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NYC’s Top Urology Practice

Specializing in the treatment of Erectile Dysfunction and Penile Implant Surgery.


Welcome to Fifth Avenue Urology, the practice of Drs. Michael S. Brodherson, Yaniv M. Larish, and Leonard Glickman. We specialize in Penile Implant Surgery & the treatment of Erectile Dysfunction, as well as general urological care of both men and women.

Dr. Larish is an expert in penile implant surgery for advanced erectile dysfunction. He has trained and has extensive experience in performing these delicate and artful surgeries. He is an expert on all types of penile implants and the latest technology. He teaches resident doctors on urological surgery and therefore keeps up with all the latest advancements in penile implant surgery and the newest advancements in the actual implant technology.

Dr. Larish utilizes different types of penile implants based on his expert opinion and vast experience for each individual patient’s specific needs. He uses semi-rigid or inflatable implants. The pump inflatable implants come from different manufactures and are each slightly different in their application. He will use his experience in determining which implant is right for each patient.

penile-implant-specialist-nycDr. Brodherson has been the Interim Chief of Urology at Lenox Hill Hospital and Dr. Larish served as the former chief resident in the same department. Dr. Glickman is specialty-trained in robotic and minimally invasive surgery. We are focused on providing exceptional, detail oriented, unrushed, and compassionate urological care to men and women of all ages. As physicians, we view the ability to practice medicine as a privilege, not a right. We treat our patients with respect, professionalism and compassion.

We are located in Manhattan, in New York City’s beautiful Upper East Side. We offer the most advanced state of the art diagnosis and treatment for all problems of the male and female urological and reproductive systems.

We emphasize discretion and compassion with all of our patients no matter how large or small their problems are. We understand the emotional and physical attributes of urological problems. We understand that problems of the urological system, from the kidney to the genitals, can be worrisome, embarrassing and sensitive. We provide a compassionate and safe atmosphere to discuss and treat problems in a comfortable and confidential environment.

dr-leonard-glickmanWe are experts in conservative and surgical treatments. We never rush patients and never push surgery when alternative, less invasive treatments are possible. We are proud to be ethical and altruistic physicians with a reputation and history to prove it.

We keep up to date with the most advanced technology and pharmacology as the field of urology changes with the times. New medications and procedures are introduced regularly. We are involved with doctor education and training allowing us to easily keep on top of all the new and exciting breakthroughs in the field of urology.

And lastly, we have a great back office team that is well versed in the ins and outs of insurance company procedures and rules to make sure your care and surgery are covered. We run our office with customer care in mind by trying to make sure every patient is comfortable and visits occur in a timely manner.

Penile Implant Surgery Information

About penile implants

how-does-inflatable-penile-implant-work-03A penile implant is a specialized medical device that is surgically implanted within the penis and the scrotal sacs of men diagnosed with erectile dysfunction. The surgical procedure is carried out on ED patients for whom the traditional or contemporary treatment has proved ineffective. The penile implant which is bespoke enables the individual to have and feel an erection that is almost natural.

A man whose erectile dysfunction can be traced to an underlying medical condition is a potential or ideal candidate for a penile implant. Since the implanting of the prosthetic device involves surgery, the patient should be aware of what the procedure is about, the likely complications and risks, and postsurgical care.

 Penile implants types

All different kinds of penile implant devices can be grouped under two broad categories-inflatable implants and semi-rigid implants. The modus operandi for both types is distinct, and each has its advantages and drawbacks.

  • implants-for-ed-problems-surgical-information-types-of-implants-01Semi-rigid implants: The most distinguishing feature of semi-rigid penile implants is their steady firmness. This distinctive quality implies that the device can be manipulated for performing coitus and moving the same in the direction of the pelvis for disguising. The segmentations that keep the semi-rigid implant flexible are held in place by springs attached on either side.
  • Inflatable implants: As the name suggests, an inflatable penile device can be blown up like a balloon for facilitating an erection and easily deflated as well. Inflatable implants are the most extensively used penile implant devices. A typical inflatable implant has three sections-a reservoirs or pool for holding the fluid and inserted beneath the abdominal layer, a piston and a discharge valve that is embedded in the scrotum, and two tubes (implanted inside the penis) that can be inflated.

