What is an Erectile Dysfunction? with Dr. James E. Renehan

Erectile dysfunction (ED) is a man’s inability or difficulty to get or keep erections that are firm enough to enable sexual intercourse.

While occasional ED is very common in men, particularly during times of stress, depression or fatigue, frequent ED can really ruin a man’s life. For instance, some men with erectile dysfunction may avoid contact with their partners for fear that they will have trouble satisfying them sexually in the bedroom while others may get into a complete emotional and psychological meltdown.

Forms of erectile dysfunction

According to Dr. James E. Renehan of Advanced Urology Institute, erectile dysfunction can take a variety of forms. For example, some men may be unable to get an erection under any circumstance, while other men with ED may occasionally get an erection. In other men, getting an erection is possible but the erections are not strong enough for satisfying sexual intercourse.

“Erectile dysfunction does not mean that you are infertile,” says Dr. Renehan. “In fact, the majority of the men having difficulties with getting an erection are still quite capable of achieving an orgasm and getting children. ED just means that you cannot consistently get or sustain an erection.”

What are the symptoms of erectile dysfunction?

You could be suffering from ED if you frequently have:

  1. Difficulty getting an erection.
  2. Trouble sustaining an erection throughout sexual intercourse or during sexual activities.
  3. Diminished interest in sex.

However, there are also a number of factors related to erectile dysfunction, such as:

  1. Premature ejaculation.
  2. Difficulty achieving orgasm even after ample stimulation (anorgasmia).
  3. Delayed ejaculation.

Experiencing such symptoms for 2 or more months may indicate that you have erectile dysfunction. So it is important to speak with your urologist to determine if you have a sexual disorder.

“Men should know that erectile dysfunction is not in the head,” says Dr. Renehan. “You will not simply get an erection by stimulation, as 80 percent of all cases of ED are usually caused by treatable physical disorders, such as high blood pressure, high cholesterol or diabetes. So make sure you visit your doctor for advice.”

Causes of erectile dysfunction

Erectile dysfunction may have several possible causes, including both physical disorders and emotional problems. The most common causes are:

  1. Diabetes
  2. Obesity (being overweight)
  3. Smoking, alcohol use or drug abuse
  4. Hypertension
  5. Cardiovascular disease
  6. Hyperlipidemia
  7. Injuries
  8. Stress, anxiety or relationship problems
  9. Damage from surgery or cancer treatment
  10. Increased age

Because there are many possible causes of erectile dysfunction, it is important to work with a urologist so that any underlying medical conditions are identified and treated.

Diagnosis of erectile dysfunction

When you visit your urologist, you will be asked questions related to your symptoms, health history, emotional and physical problems. You also should expect a physical examination in which the doctor will listen to your lungs and heart, examine your penis and testicles and measure your blood pressure. The doctor may order various tests to determine whether you have an underlying disorder, such as blood and urine tests. A rectal examination may be requested to check your prostate.

Treatment of erectile dysfunction

The treatment chosen by your doctor will depend on the type of symptoms and any underlying causes for the dysfunction. At times, a combination of treatments may be necessary. The most common treatments for ED include:

  1. Medications: The doctor may prescribe medications to improve blood flow to the penis and improve ED symptoms. The drugs commonly indicated include Alprostadil (Caverject), Avanafil (Stendra), Sildenafil (Viagra), Tadalafil (Cialis), Testosterone (Androderm) and Vardenafil (Levitra).
  2. Talk Therapy: If it is established that the erectile dysfunction is caused by psychological factors such as stress, depression, anxiety or post-traumatic stress disorder, the urologist may recommend that you see a therapist. Working with the therapist, you will attend several sessions in which you will be helped to recover from stress, anxiety, subconscious conflict or negative feelings around sex. A relationship counselor also may be called upon if the ED is affecting your relationship.
  3. Alternative Treatments: Treatments such as prostatic massage, acupuncture, yoga and pelvic floor exercises also may improve your condition. Likewise, lifestyle and diet changes, such as regular exercise, losing weight, lowering your blood pressure and avoiding cigarettes and alcohol can be recommended to help you overcome erectile dysfunction.
  4. Surgery: When medications and exercises fail to work, the urologist may perform a surgery to correct any problems in the penis or to add a penile implant. Penile implants help to generate spontaneous and controlled erections.

Erectile dysfunction is treatable

Most cases of erectile dysfunction are treatable. At Advanced Urology Institute, we have helped thousands of men to improve their symptoms and regain their confidence through compassionate, multidisciplinary, patient-centered treatment approaches. Depending on your condition, we will administer the right medications or treatments to ensure that you achieve an erection and be able to have satisfying sexual intercourse. Come and discuss your symptoms with us so we can fix your problem. For more information on help with erectile dysfunction, visit the “Advanced Urology Institute” site.

What is Da Vinci Robotic Prostatectomy?

The da Vinci system is a revolutionary, minimally-invasive surgical robot for treating prostate cancer. Designed by Intuitive Surgical to help overcome the shortcomings of both the traditional laparoscopic prostatectomy and open prostatectomy, the da Vinci system enables a surgeon to conduct highly precise, nerve-sparing surgery using several dime-shaped incisions. With the da Vinci surgical procedure, entire cancerous tissue or prostate can be removed, cancer completely eradicated and internal repair achieved without interference with sexual function, potency and bladder control.

Also called robotic prostatectomy, the da Vinci uses a finely-controlled robotic apparatus, including micro-surgical instruments and high-resolution cameras, to perform prostate surgery safely, achieving faster patient recovery and better treatment outcomes.

High-Precision Prostatectomy

During da Vinci robotic surgery, urologists use the “motion scaling” feature on the system to convert subtle hand movements made outside the body into extremely precise and accurate movements inside the body. The urologist controls the robotic arms of the da Vinci console by applying natural wrist and hand movements. Through motion scaling, filtration and seamless translation of hand-and-wrist movements, the urologist can achieve greater precision that is normally not achievable during traditional laparoscopic and open surgery procedures. The da Vinci system not only provides urologists with enhanced dexterity, range of motion and flexibility, but also enables surgeons to safely access difficult-to-operate areas of the pelvis, abdomen and closed chest. The robot also filters and eliminates unpredictable hand movements and hand tremors that may occur during the operation.

Computerized 3-D Visualization

The da Vinci system dramatically improves visualization by providing a sharper and brighter view than can be seen during traditional laparoscopic endoscopes and by the eye during open surgery. The robotic system comes with a proprietary camera, enabling the surgeon to zoom in, rotate and even change image visualization. As a result, the 3-D image produced is clearer and brighter, and with no flickers as seen in traditional laparoscopic systems.

