Frequently asked questions from patients like you

Penis enlargement



How many centimetres are usually gained in thickness with penis thickening?

It depends on each patient, their particular conditions and as far as the surgeon can go, but speaking in a range where the technique does not involve a high risk, we speak of between 1 and 2 cm in diameter at most. Going beyond these figures increases the risk.

I have heard that with this intervention the thickness gained is in a state of flaccidity. Is this true?

You can't say that you don't notice anything at all when is erected, but we can say that you really notice it when is in resting state. You have to think that if the patient's erection is of medium or large size, once the penis gains length the transferred fat is distributed evenly. Therefore, those people are seeking a thicker erection.

What about the glans? Can this area of the penis also be thickened?

If the techniques of penis thickening have to be treated cautiously and always going to Centers that have a lot of experience, the techniques of glans thickening on the other hand we totally discourage them. They are based on the controlled inoculation of synthetic material into the glans, which can lead to a number of problems. The volume of the glans is indeed increased, but it rarely leads to a natural and satisfactory aesthetic result. As an added counter-indication, it numbs the nerve endings in this important area of the penis.

I underwent an operation to increase the thickness of my penis and I am not happy. What can I do?

There is no simple and general answer, since each case is a world and an operation of this type badly performed can generate a multitude of unique and special problems. The ideal would be to go to a center specializing in reconstructive phalloplasty as is our case and thoroughly review which have been the errors of planning or execution to assess whether they can be retouched and improved (something very rare, the truth) or if as usual we choose to return (for health and safety) to the state prior to surgery.

Penile curvature

How frequent can Peyronie's disease be among men? What is its prevalence?

Although deformities of the penis are common, they are rarely pathological. However, it is estimated that between one and three per cent of all men of reproductive age have Peyronie's disease.

There are groups of men with a greater predisposition to the disease such as those over 70 years of age (6.5 per cent have Peyronie's curvature) or those with prostate pathologies (8.4 per cent).

Prevalence studies of Peyronie's disease are often difficult to document given the scarce information of clinical interest provided by the relatively few patients who seek medical help.

Can homoeopathy correct Peyronie's disease?

The homoeopathic treatments for Peyronie's disease (such as fluoric calcarea, causticum, chelidonium compose and tuberculinum) are not clear even among homoeopaths themselves and furthermore, they have not been documented and scientifically evidenced enough to be considered effective and safe. In our opinion, it is best to turn to a qualified urologist/andrologist for any deformity or discomfort in the penis.

Are vacuum pumps beneficial for Peyronie's?

The popular penis vacuum pumps can be dangerous if the patient has Peyronie's disease because the exaggerated increase in blood volume in the corpora cavernosa could cause pain and encourage the fibrotic process to advance and grow. 

It is best not to use this type of device if you suffer from any morphological alteration of the penis without medical supervision.

What action does verapamil have on Peyronie's curvature? Can it be useful in treatment?

Creams or ointments with verapamil can stimulate the synthesis of enzymes such as endogenous (i.e. produced by the same organism) collagenase at the place of application. 

Remember that collagenase is a catalytic enzyme that destroys excess collagen fibres. Applying a drug of this type increases enzyme synthesis and decreases the fibrous scar that directly or indirectly produces penile curvature.

Is it true that Peyronie's disease can be cured with herbs and home remedies? Is it safe to perform them?

Hundreds of thousands of home techniques can be found on the Internet to treat diseases like Peyronie's with herbal remedies and substances obtained from them. 

However, these remedies have not been scientifically proven based on accepted parameters of safety and trust, so it is not recommended performing them. The consequences could be worse than the current state of the disease.

Erection Problems



Can you have sex after receiving shock waves?
There is not the slightest inconvenience for the man who undergoes shock wave therapy for erectile dysfunction, to have to take sexual abstinence because the treatment is non-invasive and does not generate inflammatory effects of any kind. Sex life can continue without problems.
Is shock wave treatment painful? Could it leave me any negative after-effects?

This treatment is totally painless, so much so that it does not require the patient to receive anaesthetics or painkillers. The risks of complications are very small and are not a major concern. 

However, the patient must be monitored by the physician throughout the treatment.

How soon can I see the positive effects of the treatment?
It is estimated that improvement in erectile function may be evident within three to five months after the start of treatment. This time may vary from patient to patient. If you do not perceive any positive effect, most probably the mistake has been made by your doctor, who will have indicated it without taking into account the type of erectile dysfunction you present.
Can I take sildenafil (Viagra®) after receiving ED shock waves?
Yes. In fact, shock wave therapy increases the effectiveness of shock waves according to certain scientific studies. No contraindications or adverse effects have been reported.

