Straight to the Point released a new episode on Erectile Dysfunction (ED), hosted by Clinical Nurse Specialist Clare Akers (Coloplast) and Consultant Urologist Dr Fabio Castiglione (King’s College Hospital), with guest Professor Asif Muneer from London Men’s Clinic.

Key topics covered:

• The medical definition of ED and how it differs from other sexual health issues
• Links between ED and conditions like diabetes, cardiovascular disease, and post-prostate surgery complications
• The psychological side — how anxiety and loss of confidence can create a cycle that worsens performance issues
• Over-the-counter pills: what you should know, and why seeing a GP first is recommended
• How to recognise when it’s time to book an appointment

The episode is designed as an accessible starting point for men who are struggling with ED but unsure where to begin. It’s available on Spotify, Apple Podcasts, Overcast, Castro, Goodpods.

Circumcision is a commonly performed surgical procedure involving removal of the foreskin. In adults, it is a safe and effective treatment for specific medical indications.

What is Circumcision?

Circumcision is a surgical procedure that removes the foreskin (the skin covering the glans, or head, of the penis), leaving the glans permanently exposed.

In adults, it’s typically performed to address medical conditions.

• Indications:
  • Phimosis: A tight, non-retractile foreskin causing pain or hygiene issues.
  • Recurrent balanitis: Inflammation of the glans or head of the penis
  • Skin diseases: Chronic inflammation, lichen sclerosus or conditions affecting the foreskin/glans.
  • Warty lesions: Non-cancerous growths on the foreskin.
  • Cancerous/pre-cancerous lesions: Rare conditions requiring removal of the foreskin.
• Outcome: Resolves symptoms and improves hygiene.

At Harley Street Andrology, we offer tailored consultations to determine the best approach for adult circumcision, ensuring safety and comfort.

Why Seek Circumcision?

• Relieves discomfort: Eliminates pain from phimosis or infections.
• Prevents complications: Reduces the risk of recurrent infections or progression of lesions.
• Improves hygiene: Simplifies penile cleaning, lowering infection risk.
• Treats serious conditions: Addresses cancerous lesions, potentially preventing malignancy.
• Boosts confidence: Resolves functional or cosmetic concerns.

Delaying adult circumcision for medical issues can worsen symptoms or complications.

Why Choose Harley Street Andrology?

Professor Asif Muneer is an award-winning, internationally recognised andrologist with 30+ years of experience.

• Advanced Technology — Cutting-edge diagnostics and treatments
• Comprehensive Care — Personalised support from start to finish
• Holistic Approach — Focused on long-term men’s health and well-being

What to Expect During Circumcision

Before the Procedure

• Consultation: We confirm suitability, discuss anaesthesia options, and review medications, especially blood thinners.
• Preparation: You’ll receive TED stockings and possibly a heparin injection to prevent blood clots, depending on your hospital stay.

During the Procedure

• Anaesthesia: General or local anaesthesia, with local penile nerve blocks for post-operative comfort.
• Process: The foreskin is removed using a scalpel technique, and a double-layer closure is performed, leaving a cuff of skin just under the glans. 

After the Procedure

• Recovery: Expect swelling and bruising for a few days and the sutures dissolve after 3 weeks. The glans may feel hypersensitive for 2–3 weeks.
• Care: Keep the area dry for 24–48 hours and change the dressings regularly. Apply Vaseline to ease dryness and sensitivity. Avoid swimming for 2–3 weeks and sexual activity for 3 weeks or until the sutures dissolve.

Circumcision Costs in London, UK

Circumcision at private clinics in London typically depends on the location of the hospital where it is performed. Contact us for further details.

• Source (BAUS)

What is a Frenuloplasty?

A frenuloplasty is a minor surgical procedure to lengthen or release a tight frenulum, the small band of tissue connecting the underside of the penis glans to the foreskin. A short or tight frenulum (sometimes called “frenulum breve”) can restrict movement, cause pain, or tear during sexual activity. Unlike circumcision, frenuloplasty preserves the foreskin while addressing the issue, offering a less invasive solution.

Common Symptoms of a Tight Frenulum

• Pain or discomfort during sexual activity or erections
• Tearing or bleeding of the frenulum
• Difficulty retracting the foreskin fully
• Curvature of the penis during erection due to frenulum restriction

Why Consider a Frenuloplasty?

A tight frenulum can significantly impact comfort and sexual function. Frenuloplasty is recommended when:

Non-surgical options, like stretching or steroid creams, have failed
At Harley Street Andrology, we assess your condition to determine if frenuloplasty is the best solution, prioritising your comfort and functional outcomes.

Pain or tearing occurs during sexual activity or daily hygiene

The frenulum restricts foreskin movement, causing discomfort

Why Choose Harley Street Andrology?

Professor Asif Muneer is an award-winning, internationally recognised andrologist with 30+ years of experience.