When the individual wishes to have an erection, he forces the fluid into the tubes by pumping the reservoir. Once he is through with coitus, he opens the valve so that fluid can drain back into the tank. Two-piece models are also available where the pump and reservoir makeup one single section and operate in the same manner as three-piece models.

A few models of inflatable implants have antibiotic or antibacterial coatings to minimize infection risks.

Benefits

Penile implant surgery is an intensely invasive form of surgical procedure that is usually chosen as a last resort for dealing with ED. Nearly 95% of men who underwent this surgery have reported having an erection robust enough for coitus. The device which usually has a 10-year functional lifespan has lived up to its expectations in 60-80% of the cases.

Side effects

The usual complications of a penile implant surgery entail:

  • Infection
  • Excessive bleeding post surgery (that might necessitate a re-surgery)
  • Formation of scar tissues
  • Tearing of tissue surrounding the implant
  • Mechanical failure (calling for a re-surgery to remove the implant)

Precautions

inflatable-penile-implant-info-best-nyc-doctors-02You’ll not be allowed to take food, water or drinks the night before the surgery. You’ll also have to stop taking certain medications, like NSAIDs and aspirin to keep the risk of infection at bay. A responsible person will have to drive you home as you’ll not be in a position to leave the hospital on your own.

At home, you’ll have to take prescribed medicines and antibiotics for getting relief from pain and reducing chances of infection respectively. You’ll be able to start having sex with your partner about a month and a half following surgery. You’ll need to follow all other instructions recommended by the doctor to avoid complications in the future.

Prognosis

Most males who consider going in for a penile implant operation are extremely concerned about the recovery period. Luckily for them, the recuperation phase is normally faster than they’d like to believe. Majority of patients recover considerably within 2-3 weeks and go back to having sex in nothing less than six weeks after surgery.

 Concluding remarks

Opting for a penile implant has proven to be an efficient way of treating ED. However, the surgery could profoundly diminish the natural urge of having an erection which in turn implies that you’ll always have to fall back on the implant for the same. Regardless of the drawbacks associated with penile implant surgery, most of the men are still willing to go ahead with the procedure.

If you wish to know more about penile implants, you can get in touch with our prosthetic surgeon.

References

 

 

 

Choosing which Penile Implant Sugery

What Type of Penile Implant Would Be the Best for Me?

If you’ve decided to go for a penile implant, you’ve made the right choice. If you’ve exhausted every other method with no results, a good penile implant can be life changing. However, before you decide to get an implant, you have to understand the various types available on the market and weigh up the benefits and disadvantages of each before you make a decision. Here’s a rundown of various penile implants so you can make the right choice.

Non-Inflatable Implants

non-inflatable-penile-implant-medical-academic-information-top-nyc-surgeons-03Non-inflatable penile implants are the simplest type of penile implants on the market. Non-inflatable penile implants, often referred to as semi rigid rod implants, consist of a rod that is inserted directly into the penis. All you have to do is push the penis down from your abdomen or up from your scrotum before intercourse. Semi rigid implants are a bit similar to a gooseneck lamp that you can adjust and move in various directions.

One of the biggest advantages of non-inflatable implants is that they are easy to use and more importantly, very cheap. The procedure is also less invasive. However, the biggest issue with these types of implants is that the penis stays constantly firm, which can be an issue at times.

Two Piece Inflatable Implants

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Two-piece inflatable penile implants consist of two cylinders that are inserted into the penis and attached to a pump that is installed in the scrotum. By gently pressing on the pump in the scrotum, you’ll be sending fluid into the cylinders allowing you to achieve an erection.

One of the biggest benefits of two-piece inflatable implants over semi rigid ones is that you’ll have much more control over your erections. However, these types of implants won’t give you the most rigid erection that you can have.

Three Piece Inflatable Implants

3-piece-inflatable-penile-implant-medical-academic-information-top-nyc-doctors-02Three-piece inflatable implants are in many ways very similar to two-piece inflatable implants with the exception that a reservoir attached to the pump containing a sterile solution will be implanted into the abdomen. This solution will be sent directly into the cylinders to create an erection.

The best thing about these implants is that they create the most authentic looking and satisfying erections. They also act very fast, if you don’t want to lose spontaneity during intercourse. The only issue is that these types of implants are a bit more expensive and the procedure a bit more invasive.

