Archive for December, 2009

Unable to retract foreskin

Thursday, December 31st, 2009

In PROCIRCORG@yahoogroups.com, Leland J. wrote

Happy Holidays to all. I’m new to the group and my situation is this. I was able to retract the foreskin when erect and soft but, I only can now when I’m soft. I don’t want a full circ, maybe a partial. Any advice.

Hi Leland,

There are remedies you can consider: steroids applied judiciously, but usually the end result is not workable. You may also have a dorsal slit, or even “cigar clipping” done but recovering from this may be more problematic. Lastly you can have a loose circumcision with normal ease of recovery. Please look at
http://www.penisdoctor.com/photo-circumcision.htm

We have performed over 5000 cosmetic circumcisions in the past 35 years and usually do several cases every week.

We do ask that you stay for one, ideally 2 days at the Baltic Hotel (advanced tourist class) and I will see you there daily.

You could return to an office environment in about 4 days after circumcision. Our 2 layered wrap of soft conforming gauze and Coban will provide comfort and reduce swelling.

We have done sons of physicians, medical students and residents, brothers, religious circumcisions, men who have not seen the heads of their penis for 20 years! This is your circumcision or partial circumcision and we do it the way you want with respect to 4 parameters.

Please don’t be like the patient who writes: “Dr. Reed I just got circumcised two days ago and my result was not what i expected. I was wondering when i recover can i get a consultation with you.” Photos sent and received (unspoken comment “disaster zone”)

Be assured we will show you every courtesy,

Happy Holidays and a Healthy New Year,

Harold M. Reed, M.D.
305-865-2000

 

Prolonged swelling after circumcision

Thursday, December 31st, 2009

December 31, 2009

Prolonged swelling after circumcision.    I am 44 years old and recently had a circumcision due to phimosis.  Unfortunately the results are not good and I am left with unsightly swelling/scaring just inside the scar line. It has been 4 months since the operation and my Urologist (very reputable) tells me he does not think the swelling will go down and he recommends a new procedure to remove additional tissue. He also recommended individual stitches in lieu of continuous spiral stitching in hopes for better healing. Although my Urologist has done hundreds of adult circumcisions, he has not seen one heal as poorly as mine and he has encouraged me to get a second opinion.
So here I am in Texas, needing advise on locating best doctor to correct poor circumcision results.
Brad
Dear Brad,
There is a lot of normally loose connective tissue underlying the skin which contains an abundant amount of lymphatics. If this tissues has been cut but not reconstituted in surgery by a deeper layer of sutures (sure it takes more time to put in an extra layer) you most likely have a deep scar which is blocking lymphatic drainage. Spiral sutures are not used in our practice, saves time yes, but the skin needs to be able to expand for a few days and with spiral sutures for sure you will have cross hatch marks very reminiscent of a baseball. Is that what you want? Lastly immediately following circumcision you need to be on bed rest, your heart at the level or below your penis, for 1 ideally 2 days. Was that recommendation made?

It’s in the details that make the difference. At this time most likely, if after 4 months and you have plateaued out with no improvement, you will need a revision with removal of wet tissue and yes re- approximation of the lower loose layer (Dartos fascia). In all honesty, in our own practice every so often we have a case like yours. Our approach would be the same.

Think of Dr. Reed in Miami.

— In PROCIRCORG@yahoogroups.com, D Pit <dpit2525@…> wrote:
>
> I am 44 years old and recently had a circumcision due to phimosis.
Unfortunately the results are not good and I am left with unsightly
swelling/scaring just inside the scar line. It has been 4 months since the
operation and my Urologist (very reputable) tells me he does not think the
swelling will go down and he recommends a new procedure to remove additional
tissue. He also recommended individual stitches in lieu of continuous spiral
stitching in hopes for better healing. Although my Urologist has done hundreds
of adult circumcisions, he has not seen one heal as poorly as mine and he has
encouraged me to get a second opinion.
>
> So here I am in Texas, needing advise on locating best doctor to correct poor
circumcision results.
>
>

High, tight or loose

Thursday, December 31st, 2009

December 31, 2009

Re: High or low, tight or loose?

Hello Magellan,

This is all your call. As mentioned a few messages ago, if you have phimosis, for sure, the bad tissue has to be removed and then you may be looking a moderate or low cut. Regardless you still will be every bit as handsome as you are now, but just a little bit cleaner down below. We give our patients four options, remove or do not remove the frenulum, high medium or low cut, tight or loose or any way in between, and the cut can be parallel to the rim (corona) which is on a slant or perpendicular to the long axis of your penis.

If it is on the diagonal the inner skin is equidistant in width all the way around.

Happy and Healthy New Year,

Harold M. Reed, M.D.

PS. We recommend the Baltic Hotel in Miami Beach (advanced tourist class) with freshly baked gourmet Danish daily, hot coffee, sparkling white thick linens, 8 minute drive to the office, and I make rounds there every morning. Cristina, the owner maanger has shown a strong partiality to our patients. For reservations 888-622-5842.

Frenulum, to be or to remove it

Thursday, December 31st, 2009

December 31, 2009  

 In PROCIRCORG@yahoogroups.com, “luigidecorimani23″ wrote:

Dr. Reed, when you do a circumcision what are your recomnmendations?   Will I lose any pleasure if it is removed?  
Luigi from the Bronx.

Good afternoon Luigi,

We have noted that 80% of our patients request the frenulum be removed, some wish that because it has been problematic in the past with bleeding, minor tearing, some downward tilt of the glans (head). Interesting;of the 20% that don’t want it removed, 80% of these patients come back and say,  “Doctor, now remove it.”

