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can a penile inplant oper be reveresed. i have a lot of scar tissue in my penise so the dr said he could there was no room to put another implant in so is it possible to have the scar tissue lazered out
contact: Thad by Email

July 4th, 2010

Good morning Thad and Happy July 4th,

Thank you for your interest in what we do.

Removing scar tissue associated with prior implantation is a well understood and this procedure is called a corporotomy.

Yes, we can do this procedure.   Please do not abandon hope for penetrating sex.  There are no uninvolved partners.

If you believe I am the doctor for you, please initiate a consultationvwith our office by sending us your name, address, and phonevnumber in an envelope along with a check for 250 and you will receive a call ASAP.  We’ll have a lot to talk about.

Harold M. Reed, M.D.
305-865-2000
1111 Kane Concourse, Suite # 311
Bay Harbor Islands, Fl 33154-2041

BellaDerm for penile girth enahncement is about implanting “like into like.”

Michael Kawas, President of MTF’s skin division, notes that plastic surgeons typically rely on other materials, some of them from animals (like pigs) and some of them are synthetic. “Now they will have an option to use human skin, which provides a more natural choice. We have gotten a lot of comments about the desirability of implanting “like into like” – in other words, implanting tissue from one human into another. It seems to be preferable to using animal products or synthetic materials ”

“We have a history of positive clinical outcomes using other MTF tissue”, noted Dr. Philip Bonanno, Director of the Institute of Aesthetic Surgery and Medicine at Northern Westchester Hospital. “Thus we’re comfortable using BellaDerm as a natural human dermal graft for support and reinforcement in many of our procedures.”

Donation of skin for BellaDerm is restricted to living donors who have given specific consent for their skin to be used for these types of procedures. To assure the utmost safety and quality, MTF has the highest standards for tissue donation. Living skin donations are held to the same high standards for acceptance and processing as skin which is recovered from deceased donors.

“It is very important for us to have confidence in the providers of all materials we use” continues Dr. Bonanno, “and MTF’s high standards exemplifies their commitment to providing only the best tissue possible for my patients.”

MTF is a non-profit service organization that has been dedicated to providing high quality tissue to health care providers for over 20 years. Since its founding by surgeons in 1987, MTF has received tissue from more than 74,000 donors and has provided more than 3.5 million tissue grafts for transplantation. For more information, visit www.mtf.org.

Harold M. Reed, M.D.

305-865-2000

At 09:43 AM 5/22/2010, you wrote:

Hi Dr. Reed:

quests: I have tried oral meds, intraurethral pellets,and intracavernous injections (as advertised by national urologist chain). all eventually failed. Is a prosthesis the remaining solution.

Michael

May 22, 2010

Good morning Michael,
Thank you for your interest in what we do.  Sometimes, a less than optimal injection technique can be modified to  produce a good result, or the result can be augmented with a constriction band.  Also we should consider a vacuum erection device.  Please call the office and make an appointment.  These choices can be reviewed  and shown in detail

Patient satisfaction for a penile implant runs about 90% as does partner satisfaction (national averages).   Not too shabby.    A newer technique permits a somewhat longer erection than otherwise, if you should choose an implant.

Have a restful weekend,

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

a large penile size. 

Titan Pump – Coloplast

The FDA approved the improvements to the pump component of the Coloplast Titan prosthesis in July 2008. Although the cylinders and reservoir remain the same as the previous model, the pump now features a one-touch-release (OTR) deflation valve — easy for patients to locate and operable with one hand. In addition, the pump offers a non-bulky, low-profile size; enhanced silicone for higher threshold “tear strength” (likely to result in increased product durability, an issue with previous versions); and an overall simplicity likely to decrease repeat office visits, phone calls, and repeat training time. From a hospital standpoint, intraoperative prep of the device provides for easier priming of the implant system (the removal of excess air prior to filling) and may reduce slightly the overall intraoperative time.

“This remains a great device for the patient with a larger penis, as these are the only cylinders that will expand to 22mm girth.” In addition, only Titan cylinders are available in lengths of 24cm, 26cm and 28cm.

Although the pump is easily identified and operated by patients, the small size of the deflation valve sometimes requires a longer learning curve.

In a recent study (“Evaluation of Three Penile Prosthesis Pump Designs in a Blinded Survey of Practitioners,” Urologic Nursing, 2008), 32 medical professionals, all familiar in teaching the operation of penile implants to patients, reviewed currently available penile pumps. The blindfolded reviewers, examining the pumps under time constraints through mock scrotal sacs, were asked to rate device:

--  ease of location of deflation valve
--  ease of inflation
--  ease of deflation, and
--  anticipated ability to train patients in clinical setting.