• Advanced Technology — Cutting-edge diagnostics and treatments
• Comprehensive Care — Personalised support from start to finish
• Holistic Approach — Focused on long-term men’s health and well-being

Frenuloplasty Procedure at Harley Street Andrology

At our men’s health clinic in London, we perform frenuloplasty as a quick, effective procedure, including:

1. Diagnostic Assessment

• Consultation: Detailed discussion of symptoms and medical history
• Physical Examination: Assessment of the frenulum and foreskin to confirm the need for surgery

2. The Procedure

• What it involves: The tight frenulum is cut and lengthened using fine stitches, often dissolvable, to allow free movement
• Anaesthesia: Performed under local or general anaesthesia, based on patient preference
• Duration: Typically 20-30 minutes, often as a day case
• Benefits: Preserves the foreskin, relieves pain, and improves sexual function

3. Recovery and Aftercare

• Recovery time: Most patients resume light activities within a few days and sexual activity after 3-4 weeks.
• Post-operative care: Keep the area clean, avoid heavy lifting, and follow wound care instructions
  Our frenuloplasty specialists in London, led by Professor Muneer, provide comprehensive support to ensure a smooth recovery.

Risks and Complications

Frenuloplasty is a low-risk procedure, but potential complications include:

• Infection or bleeding (rare, <2%)
• Scarring or recurrence of tightness (uncommon)
• Temporary discomfort or swelling, manageable with pain relief
  Our team uses advanced techniques and meticulous aftercare to minimise risks.

Cost of Frenuloplasty in London

Frenuloplasty costs at private clinics in London typically depend on the procedure and anaesthesia. Contact us for further details.

What is Priapism?

Priapism is a prolonged, painful erection lasting more than four hours, unrelated to sexual stimulation. It occurs when blood becomes trapped in the penis, preventing it from returning to the body. If untreated, it can lead to permanent erectile dysfunction or tissue damage, making early treatment critical.

Types of Priapism

• Ischaemic (low-flow) Priapism: The most common type, caused by blocked blood flow. Painful and requires urgent care.
• Non-ischaemic (high-flow) Priapism: Less common, often painless, due to excess blood flow from injury.
• Recurrent (stuttering) Priapism: Repeated episodes, often linked to conditions like sickle cell disease.

Common Symptoms

• Persistent erection lasting over four hours
• Pain or tenderness in the penis (especially in ischaemic cases)
• Rigid shaft with soft tip

If you experience these symptoms, seek immediate help from a priapism specialist in London.

Causes of Priapism

Priapism can result from:

• Medications: Erectile dysfunction drugs, antidepressants, or antipsychotics
• Medical Conditions: Sickle cell disease, leukaemia, blood disorders
• Injury: Trauma to the penis, pelvis, or perineum
• Substance Use: Alcohol, cocaine, or other recreational drugs

At Harley Street Andrology, we conduct thorough assessments to find the cause and tailor treatment.

Why Prompt Treatment is Essential

Untreated priapism can cause scarring or erectile dysfunction. Ischaemic priapism especially needs emergency care within 4–6 hours. Our team is equipped for urgent intervention to protect your long-term health.

Priapism Treatment Options in London

At our men’s health clinic in London, we offer advanced treatments:

1. Conservative Measures

• What it involves: Physical activity, or oral meds
• Best for: Early stages 

2. Aspiration And Injection Of Alpha Agonists

• What it involves: Draining trapped blood using a needle with injection of alpha agonist agents
• Benefits: Effective for ischaemic priapism; local anaesthesia

3. Surgical Intervention

• What it involves: Creating a shunt to redirect blood
• Best for: Severe or resistant ischaemic priapism

4. Management of Underlying Conditions

• What it involves: Diagnosing and treating causes like sickle cell disease or medication side effects
• Best for: Recurrent or stuttering priapism

In cases where all treatment options fail, an early penile prosthesis can be offered. 

Professor Muneer has conducted extensive research related to priapism and this has led to a change in international guidelines.  

Why Choose Harley Street Andrology?

Professor Asif Muneer is an award-winning, internationally recognised andrologist with 30+ years of experience.

• Advanced Technology — Cutting-edge diagnostics and treatments
• Comprehensive Care — Personalised support from start to finish
• Holistic Approach — Focused on long-term men’s health and well-being

What to Expect During Priapism Treatment

1. Consultation – Immediate evaluation of symptoms and history
2. Diagnosis – Physical exam, ultrasound or blood tests if needed
3. Treatment – Aspiration or surgery, usually within hours
4. Recovery – Mild discomfort for a few days; follow-up to check function

Risks and Complications

While generally safe, potential risks include:

• Infection or bleeding (rare, <1%)
• Erectile dysfunction (higher risk with delayed treatment)
• Recurrence, particularly in stuttering priapism

Our team minimises risks with precision and attentive aftercare.

Cost of Priapism Treatment in London

Treatment costs vary by procedure at private clinics. For a quote, contact Harley Street Andrology.