Interested in cure for Erectile Disfunction — vacuum constriction device. 52-year old male (Metthew)
Good evening Metthew,
There are not many cures for ED but a lot of treatments and the vacuum erection device is certainly one.Please make an appointment for consultation at our Bay Harbor Islands office.
Have a great weekend, and see you soon,
Harold M. Reed, M.D.
305-865-2000
Penises and their foreskins come in all shapes and sizes. The foreskin has 2 surfaces an inner or mucosal skin and an outer of epidermal skin. The inner, in situations where there is not a lot of exposure to the outside world, may take on a wrinkled, smooth slightly moist glistening appearance,
A circumcision in its simplest form is really about removing a large portion of the foreskin, usually some from each side, and reconstituting the edges so when healed the skin does not lie on the head of the penis.
Still in that most always some inner skin remains what to do. Needless to say, this has to be discussed with the patient beforehand. More could be removed but what remains is still wrinkly. One could remove a strip from the underside of the inner skin where a fine scar would be least seen.
All in a days work, but conferencing beforehand with the patient is most important.
Harold M. Reed, M.D.
I have balanitis xerotica obliterans and have been put on a waiting list for a circumcision in the UK - I am emmigrating to New Brunswick Canada next month and will need this operation when I get there. Gordon contact: Email
Good afternoon Gordon,
Thank you for your interest in what we do. BXO, now called by the preferred term lichen sclerosis, does need to be treated because of its slow premalignant potential Several reports have suggested the development of squamous cell carcinoma. More commonly there is a slow spread and tendency to grow into the urethra and producing scars and strictures there. At times, the foreskin in some areas is densely adherent to the glans (head of the penis). We see this a few times a year and have performed very possibly more adult cosmetic circumcisions in our office than anywhere else in the United States. Well over 5000 thus far. Usually several every week.
Please do not be like the patients we hear from every so often who send in photos 2 days after their procedure with obvious hideous result, and ask “what do I do now.” Needless to say, a fair amount of circumcision revisions are also done here.
This is your circumcision and we do it the way you want. There are four important parameters. A hand held mirror is available in the operating room so you can be assured that each detail is done in accordance to your wishes.
We are looking forward to seeing you in Miami soon and showing you every courtesy. White stuff has to go.
Sincerely,
Harold M. Reed, M.D.
305-865-2000
am 29 years old and I would like to be circumcised. I want to know what is the average cost of a circumcision. Also, I am terribly afraid of needles. How many injections do I have to get for the anaesthetics? Is it one or three? In your experience in working with patients how painful do these injections appear to be?
Theo from Jamaica
Hi Theo,
Please don’t worry about needles. We can apply some numbing cream to your skin so you will not feel them. Cosmetic and painless circumcision is the specialty of the house.
Usually 3 needle sticks are involved, but we try to inject stick # 2 and # 3 in an area previously anesthetized. Also we use the technique of the “advancing wheal” meaning the anesthetic fluid already inside the tissues precedes the needle, so when the needle gets that area it usually is not felt. At any rate trust us to treat you very gently and compassionately.
This is our bread and butter. My girlfriend is from Portland and remembers Bob Marley as a young man, playing down below in a canteen with his friends.
All the best,
Harold M. Reed, M.D.
305-865-2000
— In PROCIRCORG@yahoogroups.com, “jamb1234″
I was wondering Dr. Reed if a patient would want to get recut and they wanted the cut done with the Tara Klamp, would you do it?. Seeing alot of pictures, the cut-line never comes-out as well as using a clamp. Sutures, can be fastidious and the best painter would not get be able to get that line as fine as with a clamp; and any thing else will never look neo. My friend got cut and freehand but it’s not as smooth as mine. I believe that using the Klamp would be great for him. He doesn’t want stitches; one can always tell the
difference.
If you can do it, I will let him know and we will be driving over for him to
get it done. If you want I can send you pictures of his peepee:-) Thanks, JAMB.
Jamb, we do not use the Kara Klamp. We believe we have more precision and neatness with a 15 blade, and of course a steady hand. We do show work in progress to patients with a hand held mirror and have been known to tighten a circumcision from as little as 1/8 to 1/4 of an inch if needed. This would not be feasible with a Klamp. We cannot possibly do every adult circumcision in the
world, and gladly say to those who wish to Klamp, look for a Klamp doctor.
Would certainly be interested in seeing some Klamp results. My E-mail address in infos@penisdoctor.com First, send me a simple letter to let me know it is on the way, as we receive over 250 E-mails a day.
Many thanks,
Harold M. Reed, M.D.
>
— In PROCIRCORG@yahoogroups.com, “Ms. VG”
I’m curious to know with local injections, to which part of the penis or pubic area is injected? Also how many injections are there?
if there is more than one, does the doctor wait at least until the first injection takes effect? How many injections total?
THanks.
VJ
Hi VJ,
The penis is innervated (supplied by nerves) which enter both from the top and underside. A ring of anesthesia could be placed around the base of the penis and ultimately the penis would become anesthetized for 3 to 4 hours if long acting agents are used (which is what we do). Please understand distal nerves are always in the center of the nerve bundle, so when injecting they are the last to become anesthetized. This could take up to 20 minutes as patients don’t want to feel anything.
Our injection technique uses the “advancing wheal” principle. A wheal is a swelling like you could get from an insect bite.
In that we are always pushing anesthetic in with our syringe in advance of the needle, ideally you should only feel one needle stick.
However, waiting for a ring of anesthesia at the base to take effect distally could take 20 minutes, if we inject anesthesia both at the base and more distally in the circumcision area, we achieve total anesthesia in about 10 minutes. Anesthesia costs virtually nothing, so this is what we do staying within the limits of safety.
