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.

by Dr. M Culha and group from Turkey   Traction was applied from 3 to 8 hours a day for 6 months.  Results 93% (27 patients) noted curvature reduction (from 10 to 30 degrees), length increased from 1/4″ to 3/8″   In another group, comprised of patients who refused to use the penile extender device, a small portion noted penile shortening. 

Harold M. Reed, M.D.

As reported by J. Chen  (J. of Sexual Medicine).  45 men were treated and only one patient reported improvement.  Each patient was treated with 8 weekly injections.  Conclusion: Verapamil is not effective in correcting curvature or facilitating vaginal penetration.

Harold M. Reed, M.D,.

The incidence of spontanous resoltuion of Peyronie’s (without any medical intervention) is about 15%.  This give credence to many medications and non-operative treatments.

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.

May 22, 2009

Good afternoon Ron,

How timely you should write.  A paper was presented
in April saying that circumcision is not necessary with
Peyronie’s surgery.

There is probably more to it beside that and certainly we
can review your records and offer some suggestions.

Our consultation fee is 250.

This could be initiated over the phone.

Sincerely,

Harold M. Reed, M.D. FICS
Senior Member of the American Urological Association
Member Society of Genito-Urinary Reconstructive Surgeons
Founding Member and Treasurer of American Academy of Phalloplasty Surgeons
Founding Member Sexual Society of North America

305-865-2000

At 03:05 PM 5/21/2009, you wrote:

quests: I had a circumcision done and at the same time my doctor recomended that I have a curve fixed at the same time. (Peyronies). I consented but am now very unhappy, I have lost half ot the length I had when fully erect. Can anything be done to give me bay some of the length. I now have a hard time getting and keeping pentrated while making love with my wife? The circumcision is not pleasant to look at either.
contact:

Looking back at 9 patients who had Peyronie’s and underwent installation of an inflatable penile implant and simultaneous modeling to correct penile curvature, that is to say, bending of the inflated or erect penis in the opposite direction to correct for angulation, the incidence of mechanical malfunction that followed was 33.3%. Admittedly a small group for a study, but in the control group, the incidence of mechanical malfunction was 4.3%, after a mean followup of about 19.6 months. Reported by Dr. Christopher DiBlasio and group from Memphis, TN. at the April 2009 AUA meeting.

Harold M. Reed, M.D.
Penile Implant and Phalloplasty Surgeon

Presented at the AUA April, 2009 (Chicago) by Drs. Sergio Moreno and Abraham Morganthaler.

121 patients seen for Peyronies were evaluated. 54% of the patients had testosterone deficiency compared with non Peyronies of 37%. Testosterone is helpful in wound repair and erectile function.
Further analysis will be done.

Harold M. Reed, M.D.

 

Developed Peyronie’s Disease after the 3rd of 3 failed Transurethral Resections in 4 months in 2006. Is this common? What help short of surgery? Use a VED device already–thanks GWJ

 

Good morning George,

This is not common, but certainly I have seen this on a few occasions.  With Peyronie’s there may be also associated loss of length, plaque, waist banding of the circumference, erectile dysfunction and pain.   The treatment options are many and with every one there are some responders.

We have also seen erectile dysfunction following TURP, and of course urinary incontinence.

The vacuum erection device (VED) is a 2 edged sword as pooling of blood in the penis without adequate oxygenation may cause atrophy and injury to your delicate spongy erectile tissue.

I would be pleased to discuss in depth the any options available to you after you initiate a consultation with our office.     

                                                                            

With kindest regards,

Harold M. Reed, M.D.

305-865-2000

I have Diabetes, and had two stents (2 little tubes in one of my arteries) placed in 01/2004. I asked my insurance, and they want to know if the operation last more than one day or there is a hospitalization involved. My Insurance is Aetna. And I have to pay the Copay of $250.00. I live in California. Do you have any clinic here?
Because the Peyronies (Developed right after the operation of 2 stents in 2004) I’ve lost sizeAnd because the Diabetes I lost hardness and I prefer the prosthesis than lengthness Operation.
Thanks
Victor

Good afternoon Victor,

We would love to take care of you, but we are no longer under contract with Aetna.  Aetna may pay out of network.

