It happened again, didn’t it that perfect moment you’ve been waiting for everything is said, but just when things are really heating up, you get that awful sinking feeling that something isn’t working. Yes, erectile dysfunction. What excuse can you use this time a feeling, frustration, embarrassment, ill failure, letdown distress, inadequate guess what you are not alone: 33 million men are affected by erectile dysfunction, 2 in 10 minute, 20 years old, 4 in 10 men at 46, in 10 men at 68, in 10 minutes, 70 years old, have erectile dysfunction on a long-term basis. Erectile dysfunction is the difficulty in achieving or keeping an erection so that sexual intercourse is possible, also called impotence, diabetes, high blood pressure, heart disease, alcohol and smoking enlarged, prostate, prostate cancer, bladder surgery, obesity, low testosterone and hormone imbalance, depression, performance, anxiety and prescription medications can escalate edie dramatically and cause edy to occur earlier in age. So have you had enough? You really wanted a solution that aren’t you looking for safer or more effective natural alternatives. Drugs like Viagra and Cialis can have side effects and drug to drug interactions, I play injections and romance killers and scary. At the very least, here’s a quick video entry, urethral suppositories, are untimely mood breakers and can be painful and messy prosthetic implants are expensive, last resort treatments requiring surgery with scalpels cutting hydraulic pump, stitches vein and infection risk. There is a better, safer, organic treatment available for erectile dysfunction. The Priapus shot, also known as the pee shot. The private facade uses your body’s platelet-rich plasma or PRP to increase blood flow to the penis. This makes your erection stronger, maybe you’ve seen our TV and media coverage, hello, everyone, tom policie. Here I am the owner of Las Vegas aesthetics. We are probably the busiest facility in the Las Vegas area for the Priapus shot, and here the number one concern is the safety all of our equipment is FDA approved and we are probably one of 500 providers in the world who are trained, certified and licensed to perform the prior shot and I’ve been doing it for a couple of years now and there’s a lot of experience there. We do a lot of these for people and a lot of a lot of people come from all over the world. The farthest so far is Singapore and the thing I like the most about the private shot is it is as organic a procedure as you can get theirs, you’re using your own body to heal itself, as if you were a kid and you scrape your knee and then your knee with it after a week, the skin is completely real de ghin. The body knows what to do same effect in, in this case, with the prior shot it will reveal and restore and rejuvenate the area. So there is no cutting, there’s no scalpels, there’s no sutures. There is no pain, there’s no stitches! None of that. It’s an in-office procedure takes about 90 minutes to do total front to back and the probably the number one question is: does it hurt? No it actually doesn’t you don’t feel it? We know how to numb the area very well, so doing your research I. Take all this into consideration. We hope to see you here all right. Thanks ton, please see Las Vegas aesthetics, here’s what some of our patients have to say, restore your happiness, confidence and enjoy sexual satisfaction, again call Las, Vegas esthetics. Today, for a private consultation, come visit, Las Vegas aesthetics in Fabulous, Las, Vegas, Nevada, 702 66 for 1300 hi. My name is William Brandt I’m, a urologist here at the University of Utah, the division of urology Center for reconstructive, urology and men’s health. We’ve had another segment where we talk about erectile dysfunction in general, and what I want to talk more about today are the treatments for erectile dysfunction. Obviously this is a sensitive subject and I am gonna. Have some props here. So we do recommend this for the more mature viewer, although we won’t show anything too explicit. So what are the treatments in general I’m going to cover these first before we get to the specifics, but in general there is medical type treatments and non-medical treatments. The medical treatments that most people familiar with are the pills such as Viagra, levitra, Silas, there’s other kinds of medical treatments such as injections and suppositories, and then there’s non-medical treatments such as the vacu device or penile prosthesis, and we’ll cover each of these in turn. So what happens? A lot of men? Ask if you don’t do anything. Let’s say you just have a wreck tile dysfunction and you just don’t do anything well. What happens, unfortunately, is that the penis, like a lot of other things in the body, is a use-it-or-lose-it organ and just like a bodybuilder who stops lifting weights, they’re, gonna shrink and atrophy, and the penis is no different. So, for example, men who’ve had prostate cancer surgery and have had the prostate removed and have profound erectile dysfunction. As a result, they find an average of about two centimeter loss and the longer they go without erections they tend to lose some more size as well. So we do not recommend doing nothing if you want to preserve erectile size- and this has been true in animal studies and human studies. So the pills are the thing that I think most people are familiar with. Viagra was introduced to the com market in the late 90s and then Silas and levitra came out in 2003 and they do work pretty well. So if you look at studies that look at how much they improve the erection about 80% of men will say that the erections are improved versus about a quarter of men who are just taking a sugar pill or a placebo. Now, if you ask the question how many men are able to have successful intercourse? Of course, that’s not as good as 80%, because you can’t just have a better reckon. You have to have an erection that sustains long enough for intercourse. That is hard enough for intercourse, but it’s still pretty reasonable. Now, the the medications are not for everyone. There are certain medications that will not allow a man to take one of these pills for Edie, such as certain medications that are used for high blood pressure that can be dangerous. Additionally, about 30% of men have side effects from using these pills, whether it’s headache or feeling flushed or nasal congestion, but only about 5% of men stop using the pills as a result of that- and there are some keys to using these pills successfully there they are amplifiers, they are not magic pills, so we always tell men. If you take these pills and go watch a baseball game, you will not have an erection unless you love baseball. Another key element is that they work best if you have an empty stomach, so you take the pills either before dinner or after a snack, but not after a big meal, and the third thing is often they don’t work the first couple times, so you have to try them several times before you even decide whether they’re worth it for you or not so one option for patients if the pills are unsuccessful, is to use what’s called a vacuuming device. A vacu device is not a drug at all. It’s a mechanical object and I brought with me models of this. This is just one older model. There are many variations on this, but you can see this. It has a plastic cylinder and a pump and if I put the plastic cylinder on my hand, for example and I start squeezing this, it’s going to start creating a vacu down here. So if the man’s penis is in here, it’ll start drawing in blood and then there’s this, which is like a fancy rubber band that goes around the base of the penis to hold the blood in now this because it’s not a drug, does not have any drug side effects and that’s a positive thing. They’re also relatively inexpensive insurances, usually cover them and they work fairly. Well. If a man can get the hang of it, the downside is, unfortunately it’s so unnatural. It’s a very unnatural way to have an erection. The the erection itself is not normal arterial blood, and so sometimes the patient will complain that the erection feels sort of cold. The partn