Now that you know the difference between different penile implant types, you’ll be able to choose which model would work the best according to your needs. If you want more information about penile implants and the procedure in general, contact us today to schedule an appointment with the best penile implant doctor in NYC.

What to expect during and after Penile Implant Surgery

What Should I Expect Before, During and After My Procedure?

penile-implant-procedure-medical-expert-information-best-nyc-specialists-01Getting a penile implant and regaining control over your sex life can be exhilarating. But it can be a nerve wracking experience as well. However, penile implant procedures are very safe in general and understanding the process can help you alleviate some of the apprehensions surrounding it. Here’s what you should expect before, during and after you get your implant installed.

Before the Procedure

Most of the time, your implant surgery will be taking place either in a hospital setting or a surgery center. In some cases, you might undergo general anesthesia or spinal anesthesia to numb the lower part of your body.

Your doctor may also administer an antibiotic IV injection to reduce the risk of infections during the procedure. To further lower the risk, the surgery site will be completely shaved as well.

During Surgery

penile-impant-procedure-information-top-nyc-surgeons-02At a certain point during the surgery, a tube might be inserted directly into your bladder to collect any urine. The surgeon will then start by making an incision either at the base of the penis, below the penis’s head or the lower abdomen.

Your doctor will then proceed to stretch your penis’s spongy tissue. This is the part that swells up with blood when having an erection. The doctor will then choose the right size implant and insert it into the penis. The implant will have previously been customized according to your body measurements.

In the case you’re getting a 2-piece implant, your doctor will make an incision in your scrotum and place the pump there. In the case of a 3-piece implant, another incision will be made in your abdomen and the fluid reservoir will be placed right behind the abdominal wall.

Once all the devices have been implanted, your doctor will stitch the incisions shut. The whole procedure should take between 45 minutes to 1 hour in total.

After the Procedure

post-penile-implant-for-ed-surgery-info-specialists-03After the procedure, you’ll be more than likely prescribed medication so that you can deal with the pain. You might experience mild pain for a few weeks after the procedure. You might also be prescribed antibiotics to reduce the risk for infection.

Your doctor will give you instructions as to when you can resume normal physical and sexual activity. In most cases, recovery should take between 4 to 6 weeks. And you’ll also have to come back so your doctor can remove your stitches a few weeks after the procedure. He may also give you a set of exercises to perform to get you and your body used to the implants.

Knowing how the whole penile implant procedure works will help you get prepared for surgery and know what to expect after. If you need more details about penile implant surgery, contact us today to schedule an appointment with the best penile implant doctors in NYC.

Treatment for Erectile Dysfunction NYC

What Are the Top Treatments for Erectile Dysfunction?

ed-erectile-dysfunction-specialist-nyc-urologists-01Having to deal with erectile dysfunction is never easy and can be disheartening. While it can be easy to panic when you start noticing decreasing sexual performance, the good news is that there are plenty of treatment options available for you. In this article, we’re going to introduce some of the most common treatments for erectile dysfunction available.

Erectile Dysfunction Medication

ed-erectile-dysfunction-treatment-medications-nyc-urologists-02For many, the first option they might consider is getting medication. The most common medication prescribed for erectile dysfunction is Viagra, or Sildefanil. Viagra was originally developed to treat high blood pressure and started being prescribed for erectile dysfunction in the late 1990’s.

Viagra works by facilitating blood flow to the spongy tissue in the penis, which makes it much easier to achieve an erection. One of the issues with Viagra however, is that the action isn’t instant, and erections can last up to 5 hours in some cases, which can be very inconvenient.

Other medications that are often prescribed for ED include Tadalafil, also known as Cialis, and Levitra.

Natural Treatments

If you don’t like the idea of taking medication, there are plenty of natural treatments out there that could help. Panax Ginseng, for instance, has been shown to have positive effects on erections. However, the effects seemed to be more conclusive on people suffering with metabolic syndrome or those with uncharacteristically high levels of lipids in their blood.

Rhodiola Rosea is another plant that can help promote better erections. In a study involving 35 men, 21 have shown significant improvements after they’ve been given between 150 mg and 200 mg per day of the herb.

