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How To Cure Sexual Dysfunction In Men - Treatment, Symptons, Causes

Do you suffer from sexual dysfunction? There are treatments available that can help. Learn about the symptoms, causes and treatments for sexual dysfunction in men.

 How To Cure Sexual Dysfunction In Men

 Sexual dysfunction in men is a condition where a man is unable to either maintain or achieve an erection during sexual intercourse. It can also be referred to as erectile dysfunction.

 There are several potential causes of sexual dysfunction in men, including physical and psychological problems. Physical causes can include conditions such as diabetes, heart disease, and obesity. Psychological causes can include stress, anxiety, and depression.

 There are several treatment options available for sexual dysfunction in men. Treatment options can vary depending on the underlying cause of the condition.

 If the cause of sexual dysfunction is physical, then treatment options may include medication, surgery, or lifestyle changes. Medications that may be used to treat sexual dysfunction include Viagra, Cialis, and Levitra. Surgery options include penile implants and vascular surgery. Lifestyle changes that may be helpful include losing weight, exercising regularly, and quitting smoking.

 If the cause of sexual dysfunction is psychological, then treatment options may include counseling and therapy. Counseling can help to address the underlying psychological causes of the condition. Therapy can help to improve communication and intimacy between partners.

 Sexual dysfunction in men can be a frustrating and embarrassing condition. However, there are treatment options available. With treatment, most men are able to either improve or resolve their condition.

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Video transcription:

For dr henry jones night talk, let’s welcome dr ty function for to host the next session. Thank you thank you and good afternoon. Ladies and gentlemen, it’s my honor to moderate the following session with our honorable invited speaker, professor eric jung from australian, I’m so glad for professor jones background. Let me flashback my unforgettable days of study in the university of new south wales, sydney in 2004. Actually, my sister-in-law still lived nearby. The macquarie university professor zhong is a consultant urology surgeon at the angel urology center for sexual urinary, reproductive excellence and hold professional academic appointments at the university of queensland in brisbane and the macquarie university hospital in sydney, australia. He is the chair for the male arts and the andrology section we within the: u neurological society of australia and the new zealand known as usain’s secretary general for the asia, pacific, pacific society of sexual medicine, apssm and the chair of the scientific committee and the membership committee at the international society of sexual medicine issm. He has been invited as speaker and the surgeon mentor in at many national and international meetings. He has also more than 120 peer-reviewed papers and the 20 books chapters with each index of 29 and the corresponding i10 index of 62. He serves on the editorial board for more than 10 scientific peer review journals. So now, let’s give professor john a big hand for his speech with the title of prp for ed the real regenerative technology in server-based therapy. Professor john, please thank you very much, professor fung, for the introduction I’d like to share my screen all right so again, thank you again for the introduction I’d like to take this opportunity to thank professor chang for inviting me to the taiwan, innovative medical association, educational for I’d like to thank this opportunity to to say hi to all my taiwanese friends. I hope everyone is staying safe in the current cove. I also like to take this opportunity to thank the previous two speakers for setting the scene nicely to my talk, so this talk was given to me by professor chang to make me sort of put on my thinking head to share with you. What do I think about prp data for erectile dysfunction so for the next 15 minutes, or so I’d like to discuss with you the current understanding, based on the published study, which my two previous speakers cover and importantly to outline to you, the current controversy and also the limitation related to prp therapy for ed and also the future direction of where we should be going so for many of you that had visited brisbane brisbane has one of the highest population of taiwanese in australia and the reason probably relate to the temperature climate and brisbane is the official sister sister sister city of culture, so in terms of erectile dysfunction, we know that the traditional treatment for erectile dysfunction has been there to address the symptoms of erectile dysfunction rather than the underlying pathogenesis in recent years. We do know that there is a lot of interest in the use of regenerative technology, including stem cells, to try to potentially reverse underlying endothelial dysfunction. More importantly is that we do realize that, despite there is numerous basic signs and animal model studies showing that cellular based therapy like stem cell can be effective. There are limitations with the translation to clinical practice, so the new emerging data on blatant, rich plasma is certainly very exciting, as you can hear from the two previous speaker. So this is what we currently accept as the current standard medical therapy or surgical therapy for mandate of erectile dysfunction for those that have hyper geneticism testosterone therapy could be effective for those that have genetic or other form of erectile dysfunction. Certainly, pde5 is the first line, treatment and escalation to injection vacu or penile implant in medical refractory, erectile dysfunction. So, as the previous speaker has illustrated to you, the platin rich plasma is derived from the patient autologous on blood product, and what we do know about this is that it has being a concentrated level. It has at least four times the normal concentration compared to the plasma. So this is very important because this delivered to you a very high concentration of cytokine and growth factors. That’s available in the planet itself. Now it’s important to understand that this autologous product do provide a fibrin. So, after all, flatland is a freebie like product and it provides a framework so that it can then support regeneration that occur due to the various cytokine and growth factors and those goal factors has been covered by the professor zhang in the first talk and that it has various important factors in particularly of interest would be the vgf vascular, endothelial growth factors, because this is pretty much the main growth factor responsible for neurovascularization. Now it’s important to understand that majority of data that we do know from battle. Ridge plasma is derived from the stem cell therapy studies, so we know that compared to stem cell prp certainly appears to have a higher concentration of growth factors, certainly on surface. It is easier to prepare and perhaps easier to activate compared to stem cells and being a more direct preparation. You also get the more direct effect of the growth factors acting on the penile tissue, resulting in various changes. Being a blood product certainly has less regulatory red text. So, from a research point of view, it’s a lot simpler to go through the ethics and, lastly, from a safety profile. Point of view, because the platelet is more localized as compared to center, which has more multipleton regenerative capacity. Therefore, the safety profile for stem cell may be a bit more questionable compared to something like the prp, so the basic science for prp regenerative properties is about recruitment of various immunomodulation due to the recruitment of growth factors that stimulate inflammatory response, stimulate neuroangiogenesis stimulate, perhaps even stem cell differentiation. It’s important to understand that platelet-rich plasma is available either in a activated or non-activated form. So if you have a patient that you give a prp in a non-activated manner, it has to be activated in order for the platter to be effective. So this is a very important critical step to the success of prp therapy. Animal models has been covered by the first speaker. Certainly, we know that in various animal models, especially with the covenant nerve injury model, the injection of prp increases intra carbon also pressure, and that translates to better erectile function in the rats model, neural regeneration, upregulation of nitrate, neuronal, nitric oxide synthesis. When you do cross-sectional of the penile tissue. That is certainly something that we see and something that is reassuring to know that it actually translates to something. Physical. Importantly: in the cabinet’s nerve injury model, there seems to be some preservation of the axon regeneration we reduce in the apothosis index clinical studies. To date we have three published open study and one randomized control trial, and I didn’t know ahead of time, which I apologize about the two great study that came from the taiwan national university hospital also from the fujian catholic university hospital. So from the three published open level study they came on before year, 2000, the main group are from the russian, so the russian has been leading in terms of the animal study of the use of prp and in the original published, open level study. Looking at three various groups, they found that in group one and group two patients where they have about thirty patients in each group, we’ve activated prp and also a patient, had activated prp with pde5. It seems to work a lot better compared to group 3, which have the inactive prp group, then. Secondly, we have the wake forest group from u.s, so this is the group that is known for all the regenerative technology and in the very small number of 17 patients. They find that there is an increased ief 5 score by 4.14 points and from the I guess, from the middle east group again looking at about 61 patients. They find that there is an increase in ief score of about 5.2 and the second speaker, professor, has basically show us that the study from greece, which is a placebo, randomized control trial of the 30 to 30 patient the ief score increase, was about 3.9. Now this is very important to take into account that the increase in iavs score at this point in time is around less than five. Now we know for major clinical study that you need to have a minim increase in iv, score of at least five points to be considered of clinical relevance. So what are my criticism about the current prp data? Now? As we all know, many of the study have low number patient with relatively short term data, and again many of these are single center report. And apart from the recent study published by the greece group, they are lack of placebo control arm. We know that there is significant possible effect in patients on eating therapy, so up to about 30 percent of patients will respond to any treatment for erectile dysfunction. If given something the co-administration of other erectile agents is not clear in many of the studies, because many