Penis prosthesis



Si soy una persona que practica mucho ciclismo ¿La prótesis de pene es recomendable?

Sí, no hay ningún inconveniente con las prótesis de pene y prácticamente ningún deporte, incluido el ciclismo. Si se recomienda evitar los deportes de alto riesgo de contacto como el karate, que puedan recibir algunas patadas o traumatismos severos que pudiera condicionar la rotura de algún componente de la prótesis.

Realmente el apoyo del sillín de bicicleta es recomendable que sea lo más ancho posible y que no haya un apoyo en ninguno de los componentes, pero la prótesis normalmente va alejada de los sitios de apoyo del asiento de la bicicleta.

¿Cuánto dura un implante de pene o una prótesis hidráulica en tu experiencia?

Los implantes de prótesis de pene están garantizados de por vida. Tenemos experiencia con pacientes de más de 25 o 30 años sin problema alguno en los componentes de la prótesis.

¿De qué tamaño queda el pene con la prótesis?

El tamaño del pene no se verá afectado por la prótesis. En todo caso es posible que gane algo de tamaño si es el deseo del paciente. Las prótesis actuales expanden y son capaces de rellenar completamente el cuerpo cavernoso y siempre intentamos, en andomedic, maximizar el tamaño y mejorar el tamaño con el que se termina con respecto a con el que se empieza la intervención. El tamaño del pene va a quedar igual a como estaba o mejor.

¿A qué se debe que hay tantos testimonios en internet que comentan que con la implantación de la prótesis de pene les ha quedado un menor tamaño?

Hay varios factores que pueden condicionar una disminución o la sensación de pérdida de tamaño.

Uno de los factores es que el paciente recuerda cuando tenía erecciones y su miembro era de tamaño superior y luego después de un tiempo sin sufrir erecciones sufre una atrofia y eso es difícilmente recuperable.

Una buena medida es medirse el pene estirado al máximo, en la parte de arriba estirado, antes de colocarse un implante. Ese tamaño de estiramiento máximo va a ser, aproximadamente, el tamaño que va a tener después de la prótesis.

¿Cómo se puede evitar el problema del glande frio a la hora de implantar o la prótesis de pene?

El glande frio viene sobre todo producido por una falta de excitación, la erección del glande se produce sobre todo cuando hay una buena excitación sexual.

En ocasiones, aunque es raro que ocurra, se puede manifestar aún incluso a pesar de tener buena excitación. En esos casos algún tratamiento con inhibidores, o algún tratamiento con alprostadilo en crema a nivel del glande o la uretra, pueden beneficiar la aparición, o sea pueden evitar que aparezca el glande frio, pero no es durante la intervención, ni antes.




Can laser surgery be used to treat prostate cancer?

Although much less common than open surgery with a scalpel, lasers can also be used to surgically treat this disease. However, surgeons and urologists are faced with a problem: the cancer is often poorly located within the prostate, complicating its resection by means of a transurethral laser.

Can i have sex after prostate surgery?

Doctors advise against having sex for at least two weeks after prostate surgery because ejaculation could be painful, hemorrhagic (hemospermia) and slow the healing process of the urethra.

How long does the surgery take?

This type of surgery is usually quite fast compared to traditional techniques. It rarely exceeds two or three hours of surgery (added to the 24 or 48 hours of hospital recovery).

STD (Venereal Diseases)



What are the most serious complications?
If infection with herpes simplex virus type 2 is not adequately treated for a very long time, or if the person has an immunosuppressive disease (such as HIV), life-threatening complications can occur. Among the most common complications are aseptic meningitis and neonatal herpes.
Is neonatal hsv-2 infection preventable?

It's somewhat difficult to prevent a newborn child with an infected mother from getting the disease.

In any case, within prenatal care there are tests for this infection because of the great risks to the life of the newborn.

If the pregnant woman develops symptoms similar to genital herpes (or has suffered it before) is recommended cesarean delivery, to prevent the newborn has direct contact with the female genital organs.

In addition, this group of patients (pregnant women) can receive treatment with antiviral drugs from the 36th week of gestation.

Before this period, there is a risk of fetal damage.

If i am infected, can i have sex?

That is not recommended. However, the treating physician will be responsible for giving specific instructions for the patient to have sex with a decreased risk of transmissibility.

Vasectomy and Vasovasostomy



Is vasectomy a safe method?

Vasectomy is one of the most effective surgical methods of contraception, with a failure rate of less than 1% - about 4 men in 1000 would remain fertile even several months after the vasectomy.

