I would like inquire about a dorsal slit reversal. Is it possible? if it is, will the outcome be just like an intact penis with all the foreskin restored?  Please give details regarding the costs of operation and recovery period.  Thanks in advance.   Matthew.

Good morning Matthew,

As you may know, a dorsal slit is a longitudinal release of the foreskin on the top side which opens the phimotic ring and usually results in a waddle of skin under the head and distal shaft.  Not that pretty, but often convenient when the patient may not be a suitable candidate for circumcision, such as  a gent with a severe penile infection.   A circumcision could be done secondarily.

Thank you for your interest in what we do.  Several thought come to mind.  Reversal is possible with some caveats.

A dorsal slit is usually done by a crushing clamp technique to reduce bleeding followed by an incision over the crushed area.   The edges are then oversewn to prevent delayed bleeding.  This reduces the amount of foreskin available to reconstruct unless you were very generously endowed to begin with.

Normal for men is a preputial ring at the end of the foreskin which upon reconstruction is the weak point and could lead to tearing with erections.  So while an attempt can be made to do this, there is no guarantee everything will be smooth sailing afterwards.

Fee for reconstruction 1500.    You will need to be on an anti-erection medication for 6 weeks.

Cordially,

Harold M. Reed
1111 Kane Concourse, Suite # 311
Bay Harbor Islands, Florida 33154
305-865-2000

Re: anti-erectile medication for circumcisions?

PROCIRCORG@yahoogroups.com,

It seems that the occurrence of erections will prevent an adult man from getting an ultra tight circumcision, otherwise there will be suture marks from pulling during healing.

Are there any safe, reversible methods to block erections for a couple of months to let the wound heal?

Kendall

Hi Kendall.

Thank you for your interesting question. First let’s talk about overly tight circumcisions. Two “no-no’s”. You don’t want it that tight you see lifting of the peno-pubic angle or raising of the pubic skin to meet the needs of the penis, nor do you want your scrotum drawn into the base of your penis creating a peno-scrotal web.

Next for those patients who request tight circumcision, the use of steri strips, left on for about 12 days should suffice. Also plan on being on bed rest for 2 days, after circumcision, in that wound separation is seldom caused by an erection alone, but more often by a simultaneous collection of fluid under the skin which impedes good wound healing. We mean being in bed within 8 to 10 minutes after the patient leaves our office. If the patient lives beyond that distance, he has to stay at a nearby motel. No shopping at the Mall or weddings for the next few days.

Lasting we do procedures such as foreskin reconstruction and after the first stage, have to bury the penis under the scrotum and of course, erections are to be avoided. For that spironolactone 100 mg twice a day (avoid high potassium foods) is what we recommend. This is an anti-testosterone drug. 

To control nocturnal erections, the use of the old styled Sudafed (pseudoephedrine) 2, 30 mg tablets every 6 hours is helpful. Please read the brochure, can cause elevated blood pressure, etc.

Incidentally in our operating room, the patient gets a hand-held mirror and we make the circ is as tight as the patient wants (of course avoiding extremes, that will come back to bite us)

Hope that gets you off to a good start.

Harold M. Reed, M.D.

Thank you for your interest in what we do, over 5,500 procedures relating to circumcisions and/or phimosis.    Kevin

Good morning Kevin,

Please keep this in mind, if you have a phimosis, all unhealthy non-stretching tissue has to be removed or you will need a dorsal slit.   If you have scarred prepuce left, that will not retract over the rim of the glans for daily hygiene.  What you may wind up with could resemble a partial circumcision.  Also keep in mind the remaining prepuce normally swells quite a bit after surgery, and you will need a Q-tip for a few weeks to cleanse the inner recessed area.    But yes, it can be done.

Harold M. Reed, M.D.

305-865-2000

I have HPV diagnosed 6 months ago. Just thought circumcision could be a help, since im not circumcised and am struggling with new warts after every treatment (podofilox) -Is that goin to help me? -either way, is there something more efficient than podofilox? surgery???? thank you    Ernest

Dear Ernest,

We have performed over 5500 cosmetic circumcisions in the past 35 years and usually do several cases every week.  We have also had a fair amount of experience treating penile warts and do not use podofilox for the reasons you state.

Our preferred treatment is figuration and if you are having sexual contact with an individual who has HPV, this access has to be thought of a causative.  We often combine circumcision with fulguration of some warts.   In that there are seeds in the penile skin that have yet to germinate, after fulguration expect some new growth for a while.  You will need followup  fulguration under local for that.