Even though the da Vinci robotic prostatectomy is a remote procedure, urologists have the feeling that their hands are fully immersed in the body and are able to complete all the necessary procedures efficiently. With the 3-D visualization and robotic hand simulation, the da Vinci system enables urologists to perform highly complex procedures more effectively than traditional laparoscopic surgery or open surgery.

Getting da Vinci Prostatectomy at Advanced Urology Institute

At Advanced Urology Institute, the da Vinci prostatectomy patients are usually discharged 24 hours after their operation. The system is used at AUI because it has superior benefits to traditional laparoscopic prostatectomy or open prostate surgery. The benefits of the da Vinci prostate surgery include:

  1. Reduced pain and higher nerve-sparing rate.
  2. Shorter hospitalization, with most patients going home the next day.
  3. Minimal blood loss, fewer transfusions and reduced risk of complications (such as impotence and incontinence).
  4. Quicker return to pre-surgery erectile function and urinary continence.
  5. Faster return to routine activities.

Are you looking for a da Vinci urologist near you? You can check out this life-changing technology at Advanced Urology Institute. For more information, visit the “’Advanced Urology Institute” site.

Types of Prostate Cancer

Prostate cancer refers to an uncontrollable accumulation of cells in the prostate gland. When the cancer occurs it means the ability to control the multiplication, growth and death of prostate cells has been lost. The prostate cells form abnormal cells that join into masses known as tumors. Once formed, a tumor can remain at its original location and not spread to any location outside the prostate. Such a tumor is called a primary tumor. But some spread to other areas of the body outside the prostate and are called secondary tumors.

Prostate Cancer Is Generally Slow-Growing

Most prostate cancers are relatively slow-growing. This means that a prostate tumor typically takes many years to grow and reach a size that is detectable. Likewise, it usually takes even a longer time for prostate cancer to spread beyond the prostate. Nevertheless, in a small percentage of men, prostate cancer can grow rapidly and spread aggressively to other areas. Because of this, it is quite difficult to know with certainty which prostate cancers are likely to grow slowly and which ones are likely to grow aggressively. It can be quite difficult to make the right treatment decisions.

Aggressive Versus Indolent Prostate Cancer

While there are many types of prostate cancers, urologists usually break them down into aggressive and indolent categories to make it easier to determine the right treatment and to treat various types of cancers effectively. Aggressive cancer is a high-risk prostate tumor that if not treated remains highly active and very likely to spread to areas outside the prostate gland. The cancer grows quickly, spreads early, rapidly and widely, and causes increased damage in the body. Because aggressive cancer spreads as secondary deposits and can quickly result in widespread damage, it progresses rapidly to advanced stage cancer and can be very difficult to treat. So for aggressive prostate cancers to be treated successfully, they should be diagnosed early and treatment should be started when the tumors are still in their early stages.

On the other hand, indolent prostate cancer is a low-risk, slow-growing and low-volume tumor that can sit in the prostate gland for many years without causing any problems. An indolent cancer is not likely to spread outside the prostate even if not treated. But if it does, the spread will be local and slow. In fact, patients with indolent prostate cancers can live for 10-20 years without the cancer causing any serious effects on their lives.

Identifying Aggressive Prostate Cancer

When a patient is diagnosed with prostate cancer, the urologist will take a biopsy of the prostate gland to make sure the cells are checked under the microscope to determine whether the cancer is aggressive or indolent.

Various cancer cells are examined and their activity graded using the Gleason score. When the microscopic exam returns a Gleason score greater than 7 for cancer that has not spread beyond the prostate, the cancer is classified as aggressive and the patient is given the appropriate treatment. However, if the Gleason score is 7 or below, the prostate cancer may be classified as indolent, depending on other patient factors.

The Gleason score also helps the urologist to decide the appropriate treatment. For instance, if it is an early-stage, slow-growing cancer with a score of 6 or below, the urologist may recommend active surveillance, which means that treatment is postponed and the patient is closely monitored for progress, such as whether the tumor is spreading or worsening. But to determine whether active surveillance is ideal, the urologist also will have to consider factors such as the patient’s life expectancy, overall health and concomitant illnesses. For aggressive cancer, the urologist will work with other doctors to create a treatment plan.

At Advanced Urology Institute in Florida we have a knowledgeable and experienced team of urologists to help diagnose and treat all types of prostate cancers. Our multidisciplinary approach to treatment ensures that even the most aggressive forms of cancer are treated safely and effectively. For more information on the screening, diagnosis, treatment, care and support for prostate cancer, visit the “Advanced Urology Institute” site.

New Treatment Options for Erectile Dysfunction

Statistically, 50 percent of all men experience erectile dysfunction (ED) at some point of their life, with the risk of ED increasing with age. Roughly 30 million men in the United States suffer from ED, a condition that causes frustration and the breakdown of marriages and self-confidence.

Evolution of Erectile Dysfunction Treatments

Over the years, the medical management of erectile dysfunction has evolved greatly. For instance, before oral phosphodiesterase inhibitors (PDESi) like Cialis, Standra, Viagra, Levitra and related medications were introduced, doctors could administer one of only two effective treatments for erectile dysfunction: surgical penile revascularization and implantation of a penile prosthesis.

The emergence of Viagra and related oral drugs for ED ushered in a new age of non-invasive treatment of the condition. These drugs relax the muscles in the penis and increase blood flow, allowing patients to have an erection. However, while these drugs are helpful for many men, they are not safe for men with high blood pressure, severe liver disease, kidney disease, or who take nitrate drugs. The drugs also come with side effects such as a runny or stuffy nose, dizziness, fainting and blurred vision. Because of these limitations, doctors have continuously looked for new treatment options for erectile dysfunction.

New Treatment Options

New treatment options for ED include:

  1. Injection therapy: Drugs such as alprostadil (sold under the names Edex, Caverject and Prostin VR) and the suppository-form of alprostadil (sold as MUSE) are currently available to patients. Alprostadil causes expansion of blood vessels and increased blood flow to the penis, enabling patients to get erections.
  2. Extracorporeal shock-wave therapy (ESWT): Also called acoustical wave therapy or linear shockwave therapy, ESWT uses high-frequency acoustical waves for treatment of the root cause of ED. During treatment, the waves are used to open and repair blood vessels in the penis. The therapy improves blood flow in the penis by creating new blood vessels or rejuvenating existing ones, which in turn increases the patient’s ability to get an erection.
  3. Melanocortin activators: These drugs stimulate erection by acting through the central nervous system. For instance, the drug PT-141 is effective in stimulating erection when given through the nose to men with mild-to-moderate non-medical (emotional or psychological) erectile dysfunction.
  4. Topiglan: This is a cream that is applied to the penis. Topiglan contains alprostadil, the same drug that is injected or applied as suppository by men with ED.
  5. Uprima (apomorphine): Working to stimulate the secretion of the brain chemical dopamine, Uprima heightens sexual interest and increases sensations. It comes in tablet form that easily dissolves under the tongue. However, because of its major side effects of nausea and vomiting, research is still going on to find a nasal spray alternative that causes less nausea but is equally effective.
  6. Gene therapy: The therapy delivers genes that help generate proteins or products that can replace those that are not functioning well in the penile tissues of men with ED. While experimental use of gene therapy has reported tremendous success, regulatory approval and the public’s acceptance of the therapy may still take some time.

