The 45 year old man who met my gaze as I walked into the exam room smiled and, at least on first glance, appeared to be relatively healthy. When there is a patient on your schedule listed as “routine health maintenance exam,” it’s hard to know what to expect. Immediately upon entering, however, you can often gauge about how long your visit is going to take. If it’s a 22 year old female who’s not obese and looks pretty normal, then you can expect to do a pap smear, some contraceptive counseling – done. If it’s an 85 year old man in a power chair who’s here with his caregiver and sporting a bulge under his shirt suggestive of a nephrostomy tube, you can expect to be running behind for the rest of the day.
“Hello, Mr. Brazil, I’m Dr. Logan,” I offered my hand in greeting. “This is one of our medical students who is working with me today.”
“Hi!” Jill smiled brightly and waved.
“Um,” Mr. Brazil eyed the attractive 24 year old medical student uneasily, “Would it be ok if I just talked to you today?”
“Sure, no problem at all.” I shewed Jill out of the room. “What can I do for you today?”
“Well, I’ve been noticing over the past several months that my penis has been getting more and more crooked.”
“How do you mean?” I asked.
At that point, the patient lowered his pants to reveal a circumcised penis that was normal in every way except that it made a nearly 90 degree turn midway through and pointed to the patient’s right.
After a bit of research and after talking it over with my supervisor, I went back to see the patient.
“I’m going to give you a referral to urology. There may be some treatment options available but, if none of them are helpful, the definitive management for this condition is surgery to release some of the connective tissue surrounding your penis.”
“Surgery?” The patient appeared to turn a light shade of green at the thought of his penis being flayed open and I can’t say I blamed him. “Is there anything else I can do in the meantime?”
“Well,” I mused, “Are you right or left handed?”
“I thought so. I would say, in the meantime, try masturbating with your left hand. See if things improve. Either way, I’ll go ahead and put in the urology referral.”
I must confess, I haven’t looked at the literature on this – not even sure if there is any. Would any urologists who may read this care to comment on whether there is an association between Peyronie’s disease and which hand a patient masturbates with? Could be a good research project.
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