The Titan OTR pump design performed very well and “consistently demonstrated a significant advantage in subject preference.” (Quallich, Ohl & Dunn, 2008, p. 5).

After displaying the various models, many of my patients will favor the AMS 700 with LGX cylinders and other features described below

Durability

LGX cylinders are as durable as the CX, the most popular IPP cylinder in the world.²

Controlled Expansion

Designed to allow for up to 15-20% elongation, depending on patient’s anatomy.²

Unrivaled Technology

The only penile implant that provides controlled length girth expansion.

Three more reasons to choose LGX:

• Momentary Squeeze Pump with Lock-out Valve and Deflation Button
• InhibiZone® creates a Zone of Inhibition, effective against the bacteria commonly associated with IPP infections³
• Parylene—coded reservoir designed to mitigate cylinder fatigue and improve reservoir durability

This product is not for men with active urinary infections or active skin infections in the region of surgery; with known sensitivity to silicone or the antibiotic rifampin or tetracyclines; with lupus erythematosus; taking warfarin, thionamides, isoniazid and halothane; or with renal disease. Implanting a penile prosthesis is likely to damage or destroy any remaining natural ability to have an erection.

Montorsi F., et al; “AMS Three-Piece Inflatable Implants for Erectilie Dysfunction: A Long-Term Multi-Institutional Study in 200 Consecutive Patients”; Eur Urol 2000; 37: 50-55

1. Data on file at AMS
2. Carson CC 3rd. Efficacy of antibiotic impregnation of inflatable penile prostheses in decreasing infection in original implants. J Urol. 2004 Apr;171(4):1611-4.

Dr. G. Garaffa (London) and group compared 129 patients who had correction of Peyronie’s by insertion of an inflatable penile implant versus 80 of those who had a semi-rigid rod type implant.  Despite revision surgery in 18 of the first group versus 8 in the second group, the satisfaction rate for inflatables was higher 86% versus 72%.   Our experience has been after you show an inflatable model on the desk top versus a semi-rigid rod almost all patients will opt for an inflatable after learning of the pros and cons.   

Harold M. Reed, M.D.

How well did they fare?  A paper by Drs. M. Zanoni and Steve Wilson et al.

During revision surgery for clinically non-infected implants, cultures were positive for 70% of non-coated, and 60% of coated.  Thus the authors concluded that culture positive implants as a simple test (unrelated to why revision surgery was being performed) obtained at the time of revision surgery occurred in the majority of non-coated as well as coated implants

Harold M. Reed, M.D.

by Dr. Ohl and group, University of Michigan, a multi-centered study.   Mentor’s one touch is a catch up to the AMS (American Medical Systems), MS or momentary squeeze  valve.  At 6 months the Titan satisfaction rate is reported to be 76% meaning somewhat/or very satisfied.

I do believe more table top demonstrations of how the implant works in the doctor’s office are needed before surgery.

Harold M. Reed, M.D.

by Debo and group, a multi centered study.  Average time for re-intervention for implant malfunction was 50 months, a little over 4 yours.  Average time for re-intervention for infection was 18 months which occurred in 11%, and a patient dissatisfaction rate of 34%.

This study is of course at variance with what manufacturers say.  Their classic explanation is if the Doctors don’t tell us, how are we to know.   I do believe our experience is quite a bit better than that, but our office is not a training center.  Last week, I  removed an implant that had been implanted in May, 1987, the implant had been operational for 22 years.  Patient did receive radiotherapy afterwards for prostatic carcinoma.

Harold M. Reed, M.D.

 I asked for the Ultimate AMS I was given the step down with out my conscent. Ilost 2′ and some Dimension. The Pump leaks and partially fills when its deflated. Can I get back my inches and a better girth?    Rudy

Good morning Rudy,

Thank you for your interest in what we do.  Hope you can relate to our gallery of “ups and downs.”   Have been doing implants since 1975, and probably have done over 2000.

Fortunately your AMS product has a life-time warranty applicable to any treating physician.

We have been known to perform some magic in situations such as yours, but you do need to be seen at the office so I can best advise you.

Please understand it may be as simple as revising some technical errors during your previous installation, but you do need to have this reversed ASAP as scar contracture will make it more difficult to regain the length loss.

Also bear in mind any operation is associated with risk.  The experience of your urologist and his focus to the problems at hand will help minimize this.

You may wish to initiate a consultation over the phone by sending us your name, address, and phone number in an envelope along with a check for 250.

All the best,

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