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#15311 - 10/19/09 11:16 AM Re: I have been masturbating frequently [Re: softglans]
Grifter Offline
journeyman

Registered: 01/21/09
Posts: 54
Thank you very much for your update, softglans. For many reasons it is quite difficult to find actual testimonials, but your experience, one negative side effect notwithstanding, does sound very promising. From what it sounds, the admittedly expensive operation is worth it for men in our position. I hope I soon have the money saved to go under the knife myself--right now I'm living in South Korea, so luckily a flight to Taiwan won't be very expensive. It may be a few months, but when I'm finished I'll post my results here too.

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#15325 - 10/19/09 03:01 PM Re: I have been masturbating frequently [Re: Grifter]
softglans Offline
newbie

Registered: 08/29/09
Posts: 29
Grifter,
You may just relax as it will be beneficial to you to wait a few months now. The reason is that Dr.Hsu is establishing his private clinic with all the necessary equipment for complete diagnosis and surgery. He expected within the end of the year to have it ready. At the moment he does not always have available his desired/best staff, which added an unnecessary element of risk for my surgery. Hence it should be a better environment for the surgery after this move.

I'm myself a bit careful to completely trust the track record of success. Not that I mean it's dishonest in any way, but there may be interpretations such as "satisfied patient", which may possibly not mean a 100% erection quality. Also for patients with history of ED for 5-10 years, are they able to know what 100% potency is like, or fully satisfied with less? For patients with severe conditions however, this is not so important. But for me who had perhaps a 75% condition, any side effect becomes quite critical, as you are very determined to regain 100% erection quality, but on the flip-side you also have a lot to lose.

Still, I believe if your condition is quite weak, the chances that you will see significant improvements should be rather good. And I will never let any other surgeon operate on my penis, as long as he is practicing.

Another thing that you may encounter is that there is a small language barrier, so be sure that questions you have are answered fully, or else it's always a chance that it was not understood completely. Specially if you have particular concerns about your own condition that you think needs special attention.

One thing you should be aware of is that he will perform a circumcision as part of the surgery. I requested not to do that, and he preserved most of my prepuce. However this apparently made the operation quite complicated, a consequence that was not communicated beforehand. I guess this is a little bit of the cultural&language differences, that it's not so easy to have the clear technical discussions as you are used to with a European doctor. So you need to pay attention to your own concerns so there are no misunderstandings. But for the circumcision that is something you can think through, so it does not come as a surprise.

On the personal side, Dr.Hsu is a very warm and caring person, and has a very high conscience and feeling of responsibility for his patients. So you will feel very welcome in his presence.


We should also take notice though, that we have here in this short thread already "Lou", who unfortunately has an unsatisfactory result. I see Lou, that you were a "salvaging case", since you had a previous surgery, something that Dr.Hsu says is quite complicated. I don't know if he has given any more reason or advice on your current condition, Lou? Were there veins he was not able to access for some reason? Are you a candidate for a 2nd surgery? If you have more info it would be interesting to hear about.


Edited by softglans (10/19/09 03:32 PM)

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#15346 - 10/19/09 11:01 PM Re: I have been masturbating frequently [Re: softglans]
Big Al Offline
Sponsor
enthusiast

Registered: 07/16/08
Posts: 293
Have any of you gentlemen tried doing kegels or other stamina exercises to attempt to plug up your venous leaks?

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#15353 - 10/20/09 09:47 AM Re: I have been masturbating frequently [Re: softglans]
Lou Offline
stranger

Registered: 07/16/09
Posts: 8
Loc: armenia
Softglans:I am happy to hear that you are very optimistic and your erections are good.I am sorry to hear that you had a lot of pain just like me..you know my surgery was 6.5 hours and we did local anestetic shoots several times which was also painful.

It is an uncommon side effect which you expirience.i dont think that there is a damage on the nerves..i believe that it will be alright during healing.

tell me about Hsu, he is very polite and kind isn't he?Have you meet Boss his friend?

i hope you will be ok

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#15354 - 10/20/09 10:07 AM Re: I have been masturbating frequently [Re: softglans]
Lou Offline
stranger

Registered: 07/16/09
Posts: 8
Loc: armenia
Sorry i missed to read your final letter.You know softglans the only important vein which can not be ligated or stripped is the spongy vein in the corpus spongiosum because of the possible side effects.therefore IF after the surgery there are some very small persisting veins which communicate with the corpus spongiosum and IF you have leak from the corpus spongiosum then you will loose blood from the corpora cavernosa too.Thats what i believe is happening to me and my urologist will do to me a cavernosography to see what is happening.Dr.Hsu told me that more time is needed for recovery.So the time will show us..

