Dr Franklin Kuehhas is an outstanding doctor and specialist in Vienna who specializes in reconstructive andrology and genital surgery. With a clear focus on the health and issues of the male genital area, he has earned an excellent international reputation. Dr Kuehhas is widely appreciated for his empathy, discretion and professionalism and is regarded as an expert in performing complex operations in the field of the male genital tract. At his Vienna practice, located just behind City Hall, Dr Kuehhas offers a premier destination for men seeking to address intimate health issues. He understands that many men are reluctant to discuss such matters with their GP or urologist, as they are often perceived as embarrassing. Dr Kuehhas provides an open and trustworthy environment in which men can discuss all possible genital issues, regardless of their nature or presentation. Professionalism and discretion are his top priorities.
As a highly specialized andrologist, Dr Kuehhas treats both congenital and acquired conditions of the genital area. He places great emphasis on aesthetic genital surgery, as the appearance of the genital area is of great importance to many men. He is a member of various international medical societies and a sought-after speaker at conferences worldwide. Dr Kuehhas completed his specialist training in urology and andrology at prestigious university hospitals in Heidelberg and Vienna. During this time, he was able to specialize in the surgical treatment of the male genitalia. Further specialist training at the renowned University College London led him to reconstructive andrology, in which he is now regarded as a recognized expert.
Dr Kuehhas treats various genital conditions, including penile curvature and erectile dysfunction. When treating penile curvature, he can draw on a range of surgical methods and has even contributed to the development of new surgical techniques. With regard to erectile dysfunction, he offers penile prosthesis implantation as a solution for severe cases. In addition to medical genital surgery, Dr Kuehhas specializes in aesthetic procedures in the genital area. This includes surgical penile lengthening, penile thickening, glans thickening and other aesthetic enhancements. His wide range of services enables men to rediscover the joy of their sexuality and feel more comfortable in their own bodies. The editorial team at Leading Medicine Guide took the opportunity to learn more about reconstructive andrology and intimate surgery.
In a world where aesthetic enhancements and the pursuit of self-confidence are growing in importance, male genital aesthetics are also coming into focus. Modern medical approaches offer innovative methods for penile lengthening, thickening, glans thickening and other aesthetic enhancements. The focus is not only on the physical aspects, but also on men’s emotional well-being and self-confidence.
“A penile prosthesis is generally an option for men for whom other treatments for erectile dysfunction have not been effective. It is important to assess the severity of the problem and ensure that all other possible solutions have been exhausted. The patient’s general state of health plays a crucial role in the decision to proceed with a penile prosthesis. Men suffering from erectile dysfunction should first have tried all conservative therapies before considering surgical intervention. Erectile dysfunction can be treated using various conservative approaches, although effectiveness may vary from person to person. Lifestyle changes play an important role, including a healthy diet, weight management and regular physical activity. Quitting smoking and controlling alcohol and drug consumption are further approaches. Psychological counseling can be helpful, particularly in cases of psychologically induced erectile dysfunction caused by stress or relationship problems. Furthermore, there is drug therapy with prescription PDE-5 inhibitors, such as Viagra or Cialis,” explains Dr Kuehhas at the start of our conversation.
Finally, surgical procedures always carry risks, so the patient must also be healthy enough to cope with the operation and the recovery period. Dr Kuehhas explains how a penile prosthesis can help men: “The psychological pressure on those affected is usually very high, and psychosexual problems also play a role here. It is also important to take the patient’s lifestyle and sexual habits into account. Ultimately, a penile prosthesis can significantly improve a man’s sex life, particularly when other treatments have proven ineffective. It enables men to achieve and maintain an erection whenever they wish. This can lead to increased self-esteem and improved self-confidence, as well as enhancing intimacy within a relationship. However, one should not imagine a penile prosthesis as a rubber dildo; it is rather a replacement for the erectile tissue that allows for orgasm. It is very important to note that a penile prosthesis is irreversible, as the non-functioning erectile tissue is destroyed during the operation. Therefore, the decision should be well thought out and only made in consultation with an experienced doctor.
The surgical insertion of a penile prosthesis is a minimally invasive procedure. “As with any operation, there are risks involved, but these are not considered high. Bleeding or inflammation can, of course, occur from time to time. The probability of inflammation of the prosthesis itself is less than 1%. The operation is quick, and the patient can theoretically have sex four weeks after the procedure,” explains Dr Kuehhas optimistically.
Penile curvature, Induratio Penis Plastica (IPP), is a condition in which scar tissue causes hardening of the connective tissue in the erectile tissue of the penis. The exact causes of this condition are not fully understood, but there are various factors that can lead to IPP.
The scar tissue leads to a curvature of the erect penis. The exact cause of Peyronie’s disease is not fully understood, but it is often associated with microtrauma, trauma to the genital area, genetic predisposition and inflammation. Inflammatory processes in the penis, which can occur with certain infections or conditions, are another possible cause of scarring and curvature. It is also believed that a genetic predisposition to IPP exists, as the condition occurs more frequently in some families. The symptoms of IPP usually include a painful curvature of the erect penis, which is often accompanied by pain or discomfort during sexual intercourse. Men with IPP may also have difficulty achieving or maintaining an erection.
