penisdoctor.com

January 24, 2012

Hi Dr Reed,

I hope this email finds you well.

I have a few more questions.

I would be flying from California, and would like to get circumcised the same day that I arrive, stay the night at a hotel, and then fly back the next morning. Would you recommend that?

What dates do you have available next week or the beginning of February? please review the pics I sent you before. I don’t think i need curvature correction unless you believe I do.

Thanks,

Albert

Good morning Albert,

Thank you for your continued interest.  Presently I am on retreat in the Carolinas.

The desirability of correction of a curvature in the range of 10 to 20% (estimated from photos) is your call. 

Some things to think about.

1.  About 5% of men have similar curvatures and live with them.

2.  If it does not bother you cosmetically or functionally or hurt your partner or provoke comment, then you could leave this alone.

3.  If this is a process in evolution (getting worse or better) we should talk about that, as surgery at this time may not be indicated for the curvature.

4.  Add-ons if you are already in  then operating room are very inexpensive (at least at our facility).  For example your circumcision is done for free, your only fee is correction of
curvature.

5.  You could always have correction of curvature later on, if you wish, but costly… so you haven’t burned any bridges.

6.  If this were my penis, yes, I would opt for simultaneous correction.  Ideally you would need to stay here for 2 days and I would see you daily.. 

Our fee for correcting curvature is 6,200 and includes: local anesthesia with or without IV sedation, use of the operating room and any followup care I provide.

Please call Anne at the office and schedule in with her.  She is also the maker of deals.

Sincerely,

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

December 11, 2011

Dear Dr. Reed,

I’ve got Peyronie’s disease and would like to correct it. I’m also interested in Penile Lengthening, Penile Enlargement, Penile Girth and Glans Enhancement. And I’m wandering if it could be done at the same time?  Thank you,  Label

HEAR: Google.    

Good morning Label,

Thank you for your interest in what we do.  The procedures you are interested in should not be done at the same time.  Too much risk.  You cannot apply traction if you have fresh incision lines on your penis.

Let’s also talk non-operative approaches.

After reading the attached, if you believe I am the doctor for you, please initiate a consultation over the phone with our office by sending us your name, address, and telephone number in an envelope along with a check for 300.  We’ll get started ASAP.  We’ll have a lot to talk about.

Cordially,

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

December 4, 2011

Good afternoon Dr. Reed,

My husband had a dorsal plication last Monday. He is not recovering well. How long is the usual recovery time?
He was cut all around the head of his penis and sutured on the side as well. Is this normal?

Thank you for your time and any information!    Randy

December 4, 2011

Hi Randy,

Sorry your husband is not doing well.  Could be for many reasons including just transient swelling after surgery.

I am available for consultation which can be initiated over the phone.  Would request photos and ideally a copy of the operative note.

Some discomfort and swelling after this type of surgery is the norm.  If there is an especial reason for your concern, kindly comment.  Usually I perform dorsal plication via a circumcising incision, and no further incision is needed on the side of the penis as the skin is de-gloved back on the shaft.  Sutures are placed between the dorsal artery and nerves on each side using the 16 dot or 24 dot approach.  This tends to invert the suture knot so it is less palpable afterwards.  Permanent sutures are favored. 

In a classic study published in May, 2002, at 6 months 93% reported straight erections,  7% slight curvature and 3% of erectile impairment.  At a followup interview averaging 2.6 years post-operatively 15% reported recurrent curvature, but it was severe in only 3%.  12% complained of suture knots (which are easy to remove), 11% had pain with erection, 9% had narrowing or indentation of the penis when erect, a decrease in sensation was reported by 6%. 4% had a collection of blood under the skin and 6% complained of worsening of erections.  All this says, this is not an entirely benign procedure, but usually works.  Our experience has been quite good and patients generally are grateful.

If a patient is not circumcised, we recommend that this be done at the time of the procedure as the swelling afterwards can pose healing and hygienic problems, until resolved.

Hoping this is of help,

Harold M. Reed, M.D.

November 25, 2011

Dear Dr. Reed,

Could you give me some info on correcting a curved pen.is? I’d like to know if it can be done without losing any current length and if I could possibly gain some once it’s corrected. My curve isn’t painful but it is very obvious. Thank you for your help.        Carter

Good morning Carter,

Thank you for your interest in what we do.  Surgically, the best approach is to simplest one and while grafts which would not deprive you of length (usually) could be employed, the risks are higher, than simple plication or shortening of the longer side.  For smaller curvatures, usually less than 30 degrees, but up to 45 or 60 degrees, this is ideal.  The length lost is anywhere from 1/8th to a 1/4″ for smaller curvature and may be somewhat more such as 3/8″ when more severe.

