Man fulfills his true definition of man by the satisfaction he gives to a woman.
The Big Daddy of the male genitalia is the penis. Little boys describe it as a means by which urine leaves the body but as they grow into men, they take pride in the penis as copulatory organ.
Some say the penis size does not matter because the vagina is an accommodating hostess, but rare is the man who thinks his penis is big enough, and rare too is the woman who disagrees. That’s why we have urologists who perform operations to enhance the penis.
Penile technology can lengthen the penis for three-eight’s of an inch to two inches, depending on the patient. The suspensory muscles hold the penis close to the body with no blood vessels or nerves cut.
Say’s Waldermar Alarkon, A psychiatrist, “Penile Technology… is the modern techniques in penile management and economics, and is a blend of the physician’s expertise and skill, plus the patient and partner understanding the desire.”
Definitely, it appraises patients with erectile dysfunction, and gives therapeutic decisions parallel to a conceptual modern diagnostic plan. Urologists determine whether the major disorder is impotence (inability to have erection), or the sexual dysfunction such as premature ejaculation or concerns regarding orgasm.
During the first visit a “goal-oriented therapeutic treatment plan is made. The plan involves the patient’s sexual partner. It is important that the partner understands each of the therapeutic choices including the expectations and complications.
According to Doctors Ronald Lewis and David Barrett, the major goal choices of patients with impotence are : 1) accepting the loss of vaginal penetration with a rigid penis and using alternative sexual gratification methods (which urologist fail to mention) 2) medical therapy 3) psychological sex therapy counseling 4) vacuum/ constriction devices which are an option for almost any type of dysfunction except for very rare circumstances 5) home pharmacological injections programs 6) penile prostheses and 7) vascular surgery.
If the patient gives a history of partial erectile dysfunction, and describes decreased libido or manifestations of thyroid, adrenal, or pituitary symptoms, then appropriate laboratory tests can verify the diagnosis of a disorder.
However, those who elect to go on intermittent injection therapy with parenteral testosterone should be followed every six months with a repeat prostatic specific antigen and rectal evaluation of the prostate.
Almost every organically-based male erectile dysfunction patient will also have psychological overtones. It is often wise to have sexual counseling for the couple and use of the expertise of a sexual therapist in the treatment of all forms of male erectile dysfunction. If psychogenic impotence is thought to be the major cause of the patient’s impotence, the use of nocturnal penile tumescence (NPT) is recommended. “We feel that a good history and physical, as well as response to a pharmacologic erectile agent are steps that often preclude nocturnal penile erectile monitoring, ” Lewis says.
Vacuum Constriction Devices
The patient and his partners must be carefully instructed in the use of vacuum devices. Options should be available to seek further advise is the are not initially satisfied. Patient must also understand that ” erection obtained with this devise is full penile engagement, limited to the pendulous penis beyond the constriction band, therefore, it is not fixed. Also0, the penis will become slightly cold and bluish in color. Some patients dislike the lace of spontaneity of sexual intercourse with the use of these devises. For the most part though, satisfaction has been high for patients who have chosen these devices .
Pharmacologic Injection Therapy
The use of intracavernous pharmacological agents for the diagnosis and management of male erectile dysfunction has become extremely a commonplace. The agents most commonly used are papaverine with or without phentolomine and prostaglandin E-1 -PGE-1) or a combination of 3. “The penis erect for 30 minutes, 1 hour, or 2 hours depending on the dosage used, ” Dr Jaime Jorge of Mary Chiles Hospital relates.
Mandatory close follow-up of the patient ensures that any erection persisting for longer than two to four hours will be reversed with pharmacological antidotes. However, Dr. Jerry Santos of the UST Hospital says that priapism (painful erection of the penis might occur. “With this, gauge needle is inserted into the base of the penis to draw off 20-30 ml of blood.”
Placement of penile prosthesis for treatment of male erectile dysfunction has been very popular in the United States. The first completely rigid prosthetics were followed by semi-rigid devises, and finally various inflatable (hydraulic) devises. Modern penile prosthesis consist of two makor types of devices: semi-rigid and inflatable. The semi-rigid devices currently available are solid silicone cylinders with some type of metallic core or a cable connected interlocking plastic component system covered by a synthetic covering. The inflatable devises are of three types: self- contained, two piece with a combination scrotal pump and reservoir, and three piece systems with separate scrotal pump and a reservoir that is placed behind the rectus muscle.
Having been first introduced by non-urologists in the late 1970’s, vascular surgery is recommended only in highly selected individuals, and should be performed only by urologists who have had special training in the field. The success of this surgery has varied from 50-70 percent. Some critics have stated that since there is a high failure rate. These procedures should be considered experimental.
Urologists caution that any kind of wound is predisposed to infection such as having a penile gangrene. Of course, in some cases, surgery might not work.