Penile Implants

ed-erectile-dysfunction-penile-implants-nyc-urologist-03Penile implants are also a great option for those suffering from erectile dysfunction. The most popular types of implants work with a pump that is concealed in the scrotum, and the abdomen at times, which is connected to tubes in the penis which allow the patient to control their erection at will using a pump located in the scrotum. Penile implants are one of the most effective treatments for erectile dysfunction on the market and are completely covered by Medicare.

The best treatment for you will depend on which type of results you’re looking for, the severity of your condition, and the side effects. If you want to get more information on erectile dysfunction treatment, contact us today to schedule an appointment with the best penile implant doctor in NYC.

Penile Implant Surgery in NYC

What Are the Benefits of Using Penile Implants?

While penile implant surgery has been around for a while, more people than ever are aware of them as a suitable treatment for erectile dysfunction. But while they are becoming more mainstream, many people may still be unaware of their benefits and why they should consider going for the procedure. Here are some of the common reasons you should consider getting a penile implant.

High Satisfaction Rates

penile-implant-high-satisfaction-rates-nyc-top-urologist-03One of the biggest selling points of penile implants is the very high degree of satisfaction patients have with them. As a matter of fact, studies have shown that around 93% of those who have undergone the surgery were satisfied by it. This is much higher than the 51.6% who said they were satisfied with Viagra and 40.9% who reported that they were satisfied with injection treatment.

Covered by Medicare

penile-implant-covered-by-medicare-02One of the benefits of penile implants is that they are covered by many insurance plans, including Medicare. Medicare started covering penile implants shortly after they’d been introduced and many insurance plans started covering them as well, which makes them a great option.

Completely Invisible

Many people are under the impression that penile implants will be visible, but that couldn’t be farther from the truth. As a matter of fact, penile implants are largely invisible. All the components are concealed inside the penis, scrotum and abdomen and no one will be able to tell if you have an implant.

Fast Recovery Time

Another great benefit of penile implant surgery is the relatively fast recovery time. As a matter of fact, you could be back on your feet in as little as 4 weeks in some cases. Once you’re fully recovered, you’ll be able to get back to your regular sex life.

Higher Control Over Your Erections

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Perhaps the most important benefit of penile implants is the control you’ll be able to have over your erection. Inflatable penile implants allow you to have full control of your erection using a pump system. You can control the length and rigidity of your erection at will as well, which makes them a much better option than medication in many cases.

As you can see, penile implants have many things going for them and should be considered if you’re suffering from erectile disorder.

If you want to learn more about penile implants and what they can do for you, contact us today to schedule an appointment with the best penile implant doctor in NYC.

Top NYC Urologist for Penile Implant Surgery

How to Pick the Right Urologist for Your Penile Implant Surgery

how-choose-best-urologist-penile-implant-nyc-01Choosing the right urologist can be a challenge if you’ve never had to deal with one before. If you’re thinking about getting a penile implant installed, then choosing a qualified urologist should be your main priority. In this article, we’re going to give you a few tips on how to find the best urologist for your procedure.

Get Referrals

The first thing you should do is try to get some references. In some cases, your primary care doctor may be able to help you. However, you have to make sure that the doctor they recommend has experience with penile implants specifically. You could also gather a list of urologists online and get reviews for them through third parties.

Check their Credentials

penile-implant-surgeon-credentials-02This part is absolutely essential as well. Before you pick any urologist, make sure that you check their credentials and track record. Board certification will confirm that the urologist in question has the proper skills, experience and formation to administer urologic care. It will also allow you to see if the doctor had any disciplinary actions or malpractice claims. Sites like Healthgrades will allow you to check the doctor’s training hospital, disciplinary and malpractice history, medical school, and much more.

Ask About their Experience

experienced-urologist-penile-implant-nyc-03Knowing how much experience a urologist has is one thing, it’s another to know how much they know about penile implants. While some urologists are more like generalists, others are specialized in penile implant procedures. Ask them how many patients they have treated and if they’ve ever had complications. Also ask about your risk for complications as well. Good doctors will be able to either prevent complications or recognize them fast enough so that the situation doesn’t aggravate.

Check their Communication Style

You can tell a lot about a doctor by how they communicate with you. Are they open to your questions and do they answer them in terms you can easily understand? A good doctor will want to know you, will take your treatment preferences into consideration, and will have respect for your decision-making process as well.