This can be offset with use of traction once you recover or beforehand and using proper technique your penis could even be longer than it is now.

Also plication is a lot less expensive.

Another thought to remember is 3% of men have noticeable curvature with erection and many get along perfectly well without partner discomfort or intromission difficulties.

Lastly, clarification of terms.  Not all penile curvature is truly Peyronie’s which is more traumatic based (usually) and associated with plaque.  Some is congenital when one side is hypertrophied, usually the right which produces curvature to the left.  Maformation of the urethra can produce spongio-fibrosis and downward curvature.

After reading the attached, if you believe I am the doctor for you, please initiate a consultation over the phone with our office by sending us your name, address, and telephone number in an envelope along with a check for 250.  We’ll
get started ASAP.  We’ll have a lot to talk about.

Please keep in mind.  This November is a promotional month.  Call the office and speak with Anne our amiable office
manager for details.

Cordially,

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

October 24, 2011

i’m a 30 year old male looking to do 2 or 3 types of surgery. 1 is the circumcision 2 is the vasectomy and 3 if there is any possibility to fix , my penis is tilted to the left and I want it to be a little more   Ellery

Good afternoon Ellery,

Thank you for your interest in what we do.  Your penis is one of the
most important cosmetic and functional features of your body.

Yes, all 3 procedures could be done at the same time.  I would need to see photos of your erection to provide a price quote.  Circumcision is frequently suggested at the time of penile degloving for curvature correction as the recovery is a lot smoother.  Please send down views, side views, and face on views by E-mail.

We have performed over 6500 cosmetic circumcisions and revisions
in the past 35 years and usually do several cases every week.  

We have done sons of physicians, brothers, religious circumcisions,
men who have not seen the heads of their penis for 20 years! This
is your circumcision and we do it the way you want with respect
to 4 parameters.
 
Please don’t be like the patient done elsewhere 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,
 
All the best,
 

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

August 28, 2011

I am in the Middle East and have been told about the Nesbit. The Doctor here claim there is no such think as a variation of Nesbit.  quests: What are the true side effect of the Nesbit.  I wish to have work done in U.S.

The issue here is the operation is expensive and when I spoke of you- it went like-

No such thing,who is this doctor. So,I provided your email and name.  Tell me your email is true to me?

Lester

August 23, 2011

Good afternoon Lester,
Thank you for your interest in what we do. We do not do the Nesbit but a variation of it which I believe is more physiologic and less complication prone.  We use 16 dot plication as propsoed by Dr. Thomas Lue.  Cutting the tunica albuginea, the casing for the spongy erectile tissues may create more of a risk for erectile difficulties, versus simply bringing the tunica closer together on the longer side.

After reading the attached, if you believe I am the doctor for you, please initiate a consultation over the phone with our office by sending us your name, address, and telephone number in an envelope along with a check for 250. We’ll get started ASAP. We’ll have a lot to talk about.

Cordially,

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

August 26, 2011

Good afternoon Lester,

Please read below and I am not sure you will continue to agree with your other physician.  This is what I’ve been saying.  Surely a Nesbit is a Nesbit, but the other procedures accomplish the same and perhaps offer more.

Or another way is to say, a Nesbit was a good idea in its time.

Sincerely

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

Taken from http://knol.google.com/k/peyronie-s-disease-acquired-deformity-of-the-penis#

What about surgery for PD?

In cases where medical treatment has failed to reverse the condition and penile deformity makes satisfactory sexual intercourse difficult or impossible, surgical intervention may be required. Most urologists who perform surgery for PD prefer to wait until the curvature has been stable and the patient has been pain free for at least 6 months; in other words, only in chronic phase Peyronie?s Disease. The rationale for this delay is that early intervention before stabilization of disease may result in worse defects. Although this is considered the standard of care, it is based more on expert opinion than on scientific evidence.

