/strong> after prostate cancer treatment treated with a penile implant and grafting.<\/p>\n

Read RealStories<\/strong>: 75-year-old man with penile narrowing and curvature<\/a> treated with interferon<\/strong><\/p>\n

Read RealStories<\/strong>: 47-year-old man with penile shortening, narrowing and curvature<\/a> treated with Xiaflex and plaque excision<\/strong><\/p>\n

Cost of Treatment and Insurance<\/h2>\n

At New York Urology Specialists, we offer affordable treatment for men<\/strong><\/a>. Our prices are low<\/strong> for patients without insurance<\/strong><\/span> and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs. <\/p>\n

We accept many health insurance plans.<\/strong>  We would be happy to verify your eligibility and benefits<\/strong> and to provide you with detailed information on your health plan’s coverage.  Financing options<\/a> <\/strong>and credit options are available to help you pay for medical care.<\/p>\n

Why Choose New York Urology Specialists for Treatment of Peyronie’s Disease?<\/h2>\n