Urology/ed+pe

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Question
Hi sir.how is erectile dysfunction& premature ejaculation evaluated diagnosed and what are tests done in urology.androly.homeopathy and how is it treated .are the treatment effective.is there some thing called advanced erectile dysfunction.if yes how it is treated ?thanks

Answer
Gulli:

What you have asked would be the equivalent of a textbook chapter and far too much to go into here but I will give you a brief summary.

ED is usually evaluated by a history and physical examination, review of medications, sexual history and a testosterone level.  Further evaluation depends on the situation.  We can go further and do nocturnal penile tumescence testing (looking for night-time erections), penile biothesiometry (vibrational sensitivity of the skin of the penis) and doppler ultrasound (looking at the blood flow) but these are not typically done on the average patient as they don't change therapy.

There is no specific diagnostic testing for Premature Ejaculation.

Treatment for ED is quite effective.  We usually start with pills like Viagra but can also offer testosterone supplementation, external vacuum devices, Urethral suppositories (MUSE) and Penile Injection Therapy.  If all of these fail, we can consider a penile prosthesis implant.

Treatment for PE is usually a pill like zoloft or anafranil that delay ejaculation, but the more effective treatment is sex therapy by a certified therapist where the underlying problem can be dealt with directly.

I've never heard of advanced erectile dysfuction and would not know what it refers to.

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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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