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Tuesday, Feb. 12, 2019

PERMANENT CURE FOR ED?

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Inflatable penile prosthesis an option

Approximately 50 percent of men will be affected by ED (erectile dysfunction) in their lifetime, and the incidence increases with age. While some men find comfort in knowing they are not alone, other men may be alarmed that so many are affected by this disease. It is well established that men with ED suffer from higher rates of depression and anxiety as a result. Often men will shy away from sex as a result of their ED. Many of their partners may incorrectly interpret this behavior as a problem with them. For example, many female spouses may think their husband no longer has a sexual interest in them or maybe they are no longer good enough. In reality, this actually couldn’t be further from the truth. In fact, most men with ED find shying away from sex easier than discussing their lack of potency with their partner. Shying away from sex is their path of least resistance.

It is important for men and woman to understand that ED is a complicated medical disease where the penis does not receive proper blood flow. Simple lack of interest or desire does not accurately reflect the etiology of this disease. Men who are most at risk for ED may have one or more have the following medical disorders: hypertension (high blood pressure), hyperlipidemia (high cholesterol), diabetes, cardiovascular disease, history of stroke or heart attack, smoking, prostate removed, pelvic radiation, and age greater than 50. The more risk factors a patient has, the more likely they are to suffer from ED.

The good news is that ED is very treatable. There are several different types of oral medications that are now more affordable than ever. Unfortunately, insurance still does not typically cover erection medications. Thankfully, generic versions are now available, but they do require a prescription. Physicians usually will perform a complete history and physical exam along with blood work prior to prescribing medications for sexual dysfunction. Urologists also generally like men to try and fail oral therapies before moving on to a permanent solution.

Many men and women are very misinformed when it comes to permanent treatment of ED with a penile prosthesis. Most patients typically believe they will “look weird” or “don’t want to be a freak.” I often will tell patients that I would like for them to make an informed decision, but that does require they have the correct information.

An inflatable penile prosthesis (IPP) is typically performed in men with severe ED who have failed more conservative therapies. IPPs are a great option for men with severe ED because it gives them back spontaneity. They are able to have sex anytime they want without having to plan or take any medications. IPPs do not interfere with orgasm, ejaculation or urination. They are completely hidden. I often tell men that if they go to the gym and need to shower with other men, no one will know they have an IPP. When the IPP is deflated, the penis looks normal in its natural state. The penis is only erect when the IPP is manually inflated by pumping a small pump hidden in the scrotum between the testicles. This moves saline from a small reservoir, hidden in the abdomen, into the two cylinders located deep in the penis. The penis will stay erect until the patient presses the deflation valve and the saline cycles back to the reservoir. Importantly, IPPs feel natural to the man and his partner.

There are several other key points for patients to be aware regarding IPPs. They are covered by most insurance plans, but not all. They are typically placed in an outpatient setting in approximately 30-40 minutes through a small incision above the penis or in the scrotum. Most men will need approximately one week off of work and will be sexually active in six weeks. The device typically lasts 10 years and can be repaired or replaced as necessary. There are risks associated with any surgery. That being said, IPPs are generally very safe. The biggest concern is generally the risk of infection, which is very low, around 3 percent, thankfully. Most men do very well and are very happy if properly evaluated and counseled prior to surgery. If you have any questions about treating your ED, feel free to contact our office; we’re here to help.

Dr. Jared L. Moss is trained to treat all aspects of general urology, with a focus in men’s health. He specializes in male fertility, hypogonadism (low testosterone), erectile dysfunction, sexual dysfunction and inflatable penile prosthesis (IPP). Moss has specialized microsurgical training to help restore men’s fertility. He performs microsurgical vasectomy reversals, microsurgical varicocelectomy and microsurgical testicular sperm extraction on men who do not have sperm in their ejaculate. He also maintains a passion for helping men diagnosed with cancer, preserve their fertility. To schedule a consult with Dr. Moss, contact Regional Urology, 255 W. Bert Kouns Industrial Loop, Shreveport, 318-683-0411.

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