John McHugh M.D.:

Careful for what you wish for.

Originally posted on Prostate diaries:

So… a guy goes into a bar and in front of the bartender on the counter is a tiny little man playing a tiny little piano.

“That’s neat. Where did you get that little fellow?” he asks the bartender.

“There’s a Genie in the closet over there that will grant you wish,” the bartender replies.

The customer goes over to the closet and when he comes out a million ducks start falling from the sky.

“Hey, what’s up with that Genie of yours? I asked for a million bucks, not ducks,” the customer says.

“Well duh?” the bartender says. ” You think I made a wish for a 12 inch pianist?”

Someone reviewed my book on amazon and said it was unprofessional, that the drawings looked like they had been done by a child, the printing was bad, there were no statistics, that it had too many personal stories, that she could…

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John McHugh M.D.:

Think about how Round Up works on grass. Sometimes it doesn’t kill all the grass and sometimes grass grows back where you used it.

Originally posted on Prostate diaries:


“John, don’t let short-term gratification out weigh long-term gain.” That’s what my mother said to me many times and that is why I am a doctor. It is however not why I am a urologist.

“Mom….this is John. I have decided to be a urologist.”

“Ye Gods John. Do you know what they do.” Priceless and why I loved my mother so. So real and uncensored. She was the best. Period!

So to the question: Will the urgency get better after radiation.

In my book I make a big point of saying that every prostate cancer patient should know what the prostatic urethra is. Do you know what it is and why it is important? The prostatic urethra goes away with a radical prostatectomy. The prostatic urethra is irritated with radiation and the reason why patients have urgency, frequency, getting up at night and not making it to the bathroom after…

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I just want to be lucky.

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The Cloths of the Easter Mocking Cross in Stained Glass

A woman’s intuition and the “male mastectomy”.


From “101 Aphorisms, adages, and illustrations for the urological resident and nascent physician.”


The Only Thing E.N.T.
Has over Urology is Cocaine

One day in the urology clinic the intern I have previously mentioned in this book (the one that told the BS-ing older patient that he should treat his impotence by abstaining from sex for six months-that guy), was complaining of a head cold.
“I can’t breathe. This is miserable.”
I had a friend who was the chief resident on ENT and I arranged for the intern to go to their clinic. Just as an aside, this chief resident knew my older brother from twenty years ago in Columbus, Ga. He and my brother went to St. Anne-Pacelli Catholic School there. I went there until third grade. I still remember the nuns.
So the intern goes and about hour later comes back a changed person. I mean his was showing us how well he could breathe by taking long and exaggerated breaths, and moving around excitedly and “ready to get to work.”
“What in the hell did they do to you?” I asked him.
With a big smile and after another demonstrative deep breathe he says, “Cocaine my friend, cocaine.”
The ENT boys had put cocaine soaked pledgets in his nose and let it sit for a while and the stuff must have gone systemic.
“Man that was something else. Now I know why people use this stuff. I feel great!”
I had a medical school friend who was telling me about snorting cocaine and he said he’d do it before going to parties.
He says, “I’d do the coke and then go into a room full of people and I felt like King Bad. I loved it.”
Rule: If we could just invent a “cocaine soaked urethral pledget” for the penis. No that won’t work, cocaine is a vasoconstrictor. Never mind.


72. (From “101 Aphorisms, adages, and illustrations for the urological resident.”)

A Silk Purse out of Sow’s Ear

When it comes to advising a patient to have an inflatable penile prosthesis placed, you’d better make sure it is the last resort. I don’t care how hard, or not hard, they push you to skip to that treatment option. You should you use the neurosurgeon’s technique of making it very clear that “We are operating on your back because conservative measures have not worked and I can make no guarantees regarding outcome” or “This procedure destroys the natural ability of the penis to get erect; you can’t go back once we do this.”
But this is only the start. You see, some patients think that the prosthesis makes things bigger. You can say it ten times but they don’t hear it and they don’t hear that the head does not engorge and the girth will be less. Initially, you should try to talk them out of it because there is no wrath like the impotent man scorned. If they persist, know the downside risk and that you are only promising a firm penis and that is all, you may want to proceed. Make sure they know about the potential for prolonged post-operative pain after insertion. Oh, and don’t forget that there may be an infection and that the prosthesis may need to be removed and if removed, you may not be able to put another one in. And since the cavernosa are now sclerotic, “happy days” will not be here again.
After all this and every “I” is dotted and all “Ts” crossed, you successfully put in the prosthesis and you are now showing the patient how to cycle it up a month later. It turns out the patient has poor hand to eye coordination, and this is a task that he can’t master in one office visit. But even now, this isn’t the kicker.
“Doc, my penis was much bigger than this before you put this in. I bet it is at least an inch and half shorter,” he says as his wife, who is in the room as well, nods in agreement.
Rule: You can make a penis firm; you can’t make a purse from a sow’s ear.


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