A Team Approach to Care
Male sexual dysfunction can result from a variety of reasons. This dysfunction
It’s a good idea to go see a sexual dysfunction doctor at Comprehensive Urology if you notice that sexual issues are creating problems for you and your partner. Certain diseases like heart disease, diabetes, or other health problems can lead to sexual dysfunction as well, so it’s best to talk about these conditions with your erectile dysfunction doctor in Los Angeles.
Symptoms of Male Sexual Dysfunction?
There are key factors that indicate sexual dysfunction in men. If you experience any of these symptoms, it’s important to address them right away so additional problems will not come up. Common sexual dysfunction symptoms in Beverly Hills include the following:
- Problems obtaining an erection
- Issues maintaining erections
- Sexual desire decreases
Causes of Sexual Dysfunction & Impotence
For males, sexual arousal is complex. It involves the male’s brain, emotions, hormones, muscles, blood vessels, and nerves. If there are any problems with these areas, it can lead to a problem with male sexual arousal. In addition, stress either physical or mental can make erectile dysfunction worse. A sexual dysfunction specialist in Los Angeles can help determine some of the probable causes and issues behind the condition.
The following are physical causes of male sexual dysfunction:
- High cholesterol
- Heart Disease
(blood vessels that are clogged)
- Increased blood pressure
- Metabolic syndrome
- Low testosterone
- Multiple sclerosis
- Parkinson’s disease
- Peyronie’s disease
- Tobacco use
- Specific prescription medications
- Pelvic area surgeries
- Spinal cord surgeries
- Prostate cancer treatment
- Enlarged prostate treatment
These factors in combination can actually create a sexual dysfunction in men. At Comprehensive Urology, we have state of the art programs that treat a variety of urological conditions including benign enlargement of the prostate gland. In terms of psychological causes for male sexual dysfunction, there are certain factors that trigger erectile dysfunction.
These can include:
» Anxiety, depression, as well as other mental conditions
» Problems in a relationship caused by stress or poor communication
As men age, erections can become more and more difficult to develop and maintain. However, age is not the only factor contributing to male infertility in Beverly Hills. Certain factors outlined above like underlying health issues, medications, or mental health conditions can increase the chances of developing a sexual dysfunction.
Male sexual dysfunction can result from a wide variety of causes and lead to numerous effects. However, these many forms of dysfunction all interfere with relationships and everyday health. The thousands of men dealing with sexual dysfunction face challenges that affect them on both a physical and mental level. As such, understanding male sexual dysfunction and finding help from an experienced urologist are two vital components for recovering from sexual dysfunction as quickly and completely as possible
What is Male Sexual Dysfunction?
As a term, male sexual dysfunction can be applied to any condition that interferes with normal sexual functions and activities. However, these conditions can result from many different factors. While some are minor problems that can be resolved through changes in diet, exercise, and everyday activities, others are major health conditions that require immediate treatment.
In either case, most male sexual dysfunctions result in problems obtaining an erection, issues with maintaining an erection, and/or decreases in sexual desire. As these signs can indicate any number of medical conditions, the best first step toward treatment is seeking out a diagnosis from an experienced urologist. This diagnosis will get to the underlying cause in order to determine what steps should be taken in treatment. Whether those steps involve medication, surgery, changes in everyday habits, or a combination of all potential treatments, these procedures will help restore health and normal function as soon as possible.
Erectile dysfunction is the inability to achieve or sustain an erection during sexual activity. While it is not uncommon for men of all ages to have trouble getting and keeping an erection on occasion, if the issue is ongoing and creates stress and anxiety that may even contribute to relationship problems, it may be time to seek treatment.
The physiology behind male arousal is a highly complex process involving the brain, hormones, nerves, blood vessels, as well as the individual’s emotional and psychological state. Any number of factors can interfere with a man’s ability to get and keep an erection, but if erectile dysfunction, also known as impotence, becomes a frequent issue, there are several solutions available.
The urologists at Comprehensive Urology understand that discussing erectile dysfunction can be embarrassing, impotence may be the result of an underlying issue that may need to be addressed. For compassionate, effective treatment, set up an appointment with our team today.
What Causes Impotence?
