Jonathan Clavell MD, FACS
@clavelluro
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Board Certified Urologist, Men’s Sexual Health Specialist. proud Girldad. Husband. Paradigm shifter #GatekeepersofMen . From Puerto Rico🇵🇷 to the 🌎
Houston, TX
Joined January 2018
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Send us removal request.
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Officially snipped.
What’s the big fuzz about? Couples who wish to get sterilized, vasectomy is the way to go.
Men, time to take one for the team !😎🥸😄
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Surgeon: I need X Medication for the patient.
Hospital: patient needs to pay for it upfront
S: patient is under gen anesthesia, send bill after case
H: it has to be paid upfront
S: …
H: You can provide your credit card and we can charge you.
Yes, this happened!
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I am shocked as to how an insurance company is allowed to “recoup” money (11 months LATER) from a claim that met medical criteria AND was authorized prior to the provided service. 11 months later! 😳😳
How is that legal? That is THEFT!!
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I thought a peer to peer to approve a surgery would be with…. A urologist.. who is my peer.
However,
@UHC
decides to send a hospitalist for me to discuss Peyronie’s surgery. Had to describe the surgery to “my peer” who still denied the codes.
Ridiculous!
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If Twitter ends tonight, we all know it’s anesthesia’s fault.
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PSA: A Suprapubic catheter is easier to change than a urethral catheter.
Dear Hospitals: Let nurses change them.
Sincerely,
Every urologist.
#UroSoMe
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A physician gets invited to be an (expert) speaker/panelist in a conference but he/she needs to pay for his/her registration, airfare and hotel stay...
Does this happen in other professions?
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It is so gratifying to see patients whose nocturia resolves after their OSA is treated.
Not all Nocturias are due to BPH.
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@fr8tshaker
Any man who sees hisbpartner go through birth should undoubtedly have the same reaction. A vasectomy is NOTHING compared to what women go through during pregnancy and birth.
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Consult for “bilateral hydronephrosis”...
Forgot to mention
1. the other CT findings and...
2. order a Foley catheter for the patient?
4.8 L of urine 🥴
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No surgeon is immune to complications.
Im sure someone out there needs the reminder.
Stay Calm, learn from this experience and carry on providing quality care for your patients.
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Why do hospitals settle with a partial payment from an insurance but expect (and legally threaten) an individual to pay the full amount? 🤔🤔
...crazy and extremely unfair...
#MedTwitter
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PSA:
Urologists dont take care of hemorrhoids.
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Feeling blessed and motivated!
We reached 1,000 (career) 🍆 implant surgeries. 💪🏽💪🏽💪🏽
#sexmed
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If a patient has Peyronie’s, has good erections and is NOT bothered…. There is NO need to treat him. Reassure him and be available for him if something changes.
… and .. By all means, dont let him spend his $ on your SWT machine.
Hippocrates will be proud of you 👍
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@fr8tshaker
@AshleyGWinter
It IS a tough call, but they have the right to decide what they want.
We are not “castrating” them. They can still father children, it will just be more difficult to get it reversed or do IVF. If they understand those risks, it is their call, not mine.
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@caney_u
High BP is only one of many side effects. OCPs are poison, in my opinion. Men should be the ones to avoid getting their partners pregnant
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Today’s
@UHC
peer to peer to approve surgery for ED and Peyronie’s was with an ophthalmologist.
@DGlaucomflecken
, Im expecting a call with you in the next one.
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Patient: im in great health. i even brought a stool sample for you to evaluate.
Me: …😐
Patient: you want to see it?
Me: …I dont need to..🤢
Patient: let me show you
(takes this out of his pocket)
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Announcement for all Pharmacists and MD/DOs:
In most occasions: It is SAFE for a patient take a daily dose of Tadalafil 5mg WITH an occasional Sildenafil 100mg as needed.
There is a reason we prescribe it.
Att.
- Your friendly urologist.
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@TrenaryJL
Liposomal bupivacaine for intraop and postop pain control. Wish to avoid use of narcotics on my patients both intraop and postop.
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Pro-Tips for residents/fellows in ANY surgical specialty:
1. STUDY. STUDY a case before scrubbing in. If you go in clueless, it is likely you will leave the case justclueless because you wont even know where to start for the next pro/tip…
Which is….
#thread
1/
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It is with great honor that I announce: I am officially a Fellow of the American College of Surgeons 💪🏽🙌.
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Pride can be a dangerous attribute in medicine.
If I dont feel comfortable doing a certain procedure, I do what’s best for the patient and refer him/her to someone who has the skills/tools to help. At least…. Ask for help. It is NOT a sign if weakness.
First do no harm.
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21 yo male presents requesting vasectomy. He is single, has no children, but is 💯 sure he does not want to father children. You find him competent and capable to make medical decisions.