Finding a good urologist is essential for a procedure as important as a penile implant surgery. Make sure that you follow the few tips in this article if you want to find a reputable and competent urologist to perform on you.

If you’re looking for an experienced urologist for your penile implant surgery, contact us today to schedule an appointment with the best penile implant doctor in NYC.

An Introduction to Penile Implant Surgery NYC

An Introduction to Penile Implants

Penile implants are the subject of many discussions online, and for many reasons. Many people like the appeal of being able to improve the esthetic and size of their penis. But in many cases, the information floating around can be misleading. In this article, we’re going to give you the low down on penile implants so that you know what to expect.

Who Are Penile Implants for?

best-penile-implant-specialist-dr-ny-nyc-01First, let’s address what penile implants are really for. While many people think penile implants are purely esthetic, the truth is they should be used as a solution for a medical condition. And while they may have some benefits performance wise, their primary goal is not to make your penis bigger. As a matter of fact, the size difference will be minor in most cases.

What Are They Actually?

Penile implants consist of materials that are placed inside the penis to maintain and trigger an erection. While they are commonly used by patients suffering from erectile dysfunction, they can also be used for other disorders as well. One example is Peyronie’s disease, which is a condition that can be characterized by a painful and bent penis. All penile implants require surgery and a subsequent recovery process.

What Are the Different Types of Implants Available?

penile-best-implant-02There are many types of penile implants on the market, all with their own specificities. Inflatable penile implants are some of the most common on the market. Two inflatable cylinders are placed inside the penis and a reservoir is implanted in the scrotum. In some cases, a larger reservoir will be inserted in the abdomen. Inflatable implants allow you to have full control over your erection through a pump that is located in the scrotum and the risk of internal damage is much lower since inflations aren’t constant.

semi-rigid-penile-best-implant-03Then you have semi-rigid rod penile implants. These are lower in cost in general, which makes them a better option for many people. Instead of using inflation, semi-rigid implants rely on stiff material that will be permanently lodged inside the penis. While these rods can be bent, the penis itself will always remain firm. However, the chance of internal damage is greater since there will be constant pressure from the rods inside your penis.

Penile implants can be a godsend if you’re suffering from erectile dysfunction. They can help gain back control of your sex life and will help you regain some of your confidence. If you feel like this could be the solution for you, contact us today to schedule an appointment with the best penile implant doctor in NYC.

Top Penile Implant Surgeon Discusses Erectile Dysfunction

4 Signs That You May be Dealing with Erectile Dysfunction

While over 40% of men will have to deal with erectile dysfunction at some point in their lives, a lot is still unknown about the condition. While in some cases erectile dysfunction is only occasional, in others, ED can be linked to something more severe and will require some treatment. Here are some tell-tale signs that you may be dealing with an erectile dysfunction problem.

You Cannot Have Sex with a Partner

erectile-dysfunction-specialist-no-sex-partner-nyc-01Some men will report that they have no problem getting an erection when they’re alone but will be unable to achieve one when having sex with their partner. Or in some cases, they’ll be able to get an erection, but it won’t be firm enough for intercourse. That’s a clear sign of erectile dysfunction and might be related to stress or other psychological issues. If you fail to get an erection with your partner over 50% of the time, then it’s definitely a sign that you may have a problem.

Night Time Erection

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Another sign that you may be dealing with psychologically related ED is if you’re experiencing lots of erections during your sleep but not with your partner. If you want to test if that’s the case, one easy way to do so is by using what is called the “postage stamp test”. All you have to do is take a ring of stamps and attach it to the base of your penis before going to sleep. If the roll is broken when you wake up in the morning, this might be a sign of nocturnal activity.

Poor Oral Health

A lot of people are unaware of the impact poor dental hygiene can have on the whole body, including erections. A Taiwanese study recently found that men who were suffering from chronic periodontal disease were also 79% more likely to show signs of erectile dysfunction. Researchers suggested that it may be because bad oral hygiene increased the number of bacteria in the mouth which then enters the bloodstream, hindering blood flow and erections.

Dependence on Viagra

viagra-dependance-ed-doctor-urologist-03While Viagra was originally intended for people suffering from erectile dysfunction only, a lot of people started abusing the drug to enhance their sexual performance. The problem is that abuse of Viagra by healthy people can eventually lead to dependence and erectile difficulties. It can also increase the risk of developing mentally related erectile dysfunction.