“A distinction is made between acquired and congenital penile curvature. Approximately 2% of the male population in Germany is affected by congenital penile curvature, and 10% by acquired penile curvature. The figures are certainly higher, but unfortunately the subject is still very much taboo. Added to this is the fact that men generally do not like to talk about their problems. As far as the symptoms of penile curvature are concerned, the greater the curvature, the more the man is affected. Penetration is usually no longer possible. And even if it is, maintaining an erection is usually no longer possible. This leads to psychosexual problems, meaning that, out of shame, intimacy with a partner is no longer sought in the first place. In cases of acquired penile curvature, a scarred area resembling connective tissue appears on the penis, and sexual intercourse can lead to recurring injuries. In the case of congenital penile curvature, the cause unfortunately cannot be precisely determined. Environmental factors may play a role, as may a simple genetic predisposition, but a diet containing soya may also, in some cases, lead to a deformity,” explains Dr Kuehhas. Soya products contain phytoestrogens, which are plant compounds structurally similar to human estrogens. Opinions differ regarding the effects of soya products on hormone balance. This has not been proven.
Congenital penile curvatures are present at birth and usually develop during fetal development. Congenital penile curvature is usually diagnosed when the condition is detected at birth. A thorough examination by a pediatrician or urologist can confirm the curvature. Treatment may vary depending on the severity. In some cases, the curvature corrects itself.
There are various treatment options for penile curvature, depending on the severity of the condition.
“Penile curvature can only be treated through surgical correction. Pills or injections do not help in this case. There are two surgical methods: surgery that shortens the penis or surgery that preserves its length. The choice of treatment depends on many factors, including the severity of the curvature, the patient’s symptoms and his personal needs,” explains Dr Kuehhas. The earlier penile curvature is diagnosed and treated, the better the prospects for successful correction are generally.
More and more men are seeking penis enlargement.
“The increasingly common desire for penis enlargement is certainly also the result of the ever-availability of pornography. The comparison with the penis size of porn actors is inevitable, yet this overlooks the fact that their size generally simply does not correspond to the norm. They are false points of comparison. There are also psycho-sexual reasons. Anyone standing in the shower at a sports facility or sitting in the sauna feels uncomfortable in the presence of their sports colleagues because of what they perceive as the unattractive appearance and size of their penis, and wants an aesthetic change, even if this is perhaps imposed by a false self-image. “They often wish for a visible thickening in the flaccid state,” says Dr Kuehhas regarding some of the motivations of men, adding: “I once had a patient who came to my practice with his wife and a desire for penis enlargement. It eventually transpired that his wife had been unfaithful to him with the sports coach, who was apparently ‘well-endowed’, and that this was the real motivation behind his desire for enlargement. I ultimately refused to perform this operation.” All surgical procedures carry potential risks such as infection, bleeding, scarring and loss of function. “The surgical penile enlargement procedure is low-risk and takes around 60–90 minutes. There is no cost coverage for this,” says Dr Kuehhas.
Patients should always bear in mind that self-esteem and satisfaction with one’s sex life depend not only on the size of the penis, but on many other factors.
A note on the diagnosis and treatment of urethral problems.
Urethral strictures, also known as urethral narrowing, can be attributed to various causes. Trauma to the genital area, such as blows or impacts, surgical procedures in the genital area, or inflammation and infections of the urethra can lead to damage and scarring, which ultimately result in a narrowing of the urethra. Repeated microtrauma caused by vigorous sexual intercourse may also play a role. It is also believed that genetic factors may be involved, as urethral strictures occur more frequently in some families.
A physical examination can reveal pain or changes in the genital area. “In a procedure known as urethroscopy, a thin tube fitted with a camera (urethroscope) is inserted into the urethra. This allows the doctor to view the urethra from the inside and identify strictures or other problems. In some cases, diagnostic imaging such as ultrasound or magnetic resonance imaging (MRI) may be used to examine the structure of the urethra. Here in the practice, we can take images of the urethra while the patient is urinating using a retrograde urethrogram. The organ in question – be it the urethra, bladder or ureter – is visualized by injecting contrast medium via a catheter and examined radiologically. “Compared to excretory urography, this procedure has the advantage that the contrast medium, which is administered retrograde, does not reach the renal parenchyma. This means that the urinary tract can be visualized using contrast medium even in patients with renal insufficiency,” says Dr Kuehhas regarding the work carried out in his practice. Proper care and handling of the catheter are crucial to preventing infections. The recovery time may vary depending on the type and extent of the procedure.
A call to break the taboo!
“It would be desirable if genital surgery and male intimate aesthetics were no longer taboo. With women, there is a completely different public attitude, whether regarding breast surgery or the use of treatments for incontinence. As for men, topics relating to the genital area are often avoided, even when a procedure is medically necessary. I would like to see more information provided in the media as well, because the psychological pressure is immense, as I repeatedly observe in my patients. I perform 50–100 penile prosthesis operations a year and repeatedly see just how positively life-changing this procedure is,” says Dr Kuehhas, bringing our conversation to a close.
Dear Dr Kuehhas, thank you very much for this important insight into this male-dominated field!
