Dr. Reed, Will you do or recommend purse string suture for foreskin restoration. Len
Hardly a week goes by that I don’t hear from a patient requesting purse string suture to promote foreskin restoration. I think this is a bad idea, because this closes the area off to daily hygiene and during erections you may tear out the suture and possible incur possible injury with loss of whatever foreskin restoration you already have produced with traction such as the Tugger device.
Foreskin restoration has been described even before Celsus, the first great Roman physician (25 B.C. to A.D. 50), wrote “De Medicin.” The procedure used today is only somewhat modified from what had been done then so “the patient could move around inconspicuously in Greek and Roman society.” Celsus drew heavily on his Egyptian and Greek predecessors. Many patients, as an alternative to surgery, may elect to use stretching devices under urological supervision which could produce an acceptable result in 2 to 3 years. With our surgical procedure, the skin of the distal shaft is advanced forward to create a neo-foreskin.
This leaves a denuded area at the base of the penile shaft, which is buried under the scrotum. The pigmentation of scrotal skin is a close match to epithelial penile skin. A catheter is left in for a few days and a dressing is placed over the foreskin pulling it forward until the laminated skin heals. After an interval of 3 months, the penis is lifted from the scrotum with wings of scrotal flaps on both sides. The flaps are closed underneath the penis. The scrotum is also closed at that time. Variation in technique may be required to best suit the unique anatomy of each patient. Erections must be suppressed with anti-testosterone medication for 3 to 4 months, to allow the scrotal flap to heal. This is ideally a 2 stage procedure which can be performed under local with IV sedation. Comprehensive fee of $7,600 does not include consultation, lab tests, medical clearance.
Please see our web-site for photos penisdoctor.com/before-after-foreskin-reconstruction
Harold M. Reed, M.D.
The Reed Centre for Urological Surgery