If you are suffering from erectile dysfunction, consider your options carefully. Talk to your urologist openly. Effective treatment of ED can improve your quality of life, ability to maintain intimate relationships and boost your self-esteem. At Advanced Urology Institute, we are always improving our range of treatment options to give the very best to our patients. When you visit our urology center in Florida, you can be sure that you will have a broad range of treatment options, including the very latest, for erectile dysfunction. For more information on diagnosis and treatment of erectile dysfunction, visit the “Advanced Urology Institute” site.

8 Easy Ways to Cleanse Your Kidneys

The kidneys are amazing little organs. Each day, they process about 200 quarts of blood, getting rid of excess water and waste products, removing toxins and keeping the body functioning smoothly. If the kidneys are not able to remove toxins and waste from the body, they will build up in the body and hinder the normal function of kidneys, liver and other organs, resulting in exhaustion, stomach pain, headaches, water retention and other problems. Buildup of toxins and waste also may lead to kidney stones, a mass of crystals or unprocessed minerals which can grow to the size of a golf ball. Kidney stones affect 10-15 percent of American adults, but also may be found in children as young as five.

Kidney stones causes and symptoms

There are many causes of kidney stones, such as dehydration, excessively acidic urine, urinary tract infections, buildup of waste and toxins in the kidneys, among others. The symptoms of kidney stones include excessive lower back, abdominal or urinary tract pain which may be sharp, mild or excruciating, severe vomiting or feeling nauseated, persistent urge to pass urine, and constant chills or sweating. While the symptoms vary depending on the size of the stones, unceasing pain and discomfort on the sides is a good reason to see a urologist. Kidney stones are easily curable if diagnosed early.

Why you should cleanse your kidneys

There are several reasons why you should flush out toxins and waste from your body. For instance, cleansing your kidneys improves their function and reduces bloating. Likewise, cleansing your kidney improves your ability to process certain foods, absorb nutrients and convert food to energy, preventing fatigue. Flushing out waste and toxins prevents potential infection and reduce the risk for bladder problems. Similarly, cleansing the kidneys reduces the chances of having painful kidney stones, corrects hormonal imbalances and prevents skin breakouts such as acne, eczema and rashes.

Below are 8 easy ways to cleanse your kidneys

1. Apple Cider Vinegar

Apple cider vinegar is effective in preventing oxidative stress of the kidneys. It increases the levels of antioxidants in the body, balances blood sugar levels and reduces blood pressure, creating optimum conditions for kidney health. Apple cider vinegar contains citric acid which dissolves kidney stones. Frequent intake of apple cider vinegar also flushes out toxins from the kidneys.

2. Kidney Beans

Kidney beans not only resemble the kidneys but also remove waste and toxins from the kidney and flush out kidney stones effectively. Kidney beans are rich in Vitamin B, fiber and several minerals which help to clean the kidney and boost the function of the urinary tract.

3. Lemon Juice

Lemon juice is naturally acidic and increases citrate levels in urine, hence discouraging the formation of kidney stones. Lemon juice also filters blood and flushes out wastes and other toxins. Daily intake of diluted lemon juice reduces the rate of kidney stone formation and dissolves calcium oxalate crystals, which is the most common constituent of kidney stones. For people with kidney stones, combining lemon with olive oil ensures smooth passage of the stones.

4. Watermelon

Watermelon is a mild diuretic. It hydrates and cleanses the kidneys. It is also rich in lycopene, which improves cardiovascular health and ensures well-functioning kidneys. Watermelon also has large quantities of potassium salts which regulate acidity of urine and prevents stone formation. In fact, eating watermelon regularly is great for kidney health.

5. Pomegranate

Both the juice and seeds of pomegranate contain large amounts of potassium and therefore are effective in removing kidney stones. Potassium lowers acidity of urine, prevents stone formation because of its astringent properties, curtails crystallization of minerals, and flushes out toxins and waste from the kidneys.

6. Basil

Basil is an effective diuretic. It removes kidney stones and improves kidney functioning. Basil also lowers the level of uric acid in blood and improves kidney health. Its ingredients such as essential oils and acetic acid break down kidney stones and allow for smooth removal. Basil is also a pain killer.

7. Dates

When dates are soaked in water for 24 hours and then consumed after seeds are removed, they are effective in dissolving and flushing out kidney stones. Dates are rich in fiber, helping to reduce the risk of kidney stones. The magnesium ingredient in dates also cleanses the kidneys.

8. Dandelion

Consuming tea made using dried organic dandelion or fresh dandelion root (pulled from the ground) helps to cleanse the kidneys. Dandelion is a kidney tonic, but also stimulates bile production to improve digestion and minimize the waste reaching the kidneys.

Another effective cleansing agent for the kidneys is cranberry juice which supports the urinary tract, fights urinary tract infections and removes excess calcium oxalate. Beets and their juices contain Betaine which increases urine acidity, prevents build-up of struvite and calcium phosphate and reduces the chances of kidney stone formation. Other effective cleansing agents are coconut water, cucumber juice and cherries. For more information on preventing and treating kidney problems, visit the site, Advanced Urology Institute.

What is Prostate and Prostate Cancer?

The prostate gland is a chestnut-shaped male reproductive organ located below the urinary bladder and surrounding the upper portion of the urethra, the duct that allows passage of semen and urine. It is a conglomerate of secretory ducts that emit fluids into the urethra and ejaculatory ducts. The prostate produces a thick, white fluid which mixes with sperm from the testicles to create semen, contributing 15-30 percent of the semen secreted by a man. The gland also produces a protein known as prostate-specific antigen (PSA), which turns semen into liquid. While the prostate matures into a small, walnut-sized gland at puberty, usually between 10-14 years old, it will still grow slowly with age. However, prostate enlargement after age 50 may lead to urinary problems, often occurring as a result of inflammation or malignancy.

Prostate Cancer: What is it?

