Urology/Help

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Question
QUESTION: Dear Doctor,
I am writing in order to request your help.
I am a 25 year old male suffering from Erectile Dysfunction.
I believe it was caused by a weekend football game with friends
and being hit with a football in the groin area.  It hurt !
Anyway I have been to more than a few doctors. Urology specialist.
One says, possible Peyrony's, other say possible Venous Leakage.
None have a specific diagnosis, other than medication.  I need to find a specific diagnosis for my peace of mind and in order to resolve what approach I need to consider. PLEASE !  I live in Florida and I need a Cavernosogram. Can you help me find where I can obtain it from a professional. Please allow me to thank you for any help you could offer.
Sincerely,
Fichey

ANSWER: Fichey:

Getting a "specific diagosis" is not always easy or even possible in ED.  Most of us take the "goal oriented" approach and use what treatments we have since fixing or curing the underlying problem is almost never possible.

Also, knowing the diagnosis does not help with treatment.

However, if you wish to pursue this, you may need to go to a university program where they have the equipment to do nocturnal penile tumesence testing, doppler studies and possibly cavernosography and cavernosometry.

We do not give specific recommendations for physicians, but you can try the Sexual Medicine Society. Members will have additional interest in ED problems.

---------- FOLLOW-UP ----------

QUESTION: Thank you for the response.
As you might know, to at least know what is the cause
one can understand and deal with what is available
to change the present situation.
To proceed with goal oriented approaches is not dealing with
what might be the specific issue. Is a cavernosography and
cavernosometry more definitive with results that the doppler studies ?
And if so, are they still being done and where.
Thanks again for your information.

Answer
Fichey:

As stated earlier, it is not always possible to determine a cause.  The most definitive study would be cavernosometry and cavernosography, penile tumesence monitoring and penile doppler studies.

Cavernosometry is rarely done now except in larger university practices and mostly as a research tool.  You will need to check with your local urologists to see if any are doing these more sophisticated studies.

Let me ask you this.  If you take Viagra and it works well, why bother with lots of testing that will not ultimately result in a treatable cause?  Well, it's your money.  Good luck.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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