What do you do?
#UroSoMe
#MedTwitter
Perform Vasectomy
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No Vasectomy
871
Refer to a colleague
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I am excited and honored to announce I am officially Assistant Professor
@UTHUrology
.
Beyond ecstatic to help others grow in this wonderful field 🙌🙌
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Erectile dysfunction is not an “old man’s condition”.
Men of all ages can suffer from it. Do not assume it’s “all in his head” in ‘younger’ men and, most certainly, do not assume “they cant be having sex” in an ‘older’ couple.
Listen, empathize and help.
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Look who arrived to my office today! 🙌🙌🙌
I apologize, couldnt wait to hang it on the wall..
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Today our New patient list included 10 men scheduled for vasectomies.
10 in one day.
Coincidence?
#RoeVsWade
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Blue Angels flying over Texas Medical Center in
#HoustonTX
in salute to frontline
#COVID19
responders.
Office view 😎
#AmericaStrong
@HoustonChron
@MDAndersonNews
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Journal asks me to review an article for FREE. In return I ask for access to see their articles… Access denied.
Just…wow!
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It’s a wrap!
3 invited lectures
4 abstracts
2 video interviews
1 podcast
And (most imp.) lots of catching up with colleagues/friends.
Always honored to play a role at the
@SMSNA_ORG
meeting.
#SMSNA23
#done
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I received many DMs about my “healing process”:
I am 3 days out, no pain, the initial minimal swelling is gone, now back to normal life (in general).
#DoIt
!
To everyone considering a vasectomy, now is a great time.
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Have a confession to make:
Ive seen at least 5 guys in the last week with concerns of low libido and delayed orgasm secondary with NORMAL Testosterone levels that were resolved with Addyi.
Should we call it the “wonder drug”?
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What we do as SexMed experts/surgeons truly matters. We may not be curing cancer but we are changing lives! We are restoring relationships. We are renewing men’s and women’s confidence and self-worth.
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Glad I was able to drop some points on this.
Vasectomies are safe, minimally invasive and do not affect sexual function. But…. Not so easy to reverse, so let’s make sure we make a sound decision.
@AshleyGWinter
quoted also 👏👏
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It’s out! Extracapsular tunneling for impending
#IPP
erosion.
A simple alternative that doesn’t require a counter-incision 💪🏽💪🏽
Honored to be able to contribute to the field.
@AmerUrological
@supsorg
@SMSNA_ORG
@ISSM_INFO
@SocietyGURS
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Shoutout to all surgeons who help restore erections. You may not be “saving lives”, but you are certainly transforming lives.
Forever grateful to
@SPuro88
for the
#dickasaurus
idea.
#HoustonStrong
(pun intended) 🤪
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@RealGatorHours
Unfortunately. That’s why we at least try to normalize it. Nothing compated to what women go through
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This week we were fortunate to host
@UTSWUrology
’s
@MaiasaurusRex
in our clinic/OR. We had a cool lineup of complex Peyronie’s, virgin and redo IPPs w reconstruction.
We gave her a
#dickasaurus
hat as her certificate 😎🤪.
We ❤️ sharing our experience to help others grow💪🏽
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Peyronie’s disease: a thread.
There are a lot of misconceptions when it comes to Peyronie’s Disease.
#1
. Many believe Peyronie’s is rare. Peyronie’s disease is NOT a rare condition. Studies show that up to 1 out of 9 men have PD. Compare it to Prostate Cancer…
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Oncologists, I have an honest question:
Hypogonadal male s/p radical prostatectomy. PSA undetectable, no mets, negative margins. Why are we reluctant on “allowing” him to get back on testosterone?
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Today I had one of the most difficult and frustrating cases in a while.
When it comes to surgery, always stay humble. Surprises can arise at any moment.
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I wish to personally congratulate my mentor (and LEGEND), Dr Run Wang for receiving the Distinguished Service Award. We are all grateful for his contributions and dedication to the field of Sexual Medicine.
@MDAndersonNews
@UTHUrology
@SMSNA_ORG
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To all fellow dudes out there:
1. Having Estrogen in your body is normal.
2. Its level does not need to be ZERO
3. It will not make you cry motr during movies.
(If you cry during the movie, congratulations! You are human 👌)
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Honored to have
@javier_piraino
from
@MayoUrology
join us this week for some IPP and complex Peyronie’s cases!
Midway through I found out
@mjziegelmann
was spying 🕵🏽♂️ on us…. Thanks for sending him over!
We had a great time 😎
🍆🦖 unleashed!
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Insurance companies made $billions$ during the pandemic when many did not seek healthcare while still paying their premiums and government covered covid-related expenses, and now that people seek healthcare… they will raise the rates. 😬😬🤦🏻♂️
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3 implants, 1 plication. Done before 3pm without a swing room...
