erectile dysfunction Archives

Climacturia After Radical Prostatectomy: What is It? Why is It? How Do We Treat It?

by Brian S. Christine, MD | Jan 2025

Brian S. Christine, MD, Brian S. Christine, MD, addresses the overlooked issue of climacturia in men who have undergone radical prostatectomy.

In this 19-minute talk, Dr. Christine outlines both conservative and surgical management strategies for climacturia. Simple approaches include bladder emptying before intercourse and the use of constriction rings, pharmacologic treatments, and surgical options like suburethral slings. For patients with severe erectile dysfunction requiring penile implants, he discusses an innovative approach using a Mini Jupette sling.

Dr. Christine emphasizes the need for better preoperative counseling on climacturia and highlights the range of available treatment options tailored to individual patient needs, from conservative measures to advanced surgical interventions.

Priapism: How Do We Manage, and How Do We Learn How to Manage in 2024?

by Thomas J. Walsh, MD, MBA, MS | Aug 2024

Thomas J. Walsh, MD, MBA, MS, discusses practical strategies for evaluating, diagnosing, and managing ischemic priapism. He begins with an overview of the symptoms, diagnosis, associated risks, and standard treatment procedures for the management of ischemic priapism.

Dr. Walsh then turns to effective treatment options after intracavernosal phenylephrine and corporal aspiration fail. He outlines various types of distal shunting, corporal tunneling, penoscrotal decompression, and early prosthesis placement.

Dr. Walsh concludes by addressing the lack of standardized training for treating ischemic priapism. He outlines a simulation curriculum designed to quickly train and presents the results from the pilot study.

Erectile Dysfunction Treatment – State of the Art Care in 2024

by Thomas J. Walsh, MD, MBA, MS | Jun 2024

Thomas J. Walsh, MD, MBA, MS, reviews erectile dysfunction (ED) prevalence, risk factors, lifestyle, and treatments available for patients. He addresses the stigma and the biology of ED, emphasizing the importance of explaining both to patients as part of the treatment discussion.

Dr. Walsh explains that for approximately half of men, oral medications are insufficient to treat ED and shares the updated American Urological Association (AUA) guidelines for ED treatment including oral agents, intra-penile therapies, surgery, and lifestyle changes. He outlines advantages and disadvantages of therapies such as type-5 selective phosphodiesterase inhibitors, intraurethral and topical alprostadil, intracavernosal injection, penile implants, vacuum erection devices, and low-intensity shock wave (LISW) therapy.

Dr. Walsh concludes by outlining his approach to patients, emphasizing the importance of general health and using the opportunity to help patients understand the link between lifestyle and ED. He also emphasizes the importance of referring patients to a specialist when a practitioner is outside their comfort zone or if the patient requires treatments outside of their toolbox.

In-office Therapies for Men with Erectile Dysfunction

by Jesse N. Mills, MD | Mar 2024

Jesse N. Mills, MD, discusses the effectiveness of a selection of experimental in-office therapies for erectile dysfunction treatment. Throughout his presentation, Dr. Mills explores the outlook, benefits, and challenges of experimental therapy options currently pushed by external market forces, including:

Low-intensity Shockwave Therapy (LiSWT)
Platelet-Rich Plasma (PRP)
Stem Cell Therapy
Intracavernosal Injection (ICI)
Hyperbaric Oxygen

Dr. Mills concludes by stressing that although these therapy options are still considered experimental, urologists should strive to observe these therapies and hold balanced conversations with patients regarding their efficacy. He encourages urologists to stay optimistic about erectile dysfunction treatment as stewards of male health, suggesting they watch for new data in the world of experimental treatments.

Sildenafil: 25 Years Later

by E. David Crawford, MD | May 2023

25 years after the FDA approval of sildenafil, Dr. Hirsch, Dr. Rosen, and Dr. Goldstein reflect on the past and future of PDE5 inhibitors.

Changing Paradigm in the Diagnosis and Management of Erectile Dysfunction

by Mohit Khera, MD, MBA, MPH | May 2023

Mohit Khera, MD, MBA, MPH, discusses the shared decision-making model of ED treatment and the current shift toward regenerative therapies.

Guidelines and Practical Applications: Erectile Dysfunction

by William O. Brant, MD, FACS, FECSM | May 2023

William O. Brant, MD, FACS, FECSM explores the latest clinical guidelines and their application in managing erectile dysfunction (ED).

Treating Erectile Dysfunction – A Novel Option

by Neil H. Baum, MD | Feb 2023

Grand Rounds in Urology Contributing Editor Neil H. Baum, MD, Professor of Urology at Tulane Medical School, discusses a novel option for treating erectile dysfunction (ED) alongside phosphodiesterase type 5 (PDE-5) inhibitors: healthier diet and regular exercise. Dr. Baum explains that discussing this with a patient does not take long; emphasizes the patient’s responsibility for, and agency in, controlling his own health; and may lead him to an inexpensive and effective solution that helps not only with ED but with the many comorbidities that often exist alongside it.