Grifter:If you dont consider the implant as an option the only thing that is sure is that a surgery with Dr.Hsu is the best option.You are young like me and i know that you cant stay like this..good luck to yo either

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#15355 - 10/20/09 10:33 AM Re: I have been masturbating frequently [Re: softglans]
Grifter Offline
journeyman

Registered: 01/21/09
Posts: 54
Originally Posted By: softglans
Grifter,
You may just relax as it will be beneficial to you to wait a few months now. The reason is that Dr.Hsu is establishing his private clinic with all the necessary equipment for complete diagnosis and surgery. He expected within the end of the year to have it ready. At the moment he does not always have available his desired/best staff, which added an unnecessary element of risk for my surgery. Hence it should be a better environment for the surgery after this move.

I'm myself a bit careful to completely trust the track record of success. Not that I mean it's dishonest in any way, but there may be interpretations such as "satisfied patient", which may possibly not mean a 100% erection quality. Also for patients with history of ED for 5-10 years, are they able to know what 100% potency is like, or fully satisfied with less? For patients with severe conditions however, this is not so important. But for me who had perhaps a 75% condition, any side effect becomes quite critical, as you are very determined to regain 100% erection quality, but on the flip-side you also have a lot to lose.

Still, I believe if your condition is quite weak, the chances that you will see significant improvements should be rather good. And I will never let any other surgeon operate on my penis, as long as he is practicing.

Another thing that you may encounter is that there is a small language barrier, so be sure that questions you have are answered fully, or else it's always a chance that it was not understood completely. Specially if you have particular concerns about your own condition that you think needs special attention.



Thank you again for another great post. As for circumcision, that's not an issue because I was circumcised as an infant (pretty standard in the USA).

It's very difficult for me to quantify, in percentile or otherwise, my decrease in erection quality. Two years ago, I had what I understood to be normal erections--they were rock-hard. And although spontaneous erections seemed inconvenient at the time, I badly miss having them!

I'll just say that my penis isn't quite as large as it used to be when erected (I probably lost about a half to three-fourths of an inch in length). The glans doesn't seem to fill up with as much blood and my penis certainly isn't as rigid as it once was. I mean, I do get it up enough for sex. I can get it up enough to stand at its normal upward angle, but that's only if I'm exerting force to maintain my erection. I lose erections very quickly without direct stimulation, which also sucks. If I had to make a rough guess, I'd say that the actual rigidity is between 50% and 65% of what it used to be. But again, it's tough to say.

Big Al--thanks for the tip, but upon reading about those exercises I can't see that they would 'plug' any venous leaks.

And Lou--thanks for the well-wishes!


Edited by Grifter (10/20/09 10:34 AM)

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#15358 - 10/20/09 12:14 PM Re: I have been masturbating frequently [Re: Grifter]
Big Al Offline
Sponsor
enthusiast

Registered: 07/16/08
Posts: 293
Originally Posted By: Grifter
Big Al--thanks for the tip, but upon reading about those exercises I can't see that they would 'plug' any venous leaks.


ED caused by weak valves, atherosclerosis, as well as other penile issues can usually be combatted by doing various stamina exercises. A lot of men have radically improved their erectile quality with them. It's certainly worth a try, considering the alternatives. You don't have to take my word for it though- do a thorough search on the net or visit your local library and educate yourself as much as you can on this issue.

To anyone else in a similar predicament: While there are a lot of helpful entities on this forum, no one here has the ability to medically assess what may be truly wrong with you. Before even thinking of doing anything radical you should get a thorough exam done- including a cavernosagram. If you visit a urologist and they won't help you, find one that will.

Surgery of any kind is usually not necessary except in the most extreme cases and should be considered a final alternative. Viagra, Cialis, etc. don't cure ED- they just mask the symptoms; and in cases of extreme venous leaks they won't be of much help.


Edited by Big Al (10/20/09 12:57 PM)

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#15361 - 10/20/09 02:13 PM Re: I have been masturbating frequently [Re: Big Al]
softglans Offline
newbie

Registered: 08/29/09
Posts: 29
It's indeed true that pelvic exercises can help many with erectile dysfunction. This is also supported by a published study. The benefits of the pelvic floor exercises with respect to erection quality is increased blood inflow to the penis. Reduced arterial inflow is one of the main causes of erectile dysfunction, and is mostly seen in elder men. The other common cause of erectile dysfunction is venous leak, and is found in all age groups. The venous leak is technically a completely different condition, and requires a totally different treatment. For people with venous leaks, these exercises can not counteract the problem, because the arterial inflow is typically normal, and an increased inflow will lead to higher flow rate, but not an increase in the Pascal law pressure buildup which creates rigidity. The study supporting the pelvic floor exercises is done on men at average age of 59 years. Statistically the cause of erectile dysfunction at that age is typically reduced arterial inflow, and not venous leak. Of course, reduced arterial flow can exist also in younger patients, even though it's much less frequent. Obesity, diabetes, recreational drugs or medical drug side effects may contribute to this in all patients. However for younger healthy patients, venous leak is a frequent cause.

Testing of the arterial inflow was one of the tests performed along with cavernosography prior to my surgery. The doctor does not allow any venous ligation surgery on patients unless it's confirmed significant leaks along with healthy arterial inflow. Alternative type of surgery for patients without venous leaks, but with weak arterial inflow is vascular reconstructive surgery. However for these candidates, as suggested, the pelvic floor exercises should be performed as a first remedy, for at least 3-6 months, to see the results.

