Peyronies Disease Treatment
Bent Penis Surgery & Penis Curvature Correction

Peyronie's disease surgery cost varies. Surgery cost is most affected by whether the patient is suffering from Peyronie's disease erectile dysfunction (ED) and requires implantation of a penile prosthesis in addition to correction of penile curvature. Dr Perovic almost always uses graft materials in Peyronie's disease surgery so that does not impact on surgery cost. Click here for more details. Submit this form for a long-distance evaluation of your case and cost quotation.

Submit Information for Urological Evaluation by Dr Perovic

Full Name (as it appears in your passport):

Nationality:

Passport or Travel Document Number:

Date of Birth:

Your Current Address:

Your Phone Numbers:

Your Email Address:

Weight:

Height:

Name of Persons to Contact in Case of Emergency:

Contact Person's Email Address:

Contact Person's Phone Number:

Contact Person's Address:

Planned Date of Surgery:

Dr Perovic has no “waiting list”. Request the surgery date you want and we will confirm it or propose the closest available date.

Date You Expect to Fly Home:

Penis Surgery Details

What Procedure(s) Do You Require?

What Specific Results Do You Expect?

Questions for Professor Perovic:

What is your flaccid penis length?

What is your flaccid penis circumference?

Are you able to have an erection? Yes No

How long are you able to maintain an erection?

What is your erect penis length?

What is your erect penis circumference?

Have you sent to us some sharply-focused, clear, well-lit, unedited photos of your penis in flaccid & erect states from left, right & center?
Yes No
Send as email attachments digital photos of your penis from left, right, center, above and below in flaccid and erect states. No need to crop, re-size or do anything to the photos. Send them to us exactly as they come out of the camera and we will prepare them for Dr Perovic's optimum viewing. They must be in focus. Do not get the camera too close. It does not make better photos. Flash photos in a room with good ambient daylight from about 100-150 cm (3.5-5 feet) away tend to come out best.

Medical Conditions

Diabetes or Blood Sugar Problems?    Yes    No

Thyroid Problems?    Yes    No

Heart Problems?    Yes    No
If yes, please explain:

Lung Problems (such asthma or other other breathing difficulties)?
    Yes    No
If yes, please explain:

Blood Pressure Problems?    Yes    No

Previous or Current History of Cancer?    Yes    No
If yes, please explain in detail:

Kidney or Liver Problems?    Yes    No

Have you had any traumatic experience during the past year such as a divorce, loss of a loved one or extreme stress?    Yes    No

Problems with Anesthesia?    Yes    No

Blood Disorders (such as bleeding or clotting problems)?
Yes    No          Are you HIV+ or do you have AIDS?     Yes     No
All patients must have HIV, Hepatitis B & Hepatitis C tests. Send the results to us as an email attachment or bring results when you come. Tests can be done in Belgrade but are not included in price & cost Euros €50. HIV+ or Hepatitis C positive results disqualify a person from elective surgeries.

Have you been hospitalized, had surgery or received medical care within the past 12 months?    Yes    No
If yes, when?
If yes, for what reason?

Have you had weight loss surgery?    Yes    No
If yes, when?
If yes, which procedure did you have?
If yes, how much weight have you lost since your surgery?

Do you have any implants or any metal objects in your body?
    Yes    No
If yes, please specify:

Do you form keloids or have any difficulty with healing or scarring?
    Yes    No

Any Nervous Breakdowns or Depression?    Yes    No

Neurologic Problems?    Yes    No

Have you previously had any type of surgery?    Yes    No
If yes, list procedure(s) and date performed:

List all medications you currently take, including dosage:

List all vitamins or other nutritional supplements you take:

Any Allergies?    Yes    No
Food Allergies?    Yes    No
Drug Allergies?    Yes    No
If you have any allergies, please specify:

Have you ever taken an MAO inhibitor such as Nardil®, Marplan® or Parnate®?    Yes    No
If yes, when was your last dose?

Have you ever taken an anticoagulant such as Coumadin®, Heparin ® or a daily aspirin?    Yes    No
If yes, when was your last dose?

Have you ever smoked tobacco?    Yes    No
How much do you smoke now?
When was your last cigarette or tobacco product?

Do you drink alcohol?    Yes    No
If yes, what type, how much and how often?

Have you had or do you have any medical conditions not mentioned above?    Yes    No
If yes, please explain:

Additional info Dr Perovic should know but we didn't ask about:

Are you taking any form of anti-depressants?    Yes    No

Have you made yourself aware of the risks involved in the the medical treatment you want?    Yes    No

Have you made yourself aware of all the possible complications that can occur from the medical treatment you want?    Yes    No
Have you read the article: “Complications of Surgery”?    Yes    No

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Penis Enlargement Surgery with Prosthesis Implantation