Erectile Dysfunction (ED)
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Transcript of Erectile Dysfunction (ED)
Erectile Dysfunction (ED)What Men Should Know
Paul Gittens, MD, FACSMedical Director Philadelphia Center of Sexual
Medicine
P
Dr. Paul Gittens is the medical director of PCSM Expert in the field of Sexual Medicine Dr. Gittens is a board certified urologist that
underwent specialty training in Sexual Dysfunction, Hormone Replacement and Male Infertility
PCSM is a concierge modeled practice treating only problems dedicated to the sexual health of men and women
More time dedicated to patient and education Excellent outcomes
Male Sexual Dysfunction & Infertility
Hypogonadism (Low testosterone)
Erectile Dysfunction
Penile Prosthesis
Peyronie’s Disease
Premature Ejaculation
Ejaculatory Dysfunction
Male Infertility
Orgasmic Dysfunction
Vasectomy Reversal
No Scalpel No needle vasectomy
Libido
What is ED?
ED is the persistent inability to achieve and maintain erection significant for sexual intercourse
The reality is that ED comes in many different forms Difficulty initiating an erection Difficulty sustaining an erection Stuttering erections, etc
What causes ED ?
Vascular disease- heart disease, high cholesterol, hypertension
Neurologic disease- Parkinson disease, spinal cord injury, MS
Iatrogenic- prostate cancer treatment, radiation, pelvic surgery
Environmental- smoking, alcoholism, drugs Hormonal- low testosterone, steroid abuse, excess estrogen Medication- beta blockers, anti-depressants, water pills,
SSRI Psychological- anxiety, depression, anger, stress
Shared risk factors with cardiovascular disease
Diabetes High blood pressure High cholesterol Cigarette smoking Lack of exercise Obesity Metabolic Syndrome
Does the size matter?
Having ED proceeds the onset of heart attacks – Smaller vessels are affected first.
3.0- 4.0 mm1-2mm
Speak to a sexual medicine physician
Focuses only on men’s health Expert in the treatment of all
sexual dysfunction and hormone disregulation
Time to explain your problem Education on how to treat Provides effective treatment for
your sexual dysfunction, male infertility or hormonal needs
Is there treatment? Yes!
Life style changes Calorie restriction Weight reduction Stop smoking, decrease alcohol intake Exercise Stress reduction Sleep
Will also decrease rates of cardiac disease, diabetes, high blood pressure, and stroke
If you help your body you will help your penis
Medical Treatment
Oral Therapy Viagra Cialis Stendra Levitra
Not just giving you a pill and kicking you out of the office
Better education leads to better results with oral medication
Direct Penile therapy ?
Penile injection therapy FDA approved medication Trimix
Muse- Medicated urethral system for erections
Your Sexual Medicine Physician (SMP) needs to be be able to dose medication to obtain a penetration hard erections, appropriately provide thorough teaching on how to use medication, and be able to manipulate dose. PCSM has a variety of penile injection doses which are tailored for each individual patient. It is important that the SMP knows how to manage any side effects, i.e. priapism, burning
External Devices
Vacuum erection devicesProvide negative pressure
suction to the penis causing erections.
Different techniques can be used to obtain an erection and stretch the tissues of a damaged penis.
Penile recovery after prostate cancer treatment
Philadelphia Center for Sexual Medicine- Penile Rehabilitation Program
Dedicated programTo preserve erectile function and prevent negative structural changes in the penis after prostate cancer or pelvic surgery and radiation
Therapy begins before or after therapy
Uses a mixture of medication and treatments depending on individual needs
If you don’t use it…..?
Penile Implant
Surgical treatment for severe ED Short surgery Effective Highest satisfaction rate
amongst therapies Ready when you are
Dr. Gittens is an experienced prosthetic surgeon and has placed hundreds of penile prosthesis
Summary
Erectile dysfunction is common
ED and cardiovascular disease share common risk factors
Treatment should be provided by a physician dedicated to sexual medicine and men’s health
Treatments should be multi modal and individualized
Lifestyle
Effective Treatment
PCSM
Take control of your penis?
Thank you
PhiladelphiaSexualMedicine.com