Our only office is in the greater Miami area.

Thanks for visiting our web site on Peyronie’s disease and penile curvature http://www.penisdoctor.com/peyronies.htmPerhaps you can relate to the befores and afters posted in the gallery.  

We are doing several Peyronie’s patients every month.  One memorable patient from Ohio was done with a length gain of 1 1/4″ immediately on the table.  When the patient arrived in the recovery room and said to me, “how did I do,” I drew the urtains around his bed and pulled back his sheets and blanket and said, “look.”  An approving smile came across his face.

With post operative use of a vacuum erection device, he’ll even do better than that over the course of the next 6 months. Correcting penile curvature is one of the mainstays of our practice and the enjoyment we derive is making two people happy.  We see patients from all over the orld who seek remedy because of functional or cosmetic disabilities.

My knowledge is updated yearly by attending the AUA meetings.  At any lecture dealing with Peyronie’s you’ll find me sitting very attentively in the audience. 

While our surgical success rate is better than 95%, we do recommend a trial of conservative therapy for at least 6 months as this may often produce a sufficient enough resolution to make you a happy man.  But have you had this without success?

When your travel plans include the Miami - Ft. Lauderdale area please avail yourself of a proper urological consultation.

Or call our office to verify insurance coverage.  Anne is very knowledgeable.  We can even make a conference call with your company to verify your benefits.

If you are over 40 and are on medications other than hormones, please call the office before scheduling surgery, as a letter of medical clearance will most likely be needed.

If you are a smoker, you must stop completely for 2 months before surgery and please never again.  Smoking causes vaso-spasm, impairs wound healing, produces excessive scarring, tissue necrosis, irritates and inflames pulmonary membranes and enhances anesthetic risk.

This goes also for any products containing nicotine or nicotine like agents including nicorette gum, nicotine patches, Nicotrol inhalers, and second hand smoke.   Again not for 8 weeks before and not for 8 weeks afterwards.  Hopefully never again.

No aspirin or aspirin products, blood thinners such as Plavix, Coumadin, no anti-inflammatory drugs such as Motrin, Advil, Alleve, or Cox 2 inhibitors such as Celebrex or Vioxx for
a week before surgery.  No Vitamin E or excessive alcohol or spices for a week before surgery as this may promote bruising.  Bruising can be reduced (many believe) with Bromelain 500 mg 1 twice a day, Arnica montana dose 30C (take 4 small tablets sublingually, 4 times a day),
vitamin C 500 mg (3 times a day) starting 1 week before surgery.

Sincerely yours,

 

Harold M. Reed, M.D. FICS
Senior Member of the American Urological Association
Member Society of Genito-Urinary Reconstructive Surgeons
Founding Member and Treasurer of American Academy of Phalloplasty Surgeons
Founding Member Sexual Society of North America

305-865-2000

 

A very nice gentlemen in  his 50’s presented with a history of gradual erectile impairment and was now on pharmacologic injection, shots to the penis with medications usually containing prostaglandin E-1 to produce erection.

On erection his penis was not bent, but there was a small crease in the distal shaft.  The size of his penis was about 3 times volumetrically of average.   He had injected that area on occasion but could not correlate loss of contour with any particular injection.

Thoughts and advice…    Injections into the penis have to be compressed just like ideally a vena-puncture in an arm vein for 5 minutes or so.  The leakage of blood outside the vascular system is a great stimulus for fibrosis and of course loss of spongy tissue.  In this case, spongy tissue of the corpora cavernosa.  Injection techniques were reviewed with the patient.

While I do not believe medications for Peyronie’s will help, perhaps in the future stem cell research may be able to replace lost corporal tissue or impaired corporal tissue.  Some urologists believe
men with large penises may experience erectile impairment earlier because there is a larger demand for rapid filling.

Harold M. Reed, M.D.