Prostate cancer is a disease that occurs when changes in prostate cells make them grow uncontrollably or abnormally. The abnormal or cancerous cells then may continue to multiply non-stop and even spread outside the prostate into nearby or distant areas of the body. Prostate cancer is rare before age 50, but is common among older men and is the second most frequent cause of all cancer-related deaths in American men. The disease is typically slow growing, often showing no symptoms until it reaches advanced stage. Hence, most men with the cancer will never know it and will just die of other causes. Nevertheless, when prostate cancer starts to grow and spread quickly, it can be very lethal and requires prompt treatment.

Causes of Prostate Cancer

Prostate cancer occurs mainly in older men, with more than 80 percent of cases seen in men older than 65 and less than 1 percent observed in men younger than 50. Men who eat lots of high-fat diets such as red meat have a higher risk of getting the disease. Studies have shown that the disease is more common among men who consume meat and dairy products regularly than in those who eat vegetables, rice and soybean products. Fats increase the amount of testosterone in the body and in turn speed up the growth and spread of prostate cancer. Men from families with a history of the cancer are at a higher risk, as are welders, rubber workers, battery manufacturers and men frequently exposed to metal cadmium. Failure to exercise regularly also may make the cancer more likely.

Symptoms of Prostate Cancer

Prostate cancer tends to show no symptoms in the early stages, but will show some symptoms in the later stages. Common symptoms include sudden or frequent urge to urinate, trouble starting a urine stream or knowing when to urinate, pain or discomfort when urinating, blood in urine or semen, and pain in the upper thighs, lower back or hips. While these symptoms may not necessarily mean you have prostate cancer, you should see a urologist or GP when you have any of them.

Diagnosis and Treatment

When you visit a urologist, a medical history and physical examination will be performed followed by a digital rectal exam (DRE) and PSA test. If the doctor detects that you are at risk of prostate cancer, a biopsy will be requested to confirm it. There are several treatment options for prostate cancer including active surveillance (watchful waiting), surgery, radiation therapy, cryotherapy, hormone therapy, chemotherapy and bone-directed treatment. Remember that early diagnosis and treatment of prostate cancer improves your chances of survival. For more information on treatment of prostate diseases, visit the site, Advanced Urology Institute.

Most Common Forms of Prostate Diseases

Located just beneath the bladder and in front of the rectum, the prostate is a tiny gland in men that helps to make semen. It is a walnut-sized gland in young men which is wrapped around the tube carrying urine away from the bladder. The prostate grows larger with age, but when it becomes too large medical problems may arise. For men older than 50, the risk of having prostate related problems is quite high.

The most common prostate diseases are:

  • Prostatitis: Inflammation of the prostate, often caused by bacteria.
  • Enlarged prostate (BPH): Benign prostatic hyperplasia is a frequent problem in older men and is characterized by the frequent urge to urinate (especially at night) and dribbling after urination.
  • Prostate cancer: A common cancer in men which responds well to early treatment.

Benign prostatic hyperplasia (BPH)

This is the most common prostate disease found in men older than 50. BPH occurs when the prostate gland has enlarged to the extent of squeezing the urethra and obstructing the flow of urine from the bladder. Benign prostatic enlargement only means the prostate has enlarged, but there is no cancer. It is treated using active surveillance or watchful waiting when symptoms are not severe, but medications or surgery may be needed in severe cases. Other treatments such as microwaves, radio waves and lasers also may be used.

Prostatitis

Inflammation of the prostate (prostatitis) is frequent in men older than 50. There are three forms of prostatitis: acute bacterial prostatitis, chronic bacterial prostatitis and chronic prostatitis. Acute bacterial prostatitis has sudden onset after a bacterial infection and is characterized by chills, fever and pain in addition to other prostate symptoms. A combination of antibiotics and pain medication may relieve the problem.

Chronic bacterial prostatitis is a recurrent bacterial infection of the prostate. It can be relieved by taking certain medications for a long time, but you contact your doctor immediately when symptoms occur. Chronic prostatitis (also known as chronic pelvic pain syndrome) is a common problem which causes pain in the groin, lower back and tip of the penis. It may be treated by a combination of medication, surgery and lifestyle changes.

Prostate cancer

It is the most frequent cancer diagnosed in American men, affecting almost 50 percent of men older than 70. An estimated 200,000 men are diagnosed with the cancer in the U.S. every year, but many men can live with it without problems as it causes few symptoms unless it has spread to other areas of the body. The risk of getting prostate cancer depends on age (men older than 50 are at higher risk), race (African-American men are at higher risk than Native-American), family history (you are at higher risk if your father or brother had it) and diet (more common in men who eat high-fat diets). It is highly curable when detected early. Prostate cancer is diagnosed using a digital rectal exam or prostate-specific antigen (PSA) test. Treatment options include watchful waiting, surgery, radiation therapy and hormone therapy.

Symptoms of prostate disease

You should visit your doctor if you have any of these symptoms:

  • Frequent urge to urinate
  • Painful or burning urination
  • Need to urinate several times at night
  • Painful ejaculation
  • Dribbling of urine
  • Blood in urine/semen
  • Frequent stiffness or pain in lower back, pelvic area, hips, upper thighs or rectal area

At Advanced Urology Institute, we have experienced physicians and state-of-the-art facilities for diagnosis and treatment of prostate diseases. If you have any of the symptoms above, visit us for help. For more information, visit the site Advanced Urology Institute.

Vasectomy Poses Minimal Risk of Prostate Cancer

For men who are done having children, vasectomy is an effective method for birth control. As a surgical procedure that involves the cutting, blocking or sealing off tubes that transport sperm out of the testicles, vasectomy prevents the release of sperm during sex and is therefore a long-term form of birth control. About 1 in 7 men undergoes vasectomy after the age of 35 years. However, while the procedure is fairly simple and generally safe, it has sparked controversy about various long-term risks, particularly its link to prostate cancer (PCa). The prostate gland is located just behind the tubes and adds essential fluids to semen, so there has been a longstanding fear that vasectomy may cause prostate cancer.

Does vasectomy increase the risk of prostate cancer?

A 2014 Harvard research generated panic when it associated vasectomy with a 10 percent increase in the risk of prostate cancer and a 20 percent increased risk of the aggressive form of the cancer. But according to a recent report published online in the JAMA Internal Medicine, those numbers were probably overblown. Based on a comprehensive review and meta-analysis drawing on more than three decades of epidemiologic literature, the researchers in this study demonstrated that any risk posed by vasectomy, if at all existent, is too small to be of clinical importance.

