Ivy Family Health Updates

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In this segment, Dr. Paul Perito discusses erectile dysfunction with Drs. Edward, Kathryn and John Martin. Dr. Perito is a board certified urologist who specializes in erectile dysfunction and penile implants.

There are many causes of erectile dysfunction, all related to oxidative stress to the blood vessels in the penis. Examples would be diabetes, hypertension, smoking, and vascular insufficiency, which is similar to having a varicose vein in the penis.

Dr. Perito performs a full medical work-up on his patients, including testosterone levels to rule out any endocrine problems. He also does a special study which looks at the veins and arteries in the penis to more accurately diagnose any specific problems.

The treatment options are three tiered:

1. Pills: such as Viagra, which dilate the veins, and are an excellent option for early erectile dysfunction.

2. Injections: a vasoactive medicine is injected directly into the penis which allows the veins to dilate for 30 minutes to hours. Although the injections are not very painful, there is a high dropout rate for this option.

3. Penile Implant: Dr. Perito uses a technique that he developed to insert an implant through an infrapubic incision in about 10 minutes. The implant consists of two cylinders that can be filled with saline, which simulates what occurs naturally in the penis when it fills with blood. There is a small pump that the patient will squeeze to fill the cylinders, which will then be deflated after sexual intercourse. These come in various sizes to fit different penile lengths. During surgery he will measure the length to determine the appropriate size implant.

The penis will shorten during long periods of impotence, and can shrink from .5 to 5cm in a matter of 14 months. Therefore it is important to commence therapy as soon as possible.

Penile implants are now covered by most major insurance companies and medicare.