Jonathan Clavell Jonathan Clavell
Dr. Clavell was invited to give lectures regarding his specialties in the management of erectile dysfunction and BPH. He had the opportunity to speak at two American Urology Association (AUA) events, the AUA Southwest section in San Diego, CA and the Puerto Rico Urology Association.
At these events Dr. Clavell shared his experience using Rezum Water Vapor Therapy for BPH and how to manage complications during and after Penile Implant Surgery.
In the month of June, Dr. Clavell & staff had the opportunity to be apart of the Prosthetic Urology Institute’s, Emerging Implanters Course, hosted by Boston Scientific in San Francisco, California. We had the opportunity to be part of the faculty and continue to teach other surgeons on how to refine their surgical skills and optimize outcomes when it comes to penile implant surgery for men with erectile dysfunction and Peyronie’s Disease.
Dr. Clavell was invited and served as faculty for the Men’s Health Prosthetic course for Experienced Physicians in Phoenix, Arizona on May 21-22, 2022. This course was hosted by Coloplast and was focused towards Urologists already in practice who are seeking to master advanced skills and management of complications that relate to penile implant surgery. Dr. Clavell shared insight on the prevention and management of infections and led a hands-on course where he shared surgical techniques for the management of complications that may be encountered during penile implant surgery.
Dr. Clavell is experienced in advanced Men’s Health Prosthetic Course for Experienced Physician surgical skills and techniques that are able to optimize outcomes related to penile prosthesis surgery. If you have erectile dysfunction that is not responding to medications, we encourage you to call our office at (713) 424-4030 and schedule your appointment today!
Remember: We are Gatekeepers of Men!
At this year’s Sexual Medicine Society of North America (SMSNA) Annual Meeting annual scientific meeting, board-certified urologist Dr. Jonathan Clavell had the privilege of presenting his novel approaches and techniques for the management of Peyronie’s Disease and how to manage Non-Infectious Complications related to Penile Prosthesis Placement. We congratulate Dr. Clavell for being a pioneer in the field of Urologic Sexual Medicine!
If you missed out on this presentation, don’t worry, he will be presenting this new technique at the International Society of Sexual Medicine in Tokyo, Japan (November 2021). This seminar is virtual and will be available on-demand, so even though most will not be able to attend it live, you can still watch all sessions at your convenience
For more information about all upcoming Sexual Medicine Society of North America meeting and how you can attend, please visit the link below:
For more information about the International Society of Sexual Medicine’s virtual conference and how you can attend, please visit the link below:
At Clavell Urology, you can have the certainty you will be evaluated by one of the experts in the field of Men’s Health. If you have Peyronie’s Disease or Erectile Dysfunction, call us at (713) 424-4030 and schedule an appointment with Dr. Clavell today!
Throughout the months of June and July, board-certified urologist Dr. Jonathan Clavell led multiple Surgical Skills Workshops on Penile Implant Surgery across the state of Texas. Dr. Jonathan Clavell hosted the surgical skills workshops in the following locations:
As an expert in the field of Urologic Sexual Medicine and Prosthetics, Dr. Clavell shares his expertise with residents and other urologic surgeons on how to perform the surgery and increase efficiency in order to maximize patient outcomes. He is committed to research, innovation, and sharing techniques in order to provide better care for patients.
If you are interested in learning more about penile implant surgery or when Dr. Jonathan Clavell will host his next workshop, call our Houston urology office today at (713) 424-4030 to schedule an appointment!
Board-certified urologist, Dr. Jonathan Clavell, recently published an article with Science Direct presenting the effectiveness of the Proximal Extracapsular Tunneling technique. Through his research, Dr. Clavell disco
vered that this approach is a viable technique that may help treat distal cylinder impending erosion and floppy glans syndrome, among other corporal dilation-related complications, with minimal operative time or complexity.
This technique is simple and can be safely performed by both high and low-volume surgeons. It avoids the need for additional counter incisions on the penis and, therefore, theoretically decreases the risk of infection.
Take a deeper look into his research, and learn more about proximal extracapsular tunneling, by checking out his article on Science Direct.
For more information about how Dr. Clavell can help you treat distal cylinder impending erosion & floppy glans syndrome, contact our office in Houston, Texas, at (713) 424-4030 today!
Every day in clinic I meet men who complain that their erection is weaker. I repeat: every single day. Erectile dysfunction is very common and occurs to approximately 40% of guys above 40 years old. These men often come in to see me after they‘ve done their research online to know what their options are. They find many alternatives which include oral medications, injections, urethral gels, vacuum therapy, shockwaves, PRP, stem cells and the penile implant. Unfortunately, some of these are experimental and have not been proven to work. Without knowing the pros and cons of each treatment option, it is hard to know what is the best option for each individual.
