Human sexuality and fertility are under explored branches of medicine. This is attributed to the fact they are sub-specialties in most institutions. This has lead to precipitation of many unsolved problems, and accumulation of disabled males that have no hope at cure and are subjected to random treatment that –in many cases- has aggravated their ailments.

 

Being a specialist in the field of Andrology, I have been totally devoted to the management of male sexuality and infertility disorders. I have upgraded my medical and surgical skills to collect the tools necessary for creating innovative solutions to the problems at hand, and have started targeting them one after the other.

 

My first accomplishment was a surgical technique for treating male infertility resulting from obstruction of the “vas deferens“ due to surgical mistakes. The vas deferens is the canal that transfers the sperm from the testis to the penis. It can be occluded as a complication of hernia repair and other surgeries. One author reported this catastrophe to be up to 27% of cases of childhood herniotomy:

 

Matsuda T (2000) Diagnosis and treatment of postherniorrhaphy  vas deferens obstruction. Int J Urol 7 (Suppl):35–38.

 

As common as it is, this problem had no reasonable solution. The options were to perform intracytoplasmic sperm injection (ICSI) (the so-called tube babies) or to open up a large incision on each side of the abdomen on top of the previous large incisions of the hernia repair, and try the impossible  process of finding and re-attaching the remnants of the vas deferens within the chaotic site of the previous surgery.

 

In 2004, I proposed for the first time my surgical technique: “Pelvi-scrotal vasovasostomy”, where the natural reserve of the vas deferens that is found deep in the pelvis is utilized to go straight to the testis bypassing the site of obstruction. This was achieved through very small incisions, a virtue of laparoscopy.

 

 

This technique was published in the German “Andrologia” and the American “Journal of Urology”

 

Laparoscopy-Assisted Pelvi-Scrotal Vasovasostomy

O. K. Z. Shaeer And K. Z. Shaeer

Andrologia 2004, 36, 311–314

 

Pelviscrotal Vasovasostomy: Refining And Troubleshooting.

Osama K. Z. Shaeer And Kamal Z. Shaeer

J Urol, 2005, 174:1935–1937

 

It was presented in the International Congress of Andrology (North Korea, 2005) and the Congress of the French Society of Andrology (France 2005). The International Congress of Andrology is the most prestigious event in the field of Andrology. In this very congress, I was honored to be Chairman of a session, in addition to my lecture, in appreciation to my scientific contributions to the field.

 

 

Moving on to plastic surgery of the genital organs, I invented a number of surgical techniques that not only serve the purpose of aesthetic surgery, but help save patients with extreme disabilities due to brutal injuries or in-born disfigurement (congenital anomalies).

 

The first group of un-privileged patients I have targeted where those with injuries to the penis. Considering that circumcision is done to ALL the Muslims and the Jewish, it is done to millions of boys worldwide. And considering that every surgery has possible complications, a procedure done to millions must result in thousands of complications (at least). This is the case. Circumcision has resulted in total and partial loss of the penis in many. The consensus was either to leave this victim as is, or if the victim is less than one year old, convert him to a female, which is easy, especially considering that the gender identity (feeling of masculinity) is not yet well formed at this age. This harsh destiny motivated me to devise two surgical techniques that changed the future of many:

 

Construction Of Neo-Glans Penis: A New Sculpturing Technique From Rectus Abdominis Myo-Fascial Flap

O.K.Z. Shaeer and A. El Sebaie

J Sex Med 2005; 2: 259–265

 

 

 

Refining Penile Lengthening:  “V-Y Half-Skin Half-Fat Advancement Flap” Combined With Severing The Suspensory Ligament

O.K.Z. Shaeer, K.Z. Shaeer and A. El Sebaie

J Sex Med 2006;3:155–160

 

 

 

The first technique targets those with amputation of the glans (head of the penis), making it possible to restore the shape of the penis using an abdominal muscle and special sculpturing techniques.

 

The second technique targets those with total amputation of the penis, restoring the penis by utilizing the reserve that is normally attached to the pubic bone, with security measures that will prevent retraction of that reserve back to where it came from.