While older men are more likely to experience the inability to maintain an erection, young men may face the same difficulties. Whether young or old, the causes of erectile dysfunction typically fall under one of two categories: Physical and/or Psychological.
Physical Causes of ED
In the majority of cases, erectile dysfunction can be traced back to an underlying physical causes, such as:
- Low testosterone
- Atherosclerosis (damage to small blood vessels)
- High blood pressure
- Medication side effects
- High cholesterol
- Smoking cigarettes
- Heart disease
- Thyroid issue
- Parkinson’s disease
- Multiple sclerosis
- Treatment for benign prostatic hyperplasia (BPH) or prostate cancer
- Previous surgery
- Peyronie’s disease
- Pelvic trauma
- Long-distance cycling
An erection of the penis is caused by a hydraulic effect in which blood enters the penis where it is retained by sponge-like tissue. This process is initiated by nerve signals from the brain to the penis, therefore, it is not uncommon for physical factors to interfere with this process, resulting in sexual dysfunction. Once the physical condition is addressed, it is possible to reverse the effect of impotence
Psychological Causes of Sexual Dysfunction
The brain plays a major role in a man’s ability to become sexually aroused. Even if a man can physically achieve an erection, emotional or psychological factors can interrupt the physical process and cause impotence. The most common psychological causes include:
- Relationship issues (Poor communication, for example)
- Low self-esteem
- Feeling sexually inadequate
- Performance anxiety (fear of sexual failure)
In many cases, emotional or psychological factors can disrupt a man’s ability to have sex with another person, however, he can still perform comfortably during masturbation. Psychological factors can be addressed in therapy or with lifestyle adjustments.
How is Erectile Dysfunction Diagnosed?
More often than not, male sexual failure can be diagnosed simply with a physical exam and a medical history. However, in the event that a chronic medical condition is contributing to the erectile dysfunction, further tests may be needed. Comprehensive Urology offers non-invasive and invasive medical tests such as:
- Blood and urine tests – Can detect low testosterone, diabetes, heart disease, and more.
- Ultrasound or MRI – Can determine whether vascular or blood flow issues are causing erectile dysfunction. May be conducted with an injection of
medicnethat stimulates the blood flow to produce an erection.
- Nocturnal erection monitoring – A device is placed around the penis while the patient sleeps to measure the strength or number of erections the patient experiences overnight.
- Psychological – The doctor can screen for signs of depression, anxiety, or other psychological factors with a series of questions.
Depending on the cause and severity of impotence, the following treatments may help alleviate the condition.
Low-Intensity Shockwave Therapy: Comprehensive Urology is proud to offer low-intensity shockwave therapy (
What Is Low-Intensity Shockwave Therapy?
More than 40 clinical studies have shown that LISWT delivers a success rate of 75% or greater among ED patients. Additionally, our urologists use a specific protocol to optimize LISWT treatment efficacy, safety, and results.
Low-Intensity Shockwave Therapy Benefits
There are many reasons why men choose low-intensity shockwave therapy, and these include:
- Effective ED Treatment: Addresses erections that are too brief or too soft for penetration or the inability to get an erection.
LISWTactivates dormant stem cells and growth factors in the penis,rejuvenates erectile tissue,and stimulates the growth and development of new blood vessels in the penis.
- Reduced Penis Curvature: Breaks down scar tissue that causes painful curvature of the penis.
LISWTreduces the curvature of the penis that otherwise causes painful erections or makes it difficult to engage in sexual intercourse.
- Enhanced Sexual Performance: Increases blood flow to the penis, leading to improved erections and sexual performance.
- Alternative to Injections and Oral Medications: Provides a non-invasive treatment to help men achieve a natural erection without the need for painful injections or the use of oral drugs that may cause long-term addiction or other health issues.
- No Downtime: Delivers long-lasting results without any downtime.
At CU, our urologists can help men weigh the pros and cons of
What Should You Expect During a Low-Intensity Shockwave Therapy Procedure?
Low-intensity shockwave therapy is a non-invasive procedure that is performed in an office setting. It does not require any drugs or surgery and has been shown to deliver long-term results.
Prior to a
On the day of a
Patients generally require six to 12 sessions for optimal
Am I a Viable Candidate for Low-Intensity Shockwave Therapy?