For those who do not wish to feel even a needle stick, EMLA or Betacaine cream can be applied to the skin and after 20 minutes, the skin is numb.
Most of our patients are quite manly and tolerate a little needle stick or pinch without making a big to do over this.
When I see the dentist I say “no anesthesia” whatsoever unless he really insists.
I only wish you could talk to over 5000 patients we have done here and you would hear a resounding reassurance, “this is not at all painful.”
My assistant Anne and I once traveled 2500 miles to Nevada to hear a doctor lecture on ambulatory surgery and he said rule number one is never to hurt your patients. And we looked at each other and said, “do you mean we came 2500 miles to hear someone tell us this no brainer.” But you know, this was the best advice we could have ever received.
Harold M. Reed, M.D.
— In PROCIRCORG@yahoogroups.com, “Ms. VG”
>
> I’m curious to know with local injections, to which part of the penis or pubic
area is injected? Also how many injections are there?
>
> if there is more than one, does the doctor wait at least until the first
injection takes effect? How many injections total?
>
> THanks.
>
> VJ
Another paper presented at the AUA, April 2009 (Chicago) by Dr. Renea Strum and group from Houston, Tx. Two cohorts were examined, Peyronie’s patients versus all those receiving penile Doppler exams (erectile dysfunction) . The testosterone level of the Peyronie’s group was statistically lower, 306 versus, 372 ng/dl for the erectile dysfunction group.
Harold M. Reed, M.D.
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.
Circumcision is beneficial. (courtesy of Joshua, unashamedly procirc)
What is important about the article below is that it comes from the South African Cochrane Center.
Their earlier document from 2003 concluded “We found insufficient evidence to support an interventional effect of male circumcision on HIV acquisition in heterosexual men. The results from existing observational studies show a strong epidemiological association between male circumcision and prevention of HIV, especially among high-risk groups. However, observational studies are inherently limited by confounding which is unlikely to be fully adjusted for. In the light of forthcoming results from RCTs, the value of IPD analysis of the included studies is doubtful. The results of these trials will need to be carefully considered before circumcision is implemented as a public health intervention for prevention of sexually transmitted HIV.”
http://tinyurl.com/cggdaq
This statement has been held up high by anti-circ activists as “proof” that there is not enough evidence to recommend male circ and an intervention in the battle against HIV/AIDS.
The new Cochrane review (see report below) changes all that.
Siegfried now states: “”Research on the effectiveness of male circumcision for preventing HIV in heterosexual men is conclusive,” adding, “No further trials are required to establish that HIV infection rates are reduced in heterosexual men for at least the first two years after circumcision.” ”
This must count as another small victory in the battle against the psychosexually motivated anti-circ lunatics.
See 2009 abstract here: http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003362/frame.html
=========================
Studies Provide Sufficient Evidence To Recommend Male Circumcision As HIV Intervention, South African Researchers Say
Main Category: HIV / AIDS
Also Included In: Men’s health; Sexual Health / STDs
Article Date: 17 Apr 2009 - 7:00 PDT
Researchers from the South African Cochrane Center concluded Wednesday that sufficient evidence exists that male circumcision reduces the risk of HIV transmission among heterosexual men and the procedure should be considered an appropriate HIV intervention strategy, the SAPA/Mail and Guardian reports. Located at the South African Medical Research Council, the Cochrane Center is part of the Cochrane Collaboration, an international network of researchers that reviews the effects of interventions to inform health care decisions and policy. Although the center in the past did not recommend male circumcision as an HIV prevention tool because of insufficient evidence, researchers “changed their previous conclusions” after reviewing data from three recent African trials, Nandi Siegfried, co-director of the center, said.
According to Siegfried, circumcision helps prevent against HIV by removing foreskin cells, which contain receptors that enable the virus to enter the cells. She said, “Research on the effectiveness of male circumcision for preventing HIV in heterosexual men is conclusive,” adding, “No further trials are required to establish that HIV infection rates are reduced in heterosexual men for at least the first two years after circumcision.” Although Siegfried recommended that policymakers include male circumcision as an additional intervention in HIV prevention programs, she also noted that officials should consider cultural and environmental factors when designing circumcision programs.
According to the SAPA/Mail and Guardian, researchers will need to conduct further studies to determine whether male circumcision provides protection against HIV to female sexual partners or to men who have sex with men (SAPA/Mail and Guardian, 4/15).
hello i had to get a circumcision procedure from another doctor about 2 years ago. the problem is that too much skin was taken off, especially the outer skin. i never had a problem with the glans rubbing against clothes, but the inner skin is very sensitive and even painful in my everyday activities. i’d like to do some foreskin stretching to get more of my outer foreskin to hopefully cover some of the inner foreskin. i am new to all of this so i don’t what stretching techniques there are for someone like me with not much skin left??
anyone have experience in that area? also, i want to make sure that only the outer skin grows, if possible. i don’t want to do foreskin restoration, just loosen everything up as it was done too tightly… also, there was some scarring, i believe due to the tight nature of the procedure. this has caused some curving in the direction of the scarring. is there any cream, etc. that can reduce scarring or is
the only way to correct that going to be surgery? i was planning on probably going to dr. reed to get everything cleaned up once i grow a little more skin…
Dillon,
Hi Dillon,
How this could be avoided.
We make the first cut distally exactly in accordance with patient wishes, how much inner skin to leave behind. The second or upper cut is often done twice, the first is moderate and could be made tighter if when the two edges are temporarily brought together to see how much tension there is on the peno-pubic angle.
Ultimately the patient participates in making the decision for the final cut in the operating room with a hand held mirror. The urologist is an agent for the patient.
This is your circumcision, your calling card.
Harold M. Reed, M.D.