And the best part...
Enough time to celebrate my daughter’s 1st birthday 🥳🙌🙌
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Honored to have the opportunity to talk at the
@USC_Urology
Grand Rounds about the use of Social Media as a Urologist and How we can optimize IPP outcomes outside of the OR.
Thanks to
@DrLohDoyle
for the invitation 🙏🙏.
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81 yo: doc, this
#Testosterone
Ive been taking for a year is great
Me: how so?
Pt: my mind is sharper, losing fat, muscles are stronger. Even my doc told my diabetes and cholesterol are better
Me: really??
Pt: “let me show you”
Had to take a picture. 81 years old...
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Sildenafil could be used to treat Alzheimer’s disease.
🧐💪🏽💪🏽
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When you have a grown man with
#ErectileDysfunction
cry in clinic, not because he’s unable to satisfy himself, but because he is unable to satisfy his wife... told him “I assure you, we will get you there!”... what we do is priceless.
#LovetheWork
#Sexmed
#GatekeepersofMen
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And we are in for a ride😍.... sexmed urologist w a baby girl...
Black Friday’s checklist:
1. need to buy another phone
2. Book on how to answer: “daddy what do you do for a living?” 😖😰
Any recs????
Twitter family... I am excited to announce that our family is growing by 1!!
In this Thanksgiving day: we will find out the gender.
Tell us: 🐝 what will it bee 🐝???
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Watching someone try to irrigate a 16-Fr 3 way catheter
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If you’ve ever wondered what are the differences between the AMS 700 and Coloplast Titan penile implants: check this video out!
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#UroTwitter
Check out how the tunica albuginea (held by the stay sutures), separates from post priapism intracorporeal fibrosis (held by forceps).
@alextatem
@kjdelay1
@SPuro88
@UroCoop
@AshleyGWinter
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To all my SexMed/Andrology/Infertility colleagues:
What you do in healthcare is AMAZING. You are TRANSFORMING lives and restoring self-worth/confidence and relationships.
Ignore everyone who makes you think or feel otherwise. You are providing health. 🙏
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Just finished recording
@_backtableUro
podcast on management for Peyronie’s Disease. Hosted by
@drjesilva
Always fun to record these. Stay tuned!
I think We traumatized (but at least educated) our production tech. 😎
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Finally got my hard copy! A great guide and must read for reconstructive and prosthetic urologists! Honored for the invitation to contribute 🙌🙌
#UrosoMe
@SocietyGURS
@supsorg
@SMSNA_ORG
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Sometimes it only takes ONE call to screw up your entire day… this is what hospital admins don’t understand.
Knowing you MIGHT get called in, needs adequate compensation, not a minimized ‘fair-market’ value
#WhenOnCall
#medtwitter
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Excited to share the latest in Peyronie’s Disease in this year’s
@smumexico
session at
@AmerUrological
Meeting.
Best part about it: En Español! 😎
No te lo pierdas!
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Who’s life just got easier? 🙋♂️
Coloplast: about time!!!
@urol11
@faysal_a_yafi
@SPuro88
@kjdelay1
@AramLoeb
@alextatem
@AmyPearlman1
@kingurology
@mjziegelmann
@PBajicMD
@Coloplast_MD
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Im still surprised that many men taking alpha blockers are never informed about the risk of anejaculation.
Ive found this to be FAR more common than hypotension and ‘floppy iris syndrome’ that we are often asked about in exams.
Sex Matters?
Thoughts?
@kentdelay
@alextatem
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Wake up and see
#DickPicAlternatives
trending
#1
today. We have been summoned!
The urologist’s Bat-signal
#SexMed
#MensHealthMonth
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2021: I met a Hispanic man with ED and recurrent UTIs who was dependent on an SPT after complications from a prostate sc. The guy was living in the street, hopeless…
With the help of
@UroCoop
, now s/p BN recon, SPT off, UTIs gone and ecstatic with his IPP, and has a HOME!🙌
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I wish to announce a new record in my practice... placed a 32cm IPP.
I couldn’t believe it!
Interested to know what others out there have witnessed?
@kingurology
@alextatem
@SexHealthMD
@PBajicMD
@mjziegelmann
@AramLoeb
@supsorg
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@dremilyportermd
Will definitely let you know if someone is insightful or clueless about what women go through.
Maybe 5th date. 🤷🏻♂️… 😂
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Not like the big shots, but hey…. I’m proud to be part of 7 abstracts accepted for the
@SMSNA_ORG
meeting.
Thanks to those who helped prepare these! Boom!
