These notes take the published evidence for one treatment at a time and set
out what it supports, what it does not, and where the studies disagree with one another.
They quote the unflattering numbers alongside the flattering ones, because the
unflattering ones are usually the reason a man later wishes he had asked something else.
They are longer than a clinic leaflet on purpose. A decision between an operation that
clears the blockage completely and one that protects ejaculation is not a decision anyone
should make from a bullet list. If you read one before your appointment, we can spend the
consultation on your anatomy rather than on definitions.
Where a study is small, unrandomised, industry-funded or has lost half its patients to
follow-up, that is stated in the body of the text rather than buried in a footnote. Where
two good studies point in opposite directions — which happens more often than the
marketing suggests — both are given.
Every figure is sourced
Each number links to the study it came from, with the journal and DOI. Nothing is
quoted that cannot be checked.
Averages are labelled as averages
A trial mean describes a group of men. It is not a forecast for you, and these notes
say so wherever a number appears.
The evidence is graded
Each note ends with a scale showing how much confidence the literature actually
supports for each separate claim.
No treatment is being sold
I perform several of these operations. The notes are written to help you choose
between them, including choosing one I do not do.
