Adult Male Circumcision
A circumcision is perhaps the highest cosmetic calling given to a urologist. We do several circumcisions and a few revisions here every week, as we enjoy a reputation for excellence and exactitude when it comes to cosmetically performed adult circumcisions. We operate within tolerances of 1/32" or about 1/2 mm.
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.
Peyronie's Disease Correction
Peyronie's disease, named after the french surgeon to King Louis XV, is a restricting scar or plaque that exists in the lining of the erectile bodies resulting in a tethering of erections ("bent spike syndrome"). The cause is now thought to be repetitive trauma. An unappreciated example would be female above trauma which may occur after the penis momentarily slips out of the vagina. Autoimmune basis for plaque has also been ascribed. Peyronie's disease may co-exist with Dupuytren's flexion contractures of the hand.
Penile Prothesis Implants
Approximately 10% of all adult males are impotent, and of that group, only half really care. Implantation of a penile prosthesis is one of many options available to these erectilely impaired, and should be looked upon as a last resort. Other alternatives include oral medications, urethral suppositories, intracorporeal injections, vacuum erection devices and behavioral modifications. Specially qualified patients with focal areas of arterial occlusion may consider penile revascularization.
Vasectomy or Vasectomy Reversal
Vasectomy is a safe and effective means of permanent contraception. Approximately 500,000 vasectomies are performed in the United States every year. This procedure performed under local anesthesia takes about 10 minutes. The experience of the surgeon is the single most important factor assuring a smooth convalescence. Vasovasostomy or vasectomy reversal is a urological procedure to re-establish fertility. 500,000 men each year have a vasectomy in the United States, and ultimately 2% to 6% will request reversal. The most common reason is to produce secondary offspring following remarriage to a younger woman. This procedure offers the best degree of technical success when performed microscopically, because finer sutures are less likely to produce obstruction of the internal channel at the reconnection site.
Testicular enlargement (enhancement) is a procedure to better fill the scrotum using testicular implants which are ovoid in shape and are placed in front of your existing testes. Rather than a fluff bag appearance of the scrotum created by scrotal fillers, the pleasing contours of two well represented gonads are noticeable.
Gynecomastia or enlargement of the male breast may produce an unwanted feminizing appearance. This is typically caused by an increase in stromal (connective) and ductal tissue, however a serious underlying cause should always be considered. The incidence of occurrence in naval military exams is about 8 in 100,000. Gynecomastia is noted normally to some degree in pubescence with incidence as high as 65% in boys aged 14 to 15 years.