@Kareim_UroMD
@AmyPearlman1
@alextatem
@JaganKansalMD
@FMilhouseMD
@drrachelrubin
Private practice can also research😎
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Honored to have contributed a chapter to this book. Looking forward to reading everyone’s contributions!
Congratulations to
@SaveYourSexLife
and Eduardo Miranda for the publication.
We have it! An entire book on Penile Implant Surgery
#sexmed
@SMSNA_ORG
@ISSM_INFO
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Today we used the Distal Biologic Cap technique to prevent device erosion.
Thanks to E.Karpman and
@urol11
for coming up with this one 👌
@SMSNA_ORG
@supsorg
#sexmed
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Thanks
@LatinXUro
for sharing my story. 💪🏽
Physician Spotlight Series featuring Dr. Jonathan Clavell!
@clavelluro
is a urologist and men’s health specialist. He completed his fellowship training in Sexual Medicine and Prosthetic Urology at the UT McGovern Medical School and MD Anderson Cancer Center in Houston, TX.
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Ok.. PSA to everyone in healthcare:
TESTOSTERONE is not a dorect indicator of ERECTILE FUNCTION.
Yesterday I saw 2 men w 1ry complaint of ED being treated at T-clinics. Increasing doses for IM Testosterone at supraphysiologic levels...
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Amazing success story:
71 yo male w BPH, failed Urolift, presented w urinary retention (on CIC retaining 900cc!).
Discussed options, possibility of underlying bladder dysfunction, and he Decided to go w
#Rezum
…. Now catheter free, with post void residual of 10mLs.
🙌💪🏽
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PSA: Gainswave has no role in the treatment of Peyronie’s disease.
Do
Not
Waste
Your Money 💰
See an expert. If not urologist=not an expert. (Hint hint)
There are many UROLOGISTS who can help you.
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We were honored to have
@PetrellaMD1
visiting us from University of Miami this week to do some IPP cases. This doc has a bright future ahead!
#dickasaurus
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Woke up tired/uninspired/unmotivated today. Then:
2nd patient in clinic “doc, cheer up. I am so grateful for what you’ve done. You changed my life”.
Gave me the motivation I needed. We make a difference in people’s lives.
#Restoremenshealth
#GatekeepersofMen
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During fellowship, I often heard my mentor () tell patients “I’ll make you Tiger!” And here I am... Watching
#TigerKingNetflix
with my 🐅 Shirt.
Shout out to all the
#TigerMakers
out there! We will soon roam free again!
#Covid_19
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Attempting to manage a practice, maintain a high volume surgical practice, research, education, lectures at medical societies and peer reviews
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Re-post
Are my testicles black?

A suspected Covid-19 male patient is lying in bed in the hospital, wearing an oxygen mask over his mouth and nose. A young student female nurse appears and gives him a partial sponge bath.
"Nurse,"' he mumbles from behind the mask," 1/
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Today would’ve been a great day to train someone…
- IPP w plaque incision/grafting
- IPP w plication
- IPP with mini-sling
- IPP (straightforward)
Love what we do. 🙌💪🏽
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Today: diabetic patient on metformin for 5+ years... taken off his diabetes meds AFTER his
#testosterone
levels were optimized. Feels great and living healthier than ever.
Best part of it.. his PCP recognized that TT played a role!
@rachelsrubin1
@DrMorgentaler
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It’s been 35 days since I stepped into an operating room...
#Telemedicine
#UroSoMe
#SocialDistancing
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I’m sick of hearing men with ED only want “it resolved” to satisfy themselves.
Believe it or not: they are more concerned about satisfying/pleasing their partner.
(Same goes with premature ejaculation)
#sexmed
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They did it! Proud Husband/Father😎🤰😎
#MiamiMarathon
#MiamiHalfMarathon
Baby🤰runs half marathon before father. They are ready for tomorrow! 💪🏽🙌💪🏽
#MiamiMarathon
#marathonbaby
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Honored to be a part of this amazing group of faculty for this course.
PS- I think I was a trainee 70% of the time. Learned so much!
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I wholeheartedly agree!
Medical device reps in the operating room allows for better patient outcomes and safer surgery.
The Sexual Medicine Society of North America releases the following position statement on the presence of device company representatives in the operating room:
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Check out our latest video:
Penile Plication for treatment of Peyronie's Disease
💪🏽💪🏽
@BeatPeyronies
#peyronies
#RestoreMensHealth
@SMSNA_ORG
@jsexmed
@ISSM_INFO
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Just finished one of my toughest cases to date. IPP 4 years after Priapism.. Had to use many tricks and tools in the armamentarium... but so satisfying to see the end result!!
💪🏽
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Not at
#smsna22
, but sharing SexMed experiences nevertheless…. This time with my Puerto Rico 🇵🇷 colleagues 💪🏽💪🏽
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