Still obviously, there are no negative side effects of these kegel exercises, so any person who has reduced erection quality should do them as part of their treatment, and indeed also anyone with a perfect erection also. Indeed my surgeon also recommend these exercises for keeping a healthy erection quality into the older age, and he performs them himself.

So, the kegels are beneficial as long as the venous occlusive systems are functional. But they have no ability to repair damage to these systems, unfortunately.

But for people who yet has not a confirmed diagnosis, you may just to start to kegel today.

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#15367 - 10/20/09 04:38 PM Re: I have been masturbating frequently [Re: softglans]
Big Al Offline
Sponsor
enthusiast

Registered: 07/16/08
Posts: 293
There are eminent experts in the field of urology (e.g.- Dr. Tom Lue, a pioneer in the ED surgical field) that recommend against ED surgery (even the popular "Penile Revascularization Cure") due to the lack of permanency and because of its negative side effects.

Anyone suffering from ED should be wary of any entity that claims only surgery can cure a venous leak. One thing to consider is that the term "venous leak" is considered a blanket term used by many urologists when diagnosing ED. The internet is replete with men that have been diagnosed as having "venous leaks" that have gone on to treat them without surgery by using drugs (like "tri-mix"), devices, and/or by using exercises and supplementation.

Some of these gentlemen even fit the specific criteria of "true venous leak" due to deep dorsal vein valve issues [diagnosed by cavernosagrams] and were very dysfunctional in certain sexual positions while only less dysfunctional in others. Some of these men were able to regain some or most of their erectile functioning. How did this occur? One likely possibility is that there was some restoration of tone and strengthening of the venous walls. From that possibility alone it would make sense to perform these stamina exercises as they may be instrumental at preventing the degeneration of venal tonus. Use it or lose it applies to the vascular systems of the penis as well.

I have read about Dr. Hsu's work. His microsurgical procedures seem promising (and his novel approach not requiring a wide dissection for his stripping procedure is very impressive), but his group did state that a larger study would be required to assess the durability of his procedure. That would put it in the "experimental" category [if there have been any updates to this status please feel free to post it here]. This is a huge factor to consider since insurance companies usually don't go along with experimental procedures for non-life threatening treatments.

My intention in pointing all of this out is that I think it's a mistake to assume that ED surgery is a sure thing or the easiest way out. In addition to the outrageous out-of-pocket costs when compared with alternatives, the pain involved, the time for travel, recuperation, etc., there's still going to be the issue of viability.

Rather than promoting Dr. Hsu's procedure as an ED cure-all, it should be considered a last resort...

and in what appears to be cases of mild ED...

The suggestion of surgery for ED without exhausting all other options is irresponsible- especially when one isn't even sure of the cause!

On a brighter note, less invasive therapies like those involving VEGF look quite promising and will hopefully one day eliminate the need for extensive treatements or surgeries for ED.

Of course, the best medicine is preventative. Ensuring that your diet is in check, getting regular thorough check ups, exercising regularly (this includes sexual activity) will go a long way towards maintaining good sexual health.

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#15373 - 10/20/09 05:41 PM Re: I have been masturbating frequently [Re: Big Al]
softglans Offline
newbie

Registered: 08/29/09
Posts: 29
Yes, these are all valid points, and for people with minor leaks I would not doubt that other methods may have some positive effect. It's also obvious that the surgery does not restore the natural design of the occlusive system, so theoretically there is potential for better methods, the question is do they currently exist with successful expectancy(?).

I think however that the few people on this thread are quite severe cases of venous leak, as I think most have been confirmed as such. It is not intended as a thread for general advice, but is merely a coincidental meeting point for a few people who after exhausting all available advice, found Dr.Hsu as the best hope at this point. It is also well understood that Dr.Hsu's methods are experimental, from the sole fact that other doctors do not perform similar surgery.

At the same time I know that any person with such a condition is very interested to learn about any possible cure, whatever it may be. As you mention men that has been treated for serious venous leaks by other methods, that is very interesting. But it's hardly enough information to take any action. If you have direct references to reports, articles or other hands-on testimonials, such info would be something we could look into and evaluate, and that would be very helpful and appreciated.. I'm sure you understand that we have to make actual decisions, and act on this type of information, with our future at stake, so any hands on data is very valuable, but also required. For myself, obviously I have already had surgery, but I'm still interested in this, so I don't mind to take this investigation further. As of course, the less invasive options must always be exhausted first.

However, the statement you made before;
ED caused by weak valves, atherosclerosis, as well as other penile issues can usually be combatted by doing various stamina exercises.
..this I believe unfortunately is far from truth. Even though methods may show some improvement, in some patient groups, it seems still a very difficult condition to cure into satisfactory erection quality. Very often the standard is set by "ability to perform intercourse" etc, so it's also a big difference from what is the goal of a man of age 70, vs people in their 20s and 30s.


Edited by softglans (10/20/09 06:03 PM)

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