er will complain, this direction feels cold, the penis may have abnormal coloration, maybe blood vessels are burst and so forth and overall, unfortunately, the success rate is not very high only at about 20%. So another alternative for medication is to do what’s called injection therapy and I brought this model. That shows that the erection bodies are on the sides here and here and they communicate with each other, and so if a man takes a pill of course, the drug goes everywhere in their body, including their penis, but if they want to get a drug in very efficiently, then they can draw it up, and you can see this is a very tiny needle. This is used for diabetics, it’s an insulin, syringe and they can place it right in the erection body on the side. This is not painful, they put it right in they inject the drug and they take it out the drug diffuses throughout the penis, and so it gives a very natural erection, usually in about five minutes, and so men are very happy with that. The downside of it is what you would expect is, that is that men who are feeling frisky grab a needle and put it in their penis. It’s not the most natural thing that comes to mind and that’s the big reason for drop out and the drop it is about 50%. If you look at it over a few years, so as another option for those who were either needle phobic or don’t want to use a needle, you can use what’s called urethral suppository. This is a suppository that goes directly into the urinary channel here and I brought an example of this with me, there is a little cap that goes off. The medication is placed after the patient urinates directly in, and this is hid to deposit the medication that it’s wiggled out and leaves the pill in here, and then that works it diffuses well there. The plus side of this is that it avoids needles, which is great, and it’s very easy to use the downside. It’s is very expensive and there’s a certain amount of penile pain that can accompany the drug dissolving about 30% of men event prostatectomy experience that it doesn’t work quite as efficiently as the injections do. You can imagine another problem with either this or the injections is that the man has to have very good hand function. He has to be able to see pretty well and again can’t be too fat because he has to be able to see what he’s doing and you can’t have miss. So what about for men? Who don’t have success with these other modalities or who are just unhappy using them? They don’t tolerate the needle etc. Well, another option is what’s called a penile prosthesis. This prosthesis have been around since the early 70s and there are several different types. Each prosthesis is a device that stays within the body and in that sense, is totally concealed and and looks very natural. The simplest kind I have a puppet here, really that I’m gonna use as a model, but the simplest kind is what we call a semi-rigid. So it’s not it’s not exactly Ridge and that’s not exactly flaccid, it’s a little hard to conceal, but it’s rigid enough to have to have intercourse for men who have very poor hand function or who want the simplest kind of procedure. This is a very nice way to go about this for men who want a more natural feeling, correction. There is a one called a three-piece device and I have a different puppet here. That shows this and what it is is there are. There are hydraulic cylinders within the the penis and there’s a pump in here like a third testicle and there’s a reservoir fluid that’s hidden in the abdomen. So when the man wants to have an erection, they just pump on this and there’s a models, doesn’t work quite as well, but you can see the fluid starting to go in. They can get a very strong erection when this is pumped up. All the way is just as rigid and feels just as natural as a normal erection- and you see it’s very rigid here and when the man has had enough there’s little button they hit also in the scrot there’s no external parts, they hit it. It gets out the fluid and all the fluid comes out and they go back to being flaccid. So the positive side of these prosthesis is they’ve been around for a long time. We have lots of clinical data on them, certainly from the point of view of naturalness. These are internal, there’s, no issues with spontaneity or no stuff to use and people like them very much, they’re, very discreet. If you were in the shower, if you had one of these inflatable ones at the gym, no one would notice that you had anything like this. You could even be on the swim team with this, and if you look at this graphic that compares the satisfaction rates of prosthesis versus other modalities of treating erectile dysfunction, the prosthesis do win with satisfaction at least 90 percent, more, like 95 percent injections, more like 40 percent pills about 50 percent. Now the the pros of these prosthetics they’ve been around for a long time since the early 70s and we have tons of clinical data on them. They’re totally internal in the man has full control of room and so they’re perfect in terms of discretion and spontaneity, like everything else they have downsides and the downsides are basically three things number one is they’re mechanical objects, and so, if you give them 10 15 years, they’re gonna break and need to be replaced which which can be done, but is another procedure. Number two is and the thing we worry about, the most is infection like any foreign object like a knee replacement or a hip replacement. These things if they get infected, the bacteria live on the device and the device has to be removed, at least temporarily, in order to get the infection to resolve now. Luckily, the infection rates for penile prospects are very low at about 1% or less, but they’re still not 0%. So we worry about that and the third thing has to do with patient expectations. If a guy comes in and says, but doc I used to be this big, we say well. First of all, your memory is terrible, but, second of all, no matter what size it was. That’s not what this prosthetic or and the other treatment for erectile dysfunction can give you it can just restore a function. So if a guy thinks this is a penile lengthening procedure, it is not that it’s not going to do anything other than restore good function, and if a man thinks of that realistically they’ll be very happy and if they don’t, then they probably will not. So in this segment, we’ve tried to review some of the treatments for erectile dysfunction. If you suffer from this problem personally, I encourage you to talk to your health care, professional or contact us and we’ll happy to help you. Thank you very much for your time. You.