Dr. Harold Reed Blog

How do you manage a penile implant with distal tip erosion?

Dear Dr.  Reed  About 4 months ago, had an inflatable penile implant and it seems as though the right distal tip is very close to my skin.  Should the entire implant be removed, just remove the involved side, or remove, replace and re-site?   Neil

Dear Neil,

Surely if there is evidence of more involvement, the entire penile implant needs to be removed, as the incidence of complications including a secondary infection are too high to risk putting in another (IMHO).  If the involved side is not about to emerge from a symmetrical area on the uninvolved (left) side but more ventral, then perhaps the corpora was on the involved side was not properly dilated distally.  Yes, this could be redone, sometimes with an independent coronal incision just to be sure the cylinder is placed where it needs to be.  If you have a urinalysis and there is infection, then I would lean more to complete explantation.  So there is the concept called the salvage procedure.  If done as properly indicated, the likelihood of success has been reported to be 80%.

All in all the decision is one you have to make, but you should seek consultation with an experienced implant urologist who based on your history and physical exam will put together a “shared decision.”

Best,

Harold M. Reed, M.D.
The Reed Centre for Ambulatory Urological Surgery – Miami
1-305-865-2000

penile.implant, erosion 1

Pending extrusion of penile implant 

penile.implant, erosion 2

Erosion of penile implant distal cylinder tip into the uerthra

Penile implant for ED (erectile dysfunction)

Dr. Reed,  Have looked at your gallery of ups and downs penile implant photos on penisdoctor.com/before-after-penile-implantation Would you recommend a penile implant for a man with ED? Benje Dear Benje, A penile implant or prosthesis is the last resort for a man with ED, erectile dysfunction.  Usually this is a process which evolves, and of…Continue Reading

Can you revise my circumcision, fix a penile scrotal web, and do glans enhancement all at the same time?

Dr. Reed,  Are you able to revise my circumcision, fix a penile scrotal web, and do AlloDerm glans enhancement all at the same time?  I only get 2 weeks off a year?  Nestor Dear Nestor, We insert AlloDerm to enhance the glans via an underside  transverse incision in the coronal sulcus from about 9 to 3…Continue Reading

After photos of Dr. Reed’ s adult circumcision

Dr. Reed, Am contemplating coming to you for an adult circumcision.  Can you give me some ideal of how I will heal.  Probably I would opt for the circumcision style of moderate and tight and removal of the frenulum. Neil Dear Neil, Adult circumcision is the specialty of the house, and truly we’d like to…Continue Reading

My penis is shrinking, is that normal for a 55 year old man?

Dr. Reed,  Is it true that penile length shrinks in middle age?  I’m 55 and worried, what will happen in the next 5 years. I am still sexually active.  Paul Dear Paul, The most common reason for perceived penile shrinkage is weight gain.  Fats stores make estrogens and a blousing lower abdominal and pubic fat…Continue Reading

Purse string suture for foreskin restoration

Dr. Reed,  Will you do or recommend purse string suture for foreskin restoration. Len Dear Len, Hardly a week goes by that I don’t hear from a patient requesting purse string suture to promote foreskin restoration.  I think this is a bad idea, because this closes the area off to daily hygiene and during erections…Continue Reading

Should I be worried about my penile length?

Dr. Reed, Would like some assurance about my penis length. Flaccid about 4 inches and erect about 5 1/2 inches.  Have not had any complaints, but would like to be longer.  Brad Dear Brad, If you are not worried about your penile length and no one else is making comments, best to not dwell on…Continue Reading

Testicle Implants sought by patient on testosterone

Dr. Reed,  Have been on testosterone to enhance my sexual performance but the penalty I’ve paid is my testicles have shrunk to near adolescent size.  Have seen your before and after pictures on penisdoctor.com/testicular-enhancement and would appreciate your sending me some more information Ronald Dear Ronald, Thanks for your interest in testicular enhancement and visiting…Continue Reading

Unable to retract my foreskin for about 1 year

Dr. Reed,  Believe I have phimosis. Unable to retract my foreskin for about 1 year.  What are the options? My wife is favoring as circumcision.  Gary Dear Gary, While some doctors treat phimosis with steroid creams, the likelihood of permanent cure is nil. Another option is so called preputioplasty, often called a dorsal slit with…Continue Reading