Personalised Treatment for Erectile Failure
Erectile failure is the man's inability to achieve sufficient rigidity of the penis during sexual intercourse. To understand this problem it is useful first to know how an erection occurs in the penis.
First of all, inside the penis there are 2 tube systems (corpora cavernosa) that allow blood to pass through. Rigidity develops in the penis when blood enters this tube system at a speed of 30 cm/s and leaves at 5 cm/s. With this rigidity the man can comfortably have intercourse. If the inflow is slower than 30 cm/s or the outflow faster than 5 cm/s, the rigidity slackens and erectile dysfunction occurs.
As for the causes of this problem, vascular, metabolic and psychological causes can be listed.
Diabetes (DM), high blood pressure (HT), unhealthy living conditions and excessive stress can unfortunately cause erectile problems in men.
The biggest cause I see in my patients is usually excessive abdominal fat, inactivity and uncontrolled diabetes.
In younger patients, because of loosening of the vessels inside the penis (venous leak), the blood arriving at high speed unfortunately does not stay in the penis and leaks back. As a result, even if rigidity develops, the penis suddenly slackens at the slightest strain.
How is this condition treated?
First of all, the patient must gather his courage and make an appointment with a urologist, because training in this subject and the treatment options in all their aspects are provided only during urology residency. If a man has an erectile problem, his testosterone, FSH, LH, prolactin, 3-month average blood sugar, cholesterol and vitamin D values must be checked. Is there a condition affecting blood flow in the penis or a hormonal obstacle? This must be determined. If all tests are normal, the patient's lifestyle and psychological state should also be evaluated.
Which physician should be consulted for erectile failure?
It is important to make sure that the physician who treats you has specifically completed a urology residency. Just as a physician in a surgical branch does not have command of diabetes or cholesterol treatment, branches other than urology are not the fields in which training on this subject is given.
What are the treatment options?
The patient is first listened to carefully by the urologist and then examined. After this stage detailed blood tests are performed and, if necessary, a penile Doppler scan.
In treatment planning, if there is a hormonal disorder its treatment is started.
ESWT (shockwave therapy)
At the Androfert Clinic, shockwave therapy is applied by Assoc. Prof. Muhsin BALABAN with Piezo2 technology. Piezo2 technology is among the newest and most effective treatments in shockwave therapy. With this technology developed by the German company Wolf, unlike other devices, wave energy is delivered to 100% of the penis and it shows 87% effectiveness. In this treatment, planned as 2 sessions a week and 6 to 8 sessions in total, there is no pain and no side effects have been reported. The procedure takes about 15 to 20 minutes.
Penile PRP (P-Shot) therapy
This treatment is usually performed together with shockwave therapy. An average of 2 to 4 sessions is recommended. In the mixture prepared from the patient's own blood, the platelet-rich part of the blood is taken and delivered into the penis with a very fine needle. This mixture begins to show its effect within 1 month and regenerates the penile tissue.
Today PRP therapy is used in many fields of medicine, for example in plastic surgery for tissue regeneration, in orthopaedics for joint cartilage regeneration, or in hair transplantation for healthier hair growth.
Finally, in urology too, it is used together with shockwave therapy for erectile failure so that the effect is greater. One session a week, 4 sessions in total, is usually sufficient.
SVF (stem cell) therapy
This treatment can be recommended for patients who have not benefited from shockwave therapy and PRP therapy. The purpose of stem cell therapy is as a salvage treatment for patients who do not want a penile prosthesis. Fat taken from the person's abdomen (by liposuction under local anaesthesia) is put through a special process and delivered into the penis with a fine needle. In this treatment the effect begins within 3 months, and it shows 70% effectiveness in patients who have not benefited from any treatment. It is a day procedure and does not require hospitalisation; it can even be performed in office conditions. The person can return to normal life the same day.
Penile prosthesis (“happiness stick”)
The penile prosthesis is offered as the last treatment option. There are one-piece and three-piece types. The procedure is performed with a 1.5-hour operation and requires 1 night in hospital. After 45 days the patient can have sexual intercourse. There is no change in sensation. Ejaculation continues as before. For men who want to have children, a penile prosthesis does not prevent this.
IN CONCLUSION
If you have an erectile problem, the best treatment option for you can be planned by consulting a UROLOGY specialist trained in this subject.
