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Erectile Dysfunction (ED)

Erectile dysfunction is a common sexual dysfunction in males; it involves a change in the organic, relational, or psychological components of an erectile response. Erectile dysfunction results in the inability to achieve or maintain an erection that is adequate for sexual performance. Both the reflex and psychogenic erection are affected. Erectile dysfunction also serves as an indicator of systemic endothelial dysfunction. Additionally, it is often used as an early marker for men at risk of cardiovascular disease. The most common nonendocrine etiologies are vasculogenic, iatrogenic, and neurogenic. Diabetes, alcohol use, smoking cigarettes, benign prostate hyperplasia, and lower urinary tract symptoms increase risk of erectile dysfunction.

Erectile Dysfunction (ED) Condition Overview

Learn more on the BackTable Urology Podcast

BackTable is a knowledge resource for physicians by physicians. Get practical advice on Erectile Dysfunction (ED) and how to build your practice by listening to the BackTable Urology Podcast, reading exclusing BackTable Articles, and following the work of our Contributors.

Ep 23 Complex Penile Implants with Dr. Jonathan Clavell
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Erectile Dysfunction Diagnosis

Detailed medical and sexual history are the first step of erectile dysfunction diagnosis, along with a genitourinary exam. Peyronie disease, phimosis, or frenulum breve may be indicated by the genitourinary exam. Standardized sexual inventories and self-reported questionnaires are useful for interpreting the patient’s sexual health responses, without embarrassing the patient. Physical examinations include evaluation of the chest, penis, testes, prostate, and hair growth to identify potential hypogonadism. Hyperthyroidism, hypothyroidism, arrhythmia, and atherosclerosis may be indicated by the evaluation of the peripheral vascular system.

Erectile Dysfunction (ED) Podcasts

Listen to leading physicians discuss erectile dysfunction (ed) on the BackTable Urology Podcast. Get tips, tricks, and expert guidance from your peers and level up your practice.

Episode #23

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Dr. Jose Silva brings Dr. Jonathan Clavell back onto the show to discuss complex penile implant cases. They cover how to deal with mechanical complications of AMS700 and Coloplast Titan, penile implants in Peyronie's disease, penile implants in priapism, tips for successful revision surgery, and how to manage post-operative infections.

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Episode #19

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Dr. Ranjith Ramasamy explains the known effects of the COVID-19 virus and the pandemic on testosterone levels, vasculogenic erectile dysfunction, male fertility, and sexual practice patterns. Additionally, Dr. Ramaswamy uses evidence-based medicine to debunk myths about the adverse effects of the COVID-19 vaccine on men’s health.

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Episode #8

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Dr. Jose Silva interviews Dr. Jonathan Clavell, a high-volume prosthetic urology surgeon and assistant professor of urology at UT Health Science Center Houston, about erectile dysfunction counseling and penile implants. Dr. Clavell goes into detail about his journey as a men’s health specialist, ED workup and medical counseling, advantages and limitations of different penile implants, implants for complex ED patients (diabetics, cancer patients, etc.), and post-operative care for penile implant patients

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Erectile Dysfunction Treatment

Lifestyle modifications, such as a diet change, increase in physical activity, or medication change are the first line of treatment for erectile dysfunction. PDE5 inhibitors and vacuum erection devices are first line therapies that are followed by lifestyle adjustments. If primary treatments are unsuccessful, intraurethral suppository and intracavernosal injection can be used as other nonsurgical interventions. Erectile dysfunction is treated with surgical interventions, such as penile implants and penile revascularization, when all other therapies have been attempted.

Erectile Dysfunction (ED) Articles

Read our exclusive BackTable Urology Articles for quick insights on erectile dysfunction (ed), provided by physicians for physicians.

Peyronie's disease surgery

Peyronie’s disease is caused by fibrous scar tissue in the penis that causes painful, curved erections. Dr. Jonathan Clavell shares his surgical tips for Peyronie’s disease surgery in patients needing consequent penile implant surgery.

Penile implant device

A penile implant infection is a treatable complication of penile implant surgery. The penile implant can be removed or replaced after a washout procedure. Additionally, patients with infected implants should be started on culture-specific antibiotics.

Penile implant surgery consultation

Patients with chronic priapism require special considerations when undergoing penile implant surgery. Dr. Jonathan Clavell shares advice about assessing the extent of fibrosis present, special preoperative therapies, and additional surgical techniques in order to place a penile implant successfully.

Penile implant post-op pain medication gabapentin

Diligent post-operative care for penile implant surgery is essential because infection, capsule formation, and penile implant post-op pain are possible. A strict regimen of antibiotics, pain medications, and patient education can improve post-operative patient outcomes.

Coloplast Titan penile implant

The Coloplast Titan is one of the most popular three-piece inflatable penile prostheses in the United States. During penile implant surgery, each piece can be adjusted to fit the patient. Learn about the Coloplast Titan and how it compares to the AMS 700.

References

[1] Yafi, F. A., Jenkins, L., Albersen, M., Corona, G., Isidori, A. M., Goldfarb, S., Maggi, M., Nelson, C. J., Parish, S., Salonia, A., Tan, R., Mulhall, J. P., & Hellstrom, W. J. G. (2016, February 4). Erectile dysfunction. Nature reviews. Disease primers. Retrieved October 31, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027992/

Disclaimer: The Materials available on https://www.BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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Podcasts

Complex Penile Implants with Dr. Jonathan Clavell on the BackTable Urology Podcast)
Impact of the COVID-19 Pandemic & Vaccines on Men's Sexual Health with Dr. Ranjith Ramasamy on the BackTable Urology Podcast)
Men's Sexual Health with Dr. Jonathan Clavell and Dr. Jose Silva on the BackTable Urology Podcast)
Minimally Invasive Focal Therapy for Prostate Cancer with Dr. Amit Patel and Dr. Ranko Miocinovic on the BackTable Urology Podcast)

Articles

Peyronie's disease surgery

Optimizing Peyronie’s Disease Surgery for Penile Implants

Penile implant device

Treating Penile Implant Infections

Penile implant surgery consultation

Penile Implant Surgery in Patients with Chronic Priapism

Contributors

Dr. Jonathan Clavell on the BackTable Urology Podcast

Dr. Jonathan Clavell

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