 

Circumcision is not the only cause of injury. My colleagues all over the world and myself have treated gun shot injuries, cut injuries, caustic injuries, thermal injuries and car accidents that have mutilated the genitals. Strangest of all is the “hair-coil syndrome”, where a hair strand from the mother falls to the penis of the child, spontaneously wraps around it and tightens till it causes necrosis (death) of the penis, that falls off! We have treated a lot of these rare cases with our techniques.

 

The second group where plastic surgery may be necessary is that of males with a thin (slim / narrow) penis. This is an in-born defect that can sometimes be treated by hormonal replacement, and in many cases requires surgery. All the surgical techniques available gave short term results, because the tissues used to augment the penis may or may not continue to live after surgery. This is because those tissues are harvested from some other place in the body, leaving behind their feeding blood vessels, and are transferred to the penis where they may or may not be able to find alternative source of blood. This has changed now. I have devised a surgical technique where I transfer tissues to the penis, while they remain attached to their feeding vessels. Not only that this provides permanent results, but it also gives a chance to reach the desired size, whatever it is, contrary to older techniques where one has to limit the thickness of the harvested tissues, since the thicker the tissues are, the more needy they are to blood:

 

Penile Girth Augmentation Using Flaps “Shaeer’s Augmentation Phalloplasty”: A Case Report

O.K.Z. Shaeer and K.Z. Shaeer

J Sex Med 2006;3:164–169

 

This technique has been published in the Journal of Sexual Medicine, and presented at the conference of the European Society of Sexual Medicine (Denmark 2005).

 

 

 

 

Another form of injury to the penis is ”Fracture Penis”, where pressure to the erect penis causes it to ”snap” due to tearing of the inner wall (tunica albuginea of the corpus cavernosum). This tear should be surgically repaired instantly. Upon surgical exploration, finding the tear is a difficult process and commonly prolongs operative time and increases surgical dissection and manipulation of this sensitive organ. My technique:

 

Methylene Blue-Guided Repair of Fractured Penis

O.K.Z. Shaeer

J Sex Med 2006;3:349–354

 

Provides guidelines for easy, speedy and accurate correction of this entity, leading to loss complications and shorter convalescence than previously.

 

 

 

Another group with congenital disfigurement is males with hypospadias, where the opening of the urethra recedes from the tip of the penis backwards. Surgical correction has a very high success rate, leading to a high rate of re-do surgeries. In this situation, the local tissues of the penis are already consumed in the first surgery. The alternatives have many downsides, among which is the fact that the intended urethra should be tubular, while the tissues used in the repair are flat and have to be “tabularized”. Tubularization is performed by suturing the edges of the tissue in use along the longitudinal axis. Leaks occur along this suture line. This is the main problem. For the first time, I proposed the alternative:

 

Urethral Substitution Using Vein Graft For Hypospadias Repair: A Case Report

O.K.Z. Shaeer and A. El-Sadat

J Ped Urol.

Ms. Ref. No.:  JPUROL-D-05-00118R1

Nov 21, 2005

 

Where I use a vein to substitute the urethra. Veins are tubular by nature, ommitting the troublesome longitudinal suture line, and providing an easy. Speedy repair with much better success rates.

 

 

 

Penile curvature is a common problem, where the erect penis is bent  to a side. When the bend is more than thirty degrees, it commonly prevents a normal sexual relationship, despite good erection. Surgery is necessary. Current techniques have the drawback of making the penis shorter, since they rely upon shortening the convex side. A shorter penis is not acceptable to most people unless it is the only resort. An alternative was inserting tissues on the concave side (grafting). This resulted in sexual dysfunction. The technique I invented corrects the most extreme degrees of curvature with neither shortening nor erectile dysfunction:

 

Correction Of Penile Curvature By Rotation Of The Corpora Cavernosa: A Case Report

O.K.Z. Shaeer

J Sex Med

Manuscript ID JSM-08-2005-179.R2

18-Oct-2005