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.

Cordially,

Harold M. Reed, M.D.

I recently had an improperly performed circumcision, resulting in misalignment of the midline raphe and the line of the frenulum (frenulum was removed). The glans is rotated to the left in relation to the shaft. There is also a bunching up of skin on the left side. I am quite distressed about it, and would like to know how soon before I can get it redone. The procedure was done 4 weeks ago, and the wound has healed, but of course there is still scarring. I really would not want to wait too long to have it repaired. What is your suggestion? I’ve heard very good things about you. I hope you can assist me. Thank you in advance for your help.

Raymond

Hi Raymond,

A circumcision is perhaps the highest cosmetic calling given to a urologist. 

Please wait a good 3 months before any revision is done as the tissues need to soften and achieve optimal healing.  You bring to us a work list at that time and we’ll revise every item that is feasible.  What you mention so far should easily be correctable.

We do several circumcisions and a few revisions here every week, as we enjoy a reputation for excellence and exactitude when it comes to cosmetically performed adult circumcisions.  We operate within tolerances of 1/32″ or about 1/2 mm.

Pain is virtually non-existent among our patients.  They smile as they leave the office, and by and large remain free of discomfort as evidenced by our followup contact with them.

Cordially,

Harold M. Reed, M.D.

305-865-2000

I was wondering if my husband can get a circumcision at the age of 26? He has a penis that is curved, will it be a problem? But also a problem is he has this bed wetting issue that has been occuring for the past few years. He does this every month or so. He eats healthy and he doesn’t drink caffeine drinks. What can be the cause of this? It happens when he dreams bad stuff he says and he can’t get out of his dreams… he wakes up wet.   

Nancy

Hi Nancy,

Thanks for your E-mail inquiry and visiting our web-site http://penisdoctor.com/circumcision.htm.

A circumcision is perhaps the highest cosmetic calling given to a urologist.  
However, we must be mindful of two other important issues, penile curvature and bed wetting (enuresis).  Just to digress one of the most memorable cases in the past 31 years of practice was a bed wetting adult executive type man who had received the million dollar work up from others to ascertain exactly what his problem was.  The answer was later revealed to me.  He was sleeping on a water mattress with a very small pin hole in it, that would never leak unless about a 200 pound man and wife were on top and maybe doing things.  A web-site about bed-wetting in adults is http://www.nafc.org/bladder-bowel-health/bedwetting-2/adult-bedwetting/  One approach is timed voidings, getting up in the middle of the night by alarm clock if needed, and restriction of fluids after 6 PM

Before his circumcision is done, at least we would like to know if he wishes correction for curvature, has he received prior treatment with medication, etc.?  Please check out our penile curvature (Peyronie’s) website  http://penisdoctor.com/peyronies.htm

With kindest regards,

Harold M. Reed, M.D.

Dr. Reed:

About a year ago I was circumcised by my urologist.   He did not respect my request to leave as much inner foreskin as possible. Nor did he respect my request to remain awake and aware during the procedure. The outcome is a low and sloppy look with suture marks all around.  He also pulled scrotum skin up the shaft leaving a turkey neck web.  The result is that my penis looks much shorter and I cannot penetrate as deeply. 

The frenulum was left.  It is very sensitive and pleasurable upon initial penetration but after thrusting and becoming more erect it becomes painful.

I’d like to have a recirc if possible and have the turkey neck trimmed back and the frenulum removed.

Would photos help in evaluating if this is doable?   Can you give me some idea of fee?…healing time?

I’m 65, gay, and love sex.  But due to what I’ve described, find myself not having it as often as my partner wants.

Oh yes, I want to be as aware as possible and see as much of procedure as possible.

Thanks,
M.  O’Day

January 21, 2010

Good morning Mr. O’Day,
Thank you for your continued interest in what we do.

For most patients we recommend you stay here overnight following your revision procedure, and you can throw in a safety factor of an extra day.  Your sutures should be removed 12 days fter revision by a health care professional.

You can be seen in consultation and done the same day.

Yes of course, we wish to see you before you take off.

Taking your other thoughtful questions…

2.Can the frenulum be removed without total loss of sensation that it offers?We remove the frenulum on most patients, and of the 10 % or less that request it not be removed, 80% return and say, “now Doctor, please remove it.”   Truly doubt there will be any difference in sensation, but if there is any concern then don’t have it removed.,

3. When I am erect, turkey neck is barely visible but my balls are pulled up the shaft.  Is this the usual situation?  I very much want my balls lower for penetration again!If you have hyper-retractile testes or so called “yo-yo” testes, there is a procedure to correct for this.

