Archive for the ‘orchidopexy’ Category

Lengthening the spermatic cords, testicular enhancement

Friday, December 2nd, 2011

December 1, 2011

I am interested in lengthening the testicular cords bilaterally. Also possible testicular size enhancement, however cord lengthening may provide a good result. I understand it is done by stripping the cremaster muscle. I’m wondering what extra length can be achieved with this?

Godwin

Decemeber 2, 2011

Good afternoon Godwin,

Any urology colleague with training in microscopic surgery, vas reversal, etc, should be able to do credible job,

That you had prior bilateral orchidopexy imposes added risk factors and may make surgery somewhat more complex.  The rate limiting factors are of course vas, arterial length, and occasionally venous length, scarring from previous surgery.

I am enclosing a photo of a patient about to receive orchiectomy to show the potential length of the spermatic cord. taken from an article I wrote on transsexual surgery, appearing in Seminars in Plastic
Surgery, August 2011.

If you are leaning towards testicular implants, how important is it to move a testis from the mid-scrotum to the most dependent portion of your scrotum?

Best wishes,

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

Another peno-scrotal web patient with high

Sunday, December 19th, 2010

high riding testes.

had te pleasure of speaking with you; appreciate you frankness and approchabilty; still planning to see you for the penscrotal webbing; I’m not decided as to what else to do. if you drop the testicles’ will they still yoyo up if the scrotum contracts? is this process independent or dependent on the boys rising up?do they have to be sewn to the scrotum ? on reading your respionce to Mr oday you stated that you participate with most bcbs plans, is the still true? or are you out of network now at this time? yoyur prices for the webbing was staed as 2500.oo as well as for the orchid…; What is the charge for the ..pubic liposucktion? no matter how much weight i lose I don’t think I will lose it there. what does it involve? pleasent and prosperous holidays; God Bless – Sanford

December 18, 2010

Good afternoon Sanford,

Think of the scrotum as a hammock on which the testes will rest after orchidopexy.

If the scrotum rises, the testes will also, but should always remain on the bottom of the scrotal compartment.

We are contracted Blue Cross, Blue Shield providers.  Please call Anne to validate your plan. 

Peno-scrotal web as a procedure unto itself is 2500, and orchidopexy when done simultaneously is 4500.

Pubic liposuction should not be done at the same time, and does require a general anesthetic.  Our fee for that varies depending upon what has to be done, from 3500 up.

Sincerely and have a restful weekend,

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

Status post circumcision with sloppy look and peno-scrotal web

Thursday, January 21st, 2010

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