That said, every man who notices that he is having problems with either gaining or maintaining an erection should consider going to see his primary care doctor. They should first make sure that there is no medical condition that could be contributing to his sexual impotence. If you are diagnosed with Diabetes, heart disease, high blood pressure, thyroid problems, low testosterone, etc : these medical conditions could be the cause of your weak erections. The second thing they should do is: visit a specialist! Visit someone who knows all the treatment options and can help guide you to what is best for you.
This is a difficult question to answer because there are different causes of erectile dysfunction. For example, men with “hormonal ED” will benefit from Testosterone Replacement Therapy. Men with psychogenic ED benefit from behavioral sexual therapy. However, men with vascular erectile dysfunction, that is problems with blood flow in the penis will not necessarily respond to Testosterone or behavioral therapy. This is why it is important you go visit a SPECIALIST who can help guide you towards the best treatment specifically for you.
“My doctor told me the penile implant is the last resort”
Another thing we need to clarify is that the penile implant is probably the MOST EFFECTIVE therapy for ED, no matter the degree or severity of erectile dysfunction. Multiple research studies have shown that men with penile implants are more satisfied with their sexual function than those taking pills, injections or vacuum therapy. If you wonder, treatment satisfaction rate after the implant is more than 95% for BOTH patients AND partners. That is more than 30% more than pills, injections and vacuum therapy!
So… why do some consider it the “last resort”?
Most of the time we offer the penile prosthesis for men with severe ED that do not respond to medications or other therapies. The inflatable penile implant is a device that is placed inside the penis. It will occupy the space and disrupt that space within the erectile tissue. If the implant needs to get removed; then, other therapies (like Sildenafil, Tadalafil or injections) will not work. This is the reason some doctors consider it as the last resort. “….because once you have the implant there is no going back”. However, I do not think this way and I will explain why…
As previously mentioned, the inflatable penile prosthesis has been scientifically proven to be the BEST treatment option for ED and the therapy with the highest satisfaction rate. Even though it is mostly reserved for men who do not respond to medications or other therapies, there are men that get the procedure done for other reasons. Here are some examples:
Although erectile dysfunction is very common, there are many causes and severities that make treatments to be different for each individual. Goals are very different for every man and every couple. My goal as a specialist in Urological Sexual Medicine is to help you reach your goals. If you think a penile implant is an option for you, come visit us. You do not have to FAIL everything and all other treatment options to be a “candidate”. If you have erectile dysfunction, I have great news for you: You ARE A CANDIDATE for the penile implant. It is not the last resort. In most cases, it is the best resort and solution for ED. We can help you reach your goals! Call us! I would be honored to help you. Remember we are…. GatekeepersofMen!
This article was authored by Dr. Jonathan Clavell. Dr. Clavell is a board-certified urologist who specializes in men’s health including erectile dysfunction, low testosterone, Peyronie’s Disease and BPH.
Todos los días veo a hombres que presentan a mi clínica con la preocupación de que su erección está “más débil”. Repito: TODOS LOS DIAS. La disfunción eréctil, o impotencia sexual, es bien común y ocurre en 40% de los hombres mayores de 40 años. Muchos hombres que sufren de impotencia sexual llegan a mi clínica luego de haber investigado en el internet acerca de sus opciones de tratamiento. Estas opciones incluyen: medicamentos orales, inyecciones, terapia de vacío (Vacuum), terapia de shock, inyecciones de plasma, células madres y el implante de pene. Desafortunadamente, algunas de estas alternativas aún se consideran experimentales y no son recomendadas por la academia de Urología Americana o la Sociedad de Medicina Sexual. Por lo tanto, es difícil saber cual es la mejor opción para cada individuo si no conocemos los beneficios y riesgos de cada terapia.
Ahora bien, todo hombre que haya notado que tiene problemas con obtener o mantener una erección debe visitar a su médico primario. Usted debe de asegurarse de que una condición médica esté contribuyendo a su impotencia sexual. Si usted tiene diabetes, la presión arterial alta, problemas de su tiroide, colesterol, baja testosterona, etc.: estas condiciones pueden ser la causa principal de sus erecciones débiles. Lo segundo que esos hombres deben de hacer es: ¡visitar a un especialista! Visite a alguien que conozca a fondo las opciones de tratamiento y que pueda guiarlo y proveer una solución para usted.
Esta pregunta es difícil de contestar porque hay diferentes causas para la disfunción eréctil. Por ejemplo, los hombres con “disfunción hormonal” responden a terapia de Testosterona. Los hombres con “disfunción psicogénica” se benefician de terapias de comportamiento sexual. Sin embargo, los hombres con disfunción eréctil VASCULAR, eso es problemas con el flujo sanguíneo sanguíneo hacia el pene no necesariamente responderán a la Testosterona o terapias de comportamiento. Por eso es que es bien importante que visite a un ESPECIALISTA que pueda guiarlo a usted hacia el mejor tratamiento específicamente para usted como individuo.
