How to Choose a Physician for Peyronie’s Disease
Dr. John P. Mulhall M.D.

It is always surprising to me how little attention patients pay to choosing a physician for a medical condition. Often patients go to a physician they saw on a TV advertisement, on  an internet advertisement or that they found in the yellow pages. Most people would spend more time figuring out the right plumber to fix their leaky faucet than they do choosing a physician for their Peyronie's disease. The more uncommon a condition, the more complex it is, then the greater the amount of homework that should be done on the qualifications of the physician that you will choose.

In general, the specialty that evaluates and treats Peyronie's disease is UROLOGY. Urologists are physicians that train in the medical and surgical treatment of diseases of the kidney, bladder, prostate, testis and penis (among other organs). However, Peyronie's disease is not a particularly common condition and some urologists see very little of this problem in training. There are many training programs that do not have a urologic sub-specialist with expertise in Peyronie's disease and thus the level of training at some centers makes it difficult for an otherwise excellent urologist to be facile in the management of Peyronie's disease. This is most important when it comes to choosing a surgeon for reconstruction for penile deformity. For many urologists the only surgery they perform for a patient with Peyronie's disease is a penile implant. Many have no experience in doing other surgical procedures that do not require placement of an implant. In this situation you should consider seeking another opinion.

It is impossible to give you all the information necessary to make your decision in choosing a physician with expertise in this area, but the "expert and associate list" on this site is a start and some pointers below may aid you in making your decision. When in doubt seek a second opinion, after all, it is your PENIS, you only have one and it cannot be replaced! Before you even see the physician, when setting up an appointment simply asking the physician's assistant how many patients with Peyronie's disease are seen by the physician is a good start. If that number is one per month then you may need to consider seeing another physician.

A Peyronie's disease interview cannot be conducted in 5-10 minutes so if this is all the time you are given you may need to consider a second opinion. Many experts routinely spend 30-45 minutes with Peyronie's disease patients. The Peyronie's disease discussion should cover the cause, the natural history of the condition, medical treatment options and for patients with advanced disease not responsive to medical treatment surgical options. The physician should be comfortable answering your questions and should have some basic figures available for the success with various treatments. If the doctor's primary recommendation is do nothing or come back in 6 months then you're better off seeking care elsewhere as this physician has demonstrated their lack of interest and knowledge. Experts have heard this story way too often and the possibility to institute conservative/medical therapy during the acute phase is lost. Clearly not all patients will respond but it is still the right time to initiate some treatment. Do not be afraid to see a physician more than once if all of your questions have not been answered or have not been answered to your satisfaction. Any physician who begrudges you this time is most probably not a match for you and may not have a particular interest in Peyronie's disease.

When choosing a surgeon, be extremely careful and define the level of training of the physician in this complex surgery. In general, expertise is gained and maintained by the regular performance of any operation, the more complex the procedure, the greater the number that should be performed to achieve an expert level. Have a full discussion about the pros and cons, risks and benefits of a particular procedure. Ask the surgeon what to realistically expect with regard to penile length, penile sensation and degree of deformity after the procedure.

Physicians ! If you would like to be considered for inclusion in this database please click here and complete the form provided.

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Dr. Hernan M. Carrion
Carrion Urological Center, Inc.
1321 NW 14th Street, Suite 600
Miami, FL 33125
Tel: (305) 547-2534
Fax: (305) 326-7210
hcarrion@bellsouth.net
 

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