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Glanular hypospadias surgery, internal urethrotomy, urethroplasty with a graft of penile foreskin, ejaculation during erection. Treatment?

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Post surgery complications (two years later)
I have had some glanular hypospadias surgery (2000); surgery to correct a stricture near the meatus (10/2009); a 50% success rate XXXXXXX urethrotomy for a deeper stricture in the bulbar area (04/2010); and a 1 stage open urethroplasty with a graft of penile foreskin to revise the bulbar stricture (03/2011). The XXXXXXX urethrotomy has given me some worrying symptoms, still here after 2 years:

*A vein/lymph/artery(/fascia?) appeared on the left side of the flaccid penis, mid shaft, 1-2 weeks post XXXXXXX urethrotomy surgery, after masturbation.
*What I believe is the dorsal vein on top seems more swollen as well, and is also more prominent in flaccid state than before surgery, just like that new left side cord/vein.
*Firm flaccid penis (several times during the day). The penis may be short and tight or long and narrow (almost hour glass shape) and very firm to he touch despite being flaccid. Veins and firmness most prominent after erection/ejaculation.
*I now often see absence of erections when waking up or weaker morning erections with no swollen glans (glands).
*Erection during arousal/stimulation gives a swollen glans (glands), however, and a normal erection as prior to surgery (a little harder to achieve, and maybe 5% less rising power).
*Following ejaculation my penis will 20% of the time take about a minute to start shrinking down, and may be followed by a slight tingling sensation, where the glans (glands) turns paler/slightly spotted but yet not shrink noticeably.
*Sometimes I see a Peyronies-imitating appearance, ONLY in the semi-erect state, mostly after an erection or waking up, where the penis is sligthly bent to the left. Center of this bending seems to appear where the new cord/vein is at the left side, mid shaft, of the penis.
*Firmness + cord never occur when lying down on my back (flaccid penis becomes 'normal' and soft). Firmness can appear while urinating. Erections do not seem to change when sitting and standing up.

What could this be, and is it treatable??
Posted Wed, 23 May 2012 in Penis Problems
Answered by Dr. Rajiv goel 1 hour later

I went through the history and the nature of the complaints.

As I read through the description it appears that you are developing calcified plaque in the area because of the trauma left by the XXXXXXX urethrotomy. Please note that even operation can leave a trauma to the area. A surgical procedure might block or cauterize few veins. Few of these veins would not take up any more blood and do not regrow after the surgery. This makes the neighboring veins prominent than prior to the surgery. This is a better explanation for the prominent dorsal vein or the left side vein.

It is good to hear that your erection is not majorly affected. This is commonly complained as a complication after a period of XXXXXXX urethrotomy. If you are unable to continue intercourse you may need a revision by the Urologist. Remember not to waste time or money on medication therapy. You need not necessarily have early morning erections. Absence of it does not implicate organic cause.

As written by you it appears that the complication is not causing any pain. The gross appearance of the penis might be concerning for you. This raises apprehensions within you. I can understand that a man would like to have a good looking organ. This improves the confidence as well. The point whether it can be treated or not is a decision taken collectively by the Urologist and you on the basis of your goals and expectations.

Coming to peyronie's disease, the chord like or fibrous stricture can be because of the trauma due to the Urethroplasty and you are right that it mimics peyronie's. You can start on Vitamin E and PABA supplements under the guidance of Urologist.

So the next best step is to XXXXXXX the Urologist who operated on you. They are few surgeons who work on only on reconstructive Urology. If you can find one in a nearby metropolis it is well appreciated.
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