If you happen to exhibit any of these symptoms, then it is strongly recommended that you seek professional assistance immediately. If you’re struggling with erectile dysfunction and are looking for help, contact us today to schedule an appointment with the best penile implant doctor in NYC.

Schedule an Appointment: 212-541-6239

3 Questions You Should Ask Before Undergoing Penile Surgery

While penile surgery is one of the safest procedures out there, any form of surgery, especially in the penis area, will raise some concerns. However, if you’re going in thoroughly informed about the procedure, then some of these concerns may be alleviated. In this article, we’re going to give you a set of specific questions you should ask before you undergo penis surgery.

Do You Really Need to Undergo Surgery?

penis surgeryThis is something you should think about before you even decide to opt for penile surgery. While chances of complications are very rare, the penis is a delicate and highly vascularized organ, which means that there is a lot of blood flow in the area and therefore there is a certain element of risk involved. This is why many doctors will recommend that you try other treatments first such as penis pumps and medication before you go for the procedure.

 

Another thing you have to consider is anesthesia. You can either go for local anesthesia with a sedative if you prefer being awake during the procedure. However, if you’re especially anxious, you can go for general anesthesia, though it’s a bit riskier.

What Are My Options as Far as Implants Go?

penis surgeryNot all implants are the same. As a matter of fact, they can differ greatly in their function and performance. For instance, semi-rigid implants work by inserting rods into your penis which will keep it in a state of permanent erection. Some people may not like the idea of having to deal with this inconvenience. Inflatable implants, on the other hand, will use cylinders that will be inserted into the penis and attached to a pump that will allow you to fully control your erections. These are usually more expensive and the procedure more intrusive, but they are much more convenient in the long run.

Doctor, How Many Times Have You Performed this Procedure?

penis surgeryIt’s always better to go with a specialist in penile implants instead of going for any urologist for the procedure. Ideally, you should go for a doctor that performs the procedure 2 to 3 times a month at the very least. Some doctors will even perform multiple surgeries per day while others only do this once or twice a year. Always go for experience first when choosing a doctor since this is a very serious procedure.

 

These questions should be able to give you a clearer picture of whether you should opt for the procedure and what you can expect as a result. If you want to learn more about penile implant surgery and talk to a professional, contact us today to schedule an appointment with the best penile implant doctor in NYC.

5 Common Myths About Penile Implants

penile implantPenile implants are still fairly new on the scene and there are plenty of myths and misconceptions floating around about them. While some of these myths are benign, many of them are based on fear and could actually deter people from getting the procedure done. Here are some common myths and misconceptions about penile implants.

 

myths

The Surgery and Recovery Are Going to Be Painful

That couldn’t be further from the truth. First of all, nothing will be removed during the procedure and the surgery will only take a few minutes in total. And as far as recovery goes, most patients are fully recovered within 4 weeks at best, and 3 months at worst, and can barely feel anything inside them. From this point, you can resume your normal sex life with no problem.

The Implant May be Difficult to Control

With a penile implant, you can have total control over your erection. You can control both the time and rigidity of the erection. And there is no chance that your pump will activate itself by accident. In many ways, a penile implant is even more controllable than a natural erection, so there is nothing to fear.

Everyone Will be Able to See It

Again, this is totally false. The pump itself will be concealed in your scrotum, so there is no way anyone else will be able to see it. Whether it’s your partner or in the locker room, no one will ever be able to tell that you have had penile implant surgery done.

It’s Too Expensive

penile implantMany people may think that a penile implant may be out of reach or that their insurance won’t cover it. But penile implants are actually covered by Medicare, as a matter of fact, they have been covered since 1975. And many private insurance plans cover it as well.

The Chance for Complications is too High

Infections are very rare during penile implant surgery. The rate is around 1% for non-diabetics and between 3% to 5% for patients with poorly controlled diabetes. And doctors are constantly working to reduce this rate, so the chances you’ll have to deal with complications are very small.

Now that you’re aware of the myths and misconceptions about penile implants, you should consider contacting a reputable doctor in your area who can answer your questions and see if this is truly the solution for you. If you live in the greater New York area, contact us today to schedule an appointment with the best penile implant doctor in NYC.