Low-intensity shockwave therapy is a safe, effective ED treatment for many men. However, the procedure is not recommended for men who are dealing with one or more of the following issues:
- Active prostate cancer
- Cardiovascular problems that make it unsafe to engage in sexual activity
- Severe ED that requires a penile implant
For patients who are ineligible for
Diet & Lifestyle Modification: Since physical and mental health are intrinsically linked with sexual function, many men can successfully treat impotence by making the following changes to their diets and lifestyles:
- Lose weight – Obesity can put excessive strain on the cardiovascular system, interfering with blood flow to the penis and contributing to other health issues.
- Maintain a balanced diet
- Quit smoking – Tobacco can impair blood flow and the neuro-signals that direct blood to the penis.
- Stay physically active
- Limit alcohol intake
- Reduce stress
- Get at least seven hours of sleep a night
In the event that the blood vessels responsible for an erection have started to deteriorate, whether due to age or overall health, exercise and healthy habits can improve blood flow and provide an effective solution.
Medication: There are a variety of oral and injectable medications available to treat erectile dysfunction. Oral medicine typically works by improving the effects of nitric oxide, which is the chemical responsible for relaxing the muscles in the penis that allow the
Other medications can be administered via injection into the base or side of the penis or via a special suppository applicator. These medications can trigger an erection that lasts for 30 minutes to an hour, however, side effects may include pain, bleeding, prolonged erection, or scar tissue.
Penis Pumps & Implants: When lifestyle changes or medications are ineffective, it is possible to get an erection with a vacuum pump that pulls blood into the penis. A tension ring can be placed around the base of the penis to prevent the blood from leaving the penis long enough to have sex.
Penile implants are inflatable or semi-rigid
Counseling: If emotional or psychological factors are causing erectile dysfunction, many men can relieve
Surgery: In rare cases, damaged or obstructed blood vessels may need to be surgically repaired with a bypass procedure, which involves transplanting blood vessels from another part of the body or by inserting a vascular stent to improve blood flow.
When erectile dysfunction becomes an ongoing issue that negatively impacts a man’s sex life, fertility, self-esteem, and overall quality of life, there’s no reason to put off getting the treatment you need to overcome impotence. There are a variety of factors that can cause a man to have difficulty achieving and maintaining an erection, so it is important to seek diagnosis and treatment from a highly experienced and compassionate urologist.
At Comprehensive Urology, we understand that the idea of getting treated for impotence can be intimidating, but there are numerous non-invasive options available, such as oral medications, to make erectile dysfunction a thing of the past. ED is common among men over the age of 60, but can affect younger men as well, and may be an indication of an underlying health issue.
How Do Male Impotence Drugs Work?
Oral medications for male impotence, such as Viagra, Cialis, Levitra, Stendra, and Staxyn, can be highly effective at treating erectile dysfunction for many men. These medications work by safely and temporarily blocking a Phosphodiesterase V (PDE 5) enzyme that causes the penis to become flaccid. By blocking this enzyme, the chemical nitric oxide, which is naturally released during sexual arousal that increases blood flow to the penis, producing an erection with sexual stimulation.
Erection oral medications are often recommended for men who experience impotence as a result of physical or psychological factors or both. It is important for patients to understand that oral medications require some trial and error to find the drug, dosage amount, and treatment routine that works best. Some men have better success taking Viagra on an empty stomach or after waiting at least an hour to initiate sex.
The experienced team at Comprehensive Urology have helped numerous patients find the best erectile dysfunction medications for each patient’s unique needs and goals.
Am I a Good Candidate for Erection Medications?
As with any prescription medication, erection pills may not be suitable for everyone. It is important to discuss whether you are currently taking other prescription or non-prescription medications or supplements, are scheduled to undergo surgery, and your history with a board-certified urologist to avoid any complications.
Men who should not take prescription erectile dysfunction medications include:
- Those who are currently taking alpha-blockers, nitrate drugs for angina, high blood pressure medications, or blood thinners
- Men who have had a stroke, heart attack, or life-threatening irregular heart rate in the past six months
- Men who experience chest pains while having sex
- Those who use recreational drugs, such as
butynitrite or amyl nitrate
Potential Side Effects of Erectile Dysfunction Medications
When considering oral medication for erectile dysfunction, it’s important for potential patients to understand that ED drugs typically cause side effects and each patient may react differently to certain pills. Therefore, it is in a patient’s best interest to work with a skilled urologist when treating erectile dysfunction in order to safely test the medications and monitor the side effects to determine the most effective treatment available.