Technical failures could occur with inexperienced surgeons and result in failure due to gradual reconnection of the vas, formation of a new channel, lack of identification and cutting of the vas, for this reason, it is important to complete the seminogram checks to verify the effectiveness of the operation.

Is it a painful procedure?

It is a procedure where local anaesthesia is used and in some cases, general anaesthesia is required, some surgical and post-operative discomfort can be felt, then inflammation and areas of hematoma can be observed, with slight pain, for which non-steroidal analgesics are indicated to help control all these effects.

Will a vasectomy affect my sexual activity?

The post-vasectomy patient's sex life is completely normal and will not be affected at all. His erections, orgasms and ejaculations will continue as usual. His sexual desire will remain the same as before the operation.

The amount of semen after the operation is only reduced by 5% and retains its usual characteristics. Only with the use of a microscope is it possible to visualize the absence of sperm in the seminal fluid.

What can I do if I regret it and want to reverse the operation?

Although vasectomy is considered an irreversible technique, there is currently the possibility of reversing it, through the vasovasostomy technique, recanalization of the vas deferens is achieved.

The success of this procedure will depend primarily on the quality and quantity of sperm (for conception by natural means) and the technique used in the initial operation, the greater the number of vas deferens that was resected, the less successful the recanalization can be.

It is often said that the time elapsed from the vasectomy also contributes, a time greater than 10 years is also associated with fewer probabilities of success, something that in our long experience in the operating room has not happened.

Does vasectomy protect me from sexual diseases?

Vasectomy does not offer any protection against sexually transmitted diseases, so it is recommended to take other measures such as the use of condoms, reducing or avoiding multiple sexual partners and in more extreme cases, sexual abstinence.

How much does it cost to get a vasectomy?
The price varies depending on the hospital centre where the procedure is performed and the medical fees, however, the cost (all-inclusive) in our office in Seville is approximately 1000 euros.
Will a vasectomy affect my male hormones?

Vasectomy does not affect any male sexual characteristics, as the release of male hormones produced in the testicles continues to occur normally and in the usual amount. These hormones are released directly into the bloodstream and are not interrupted by the cutting of the vas deferens.

Therefore, it is a myth that vasectomy causes erection problems, female traits in men, and that it sharpens the tone of voice.

Are there long-term complications after a vasectomy?

There is no increased risk of prostate or testicular cancer in patients after vasectomy. Nor is heart disease or atherosclerosis associated with this procedure, which is why the World Health Organization considers vasectomy very safe and without long-term complications.

What happens to the sperm after a vasectomy?

Testicular cells continue to produce sperm, but they are naturally reabsorbed by the body, just as when a man has days without ejaculating. This is a normal process and has no complications.


What else can UI cause?

UI also causes the obvious discomfort resulting from leaks, embarrassment, and withdrawal in patients. Many who suffer from it keep silent, and the lack of information sometimes only aggravates the problem. Nowadays, thanks to web portals such as ours, many people find answers to the most common questions they usually ask in our Seville office once they make the decision to obtain treatment.

Do "normal" pads work for urine loss?
They are hardly adequate; you need another type of material that has a different (faster) absorption capacity for the menstrual flow.
Does eating worsen or improve on the symptoms?

Eating does not help to eradicate the problem, but can mitigate its symptoms and prevent them from worsening. Avoid excess sugar, alcohol and spicy foods and eat a balanced and varied diet.

If I drink less water, will I have less leakage problems?

No, and be careful. Common sense can lead us to think that if we drink less, we will have less need to urinate, but urine that is unbalanced by drinking little water can be very irritating to the bladder and increase the symptoms instead.

Can incontinence caused by a Neurogenic Bladder be cured?

This type of incontinence occurs in patients who have some type of disease/nerve injury presenting many associated pathologies (urinary tract infections, renal deterioration, etc). They require special and individualized care, which depends on the type of neurogenic bladder they develop. The study, treatment and follow-up of these patients must be specialized and intensive, with a continuous and personal doctor-patient relationship. It is complex to cure or eliminate completely. However, through Urodynamic Studies, which involve teaching these patients certain routines such as self-catheterization, and specialized surgeries, it is possible to obtain a better quality of life, while reducing complications and hospital admissions.

What are those beneficial (routine) exercises?

There are very extended routines like the classic Kegel exercises or the newest and most recommended hypopressive gymnastics.

How do I know if urine leakage is not indicating a major health problem?

You should check everything to be reassured, of course. That is why it is ideal that you seek help from a professional (urologist).

How do I know the type of UI I’m suffering from?

You can compare your case with the different types we have described above. However, it’s always ideal for you to seek help from a professional to assess everything in depth as earlier mentioned.

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