Urology/ed

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QUESTION: Hi sir.my inbox hit by mails of herbs like tongatali.maca.ginseng.which I tried from a local pharmacy but could not get single erection yet .are they or others herbs worth trying as they command expensive dollars with claims so attractive and want their customers to consume them on daily basis till some 5 to 6 months to show results & some claiming to boost testosterone naturally via herbs.     Recently read an article as per which previous testosterone therapy like gels patches were given .but the results of testosterone fluctuated and side effects were male pattern baldness but one thing that was interest to me was that there was recent breakthrough testosterone injection which is given every3 months.want to know will it be a solution to erection problems and how long those injections to be taken .will it have its share of side effects.or should I go the herbal way which I believe is slow and costly .kind elaborate and advice.thank you very much.

ANSWER: Guluman

There are no herbal products that have been conclusively proven to work. There are many treatments for ED such as Viagra (sildenafil), urethral suppositories, penile injections therapy and external vacuum erection devices. Penile prostheses can be done if nothing else works.

Testosterone therapy may be of some help in those cases where the base testosterone level is low. If you do not have a low testosterone level, taking extra testosterone will not help. Even when testosterone levels are low, taking supplements does not always work and can also be harmful.
You should talk to your physician or consult a local urologist.

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QUESTION: Hi sir .as a chronic hepatitis suffered consuming medications like vireof sustitutte counterpart of american viread.want to know are their blood tests to determine whether this medication is responsible for impotency .is it OK to take it with vireof and the premature ejaculation medicines can be taken with cialis or Viagra and without any fear of side effects.and are those prescriptions pilllls required to take when sex is wanted or does this prescribed medicines will bring sex life to normal without the need to take more pills.does they bring libido or they designed to work on the penis.how do they work kindly advice.heard of shock wave therapy.is it really effective?thanks

Answer
Gulmama:

There are no blood tests that would verify if vireof is responsible for your ED.  To do this, we typically stop the medication and look for a benefit which then disappears when the medication is started.  There is no mention of ED as a potential or noted side effect of Vireof.

Vireof has many potential side effects so there can be no guarantee about interactions with other meds.

Viagra is typically taken shortly before attempting intercourse.  While a good treatment, it is not a cure.  There is no medication or treatment that will bring sexual function and sex life "back to normal" without additional medications.  Viagra works exclusivelhy on the penis and is not likely to affect libido which is more affected by testosterone levels.

Shock wave therapy is highly effective for stones; not so much for ED. Wrong technology.

Viagra works by allowing higher levels of chemicals of arousal to persist in the penis resulting in increased arterial inflow into the erection bodies of the penis. It has no direct effect on libido or testosterone levels.  

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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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