The researchers reviewed and analyzed 53 studies, including 33 case-control studies involving 44,536 men, 4 cross-sectional studies involving 12,098,221 men, and 16 cohort studies involving 2,563,519 men. The analysis revealed no significant link between vasectomy and aggressive prostate cancer, whether high-grade cancer (Gleason score of 8 or more), advanced (normally T3-4, positive nodes or metastasis), or fatal prostate cancer (PCa). And when data from 6 case-control studies and 7 cohort studies considered to be of low risk according to the Newcastle-Ottawa Scale were analyzed, a non-significant 6 percent increased risk of prostate cancer was noted in the 6 case-control studies while the 7 cohort studies gave a weak but noteworthy 5 percent increased risk of prostate cancer.
From the data, the researchers calculated the absolute increase in lifetime risk of prostate cancer for those who have undergone vasectomy. It was found that vasectomy has an absolute lifetime risk of prostate cancer of just 0.6 percent and may only be responsible for 0.5 percent of prostate cancer cases in the population. This led to the conclusion that the association between vasectomy and prostate cancer is at most trivial, clinically insignificant and should not stop the use of the procedure for long-term contraception.

Vasectomy is Safe

This study affirms that vasectomy is unlikely to substantially increase the risk of having any type of prostate cancer. It also affirms that there is no difference in development of prostate cancer between those who undergo vasectomy and those who do not. In fact, the small risk of low-intermediate tumors reported is attributed to the fact that men who get vasectomies also tend to take PSA tests for prostate cancer, which can detect early-stage disease.

If you are looking for a safe and effective form of birth control, do not let fears of prostate cancer discourage you. Vasectomy does not increase your risk of the cancer. And while more research on the causes of prostate cancer is still ongoing, you can lower your risk by maintaining a healthy weight, regular exercise, eating a low-fat diet, increasing vegetable intake, decreasing dairy intake, and quitting smoking. Talk to your urologist about what is right for you depending on your medical history.

Becoming a Urologist – Dr. David E. Burday

Individuals who have a strong interest in caring for patients suffering from urological problems and conditions can find a good career as a urologist.

“A urologist is a physician specialized in diagnosing, treating and monitoring disorders of the urinary tract and reproductive organs, such as the ureters, kidneys, bladder, urethra and prostate,” says Dr. David E. Burday, MD, a board-certified urologist at Advanced Urology Institute.

“Urologists treat men and women for injuries and disorders of the urinary tract, pelvic floor muscle problems in women and male reproductive system disorders, but do not focus on female reproductive issues as those are handled by gynecologists,” he adds.

Urologist Education

“The path to becoming a urologist is quite long,” says Dr. Burday. “You must have a four-year college degree and pass medical college admission tests before you are admitted into medical school. Then there are four years of training in subjects such as embryology, genetics, neuroscience, biochemistry and medical ethics followed by clinical rotations before you graduate from medical school.”

The next step is attending a urology residency, says Dr. Burday. “As a urology resident, you spend a minimum of five years in training, which may be divided into a two-year general surgery residency and a three-year urology residency.”

He adds, “You may spend another one or two years in a post-residency fellowship if you want to pursue a urology subspecialty like pediatric urology or urological oncology. But you must pass an exam after completing the requisite education and training requirements before you can become a board-certified urologist.”

Conditions Treated by Urologists

Urologists diagnose, treat and monitor a broad variety of medical problems, including recurrent urinary tract infections, interstitial cystitis, enlarged prostate, kidney stones, urinary incontinence, overactive bladder, prostatitis, erectile dysfunction, male and female infertility, and cancers of the urinary tract, such as prostate, testicular, kidney, penile and bladder cancers. They also handle pediatric problems such as undescended testicles and enuresis (bedwetting).

“As a urologist, you diagnose and treat many medical conditions,” says Dr. Burday. “We resolve urinary incontinence, weak pelvic floor muscles, recurrent bladder infections and prostate cancer. We also treat kidney stones, erectile dysfunction and male infertility. Some urologists may even narrow their focus into areas such as female urology, oncology urology and pediatric urology.”

In addition to medical history and physical examination, urologists may request tests such as ultrasound before they recommend any treatments. The urologist also may work with specialists such as radiation therapists, radiologists or oncologists to ensure patients get the best treatment.
“The diagnosis and treatment process depends on the condition the urologist is dealing with,” says Dr. Burday. “Typically, the urologist will do a medical history and physical exam then request a few tests before deciding on a suitable treatment. Often, the treatment will be medication, surgery, or both, but that depends on the condition.”

Necessary Skills

Urology is a challenging field that requires determination, patience, eye-hand coordination, critical thinking and good problem-solving skills. Urologists also need excellent communication skills and the ability to make their patients feel at ease and comfortable. They also must be able to work under stress and make effective decisions in emergency situations.

“If you have the right qualities and the desire to improve people’s lives by treating urological problems, then urology is a wonderful profession for you,” says Dr. Burday. “Remember there are many job opportunities for urologists and the pay is above average.”

For more information on urology, visit the site Advanced Urology Institute.

The Truth About Testicular Cancer

Testicular cancer develops when abnormal cells grow out of control in a man’s testes (testicles), which are found inside the scrotum. The testes are male sex organs that produce hormone testosterone and make and store sperm. Compared to other cancers, testicular cancer is quite rare occurring in 1 man per 100,000. Nevertheless, it is the most frequent cancer among American males ages 15 to 35 and is more frequently found in white males than Asian or African men. It is important to note that not all testicular lumps are cancer and a man may have other conditions such as testicular microlithiasis, epididymal cysts and appendix testis, all of which may be painful but are non-cancerous. Testicular cancer is very much treatable and can be treated even after spreading beyond the testicle.

Causes

While the exact causes of testicular cancer are not known, the cancer generally occurs when healthy cells of the testicle become altered. Testicular cells usually multiply in a systematic manner to keep the body functioning normally. However, abnormalities in some cells may abruptly cause uncontrollable multiplication, resulting in a surplus of new cells in the testicle. The accumulation of new cells results in a testicular mass or lump. Almost all testicular cancers start in germ cells (testicular cells producing immature sperm).

Risk factors for testicular cancer include:

  • Cryptorchidism (undescended testicles): Development of the testicles occurs in the fetal abdomen and the developed testes move down into the scrotum before birth. A man whose testicles never descended in this manner is at greater risk of having testicular cancer than those whose testes descended normally. The risk is still high even if the testes have been surgically relocated into the scrotum.
  • Abnormal testicle development: Disorders that hinder normal development of testicles, like Klinefelter syndrome, increase the risk of this cancer.
  • Age: Testicular cancer is common in teens and young men (ages 15 to 35). Nevertheless, it may still occur in older men.
  • Family history: If your father or brother has had the cancer, you have an increased risk.
  • Personal history of testicular cancer: If you have had the cancer treated in one testicle, you may develop it in the other testicle.
  • Race: The cancer is more frequent in white males than in black or Asian males.
  • Infertility: Men who do not produce sperm when ejaculating have a greater risk.