The most common side effects that patients experience with any ED medications include:
- Muscle aches
- Upset stomach
- Hearing loss
- Facial flushing
- Vision issues (color tint, glare)
- Nasal congestion
Finding the right erection medication and learning how to get the best outcome with minimal side effects takes time and the experienced guidance of a urologist, such as Dr. Kia Michel.
In the event of serious side effects, such as fainting, painful erection, chest pain, an erection that lasts longer than four hours, or vision loss, it is crucial to seek emergency medical attention as soon as possible. While these side effects are rare, your urologist will be able to identify certain factors that may put you at risk for health complications of erectile dysfunction medications.
How Quickly Do ED Medications Work?
Each of the most common medications for impotence, such as Viagra, Cialis, Levitra, Stendra, and Staxyn, can produce varying results, but it is generally recommended that patients take ED medication within 30 minutes prior to the desired time of sexual activity. The time it takes for the pills to work will also depend on whether you have a full stomach and what you have eaten. The less food in your stomach, the quicker your body should absorb the medication.
Typically, men can expect most erectile dysfunction medications to start working with 30 minutes to an hour and the effect can last for six to 12 hours, depending on the specific drug. For example, Stendra can start to work within 15 minutes and may be effective for 12 hours, while daily Cialis medication can provide continuous results. Every patient will experience different outcomes with erection medications depending on a wide range of factors, such as age, overall health, and more.
It’s not uncommon for men at any age to experience the occasional “failure to perform” in the bedroom, but when erectile dysfunction (ED) becomes a common occurrence, the issue can be more than disheartening. Fortunately, it is possible to overcome erectile dysfunction with the expert guidance of the urologists at Comprehensive Urology. Our team
Meeting with a doctor to discuss impotence can be intimidating, but ED is fairly common, particularly as men get older. It is estimated that nearly 50 percent of all men between the ages of 40 and 70 experience some degree of impotence, according to The Merck Manual. At Comprehensive Urology, we can provide the confidential care and treatment you need to regain your sexual ability.
What is penile injection therapy?
Penile injectable therapy is an effective treatment option for men who have had no success with oral medication or behavioral therapy for erectile dysfunction. While the idea of putting a needle into your penis may be more than
Injectable therapy for erectile dysfunction works by injecting a medication into the side of the penis in order to dilate the arteries, allowing blood to flow into the sponge-like tissue, achieving an erection in a matter of five to 20 minutes. The effect can last between 30 minutes to an hour and a half, or until orgasm.
The most common injectable therapy medication men use to achieve an erection include one or a combination (TriMix) of papaverine, phentolamine, or alprostadil, which belong to a group of drugs that relax smooth muscle tissue called vasodilators.
Side effects of erectile dysfunction injections
As with any medical treatment, patients may experience side effects from injectable erectile dysfunction therapy. However, it is important to note that the side effects are typically minor. These include:
- Bruising at injection site
- Swelling and tenderness at injection site
- Penile pain
- Priapism (prolonged erection)
A small percentage of men may experience an erection that may last for more than six hours. If left untreated, priapism can cause muscle and tissue damage, so it is crucial to consult with your doctor to reverse the injection with another medication.
Finding the appropriate dosage or combination of injectable therapy drugs can take a period of trial and error, therefore, it is in the patient’s best interest to work with a skilled urologist throughout the process to ensure a safe and effective outcome.
How are self injections administered?
Patients will learn how to administer their own penile injections with
The base of the penis must be swabbed with alcohol before the medication is administered. The injection should be used within five to 20 minutes before engaging in sexual activity. Erectile dysfunction injectable therapy is highly effective, but patients should not exceed six to 12 injections, spaced evenly apart, in a single month to prevent scarring or other complications. The injection should not be administered more than three times a week and the injection site should also alternate between the left and right side of the base of the penis.
Advantages & Disadvantages
Penile injection therapy is a safe alternative to oral medications or behavioral modification for many patients suffering from impotence.
