Beyond Viagra

Beyond Viagra

If you tried Viagra for erectile dysfunction (ED) but it did not work, don't be disheartened; even better options are available. Because of advances in the area of sexual medicine this particular urology sub-specialty has proven especially rewarding for us at the Urology Center. We are very proud to have helped hundreds of men get rid of this extremely common problem. We will explain the evaluation process and treatment options, beyond Viagra.

Of course getting men with ED to come into the urologist's office is the first major hurdle. Along those lines our doctors commonly give talks in the communities we serve, basically encouraging understanding of the issue and understanding of the benefits, possible risks and options for treatment. Depending on the individual circumstances, the benefit of treatment may be great, the risks small and the options astounding. Most men have no clue what treatments are available and how satisfied they may expect to be after correction of the problem.

Evaluation begins with a simple medical history and physical exam which guides the rest of the investigation and treatment. Underlying causes are sought, not so much as for ED management, as for the overall health of the patient. Sometimes potentially serious medical problems are found, like diabetes or prostate cancer. Men undergo PSA testing for prostate cancer and, in some cases, additional hormonal testing. Many men who come in for this evaluation have not seen any doctor for any reason, in years. Therefore, this testing is very important to a man's overall health, not just the erection problem.

... men want to know why ...

Once prostate cancer and other significant medical problems have been excluded, some men are interested in learning "why". Some men want to know why they developed erection problems in the first place. Along those lines, we often perform an ultrasound test to help answer this question. Most men are relieved to learn that the test confirms that the erection problem is truly physical and not psychological.

For most patients, we provide free samples of Viagra. Patients undergo a trial course of Viagra, which sometimes works well. However, some patients cannot take Viagra because of other medical conditions or because of the possibility of severe interactions with other medications such as nitroglycerin formulations. Other men may experience intolerable side effects as the result of taking Viagra. Additionally, in a fairly large number of men, Viagra simply fails to produce erections sufficient for practical use. It is for all of these men that this article was written.

... the most successful and satisfying treatment of all ...

Many treatments are available for erectile dysfunction including skin patches, MUSE penile urethral suppositories, vacuum erection devices and injectable medications. Two new Viagra-like medications are in development. However, when Viagra fails to work, the majority of our patients opt for the most successful and most satisfying of all treatment options. They choose to have the problem permanently corrected with a penile prosthesis.

Beware of the cheaper, less desirable, inflatable penile prosthesis!

We see many men who have heard of this treatment. Some men know of another man who has undergone placement of a penile prosthesis of one type or another. Unfortunately, the reputation of this form of treatment has been somewhat inappropriately tarnished because some doctors continue to implant a cheaper, much less desirable type of inflatable penile prostheses. Like the four-piece inflatable penile prosthesis, the cheaper implant is also inflatable; however, it does not have all the parts necessary for the good results we get when using the four piece inflatable implants. Beware of the cheaper, less desirable, inflatable penile prosthesis!

The cheaper implants result in a thinner, softer erection and a bulky mass which hangs in the scrotum or even erections which never go down! Additionally the cheaper implant tends not to deflate completely, causing fullness of the penis, even when the patient desires a soft penis. In fairness, the cheaper prostheses are much easier for the doctor to implant and they usually allow at least some form of an erection. However, these cheaper implants cannot produce erections anywhere near the quality of those which result from placement of the four piece inflatable prosthesis. Obviously, we do not use the cheaper implants and we would consider using them only under very limited circumstances.

... we use the state-of-the-art, four piece inflatable penile prosthesis.

Instead, at the Urology Center we use the state-of-the-art, four piece inflatable penile prosthesis. The device is more expensive but it has a much longer proven track record and an astounding satisfaction rate. Our patients who undergo successful inflatable penile prosthesis procedure may expect to be satisfied and happy with this choice of treatment. The four piece inflatable penile prostheses has the highest success rate of any alternative form of impotence treatment with greater than ninety percent patient satisfaction. More than ninety percent of men who have undergone the procedure report they are happy and would choose this procedure again, over treatments like penile injections or vacuum devices.

A man ... can expect ... normal erotic sensation ... normal climax.

A man who has the four piece prosthesis in place can expect complete privacy after the procedure; that is, four piece inflatable prostheses are completely concealed. This is so much true that a man's family doctor or even his partner may be unable to tell that a penile prosthesis in place, even when he is disrobed. He has completely normal erotic sensation in the penis. Sexual stimulation is normal and he may expect normal orgasm, normal ejaculation and normal sexual climax. This is to say that if a man has these normal body functions before penile implantation, he may expect to have these normal bodily functions after the procedure.

The resulting erection is very hard; it is as hard or harder than before the impotence problem developed. The resulting erections are long lasting, if so desired. In fact, erections last exactly as long a man and his partner desire. For the benefit of his partner, a man with a four piece inflatable penile prosthesis may choose to sustain an erection and continue to have intercourse, even after reaching sexual climax. Of course, his penis does not remain erect all the time. At anytime he may choose to release all firmness within the penis, allowing it to return to its normal soft state for complete concealment.

... with a prosthesis ... there is no waiting ... erection occurs on demand.

Finally, men with the four-piece penile prostheses report that one of the greatest advantages of having a penile prosthesis is renewed spontaneous intimacy with their partners. This means there is no waiting for an erection, as is the case with Viagra and all other treatments. There is no wondering if the erection might fail. The erection occurs on demand. It works the first time and every time. He and his partner can depend on the results.

Importantly, the cost of both the prosthesis and the procedure itself are covered by Medicare, Medicare "65" HMO's and a significant number of other insurance plans. However, just like many insurance refusing to pay for Viagra, an increasing number of companies are refusing to pay for this proven treatment. This has absolutely nothing to so with any lack of proof of benefit to the men who receive penile implants. It is simply a "bottom-line" money issue for these companies. They get away with this by implying that the procedure is cosmetic, when nothing could be any further from the truth. There is nothing cosmetic about restoring function to a very important body part!

Thankfully, a lending company is now available to finance the cost of everything together. This company is completely separate from the Urology Center. No physician, nor employee nor any friend or family member of the Urology Center is in any way connected to the lending company.

The implant procedure is performed on an outpatient basis (generally no hospital stay) and complications are uncommon (fewer than ten percent of cases). Additional procedures are rarely required.

Penile implants for men, like breast implants in women, restore a sense of wholeness, well-being and self-confidence.

Our formerly impotent patients are among our happiest patients of all and their satisfaction is on of our greatest resources. We are very proud to be among a small number of certified surgeons who provide this type of very specialized care. The goals of the penile prosthesis procedure are much the same as the goals of the breast implant procedure for women who have undergone breast cancer surgery. Penile implants for men, like breast implants in women, restore a sense of wholeness, well-being and self-confidence.

National studies show that most men remain interested in sex throughout their entire lives! In fact, both men and women prefer to have sex twice as often as they actually do. Men who are sexually active report greater satisfaction with their lives, work, health, body image and marriages. So keep in mind that beyond Viagra there are even better treatment options.

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(You may also visit the "Make-the-Call" ED Help Line, Sexual Function Health Council of AFUD , Peyronies Disease).

If you would like additional information you may find Dr. Watson's book, Impotence -- Its Reversible, in most Louisiana public libraries. If your library does not have enough copies of this publication, contact us.