Signs and symptoms

Knowing the symptoms of testicular cancer can help you to seek treatment when the cancer is still at an early stage. The most common indicators are:

  • An enlargement or lump in either testicle.
  • Accumulation of fluid in your scrotum.
  • A dull pain or ache in the groin or abdomen.
  • The scrotum becomes increasingly heavy.
  • Discomfort or pain in the testes or on the scrotum.
  • Tenderness or enlargement of male breasts.
  • Lower back pain.
  • In rare cases, testicular cancer can spread and affect other organs resulting in coughing, difficulty swallowing, breathing difficulties and swelling in the chest.

Diagnosis of testicular cancer

A man may detect enlargement or lumps in his testicles through self-examination. A doctor can notice a lump in a testicle during routine physical examination. When an enlargement or a lump is detected, the doctor will suggest a few tests to confirm or rule out testicular cancer. The tests commonly requested are a testicular ultrasound and blood tests for tumor markers. Surgery to remove a testicle for analysis and classification of the cancer also may be performed.

Removal of a testicle is usually done to classify the cancer since it is the type and stage of cancer that determines treatment and prognosis. Testicular cancer is divided into two types, seminoma and nonseminoma. Seminoma cancer can be found in all age groups, but is more frequent in older men. The cancer is less aggressive than nonseminoma. Nonseminoma cancer tends to develop in younger men and teens and is characterized by rapid growth and spread.

Testicular cancer stages

When testicular cancer has been diagnosed, it is then important to determine the stage (extent) of the cancer. For a doctor to assess how far the cancer has spread in or outside a testicle, blood tests and computer tomography (CT) scan are requested. The results of these tests help the doctor to categorize the cancer in stages and to offer appropriate treatment. The stages include:

Stage I: Cancer that is restricted to the testicle.
Stage II: Cancer that has spread out of the testicle into the lymph nodes of the abdomen.
Stage III: Cancer that has spread to various body parts, such as liver, bones, brain and lungs.

Testicular cancer treatment

The appropriate treatment for the cancer depends on many factors, including your general health, stage and type of cancer, and your preferences. For instance the doctor may opt for surgery to remove the affected testicle or nearby lymph nodes. Alternatively, the doctor may use radiation, high-powered beams of energy, like X-rays, to treat the cancer. Another option is chemotherapy, where specific drugs are used to destroy cancer cells. For more information on testicular cancer, visit the site, Advanced Urology Institute.

Symptoms of Enlarged Prostate

An enlarged prostate, also called benign prostatic hyperplasia (BPH), is an increase in the size of the prostate. While most men have prostate growth throughout their life, not all men get bothersome symptoms. As the prostate grows it presses on the outside of the urethra and can slow down or even stop the flow of urine. BPH is common in men in their 50’s, with about 1 in 3 men above 50 years of age having urinary symptoms.

It is not clear what causes prostate enlargement. However, the following risk factors are involved:

Age – While prostate gland enlargement hardly causes symptoms in men below age 40, about a third of men in their 60’s and about half of men in their 80’s have BPH symptoms.

Hormone Levels – The balance of hormones in the body changes as men grows older, causing the prostate to grow.

Family History – Those with a blood relative, especially a father or brother, with prostate problems are more
likely to have BPH.

Ethnic Background – BPH symptoms are more common in white and black men than Asian men. Black men tend to experience BPH symptoms at a younger age than white men.

Lifestyle – Regular exercise lowers the risk of BPH while obesity increases the risk.

Diabetes and Heart Disease – The risk of BPH increases in men with diabetes, heart disease and those on beta blockers.

What are the symptoms of an enlarged prostate?

The severity of symptoms in people with BPH varies, but tends to worsen over time. Common symptoms include:

  • urgent or frequent need to urinate
  • nocturia (increased frequency to urinate at night)
  • difficulty starting urination
  • inability to completely empty the bladder
  • weak urine stream or a urine stream that stops and starts
  • straining while urinating
  • dribbling at the end of urination

The less common symptoms of BPH are:

  • inability to urinate
  • urinary tract infection
  • blood in the urine

You may never get all of these symptoms. In fact, some men with an enlarged prostate do not get any symptoms at all. In some men, the symptoms eventually stabilize and may even improve over time, while in others they may get worse. Some of these symptoms may be caused by other conditions, like anxiety, cold weather, lifestyle factors, certain medicines and other health problems. Therefore, if you have any of the above symptoms, visit your physician to find out what could be causing them.

How can a urologist help?

A urologist will take your medical history and conduct a physical exam. Depending on the severity of the symptoms, the urologist will order tests such as digital rectal exam, urine test, blood test for kidney problems, prostate-specific antigen (PSA) blood test or a neurological exam. The doctor may also request additional tests such as urinary flow test, post-void residual volume test, and 24-hour voiding diary. If the problem is more complex, the urologist may recommend a transrectal ultrasound, prostate biopsy, cystoscopy, urodynamic and pressure flow studies, intravenous pyelogram or CT urogram. If an enlarged prostate is diagnosed, the urologist has various treatment options to offer including lifestyle modifications and medicines. In severe cases, the urologist will opt for surgery. For more information and help with BPH, visit Advanced Urology Institute.

3 Effective Ways to Treat Peyronie’s Disease

Peyronie’s disease is a type of erectile dysfunction that leads to both physical and emotional scarring. It is caused by penile tissue damage resulting in the formation of scar tissue called plaque. Depending on the location and size of the plaque, the penis may bend downward or upward or become indented. The bending may occur suddenly (almost overnight) or happen gradually, beginning with soreness and lumps that develop into a hardened scar. While Peyronie’s disease is most often found in middle-aged men, it can occur at any age.
Here are 3 effective ways to treat Peyronie’s disease:

Medications

Drug therapy is helpful for most men who are affected by Peyronie’s disease, especially during the acute phase. For instance, oral Vitamin E will make the plaques smaller and help to straighten the bent penis. Potassium Amino-Benzoate (Potaba), Tamoxifen, PABA, Colchicine and Carnitine are also effective during the acute phase of the disease. Likewise, during the early stages of the condition, drugs for erectile dysfunction, such as sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra), may be beneficial.

