Erectile Dysfunction (ED)What Men Should Know

Paul Gittens, MD, FACSMedical Director Philadelphia Center of Sexual

Medicine

P

Dr. Paul Gittens is the medical director of PCSM Expert in the field of Sexual Medicine Dr. Gittens is a board certified urologist that

underwent specialty training in Sexual Dysfunction, Hormone Replacement and Male Infertility

PCSM is a concierge modeled practice treating only problems dedicated to the sexual health of men and women

More time dedicated to patient and education Excellent outcomes

Male Sexual Dysfunction & Infertility

Hypogonadism (Low testosterone)

Erectile Dysfunction

Penile Prosthesis

Peyronie’s Disease

Premature Ejaculation

Ejaculatory Dysfunction

Male Infertility

Orgasmic Dysfunction

Vasectomy Reversal

No Scalpel No needle vasectomy

Libido

What is ED?

ED is the persistent inability to achieve and maintain erection significant for sexual intercourse

The reality is that ED comes in many different forms Difficulty initiating an erection Difficulty sustaining an erection Stuttering erections, etc

Is it in my head?

Mostly No, but Yes

Anxiety

ED

What causes ED ?

Vascular disease- heart disease, high cholesterol, hypertension

Neurologic disease- Parkinson disease, spinal cord injury, MS

Iatrogenic- prostate cancer treatment, radiation, pelvic surgery

Environmental- smoking, alcoholism, drugs Hormonal- low testosterone, steroid abuse, excess estrogen Medication- beta blockers, anti-depressants, water pills,

SSRI Psychological- anxiety, depression, anger, stress

Shared risk factors with cardiovascular disease

Diabetes High blood pressure High cholesterol Cigarette smoking Lack of exercise Obesity Metabolic Syndrome

Does the size matter?

Having ED proceeds the onset of heart attacks – Smaller vessels are affected first.

3.0- 4.0 mm1-2mm

What not to do:

Speak to a sexual medicine physician

Focuses only on men’s health Expert in the treatment of all

sexual dysfunction and hormone disregulation

Time to explain your problem Education on how to treat Provides effective treatment for

your sexual dysfunction, male infertility or hormonal needs

Is there treatment? Yes!

Life style changes Calorie restriction Weight reduction Stop smoking, decrease alcohol intake Exercise Stress reduction Sleep

Will also decrease rates of cardiac disease, diabetes, high blood pressure, and stroke

If you help your body you will help your penis

Medical Treatment

Oral Therapy Viagra Cialis Stendra Levitra

Not just giving you a pill and kicking you out of the office

Better education leads to better results with oral medication

Direct Penile therapy ?

Penile injection therapy FDA approved medication Trimix

Muse- Medicated urethral system for erections

Your Sexual Medicine Physician (SMP) needs to be be able to dose medication to obtain a penetration hard erections, appropriately provide thorough teaching on how to use medication, and be able to manipulate dose. PCSM has a variety of penile injection doses which are tailored for each individual patient. It is important that the SMP knows how to manage any side effects, i.e. priapism, burning

External Devices

Vacuum erection devicesProvide negative pressure

suction to the penis causing erections.

Different techniques can be used to obtain an erection and stretch the tissues of a damaged penis.

Penile recovery after prostate cancer treatment

Philadelphia Center for Sexual Medicine- Penile Rehabilitation Program

Dedicated programTo preserve erectile function and prevent negative structural changes in the penis after prostate cancer or pelvic surgery and radiation

Therapy begins before or after therapy

Uses a mixture of medication and treatments depending on individual needs

If you don’t use it…..?

Penile Implant

Surgical treatment for severe ED Short surgery Effective Highest satisfaction rate

amongst therapies Ready when you are

Dr. Gittens is an experienced prosthetic surgeon and has placed hundreds of penile prosthesis

Summary

Erectile dysfunction is common

ED and cardiovascular disease share common risk factors

Treatment should be provided by a physician dedicated to sexual medicine and men’s health

Treatments should be multi modal and individualized

Lifestyle

Effective Treatment

PCSM

Take control of your penis?

Thank you

PhiladelphiaSexualMedicine.com