Otro argumento que debemos de clarificar es que el tratamiento más eficaz para la disfunción eréctil es el implante de pene. La prótesis hidráulica de pene es el mejor tratamiento para la impotencia sexual sin importar la severidad de la disfunción. Múltiples estudios investigativos han demostrado que los hombres con implantes de pene están más satisfechos con su función sexual que aquellos hombres que son tratados con pastillas, inyecciones y/o la terapia de bomba de vacío. Para ser más específico, la taza de satisfacción para los pacientes con implantes peneanos y sus parejas excede un 95%. Esto es 30% más que las pastillas, inyecciones y la bomba de vacío!
La mayoría de las veces nosotros ofrecemos el implante peneano a los hombres que sufren de disfunción eréctil SEVERA. Eso es, aquellos que ya no responden a otras terapias o tratamientos. La prótesis hidráulica, conocida como “la bombita”, es un dispositivo que se inserta dentro del pene. El implante ocupa y destruye el espacio dentro del téjido eréctil del pene. Por lo tanto, si el implante se remueve, otras terapias como las pastillas o las inyecciones intracavernosas NO van a funcionar. Por esa razón muchos doctores consideran el implante peneano como la última opción. Muchos dicen “…una vez te pongan el implante, no hay vuelta atrás.” Sin embargo, te explicaré porque yo no pienso de esa manera…
Como mencioné anteriormente, los estudios científicos han demostrado que el implante hidráulico de pene es la MEJOR opción de tratamiento para la disfunción eréctil y la terapia con la mayor taza de satisfacción. Aunque se ofrece mayormente a hombres que han fallado otros tratamientos, hay hombres que se hacen la cirugía por otras razones. Aquí algunos ejemplos:
Aunque la disfunción eréctil es bien común, hay muchas causas y severidades que hace que los tratamientos sean diferentes para cada individuo. Tanto cada hombre como cada pareja tienen metas distintas. Mi meta como especialista en Medicina Sexual Urológica es ayudarlo a usted llegar a sus metas. Si usted cree que el implante de pene es una opción para usted, visítenos! Usted no tiene que fallar todos los otros tratamientos para ser un “buen candidato” para el implante. Si usted tiene disfunción eréctil, tengo excelentes noticias para usted: Usted ES CANDIDATO para el implante de pene. La bombita no es el último recurso. En la mayoría de los casos, es el mejor recurso. ¡Nosotros podemos ayudarlo a llegar a su meta! ¡Llámenos! Sería un honor poder ayudarlo. Recuerde que somos… GatekeepersofMen!
El autor de este artículo fue el Dr. Jonathan Clavell. Dr. Clavell es urólogo diplomático y certificado por la Academia de Urología Americana y es especialista en Salud Sexual Masculina que incluye disfunción eréctil, baja testosterona, Enfermedad de Peyronie’s y problemas de prostata agrandada.
Penile curvatures are very common. The penis can bend upward, downward or to the sides. In most occasions, the curvature is mild and does not cause any problems. However, some men have more complex curves that make them more self-conscious. Most often, a penile curvature is due to normal differences in penis anatomy, but sometimes scar tissue or another problem causes a bent penis and painful erections.
A very common concern for men of all ages is:SIZE. I often see men who come in to my office concerned about the size of their penis. Sometimes they are originally being seen for a completely unrelated complaint, such as urinary problems secondary to an enlarged prostate (BPH) or interested in a vasectomy. Then, all of a sudden, the question comes up: “Hey doc, now that I am here, I wanted to ask you about one more thing. I have noticed that my penis is shrinking…” or ” My penis is getting shorter”… And you can imagine the rest of the conversation.
But first let’s dig into a very popular question:
According to a study published in the Journal of Urology, the average penis size in the flaccid state is 8.8 cm or 3.5 inches. During the erect state, the average size was found to be 12.9cm (or 5.1 inches). I would also like to highlight that the flaccid size, in most occasions, does not correlate with the size during the erect state. Penises tend to “grow” from the flaccid to the erect state.
Even though there are many men who are interested in obtaining a ‘larger or longer penis’, most just want to make sure they do not lose what they already have. I’ll explain…. The most common surgery that I perform is placement of an inflatable penile prosthesis (also known as a penile implant) and probably the most common question that men have when I talk about the procedure is “But doctor… will I keep my size? Will the implant make me lose length?”
There are two well-known conditions that can get the penis shorter: Peyronie’s disease and erectile dysfunction.
