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Urology (Expert Forum)
ED. Physical or Psychological?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
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ED. Physical or Psychological?
by glickmpb, May 29, 2007 12:00AM
Ill try to keep this short...
Im a 37 year old male who doesnt drink, smoke or do drugs. I do cardio regularly, take vitamins and try to eat decently. Im about 5'9" and 190 pounds. Anyway, my problems all started about 6 to 7 years ago when I was going through a stressful time. My sex drive appeared to hit a wall and I have never recovered. I cant maintain an erection and usually climax prematurely. I masturbate regularly, almost every day, but still have erection problems and climax quickly. Its now causing stress in my marriage.
Anyway, during this whole time, I have had other related issues that were diagnosed as prostatitice and have been on numerous drugs through the years to no avail. Other symptoms have included, extreme sensitivity in my testicles, burning/itching near the tip of my penis, and some groin pain. I have seen numerous urologists and had many tests. Scrotum ultrasound, testosterone tests, lower GI, and several prostate tests. All tests came back negative, although my testosterone tests were considered low. I had been put on Androgel with absolutely no effect and viagra also with no effect.
At this point I dont know where to turn for direction. My last urologist said he simply didnt know how to help me.
So, what would you recommend for the next step??
Im a 37 year old male who doesnt drink, smoke or do drugs. I do cardio regularly, take vitamins and try to eat decently. Im about 5'9" and 190 pounds. Anyway, my problems all started about 6 to 7 years ago when I was going through a stressful time. My sex drive appeared to hit a wall and I have never recovered. I cant maintain an erection and usually climax prematurely. I masturbate regularly, almost every day, but still have erection problems and climax quickly. Its now causing stress in my marriage.
Anyway, during this whole time, I have had other related issues that were diagnosed as prostatitice and have been on numerous drugs through the years to no avail. Other symptoms have included, extreme sensitivity in my testicles, burning/itching near the tip of my penis, and some groin pain. I have seen numerous urologists and had many tests. Scrotum ultrasound, testosterone tests, lower GI, and several prostate tests. All tests came back negative, although my testosterone tests were considered low. I had been put on Androgel with absolutely no effect and viagra also with no effect.
At this point I dont know where to turn for direction. My last urologist said he simply didnt know how to help me.
So, what would you recommend for the next step??
Doctor's Answer
by Kevin Pho, MD, May 30, 2007 12:00AM
, May 30, 2007 12:00AM
You have had a comprehensive evaluation, which would rule out many of the more common conditions that can lead to your symptoms - such as infection.
Low testosterone has been appropriately treated with Androgel.
I would also obtain blood tests to look for diabetes or thyroid dysfunction. An ultrasound to look at vascular flow to the penis can be considered as well.
If the tests continue to be negative, you can consider other ED treatments like Cialis or Levitra.
More invasive therapy like a prosthesis or penile pump can also be considered if the symptoms continue.
These options can be discussed with your urologist, or in conjunction with another opinion.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
Low testosterone has been appropriately treated with Androgel.
I would also obtain blood tests to look for diabetes or thyroid dysfunction. An ultrasound to look at vascular flow to the penis can be considered as well.
If the tests continue to be negative, you can consider other ED treatments like Cialis or Levitra.
More invasive therapy like a prosthesis or penile pump can also be considered if the symptoms continue.
These options can be discussed with your urologist, or in conjunction with another opinion.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
Member Comments (1)
by glickmpb, May 30, 2007 12:00AM
To: Sexual Dysfunction
0
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