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If a man has a persistent and consistent and ability to obtain and / or maintain the erection for satisfactory sexual activity, they have the condition of erectile dysfunction. It’s very important that the person understand the basis for the erectile dysfunction. Too often, a man will go to his primary care doctor and say, “Gee, I don’t have the erection I used to have.” And the doctor, without much further discussion or evaluation, will say, “Well, try these pills, the Viagra / Cialis pills, standard pills, and see exactly what happens.” So another group of patients are a little frustrated with that approach and say, “Gee, can’t you tell me what’s wrong so I can have a better approach to therapy?” So we do the bio-psycho-social approach for erectile dysfunction. We have the patient interviewed by the sex therapist for one hour, interviewed by the physical therapist to see if there is a musculoskeletal contribution.
And then we do biology testing. We look for nerve issues. We look for blood flow issues, hormonal issues. The specific blood flow issues are very interesting because the person doesn’t have an erection problem in the flaccid state. It’s very complicated for doctors who don’t have the ability to allow the patient to have an erection in the office to study the basis for the erectile dysfunction. But we have all the equipment we need to get a man to have an erection. We actually take a very, very fine needle, about the size of a human hair in diameter, and inject the equivalent of liquid Viagra into the man’s penis. And he will get a firm, sustained erection, and then we can study it. Typically we study it with an ultrasound device. So actually I can see the artery flowing blood as during the erection.
I can see all the tissues, what happens to the tissues. I can see the thickness of various chambers. I can see if tissues are healthy versus scarred. It’s a fabulous opportunity to gain insight into what’s happening with the erection. I always tell patients, if you go to your car dealer and you have a sound at 60 miles an hour that you don’t have at any other miles per hour, and the man looks as the car is parked and says, “Gee, I think I know what’s wrong with it,” he can’t really do that. So you can’t go to a regular doctor with an erection problem and be studied in a flaccid state. That makes no sense. So you need to be in a specialized facility where having an erection and testing it is how you’ll find out what’s wrong.