The advantages of ED injectable therapy include:
- Produces erection within five to 20 minutes after injection, compared to the 30 minutes to an hour needed for oral medications
- Men who are ineligible for oral medications because they take other prescription medications, such as oral nitrates, can safely use ED injections
- Injectable ED therapy has a success rate of 85 percent
- Ideal for men who have erectile dysfunction as a result of a neurologic issue, such as nerve damage caused by radical prostatectomy
Disadvantages of penile injectable therapy include:
- Patients must perform self-injection
- Risk of priapism
- Risk of scarring or bleeding
- Men who take anti-coagulant medication (blood thinners) cannot use ED injections
- Limited number of injections each week and each month
- Varying costs of medication
Erectile dysfunction (ED) is the ongoing inability to achieve and maintain an
Erectile dysfunction is not a foregone conclusion of aging. In some cases, consistent loss of an erection may be an indication of an underlying health issue, such as advanced vascular disease. To learn more about overcoming impotence with a penis implant, please do not
How Do Penile Implants Work?
There are a variety of implants available to help men with erectile dysfunction achieve the best possible results, each of which may operate differently depending on the device and manufacturer. In general, a penile prosthesis is a device that is bendable or inflatable, allowing the patient to achieve an erection whenever he wants.
Bendable penile implants are semi-rigid and can be lifted to an erection position to engage in sexual activity. Inflatable implants require a small liquid reservoir and pump to be implanted as well, in the lower abdomen and scrotal sac. The patient simply presses the pump to release the saline solution from the reservoir into the penile implant, creating an erection.
Types of Penile Prostheses
The type and size of implant that is suited to each patient will depend on the size and shape of the patient’s anatomy, including the penis, glans penis, and scrotum, as well as the patient’s age, overall health, and medical history (previous surgeries or presence of colostomy, for example).
The most common type of implants include:
Non-Inflatable Penile Prosthesis – The semi-rigid device consists of flexible rods that are implanted into the erection chambers of the penis, which produces a permanently firm penis. The non-inflatable implant can be bent up for an erection and down the rest of the time. This option is ideal for those with arthritis or limited hand dexterity.
The surgical procedure for implanting the non-inflatable penile prosthesis is fairly simple compared to the other implantable devices. However, the recovery process can be painful as the patient must adjust to a constantly firm penis.
Two-Piece Inflatable Penile Prosthesis – The two-piece inflatable device consists of two cylinders that are implanted into the erection chambers of the penis and connected to
Three-Piece Inflatable Penile Prosthesis – There are several variations of the multi-component inflatable prosthesis, but the devices typically have two cylinders that are implanted in the penis, a small pump that is implanted inside the scrotal sac, and a fluid reservoir that is placed within the abdomen. The device works by releasing the saline fluid from the reservoir to the cylinders after pressing the pump in the scrotal sac. The patient can deflate the cylinders when ready by pressing a release valve on the pump.
What are the Advantages of an Internal Penile Prosthesis?
An internal penile prosthesis is ideal for patients who have not had success treating erectile dysfunction with other treatment methods, such as medication or vacuum devices. The main advantages of these internal devices, compared to other ED treatments include:
- Easy to use
- Discreet (Concealed in the body)
- Convenient (No need to take pills or use a pump)
- Maintain erection longer
- Natural appearance and greater length and girth with a three-piece implant
- No longer have to worry about erectile dysfunction
- Ability to have sex on a regular basis
Penis implants have a high success and satisfaction rate among patients as a penile prosthesis is typically discreet and provides erections suitable for sexual intercourse. Many patients enjoy the ability to achieve orgasm and still maintain an erection for their partners.
Potential Complications and Side Effects of Penile Prosthesis
As with any surgical procedure, the penile prosthesis operation is not entirely free of potential risks and complications. These typically include:
- Tissue deterioration around the implant
- Mechanical failure
- Device erosion
- Uncontrolled bleeding
- Loss of penile length
At Comprehensive Urology, our team are dedicated to helping our patients achieve the best outcome possible. When considering penile prostheses, we strive to help each patient make an informed decision and recommend that patients bring their partners to the consultation to learn about the outcome and expectations.