As an alternative to oral medications, injecting certain drugs directly into the plaque can bring relief, particularly for men in the acute phase of the disorder who are not sure whether they want to undergo surgery. For example, verapamil injections disrupt the protein responsible for the formation of lesions in Peyronie’s disease, thus helping to relieve acute symptoms. Interferon injections prevent swelling and control scarring, while collagenase injections break down the plaque and are recommended for treating men with a penis curve of more than 30 degrees. Injection therapy may be administered using a combination of above drugs plus hyaluronidase, betamethasone or prostaglandin E1. Another method of applying these drugs is iontophoresis (electromotive administration/EMDA), where the drug is applied on the penile skin and then pushed through the skin using a low electric current.

Radiation Therapy

During radiation therapy, high-energy rays are targeted at the plaque to relieve the pain. The disadvantage of radiation therapy is that it relieves the pain on the bent penis without having a direct effect on the plaque which causes erectile dysfunction. Instead of radiation therapy, a man may opt for shockwave therapy, a form of mechanical treatment that uses a lithotripter device (such as those used for breaking up kidney stones) to break down calcified plaques or scarring. Other mechanical devices that can be used to treat the disease are low-dose radiotherapy and vacuum-based machines.

Surgery

Surgery for Peyronie’s disease is reserved for men suffering from severe, disabling penile disorder that makes it difficult to have sex. Before the surgery, the urologist will check the blood flow in the penis by injecting a drug to make it stiff and also examining the penis using ultrasound. The tests are used to assess the penis before deciding the type of surgery that is ideal. There are three basic ways through which the urologist will fix the disorder surgically. First, the urologist can remove the plaque and replace it with a tissue patch, helping to stretch the penis and restore its original length. Secondly, the surgeon may change or remove part of the tunica albuginea from the penis area opposite the plaque, an operation known as the Nesbit procedure. Lastly, the urologist may perform penile prosthesis implantation, a procedure recommended for men having both Peyronie’s disease and erectile dysfunction.

Conclusion

Since Peyronie’s disease varies extensively in how it affects patients, the treatment chosen should be carefully selected according to an individual’s condition. Most importantly, treatment should aim to preserve sexual function. If you are suffering from the disease, it is important to work closely with a urologist in order to get the right resources, prompt diagnosis and correct treatment, and to prevent the disease from turning into a crisis. For more information on dealing with Peyronie’s disease and erectile dysfunction, visit Advanced Urology Institute.

Effective Ways To Detect Prostate Cancer

If you are a man, there is a 1-in-6 chance that you will develop prostate cancer at some point in your life. Prostate cancer is basically a tumor of the prostate, the gland located in front of the rectum and just below the bladder. The prostate helps in making the milky fluid called semen, which carries sperm out of the body during ejaculation. Prostate cancer is most common among men over 65 years of age and fairly prevalent in men aged 50-64 years. Still, the cancer can occur in younger men below 50 and screening for it should begin between 40 and 45 years of age.

Risk factors of the cancer include:

  • (Age
  • Obesity
  • Family history
  • Race
  • History of STDs (sexually transmitted diseases)
  • Diets high in fats from red meat

While prostate cancer is a highly treatable condition, many men suffer needlessly because they did not know the symptoms in order to catch it before the advanced stages. And though the cancer typically shows few signs until it has reached advanced stages, knowing the symptoms can be the difference between having to face surgery and just making a few lifestyle changes. The symptoms of prostate cancer include:

In some instances of early prostate cancer, no symptoms occur and the cancer can only be detected through routine screenings.

Effective Ways to Detect Prostate Cancer

Your urologist will start by asking you about your medical history, symptoms and risk factors. A physical examination will also be performed. The doctor will then request a prostate-specific antigen (PSA) test to analyze your blood sample for higher-than-normal levels of the prostate-specific antigen, which is a protein secreted by the prostate gland. Higher PSA levels may indicate presence of cancer. In some cases, your doctor will opt to use the PSA3 test to check for levels of antigen 3 in your urine. When PSA levels are abnormal, the urologist will usually suggest that you return in 6 months for a second PSA test to confirm the presence of the cancer. Other test options that may be used to confirm a diagnosis of prostate cancer are:

(a) Digital rectal exam: The doctor will insert a gloved finger into your lower rectum and prostate gland to check for any abnormalities in size, texture or shape of the prostate.

(b) Targeted biopsy: The doctor removes tissue samples from the prostate by using either MRI fusion-targeted 3D imaging method or the ultrasound high-yield saturation method. Samples taken are analyzed to detect the cancer and determine its severity.

(c) Prostate imaging: Also called perfusion dynamic MRI, prostate imaging uses a special contrast agent inserted into the prostate to precisely identify patients with the risk of prostate carcinoma.
Once prostate cancer is confirmed, the next step is determining its aggressiveness. The aggressiveness of a cancer helps the urologist to choose the best treatment option for the condition. So, after knowing how aggressive the cancer is, the urologist can recommend:

(a) Active surveillance: You are not offered any treatment but kept under careful observation and medical monitoring.

(b) External beam therapy (EBT): The urologist refers you to a radiation oncologist to deliver a beam of high-energy proton beams or x-ray to the tumor location. The oncologist may also use other radiation techniques such as conformal external beam radiation therapy, stereotactic body radiation therapy, proton beam therapy, or image-guided radiation therapy.

(c) Brachytherapy: In this case, radiation is delivered to your prostate by placing radioactive materials inside the prostate. The two forms used are low-dose rate (LDR) and the high-dose rate (HDR) Brachytherapy.

(d) Cryotherapy: This method uses extremely low temperatures (as low as -190 degrees Celsius) to freeze and destroy cancer cells.

(e) Surgery: The urologist makes an incision through the perineum or in the lower abdomen to remove the prostate. A skilled and experienced urologist will perform the surgery without interfering with your sexual function.
At Advanced Urology Institute, we have the best pool of urologists and state-of-the art equipment to help detect and treat prostate cancer. If you want to be screened for the condition, even without symptoms, never hesitate to see a urologist. Remember, early detection is the key to successful prostate cancer treatment. To learn more about prostate cancer screening, prevention and treatment, visit Advanced Urology Institute.

Why Walnuts Make Men More Fertile

Are you a man struggling to have children and looking for a way to boost your fertility? If so, consider eating a handful of walnuts every day. According to a study conducted by the University of Delaware, eating a walnut-enriched diet boosts sperm quality and aids in preventing male infertility. Working with two groups of mice, one fed on a walnut-enriched diet and the other fed on a control diet for 9 weeks, the researchers found that the group fed walnuts had a significant improvement in sperm quality.

How Do Walnuts Work?

Walnuts reduce lipid peroxidation, a form of cell damage that interferes with sperm membranes and harms sperm cells. Sperm is made of polyunsaturated fatty acids which are liable to damage by lipid peroxidation. Walnuts are the only tree nut made of mostly polyunsaturated fatty acids and will therefore effectively replenish sperm cells. In fact, just 1 ounce of walnuts contains 13 grams of polyunsaturated fatty acids (PUFAs) in 18 grams of total fat. By preventing sperm damage and replenishing sperm cells, walnuts help to improve sperm morphology, motility and vitality.

