penisdoctor.com

June 9, 2011

Do you know any “emergency circumcision cases?”
Ling Dow Chow M.D.

Good afternoon Dr. Ling,

I guess paraphimosis with inability to reduce could be an occasion
although many urologists might just do a dorsal slit to temporize.

Conceivably phimosis with the inability to void appreciably might be one, although I has never seen that.

A significant tear of the prepuce could be converted to a circumcision
if the patient agreed.  In our country, a patient should be able to review an informed consent and contemplate risks and side effects, etc. for at least 24 hours, to avoid the surgeon being declared “overly aggressive.”   We post our informed consents for circumcision on our web-site.
Hoping this is of help,
Harold M. Reed, M.D.

June 5, 2011

Dear Dr. Reed,

I had 28 year old male painful penis and physical examination  showed swelling penis and phimosis and balanoposthitis 2days.  I did circumcision on him, am I right?  Ling Dow Chow,  M.D.

Good afternoon Dr. Ling,

We certainly have operated on patients with low grade infection and inflammation of the skin and even preputial synechia.  If the infection is clinically significant, always best if possible to try a course of antibiotics to have the patient in best possible shape for semi-elective surgery, or just do a dorsal slit.  This is a judgment call that every urologist has to make, and without seeing your patient beforehand, I am unable to advise.

My web-site shows numerous examples of patients with phimosis, who underwent circumcision without dorsal slit.  http://penisdoctor.com/photo-circumcision.htm  Concealed smegma may smell and of course is laden with bacteria and yet the deeper tissues are not involved.

All patients following circumcision will have some degree of swelling and without seeing the patient, opening your suture line may or may not have been indicated.

Our patients (everyone) receives IM or IV gentamicin pre-operatively and is placed on a course of cephalexine or ciprofloxin for one week afterwards.  If they have phimosis, the glans once exposed is re-prepped with povidone iodine before surgery.  Our incidence of  true post-operative deep tissue infection or cellulitis is virtually nil.

Penile surgery can be a very traumatic event with great potential for bruising and we advise bed rest for a minimum of 24 hours at a nearby motel, driving distance no more than 8 minutes after having spent a few hours in our recovery room.  All are told they need to be seen the next day.

I usually make rounds at the hotel the next morning.

Hoping that is of help and supportive,

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

 I had a inflatable implant Put in in 1980. It has failed. I  am having problems. The foreskin can no longer retract and I am having a hard time keeping clean. Also no sex. Can the implant be removed or replaced? Will I need to be circumcised? I am 65. my urologist suggest removing the old implant and splitting the foreskin and no sex. Your suggestions please. I do not think he wants to fool with me.

Jordan

Good afternoon Jordan,

I would consider a circumcision first. Then wait 3 to 4 months for adequate wound healing, then only if you wish, have your  implant replaced. To have done well with a single implant  for 31 years is exceptional. You do have a claim to fame. 

Hoping the attached is helpful,

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

Once again  thanks for the reply. I will contact your office and  schedule a consultation and circumcision. Enjoy your trip to the mountains.

Respectfully, Jordan

May 19, 2011

Good afternoon Jordan,

Going out for some errands and will be back about 4 PM.
 
All you need my friend is a simple circumcision. The dorsal slit is only used as a first  stage step if you have a massive infection or some rare problem
 
Look at our web-site and see photos of how patients present and have all in one visit.
 
 
We’ll talk,.
 

 Harold Reed, M.D.

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