There are a number of surgical options for the management of PD. The type of surgery recommended will be based in large part on the degree of curvature, the length of the penis, whether or not ED is present, and the personal preferences of the patient and his physician. Surgeries may be broadly divided into three categories:[41]

• Procedures that shorten the side opposite the curvature: This procedure may be done under a local or general anesthetic and is performed through either a circumcising incision or through an incision made on the side of the penis.
  • Penile Plication: In plication procedures, permanent sutures are placed on the side of the penis opposite the curvature. There are a variety of ways to place the sutures; one of the most commonly utilized techniques in the modern era is the called the 16-dot procedure. This procedure is simple to perform, safe, and very effective at reducing or eliminating curvature in almost all cases. It has, however, been associated with penile shortening and complaints of mild pain in up to 10% of cases.[42]
  • Nesbit procedure: In this operation, a small ellipse (lens shape) of tissue is excised from the tunica albuginea and the edges are sewn back together. In a large series of patients, results with the Nesbit procedure were generally favorable, with 82% reporting at least satisfactory resolution of curvature. Penile shortening of greater than 2 cm occurred in 5% of men and the majority of men had some degree of shortening.[43]
  • Yachia procedure: Similar in some respects to the Nesbit operation, in the Yachia procedure, a longitudinal incision is made on the convex side of the penis and then is sewn closed in a transverse fashion. This has the effect of shortening the conve

July 31, 2011

Dear Dr. Reed,

 I had a circumcision about 5 months ago and it was not done neatly at all there are suture tracks, raised and sensitive spots and this 3 cm scar which looks like a incision that didn’t heal let when they put in the stitch I agreed to, I agreed to a straightening bendable stitch to be put inside of my penis to make it straight because of my downward curvature but they put it too close to the surface on top of my penis right below my head and the whole area keeps getting irritated and you can see one prong of the stitch through the skin and it looks terrible would i be able to get a revision and have the stitch inside of my shaft taken out or moved to the middle bottom of my shaft without leaving extra incision marks?
contact:     Nathan

Good morning Nathan,

Thank you for your excellent case presentation. Really sorry to hear that so many things have not worked out as you
anticipated. We would never close a penile curvature case without producing an erection in the operating room to be sure
it is straight. or meets with patient approval. Look at photographic examples of our circumcision results and see if this is more to your expectations.

The following is a letter we send to prospective concussion patients.   Might be of interest.

Thank you for your interest in what we do. Your penis is one of the most important cosmetic and functional features of your body.

We have performed over 6500 cosmetic circumcisions and revisions in the past 35 years and usually do several cases every week.

We have done sons of physicians, brothers, religious circumcisions, men who have not seen the heads of their penis for 20 years!  This is your circumcision and we do it the way you want with respect to 4 parameters.
 
Please don’t be like the patient done elsewhere 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,
 
All the best,
 

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

I missed Dr. Hellstrom’s update on intralesional collagenase at the recent
ISSM meeting.  Could anyone fill me in either on anticipated FDA approval date, likelihood of approval, and/or personal experience with the agent.  I have a patient who is deferring surgery at this time in anticipation of this
therapy.
 
Thanks so much,
 
D. C., MD
 
Dr. Hellstrom replies.

We are loking at 2 to 3 yrs at minimum.  WJGH

Had referred a patient to Dr. Hellstrom and the study is apparently closed.  Followup of those treated is now underway.  The drug is not FDA available for general urological use.  Dr. Hellstrom is doing a phase 3 trial.

Harold M. Reed, M.D.

Big news at the AUA meeting in Washington.  A few phase 3 trials are on, and the injectable could be ready for private practice use in 4 to 6 months, pending FDA approval.  Already being used for Dupeytren’s contrracture (a cord like fibrosis of palm tendons).  Success rates for Peyronie’s 30 to 60%.  Please do not anticipate 100% reversal, but a non-surgical adjunct anyway that could be helpful, during the 1 year period of waiting before surgery (if needed).

Collagenase is not new,  but new serious studies give it some gravitas.

Marketed under Xiaflex https://www.xiaflex.com/?utm_source=Google&utm_medium=Paid+Search&utm_campaign=Xiaflex

Harold M. Reed, M.D.

April 12, 2011

Hello there I have a congenital penile curvature, it makes some positions difficult. Do you do penile dorsal plications. I have heard these are less prone to complications and the loss of length is less than an inch.
                                                               Thanks—Phil

Good afternoon Phil,

Sutures can be placed dorsally, however the proper technique is multiple parallel suture plication, as true dorsal sutures would injure the deep dorsal vein.  Ideally sutures should be placed between
the dorsal artery and nerve or second best lateral to the nerve fibers.   55 degrees is very close to 60 degrees and skilled urologists might also speak of a ventral graft.

If you have dorsal plication you may need 4 or more sutures on either side and please anticipate a loss of dorsal length of about 3/8″ inch.

Our office is available for consultation.

Best wishes,

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