How much scaring is left by scrotal cuts? Usually a fine white line that lays out like an inverted “Y” with limbs about 3/4″ at most in each direction.

How long is healing?Healing continues over 6 weeks for maximal tensile strength but cosmetically certain refinements such as fading of all redness an take up to 13 months.

How many weeks before sex is possible?You could resume sex typically in 6 weeks. 

4. Could lengthening be doen simultaneously? No for this reason.  Successful lengthening depends upon use of traction within a day or 2 after surgery to maintain what was accomplished in the operating room and build upon that.  If you have a circumcision revision, your penis will be much too tender for traction and also you will rip you suture line apart. 

How much would that cost in addition to other surgery?If you have orchidopexy (to prevent rising in your scrotum), that fee is an added $2,500.  Lengthening as a procedure unto it self is $4,500 and this is posted on our web-site.

Michael, have a serene weekend, and again many thanks for considering our facility,

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

January 21, 2010
Dr. Reed,
 
I’m a 66-year-young man who was circumcised as an adult over 3 decades ago. I’m pleased with the results except for the “railroad track” scar that rings my penis just below its coronal ridge. This scar has always bothered me, and I’m seriously considering a belated revision to tighten my original circumcision and to erase the unsightly scarring.
 
This revision would be done for purely aesthetic reasons — and my peace of mind.
 
Would you consider assisting me if I were to arrange a consultation? Any information you could provide would be appreciated.
 
M. R. James

Good morning Mr. James,

Thanks for your E-mail inquiry and visiting our web-site http://penisdoctor.com/circumcision.htm.

A circumcision is perhaps the highest cosmetic calling given to a urologist.  We do revisions just for the reasons you describe several times a week.  Please call a member of our office staff from Monday through Friday between 9:30 AM and 4:30 PM and be assured we will show you every courtesy.

The Reed Centre enjoys a reputation for excellence and exactitude when it comes to cosmetically performed adult circumcisions.  We operate within tolerances of 1/32″ or about 1/2 mm.

With regards,

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

P.S.   Take a look at this unsolicited web-site constructed by a patient of mine.  Is this what you have in mind?  Especially the photos taken 60 days post-op.

http://www.circlist.com/considering/davids_freehand_circumcision.html

Also view:  http://www.circlist.com/considering/findphysician.html and read several unsolicited recommendations.

Dear Harold M. Reed,

I have had a past circumcision but am dissatisfied with the results. I would like to be re-circumcised and have the skin tightened. I would like you to answer a few questions:

I want to fly from the United Kingdom so could you please tell me the nearest airports.

How long will I need to stay in Florida for (recovery time)

The cost is stated at $1500 and the consultation is $250, as I am flying I would need both to be done together, so how would that work?

Thank you very much, I look foward to hearing from you,
W.Padington

Thanks for your E-mail inquiry and visiting our
web-site http://penisdoctor.com/circumcision.htm.

Taking your thoughtful questions in the order posed….

We are equidistant between the Fort Lauderdale and Miami Airports.  Choose the flight that’s least expensive.  If at Ft. Lauderdale there are additional savings by using Share-A-Ride ground transportation or Super-Shuttle if you are at the Miami airport.  About 1/3rd the price of a cab ride.  Please stay at a nearby motel, the Baltic Hotel (advanced tourist class).  Plan on my seeing you the following day at the office or hotel.  

We would recommend you stay here one additional day, just to be sure before returning to the UK.

Your consultation and revision are done on the same day, and if you agree your revision will follow your consultation.

That simple.

You will have an opportunity to see work in progress and to be sure you are entirely happy before you get off the table.

Kindest reagrds,

Harold M. Reed, M.D.

305-865-2000

Hey Dr. Reed, i am going to visit Florida University the weekend of the February 5th, 6th, and 7th,  and i was wondering your availability around those days for a circumcision revision.   Mismatch of raphe, deep white hash marks, and puckers.  Not what I expected         
                                  Thank you, Nestor

January 20, 2010

Dear Nestor,

At least 3 months is required following circumcision before a revision is done.  If this makes sense, call Anne and arrange for an appointment.  Please bring your work list to which we will add our recommendations as well.

Sincerely,

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