Dr. Reed, Is it safe for a hemophiliac to have simultaneous penile implant and circumcision revision? My present circ status is “too loose.” Emil from Denmark
I live in a world of genital surgery and am very flattered by your question with clinical history.
First you should know a penile implant is the last resort in treating erectile dysfunction (ED). Other approaches include behavioral modification, the 5 phosphodiesterase inhibitors such as Viagra and Cialis, a vacuum erection device, a penile constriction band, intraurethral suppositories, and intracorporal injections.
We have done simultaneous circumcisions and penile implant insertions, but do caution the patient there is added risk of bruising, hematoma, and infection. We have also inserted penile implants and simultaneously corrected penile angulation (Peyronie’s) and again “informed” consent is needed. This is accepted by “mainstream” urology.
As far as your being a hemophiliac you may have a mild propensity for bleeding (mosaic pattern) or full blown attributable to many different causes. A propensity to easy bruising or prior excessive bleeding with past surgeries would be important to know. Surely your surgeon will want to do a platelet count, PT, PTT (or APTT), a venous bleeding time, a 24 hour blood clot for lysis and retraction, serum fibrinogen, and confer with your hematologist. to gain consensus of opinion that this is safe for you.
Equally important are some medications you can take during the peri-operative period to minimize bleeding and bruising. Genital compression (penile shaft and scrotum) is a must to reduce bruising. Additionally, you will need a generous amount of convalescence.
While there is no question doctors in Denmark are very knowledgeable about penile implants, you may wish to visit penisdoctor.com/before-after-penile-implantation for before and after penile implant pictures
Provide provide a followup. We wish you well. There are no uninvolved partners.
Harold Reed, M.D.
The Reed Centre for Ambulatory Surgery | Miami
Penile implant picture in erect mode (patient of Dr. Reed)
Penile implant picture of happy patient (patient of Dr. Reed)
Penile implant picture of happy patient (same patient, deflate mode)
Penile implant picture of happy patient (same patient, erect mode)