He emphasized that first of all, a detailed history of the patient, information about when the problems started and their severity should be obtained. Detailed information is collected about whether the patient has other diseases, the medications he uses, and the surgeries he has undergone. Accompanied by these evaluations, the patient is asked for blood tests and, if necessary, a penile Doppler ultrasound examination.
If there is a medication that negatively affects erection among the medications used by the patient, the doctor who prescribed the medication is contacted to change it.
All aspects of the treatment of erectile dysfunction are required. Treatment can be started by deciding which of these treatment options will be suitable for the patient, based on the results showing that there are 5-6 types of methods used in the world.
These treatments include oral medications, shock wave therapy to the penis (ED1000), injection therapy to the penis. , vacuum therapy and penile prosthesis application.
Penis injection application is taught to the patients and it is applied by applying a cocktail prepared with a single drug or a mixture of several drugs to the penis before sexual intercourse. Depending on the drug selection and dose injected, the strength and duration of erection in the penis vary. The aim is to determine the dose that will provide an erection of approximately 1-1.5 hours and to ensure that sexual intercourse occurs by applying this dose of the drug each time.
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The injection is done at most 3 times a week and at least 24 hours must pass between injections.
Penile prosthesis method in the treatment of impotence…
Penile prosthesis diper, also known as happiness bar, has been used in the treatment of impotence since 1973. While penile prosthesis was a widely used method before 2000, there was a decrease in the number of prosthesis surgeries with the introduction of oral erection enhancing drugs in 1998. However, today, the rapid development of technology has led to an increase in the number of overweight and diabetic people in societies due to the fact that people do more desk jobs.
Penile prosthesis surgery…
Penis prosthesis is a device that is surgically placed inside the penis.
There are different types of prosthesis. Prosthetic surgeries take 30 minutes to 90 minutes It is performed in a period of time between.
After prosthesis surgery, there is no change in the emotional and physiological events during sexual intercourse, for example, ejaculation still occurs in the same way, the penis does not deflate despite ejaculation, the penis softens whenever the person wishes. Sexual desire, pleasure, and the feeling structure in the penis do not change.
A woman who does not know that a prosthesis has been placed on the patient after surgery cannot understand that a man with a penis prosthesis has a prosthesis. It is not possible to understand that the person has a penis prosthesis, especially in three-piece prostheses.
Problems that may occur in penis prosthesis surgery:
1.Surgery-related: During the preparation of the prosthesis site during the surgery, the prosthesis may not be placed completely or the prosthesis may remain bent due to reasons such as urinary tract injury, inability to expand. In case of urinary tract injury, the operation must be postponed.
2.Pain: Patients may experience pain due to the surgery. Pain occurs especially in the scrotum during inflation and deflation of the prosthesis. If the pain does not decrease and continues in the following days, the possibility of wearing an inappropriately sized prosthesis or infection should be suspected.
3. Infection: Infection is an important problem due to the foreign body used in penile prosthesis surgery. The increase in prosthetic technology due to technological developments keeps the possibility of infection very low. Patients are tested before the operation to check that there is no infection in the body. Infection can be kept at very low levels by applying strong antibiotic protection during and after the operation. The risk of infection in penile prostheses is 1-3%. Situations that increase the risk of infection are as follows; The risk of prosthesis infection increases if the patient has diabetes and uncontrolled sugar levels, a chronic disease, a low immune system (immunosuppressives), and an infection in the patient's body. The possibility of infection is minimized with measures such as blood leukocyte level control, CRP control, and blood sugar regulation.
Washing the operation area with disinfectant substances for 10 minutes during the operation also reduces infection rates with strong antibiotic treatments administered intravenously to the patient. In cases where infection develops, the penile prosthesis placed in patients is sometimes completely removed. and after some time, it is planned to place a penile prosthesis again.
4.EROSION: It can be seen when the prosthetic materials damage the surrounding tissues. Such problems occur in the form of damage to the urinary tract due to pressure, or damage caused by the prosthetic pump in the scrotal cavity, called erosion. While removing the prosthesis in case of urethra damage, it is sufficient to change its location in cases of damage due to the reservoir and pump.
5. MECHANICAL FAILURE: Mechanical problems, which are stated to be seen especially in inflatable prostheses, are rarely seen today due to technical developments in prostheses. The prosthesis may have mechanical problems arising from the cylinder, pump, connection points and reservoir. These problems are usually eliminated by surgical correction or replacement with a new part.
Complications seen in penis prosthesis surgeries are almost non-existent today, thanks to technical developments and serious precautions. However, it would be appropriate for patients who will undergo penile prosthesis surgery to keep all these possibilities in mind.
What is shock wave therapy (ED1000) to the penis in the Treatment of Impotence and how is it applied?
Low Intensity Shock to the Penis Wave Therapy (ED1000) has been used successfully in the treatment of ischemic heart disease in the heart for the last 10 years and is stated to increase blood flow to the penis by causing new vessel formation. Likewise, this technology is planned to be used in the treatment of impotence. In this treatment method, the procedure is applied directly to the penis. ED1000 treatment is applied 2 days, 3 days or every day a week. The number of sessions applied is 6 or 12 sessions. The recommended practice of 6 or 12 sessions, depending on the severity of the patient's impotence problem, has been changed to giving at least 12 sessions in recent applications. The areas where the procedure is applied are applied to 5 different areas of the penis ( shock waves are applied to the penis roots (right and left, tip, middle and root parts of the penis). No side effects have been reported due to the procedure. The patient can continue his daily work after the procedure.
ED1000 procedure can be easily performed on the examination table. One session of the procedure lasts approximately 15-20 minutes, and the patient does not need to stay in the hospital after the procedure. The procedure can be performed by a doctor or technician.
Before applying shock wave therapy to the penis, the patient complaining of impotence must be evaluated by a specialist doctor. If necessary, blood and radiological tests should be performed.
As a result of the examination and evaluation of the patient's tests by the specialist doctor, some medications may need to be given in addition to shock wave therapy.
ED1000 (Shock wave therapy to the penis) To whom can the procedure be applied?
Impotence is the inability to achieve or maintain sufficient penile rigidity for sexual intercourse. It is also called by different names, such as impotence, erectile dysfunction, erectile dysfunction. The most common organic causes of impotence are vascular problems. In the treatment of impotence, the cause must be determined and a treatment scheme must be developed accordingly. In the light of today's new technological developments, a healthy sexual life can be achieved thanks to newly discovered drugs and devices. Penile shock wave therapy (EDSWT) is a technological product that has been used for the treatment of impotence in recent years. Thanks to this procedure, the aim is to increase the blood flow to the penis and provide sufficient penis hardness for sexual activity. ED1000 procedure is not recommended to be used to increase performance for people who do not complain of impotence. The patient must have a mild, moderate or severe erection problem.
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