September 18, 2015
Dr. Paul Perito, M.D., F.A.C.S
Chief of Surgery, Coral Gables Hospital, Fellow, American College of Surgeons
“Thankfully, no male needs to suffer from ED once motivated to seek proper treatment.”
Mediaplanet: What lifestyle habits are associated with ED?
Paul Perito: Lifestyle habits are frequently to blame for their ED: smoking, obesity, illegal drug use and excessive use of alcohol. In this case we hear the same old adage: “too much of a ‘good thing’ (to some) can hurt you.”
MP: What medical conditions are associated with ED?
PP: All men should be acutely aware of the fact that ED is a harbinger of bad things to come. ED translates into a higher risk of cardiovascular disease with ED presenting 3 to 5 years before a man’s first heart attack. A communication chain between a patient’s urologist and cardiologist should be present and consistent. Very often, men suffering from ED must only look to their parent’s medical history. If their parents suffered from diabetes, cardiovascular disease, hypertension or peripheral vascular disease they may suffer from the same disorders to no fault of their own.
MP: Why should men be concerned about their sexual dysfunction?
PP: ED is a serious and often devastating ailment affecting nearly 20 million men in the US alone. Patients can suffer from ED for what ends up being a fairly significant portion of their remaining time to be sexually active. Because of advances in the medical and surgical treatment of ED, no male needs to suffer from ED and all men have the option to treat their disorder.
MP: What are some of the first steps men should take when they realize they have erectile dysfunction?
PP: Men are often embarrassed to bring up ED with their doctor. Many doctors do and should ask the question. If a patient’s doctor seems uncomfortable with the topic, he should ask for a referral to an urologist. When seeking treatment for ED men should be vigilant and secure an appropriately trained practitioner. Some “Men’s Health Centers” are staffed by physicians with little or no training in the diagnosis and treatment of ED.
MP: What are the treatments for ED? How does one decide?
PP: Treatments for ED are manifold, safe and efficacious. Thankfully, no male needs to suffer from ED once motivated to seek proper treatment. The usual algorithm for patients desiring treatment is as follows: medications, penile injections/suppositories and surgery, i.e. the penile implant.
Oral medications, or PDE5 inhibitors, have revolutionized the treatment of males suffering from ED because they are easy to take and have relatively few side effects or contraindications. When this treatment alternative fails patients are often directed to medications that are either inserted or injected into the penis. Although effective, the dropout rate for these therapies is high.
Finally, men suffering from ED may turn to the surgical treatment for ED or penile implantation. Many believe, erroneously, that the penile implant makes the penis larger. A penile implant provides patients with an erect penis for sexual intercourse. The procedure is safe, relatively simple in the hands of experienced implanters with a fast recovery time. Most importantly for some patients, the implant stops the atrophy seen in patients suffering from ED.
MP: What is the impact of ED on the partner? Do you encourage the partner’s involvement in the treatment of ED?
PP: Men with ED must also consider how ED affects their partners. ED may lead to confusion, anxiety and depression in their partner. Their partners must be informed of the underlying physiologic basis for their failings in the bed. Most important to many men is the simple fact that ED, through chronic hypoxia and scarring in the penis, leads to loss of penile length and girth. Again we hear another old adage: “if you don’t use it you lose it.”
This comments originally appeared on http://www.futureofpersonalhealth.com/advocacy/the-ups-and-downs-of-erectile-dysfunction-a-panel-discussion.