Hi, I'm Dr. Scholz. Let's talk about prostate cancer.
This video is going to cover the common treatments for the correction of erectile dysfunction,
otherwise known as impotence.
Prostate cancer therapy commonly associated with difficulties getting erections, and a
number of methods and treatments have been developed to try and counteract that problem.
Everyone's heard of Viagra and Cialis, and there are other products on the market too
such as Stendra. These pills are almost miraculous in their beneficial effects and typically
without much of the way of side effects they can help reestablish normal erectile function.
Unfortunately, they don't work in everybody after treatment, so there's certainly no guarantees.
There's also a possibility for side effects from these pills though side effects are not
terribly common. Some men can develop some stuffy nose or some headaches, see blue hue
on their vision, or even get low blood pressure especially if these medicines are taken with
common products like Flomax. But for the most part, these medicines have worked well to
re-establish sexual function in a lot of men who would otherwise be completely incapacitated.
Since pills don't work in everyone, what is usually the next step to try and recover erectile
function?
There are a variety of different things that are tried.
Let's cover first the idea of a vacuum pump. [With] these devices, a cylindrical tube is
placed over the penis and blood is drawn into the penis to establish an erection with the
placement of an elastic band around the base of the penis. This can cause a functional
and serviceable erection in probably most men. In my experience, however, this approach—being
rather cumbersome and also a little difficult to implement and execute—only proves to
be popular in maybe about 15-20% of men.
In men who pills aren't working and pumps aren't working, the next level of intervention
is to consider an injection. When I was first exposed to the thought of injection therapy,
I was rather horrified because we are talking about a shot in the base of the penis—a
very tiny needle thankfully, but a needle nevertheless. I discovered over time, however,
that patients readily accept this type of intervention because it's very predictable
and very effective and very convenient. I am myself not trained in the administration
of dosing and how to actually do this therapy. I refer to specialists, and I've found over
the years that the average urologist typically are not very skilled in teaching patients
how to do injection therapy. They just don't seem to be that engaged. It's important to
seek out a urologist that spends a significant amount of time in this area and has experience
training patients. When people are properly instructed practically everyone will have
the restoration of erections that are serviceable for intercourse.
When speaking of injections, there is a product on the market where a small pellet is placed
in the urethra—the urinary passage that comes out the end of the penis. This product
called "Muse" is effective also in a relatively small minority of patients in my experience.
Perhaps 10-20% of men swear by the product and are very happy with the results. So while
Muse is not a big success in most people, a minority of men will benefit and of course,
they're attracted to the fact that there are no needles involved. So Muse is worth a try.
Some experts have said that men that are getting semi serviceable erections with Viagra or
Cialis, but that aren't quite adequate may me the best candidates to try Muse to try
and reestablish an adequate erection for maintaining good results for intercourse.
Lastly, we should talk about the placement of a prosthetic device surgically in the penis.
This is a big step—a major operation to put a plastic device inside the penis surgically.
This is also very effective and satisfaction rates with this type of a product are about
80-85% of men. So there's a percentage of men that'll go through a major operation and
not get satisfactory results. Fortunately, this is only a minority. Men certainly have
to be motivated to undergo this type of surgery. The men who have undergone this treatment
have, for the most part, been very pleased with the results. This type of surgery required
special expertise—urologists that specialize exclusively in putting in penile prostheses
are necessary to get the best chance for a good outcome.
So in summary, to treat erectile dysfunction doctors typically use a stepwise approach
starting with pills, moving on to vacuum pumps, and then perhaps to shots, and then lastly
if all these other measures are ineffective, surgical intervention with the placement of
a prosthesis is then considered.
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