F.A.Q. FOR MEN

The National Institute of Health (NIH) defined impotence as: “the inability to achieve or maintain an erection sufficient for satisfactory sexual performance.”

Cannot have an erection hard enough or maintain long enough for penetration. For those who have Peyronie’s disease, even if they have erection the penis may be too bent or painful for penetration and cannot have normal sexual function.

Many studies have shown that as many as 50% of males over 40 years old are affected to varying degrees of erectile dysfunction. Anyone under 40, would be considered young to have erectile dysfunction.

Erectile dysfunction has a multifactorial etiology. This includes organic, physiologic, endocrine, and psychogenic factors are involved. Pure psychogenic erectile dysfunction is uncommon; however, many patients with organic erectile dysfunction may also have a psychogenic component. Regardless of the causes, suffice it to say that erectile dysfunction is the result of inadequate arterial blood flow into the erection chambers (corpora cavernosa) or the inability of the chambers to prevent blood from flowing out during erection.

Yes, there is, but pure psychogenic erectile dysfunction is uncommon; however, many patients with organic erectile dysfunction may also have a psychogenic component.

The best treatment is the one that takes care of the root of the problem. First, you must take care of the patient’s general health. If he is diabetic, you must take care of the diabetes. If he has low testosterone, it must be replaced. Personal lifestyle is important. He must not drink or smoke too much. Then the problem at hand, erectile dysfunction, must be dealt with. ED is due to inadequate inflow of blood into the penis and excessive flow of blood out of the penis, or both. The ManWave treatment uses low intensity shock wave to get rid of plaques which are blocking the blood vessels. It also induces new blood vessel formation. The Priapus shot brings in a lot of growth factors, regenerative and stem cells to the area and cause new blood vessels formation. All these rejuvenate the penis and increase the circulation to the area. More than 70% of the patients respond well to this treatment. The ones that do not, will most likely not respond to other non-surgical treatments, and these patients are most likely good candidates for penile implant surgery.

ManWave is a low intensity shock wave generated by a highly sophisticated machine made by Zimmer in Germany. The waves are sent through the skin into the penis and dislodge the micro-plaques thereby unblock the blood vessels supplying the erection chambers of the penis. It also causes new blood vessels formation by a process called vascular neogenesis to improve the overall circulation of the penis facilitating a better erection. It is completely pain-free, no surgery and no drugs.

It is a treatment invented by Dr. C. Runels consisting of injecting concentrated platelet rich plasma (PRP) into the erection chambers of the penis as well as the head of the penis to increase circulation resulting in better erection and sensitivity of the penis. Dr. Liu uses an enhanced version of the Priapussshot consisting of high concentration of PRP and may add Amnion as well.

It is a treatment protocol combining the ManWave and an enhanced PriapusShot for the treatment of erectile dysfunction.

By increasing the circulation and sensitivity of the penis, erection and sexual experience are enhanced.

These are very commonly asked questions. A lot has been written about them but none of them have shown scientific answers as to their effectiveness in treating ED. Discussions include panax ginseng, rhodiola rosea, DHEA, L-arginine,nitric oxide, acupuncture, yohimbe, certain yoga posts, weight loss and so on. If you are interested in learning more, search in www.healthline.com, www.medscape.com and others.

Using a vacuum pump to inflate the penis followed by a constrictive band at the base of the penis to keep the blood in the penis resulting in an erection is used by many with some success. However, this is not satisfactory to many patients and most of them discontinue using it after a few months.

Surgeries for penile implants are very well accepted by the patients. However, it should not be considered unless all non-surgical treatments have not been satisfactory.

It is a very advanced and sophisticated ultra sound machine, which can detect direction and velocity of blood flow inside the penis during an erection. It can help determine the severity of the erectile dysfunction by determining the amount and velocity of arterial inflow and venous outflow.

PD is a condition in which plaques or scarring occur in the lining of the erection chamber of the penis, resulting in curving of the penis during erection, often accompanied by pain with or without erection. Very often the patient cannot have sexual intercourse. The cause of the disease is unknown, but likely to be the result of repeated injuries to the area causing scar formation, or it could be an auto-immune disease. Depending on the severity of the disease, treatment may consist of oral medication, direct injection of collagenase to dissolve the plaque, vacuum devices to straighten the penis, low intensity shock wave treatment together with PRP injection or surgery to remove the plaques and straighten the penis. Often, there is concomitant erectile dysfunction and insertion of penile implant may be indicated.

This is a complicated problem. If you think you may have this condition, please make an appointment to see me in my office for a free consultation. I will examine you carefully and, if indicated will do an ultrasound evaluation of your penis to see the extent of the disease and plan with you the appropriate treatment.

Penile implants are completely invisible from the outside. The recipient can have erection at will, he can have erection for as long as desired, he can have normal sensation and can have a normal orgasm and can have normal fertility. The complication rate is low consisting mainly of infection and extrusion.

There are two main types of penile implants, a semi-rigid malleable implant and an inflatable implant. The inflatable one is more satisfactory to most. However, if the patient is not dexterous enough to work on the inflation process, as in patients with severe arthritis, then a malleable implant should be considered.

All patients require different implants and is a case by case basis.

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