Studies have shown that aside from any pleasure your frenulum or foreskin for that matter provides, removing it will not effect your ejaculatory latency time, one way or the other. In other words you will be as equally orgasmic with or with it.

There will always be a rare patient who bemoans the lose of his frenulum, and I wonder if there is not always the rare female who bemoans lose of her hymen (after marriage of course).

Harold Reed, M.D.

Status post circumcision, swelling on top and bottom opened up

Thursday, December 31st, 2009

Dr Reed, i wrote  you an email a couple of months ago regarding the circumcision i had done in which the skin on the bottom of the penis split open after operation. Dr. Reed i am not happy with the way it has healed plus the swelling around the top of the head does go away and to be honest with you i cant stand the sight of it. Needless to say my self- esteem is extremely low. i value yourt opinion as a specialist and i regret whole heartedly not seeing one to begin with and having this operation done by a surgeon that does not specialize in these types of operations. i look forward to meeting with you. Again, Thank you again for your time in this matter.     Frank

Hi Frank,    Sometimes a separation like that will close like a zipper  and the result will be imperceptible versus if it had never  opened. You’ll have to take a wait and see attitude,  but they all will close. After 3 or 4 months following complete  wound healing;, if you are still not satisfied. perhaps you could  see me for a revision.

Harold M. Reed, M.D.

 

Phimosis and weighs 350 pounds

Thursday, December 31st, 2009

I am 67 yrs of age and weigh 350 lbs. I have phimosis and I am considering a circumcision. I have Medicare and AARP  and do not have other funds avaiable. I would like to get done as outpatient, no hospital stay. I don’t like the idea of spending a night in hospital. Would this be possible?   Sid

Good morning Sid,

We respectfully would decline to do your circumcision at our office based facility but would in a hospital setting and yes, most likely you needs would be best served to have you stay overnight.  However, we could request an early morning starting time, and most likely if you are stable, you could be discharged later (same day).   Accepting Medicare as the primary and Aetna as a secondary is no problem as long as their regulations are followed.

I know you would not get on a plane with a 5% likelihood of a major mechanical malfunction, why take chances with surgery?

We do ask that you stay for one, ideally 2 days at the Baltic Hotel (advanced tourist class) and I will see you there daily.

 

Harold M. Reed, M.D.

 

Penile Extender (stretching) in Peyronie’s

Thursday, December 31st, 2009

by Dr. M Culha and group from Turkey   Traction was applied from 3 to 8 hours a day for 6 months.  Results 93% (27 patients) noted curvature reduction (from 10 to 30 degrees), length increased from 1/4″ to 3/8″   In another group, comprised of patients who refused to use the penile extender device, a small portion noted penile shortening. 

Harold M. Reed, M.D.

 

Effectiveness of intralesional Verapamil on Peyronie’s

Tuesday, December 29th, 2009

As reported by J. Chen  (J. of Sexual Medicine).  45 men were treated and only one patient reported improvement.  Each patient was treated with 8 weekly injections.  Conclusion: Verapamil is not effective in correcting curvature or facilitating vaginal penetration.

Harold M. Reed, M.D,.

The incidence of spontanous resoltuion of Peyronie’s (without any medical intervention) is about 15%.  This give credence to many medications and non-operative treatments.

 

Frenulum, to be or to remove

Tuesday, December 29th, 2009
Good afternoon Luigi,

We have noted that 80% of our patients request the frenulum be removed, some wish that because it has been problematic in the past with bleeding, minor tearing, some downward tilt of the glans (head). Interesting;of the 20% that don’t want it removed, 80% of these patients come back and say, “Doctor, now
remove it.”

Studies have shown that aside from any pleasure your frenulum or foreskin for that matter provides, removing it will not effect your ejaculatory latency time, one way or the other. In other words you will be as equally orgasmic with or with it.

There will always be a rare patient who bemoans the lose of his frenulum, and I wonder if there is not always the rare female who bemoans lose of her hymen (after marriage of course).

Harold Reed, M.D.

— In PROCIRCORG@yahoogroups.com, “luigicoriman23″ <luigicoriman23@…> wrote:
>
> Dr. Reed, when you do a circumcision what are your recomnmendations?
>
> Will I lose any pleasure if it is removed?
>
> Luigi from the Bronx.
>

For penile surgery, especially circumcisions we recommend the Baltic Hotel in Miami Beach

Tuesday, December 29th, 2009

Hello Magio,

This is all your call.  As mentioned a few messages ago, if you have phimosis, for sure, the bad tissue has to be removed and then you may be looking a moderate or low cut.  Regardless you still will be every bit as handsome as you are now, but just a little bit cleaner down below.   We give our patients four options,  remove or do not remove the frenulum, high medium or low cut, tight or loose or any way in between, and the cut can be parallel to the rim (corona) which is on a slant or perpendicular to the long axis of your penis.

If it is on the diagonal the inner skin is equidistant in width all the way around.

 

Happy and Healthy New Year,

Harold M. Reed, M.D.

PS. We recommend the Baltic Hotel in Miami Beach (advanced tourist class) with freshly baked gourmet Danish daily, hot coffee, sparkling white thick linens, 8 minute drive to the office, and I make rounds there every morning.   Cristina, the owner maanger has shown a strong partiality to our patients.  For reservations 888-622-5842.
 

— In PROCIRCORG@yahoogroups.com, “magiogenero” <magiogenero@…> wrote:
>
> Dr. Reed, have an appointment scheduled for this January.  Any ideas?  What
Hotel do you recommend?
>
> Magio