of the study doesn’t really discuss to you whether the patient have received prior cellular based technology like stem cells, which are more likely to enroll to have prp data or whether many of these patients take any other herbal supplement which may not be accounted for. If it’s not a pde 5., they certainly various degree of standardization in the treatment protocol we’ve seen from both the two groups in taiwan, different dosage, different preparation and different injection methods. Clinical safety data certainly is quite promising because, as we know, this is platelet so being a platelet you’re not likely to get properism but importantly being platelet. It can potentially cause a scarring, because we all know that in the peyronie’s disease arthrophysiology, the presence of platelet causes the fibrin and also causes the propagation of fibrotic disorder. So this is something that is probably may not be seen in the short term, but certainly as this prp expanded to larger population, it may potentially be an issue, especially if we do not standardize the injection protocol from outcome point of view, as previous speakers have mentioned, to you, certainly in patients with advanced function or patients that have significant penile fibrosis. Prp certainly is not effective in this group of patients. While we sort of talk about the size, we also need to talk about the other aspect of the medicine, which is the regulatory framework we know from a prp data. Majority of them are derived from the orthopedic and the sport industry. Certainly there’s a lot of aggressive promotion and, as the first speaker has listened to, you, there’s a wide range of treatment. In fact, you can pretty much inject prp into any medical condition on earth to see whether it works or not. So from a company point of view, many companies are promoting this as being the go-to solution, certainly from a regulatory point of view, there’s a direct consumer marketing and we know that in the current digital era, social media platform is being used quite uncontrolled manner, to try to propagate the idea about regenerative technology to try to reverse underlying disease process. We need to balance between the potential physical, psychological and financial harm to the patient. This is very important because in many of the clinics that produce prp for patients, there is a cost involved in this group of study. Now it’s important to understand that if this study at this point in time is not accepted as a standard of care, I wonder perhaps a cost should be waived in terms of this being an experimental research. So the transparency of scientific evidence and also professional accompanity can be questionable in some patient. The lack of regulation with medical advertisement, commercial interests that outpace the clinical evidence. This is something that is of concern as we sort of trying to promote a treatment that seems to have at this point in time some limitation translating from basic science to clinical practice, can prp action be enhanced. This is very important because, if prp truly be effective, it has to be given to patients based on certain criteria. So we know that as any regenerative technology, the treatment is only as effective as the right patient selection. So from the first and also from the second speaker, we can quickly alluded that the fact that prp can be effective but is certainly more effective in patients with mild to moderate, erectile dysfunction and also patients who have sub optimal response to pde5 medication. So that means that if you have no response to pd5, you’re less likely to be effective or if you have more significant degree of erectile dysfunction, you’re more likely to be not effective with any regenerative technology, especially in the setting of experimental therapy, it has to be with an informed consent, understanding what is involved and patient away. What are the limitations currently available? How do we improve prp technology? Certainly, as I mentioned before, it’s about activating the platelet component to it in order to result in higher concentration of growth factor release. So we know that there is the estologous prp versus the rich extract. Perhaps the use of activator. In addition with immunoligans or various growth factors, piggybacking to the therapy can be more effective than just a single blended therapy by itself adjunctive strategy. Now this is something that is quite interesting that professor huang mentioned previously. Is this an additive effect, or this is a synergistic effect when you couple with other cellular best technology? So we know that stem cell therapy has been around for many many decades now, so more than three decades of stem cell therapy has been around, and yet we still do not have a very good understanding of how stem cell can be effective in patients with erectile dysfunction. We also know that the co-administration of cellular best technology with other stenotherapy, especially pde5, certainly have shown some great promise, especially when both work on different pathway to try to stimulate neural vascularization. New regenerate technology, like shockwave therapy, is currently invoked, as we know that they certainly the use of shockwave to try to deliver and also maximize the outcome of stem cell injection in the penis. So perhaps shockwave therapy could be the activator to the erp therapy. So where are we going from here at this point in time? So we definitely need to have more clinical study without doubt, but importantly, with any clinical study, we need to have a very strict methodology so with the first speaker with the taiwan industry hospital with range of age, from the 20 to about 70 years of age. That is certainly not the right cohort that we want to test drp on. We really want to hone it down to what we think would be the most effective, because from then on, then we can expand the patient criteria, so standardization of prp formulation is very important because at this point in time we don’t really know what is the right dose. What is the right injection? What is the right volume and also how many injections need to give to the penis and importantly, when you’re injecting the penis? How on earth is this planet going to stay in the penis? Is it going to stay in one single spot within sort of couple of centimeter of radius of the injection, or do the patient need to massage the penis to try to get more smooth and more even delivery of the platelet across the entire penile tissue? We also need to address the concern about over-commercialization and also the financial gain related to this therapy. So again, I am very strong against any patient that charged the patient a lot of money for something that I think at this point in time is considered experimental at this point in time. Regulatory pathway, consumer body are certainly important in this group of patients because we know that many of these are being advertised in a very unregulated market, so consumer bodies are getting a lot of feedback about what is going on, and I can tell you that, as the chair of the andrology section every week, I have to respond to a public inquiry to my geological society about why such therapy is effective and why such therapy is not effective. So, there’s a lot of ants among patients who have paid a lot of money for this therapy that didn’t really get a good outcome. So importantly, I think the government has to set in a good regulation to try to implement a very nice safe platform to expand the research in this field. So with that in mind, I thank you again for your time and I look forward to any question from the audience. Okay. Thank you, professor jong. I have the privilege of the moderator, so maybe I can raise the first question for professor jong. In your experience and your acknowledging knowledge, can you compare the possible mechanism for treatment between the shockwave therapy and the prp yeah, so prp is basically injection of a product that actually have growth factor in it. So, basically you skip stimulation of growth factor as compared to shock waves, where you actually stimulate the tissue to causes the release of growth factor, so it means that, from a prp point of view, you’re one step simpler compared to shockwave. Second thing is that with the shockwave therapy, as many of you are aware at this point in time, we don’t really have the right treatment protocol for shockwave, but it’s safe to say that you need at least three spot in the penis for the shock wave to be effective as compared to just two spots. So I think that from a prp injection point of view, it’s safe to say that you need at least three spots to cover the penis. But obviously, if your penis is quite small, then you may not need two three injections. But what I’m interested to know is that when I have any patient actually do some kind of manual massage of the penis after the injection, because we know that with the intracarbon also injection with cavity, you really need to sort of like massage the penis to try to get the pg e1 to sort of work across the penis. So I wonder whether, with the two previous speaker, whether today have they thought about getting the patient to perhaps match to bed or perhaps massage the penis, to try to gain more action out of the planet. Injection. Thank you for your answer and any I have two questions. Okay,.

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