Zachary Levin: Does wearing "tighty whities," or any type of restrictive underwear, negatively affect sperm count?
VI: Yes. It also affects motility, how well the sperm swim. A serious fever will do it, too. If you've had a fever of 103 to 104 degrees, three months down the line (when those sperm have matured and are ready to be ejaculated), your sperm count's gonna drop way down.
Zachary Levin: Along a different vein, surgery to enhance the size of the penis is a growing field. Does this really work? Are there risks involved?
VI: Currently, the surgery offered to lengthen the penis involves cutting the suspensory ligament. When this is cut, it no longer suspends the penis, so you have three-quarters to an inch more showing. The problem is that when you get an erection, it points straight to the floor. It doesn't suspend it at a right angle. An 18-year-old's erection points straight up to his belly button; a guy middle aged points straight out; and I guess as you get very oldif you can still get an erectionit points straight down. That's because the suspensory ligament has lost some of its elasticity.
Zachary Levin: Do you discourage patients interested in this procedure?
VI: Yes. You know, it's also very disfiguring. I've seen photographs of people that have had to have plastic surgery to make them look normal again. It's an ugly looking scar, and the scrotum can come up around the base of the penis: they call it "scrotalization" You know how the balls normally hang down below the penis? They can grow upward because of the scar, along either side of the penis. It starts to look weird.
Zachary Levin: Not to mention that the fat injected in the penis for girthanother aspect of the procedurecan become lumpy and sink to one part of the penis?
VI: That's the most disfiguring part. Sometimes the fat collects at mid-shaft, and doubles the diameter in that one section.
Zachary Levin: You must see things in your practice that most people don't even know exist. Are there any sex toys or penis tricks that can be particularly hazardous to the male organ?
VI: Sure, such as cock ring's metal or leather that are strapped around the base of the penis. They're used to amplify the erection: the blood stays in the penis a lot longer under tighter constriction, almost like a tourniquet. The penis can get very cool and blue. If allowed to go too far, you can get a thrombosis (a blood clot). I had one guy who got tied up by a dominatrix. He had rope tied all around him, including around his testicles. And then I think he did some coke and passed out, so he was like that all night long. He almost lost his penis: the skin was all chafed and he had to stay in the hospital ten days with his penis in traction.