First Study on Walnut Efficacy

The study by the University of Delaware was based on a previous study by the UCLA Fielding School of Public Health and School of Nursing. According to the first study, which was based on a randomized control trial at UCLA, eating 2.5 ounces of walnuts each day (about 30 walnut halves) significantly improves the motility, morphology and vitality of sperm in men. During the research, more than 100 healthy young men eating their usual Western-style diet participated in monthly calls to share what they ate throughout the study. At the end of the study, it was clear that walnuts improved sperm quality, though more research was necessary to verify the role of the nuts.

Second Research Study by the University of Delaware

When the University of Delaware conducted its study, it was designed to reveal the mechanism by which walnuts had improved sperm quality in the UCLA study. Two groups of male mice, one consisting of healthy male mice and the other of genetically predetermined infertile male mice, were fed on either a walnut-enriched diet or a controlled diet for 9 to 11 weeks. At the end of the study, significant improvements in sperm morphology and motility were observed in mice consuming 20% of their daily calories from walnuts (equivalent to 2.5 ounces daily in humans). Most interestingly, even infertile mice had a remarkable boost in sperm morphology and both groups showed noteworthy reduction in peroxidative damage. The researchers concluded that walnuts improve sperm quality by reducing peroxidative sperm cell damage, though recommending further studies to determine which specific nutrients in walnuts are responsible for this improvement.

Walnuts are Beneficial for Sperm Health

Fertility in men is determined largely by sperm quality and quantity. For instance, if the number of sperm ejaculated is very low or the sperm are of poor quality, it may be difficult or even unlikely for pregnancy to occur. Since one-in-five infertility cases are solely due to the male partner and about one-in-twenty men suffer from some form of fertility problem related to low numbers of sperm ejaculated, using a healthy and proven method of improving sperm morphology, vitality and motility is a good way to begin addressing fertility problems. Enriching your diet with walnuts can be an effective first step in resolving your fertility issues and, if needed, there are many other treatments for infertility using medications or surgery. For more information on dealing with male infertility, visit Advanced Urology Institute.

5 Effective Treatment Options for Erectile Dysfunction

5 Effective Treatment Options for Erectile Dysfunction

There are several treatment options available for erectile dysfunction (ED), and the right one for an individual depends on the cause of the ED, age, health and lifestyle of the patient. In most cases, the use of oral medications such as Cialis, Viagra or Levitra is the recommended first option. Then, depending on the effectiveness and tolerance of the medication, other treatments may be tried. For example, microvascular surgery is recommended for patients with blood vessel leakage or blockage, while penile prosthesis is one effective alternative for those who fail to respond to non-surgical therapy or are not candidates for surgery.
Here is a look at 5 effective treatment options for erectile dysfunction:

1. Oral Medications: Phosphodiesterase-5 (PDE-5) inhibitors

Phosphodiesterase-5 (PDE-5) inhibitors, such as sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) and avanafil (Spedra), are some of the most widely used and highly effective medications for treating erectile dysfunction. The pills work by temporarily boosting the flow of blood to the penis. Sildenafil, sold as Viagra by Pfizer, is the most commonly prescribed pharmacological medicine for ED. Though it is available in different forms, Viagra takes 30-60 minutes to show effect and has a 4-hour duration. The drug only boosts blood flow to the penis and therefore sexual arousal and stimulation are necessary in order to have and maintain an erection. Tadalafil (Cialis) has effects lasting longer (up to 36 hours depending on the dose taken) and takes effect sooner (15-30 minutes). Tadalafil is also more selective in action and does not show the side effects of sildenafil and vardenafil. Avanafil (Spedra) and vardenafil (Levitra) show similar mechanism of action as sildenafil (Viagra) and only differ in duration of onset and length of effect.

2. Urethral Suppository (MUSE)

The use of a medicated urethral system for erection (MUSE) is considered when oral pills are not effective. The treatment involves placing a small medicated suppository in the penile urethra without using needles so that the suppository is absorbed to help produce an erection. The main advantage of this treatment option is that the suppository is applied locally by the patient or his partner, and has very few side effects. After the suppository is inserted into the urethra, sexual stimulation is necessary for increased blood flow to the penis. Patients opting for MUSE should have the first suppository application done in the urologist’s office to prevent potential complications such as decreased blood pressure, urethral bleeding, and continued and prolonged erections.

3. Penile Injections

The urologist may recommend penile injections when oral medications prove ineffective. And even though the idea of injecting the penis may be quite unappealing, the effectiveness and ease of injections make this a worthwhile option to consider. Apart from Caverject and Edex that have been prescribed by urologists for a while, other commonly injected medications are papaverine, phentolamine and alprosdid. Often, urologists recommend a blend of two or three medications for use in the injections. The blend, called a Trimix, ensures a synergistic effect of three medications, keeps the dose of every drug low to prevent adverse effects, and delivers a response rate of up to 90%.

4. Vacuum Pumps

Vacuum devices are recommended for patients who have only partial erections and find other treatments ineffective or intolerable. A vacuum device is made of a plastic cylinder connected to a pump and a constriction ring. Using a battery power or manual pressure to create suction around the penis in order to bring blood into it, a vacuum pump causes an erection which is maintained by a tourniquet of sorts that is placed around the base of the penis and an elastic rind which stops additional blood from flowing out of the engorged penis. Vacuum pumps are a relatively inexpensive, safe and easy to use treatment option for erectile dysfunction with minimal side effects. Erections induced using pumps generally last for about 30 minutes.

5. Penile Prosthesis and Penile Vascular Reconstructive Surgery

Surgery is considered as the last resort when all other treatment options fail. However, it may be the best option for young men seriously injured in their pelvic area (such as in a car accident) and men with significant anatomical problems with their penis. A penile prosthesis is an effective and more invasive option in which either a semi-rigid or inflatable implant is placed on the penis through surgery. The use of penile prosthesis has been proven to offer up to 85% patient-partner satisfaction rate. Penile vascular (venous or arterial) surgery is recommended for young men who have erectile dysfunction due to congenital or traumatic leakage of the penis. Penile venous surgery is performed to boost the trapping of blood in the penis, boosting a man’s capacity to get and maintain erections. On the other hand, penile arterial surgery creates a path of blood flow to the penis by correcting/bypassing blocked arteries.

For more information on effective treatments of erectile dysfunction, visit the Advanced Urology Institute website or make an appointment with a urologist today.