Peyronie’s disease: is a condition in which the body starts forming scar tissue, known as a plaque, in the lining surrounding the corpora cavernosa, known as the tunica albuginea. Your penis has two chambers (known as the ‘corporas’) that fill up with blood in order to give you an erection. Those two chambers are surrounded by an ELASTIC layer called the tunica albuginea. When that elastic tissue has an injury or a condition that develops a plaque (or scar tissue), it won’t be able to stretch out and this can lead to 3 things: pain, curvature and a… shorter penis. These men not only have distress because they notice that their penis is now bent or curved, but now they notice it’s getting smaller!
Erectile dysfunction: can also cause the penis to lose size. Have you ever heard the expression: “if you don’t use it, you lose it”? Well, your erections work that way, in a sense. When our body stops having regular erections, the elastic tissue that stretches the penis from the flaccid state into the erect state can transform in a way that the penis loses its elasticity. If the penis is not elastic, it won’t stretch when you get an erection, and you will notice you lost length.
Radical prostatectomy (RP): Penile shortening is a common occurrence after surgical removal of the prostate in patients with prostate cancer. Research studies have reported that this can happen in 15-68% of patients after radical prostatectomy. You may wonder: but why would that happen? The real answer to that is: we don’t know yet, but we have theories. Some urologic scientists proposed one mechanism: the anatomy changes when the urethra is shortened. When the prostate gets removed, the urethra needs to be reconnected with the bladder and this makes the urethra shorter. However, one thing that we do know for sure is that after the prostate gets removed, the nerves that help men get erections are injured. This can lead to poor oxygenation of the smooth muscle inside the penis (cavernous body) which can lead to fibrosis (scar formation), erectile dysfunction, loss of elasticity and, a shorter penis.
Overweight: Weight gain can also give you the appearance of a shorter penis. Unlike women, who gain most of their weight in their thighs, men’s bodies mostly focus their weight gain in the lower abdomen (referred to as ‘panniculus’). Accumulation of fat in this area hinders the penis and limits its visibility, giving you the appearance of a shorter penis.
Traction therapy: Research shows that some men with Peyronie’s disease respond to traction therapy. This can be used alone or in combination with surgical and nonsurgical treatments such as Xiaflex intralesional therapy. There are multiple types of traction devices available that can be used to restore length and correct penile curvature.
Vacuum therapy: A vacuum erection works by creating negative pressure inside the penis and “suctioning” venous blood into the penile shaft. While inside the vacuum pump, the penis will maintain the erection. I truly believe (and research has shown) vacuum therapy can help men keep their size and helps with penile rehabilitation. My recommendation for men who don’t get erections during the night or are planning to get a penile implant in the future is: GET A VACUUM DEVICE and use it to exercise your penis. It will keep the tissues elastic and healthy.
Surgery: There are surgical procedures that can give the appearance of a longer penis without actually affecting your true penile size. These include: ventral phalloplasty, dorsal phalloplasty, panniculectomy, among others. For men with Peyronie’s disease, there are procedures that can help restore their length, but we will focus on these in another episode.
Penile Implant: Yes. A penile implant can help you MAINTAIN your length. The inflatable penile prosthesis is a medical device that’s placed inside the penis. We offer it to men with ED . The implant occupies the inside of the penile shaft in its entirety (Want to see how? Watch a video here). Earlier I described how erectile dysfunction can lead to loss of length. If there is one thing that will “halt” that process, it would be the penile implant. By occupying the entire space inside of the penile shaft, the penis has nowhere to go. This is why I encourage men to consider this option when ED continues to progress and oral medications fail. Why? Because… when you have a penile prosthesis, your penis will be in the “long” state at all times. The penile implant transforms your penis from being a “grower” to a “shower”.
Let’s go back to that original question: Why is your penis “shrinking”? Your inability to have a strong erection, Peyronie’s disease, history of prostate cancer and weight gain may be factors you need to look into.
And for the second question: will I lose size with the penile implant? The answer is simple… No. The implant does not cause the penis to be shorter, erectile dysfunction does. When it comes to penile size, it is important to understand that there are many factors that can affect it. However, I am equipped with the tools to help maximize and restore length and function. Give us a call! We will be honored to help you.
Dr. Jonathan Clavell is a board-certified urologist and men’s health specialist in Houston, Texas. Dr. Clavell is an expert in both inflatable (commonly referred to as the pump) and mechanical implants (Semi-rigid). Performing over 150 implants per year, Dr. Clavell has emerged as one of the leaders in penile prosthesis surgery and implant revision surgery in the state of Texas and the United States. Dr. Clavell can help discover the best penile implant option for you and your lifestyle. For more information about the penile implant procedure, call (713) 424-4030 to schedule a consultation with Dr. Clavell today.
This article was authored by Dr. Jonathan Clavell. Dr. Clavell is an urologist who specializes in men’s health including erectile dysfunction, low testosterone, Peyronie’s Disease and BPH.