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EP199: Artificial erection the cure for difficult-to-treat ED | PUTTING DR G ON THE SPOT
The Star
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11/25/2023
Consultant urologist Dr George Lee Eng Geap, or a.k.a Dr G, explains how does the penile prosthesis work as one of the ultimate solutions for the difficult-to-treat erectile dysfunction as a result of the treatment of prostate cancer.
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00:00
As you may recall, in the whole month of November, we have been focusing on prostate cancer and
00:06
various consequences of the treatment and also sexual dysfunction.
00:10
We talk about radical prostatectomy, we talk about radiotherapy and today we are going
00:16
to talk about metastatic prostate cancer and how hormonal suppression may result in sexual
00:23
dysfunction.
00:23
As you can imagine, that if you suppress a man's hormone, the sex drive will be reduced
00:36
and also induces this difficult to treat erectile dysfunction.
00:41
Under such circumstance, conventional treatment such as the blue pill doesn't necessarily
00:47
work.
00:48
So what are the solutions for such difficult to treat erectile dysfunction?
00:54
In fact, there are two ways.
00:56
One of them is injectable directly into the penis itself called intracarbonoso injection.
01:05
Such vasodilation will induce effective erection.
01:09
But it doesn't work for everybody.
01:12
Therefore, another form of treatment is a penile prosthesis.
01:17
Effectively, this is a device inserted into the erectile tissues of the penis and make
01:24
artificial erection possible.
01:26
It actually has been introduced a long time before the blue pill in the 70s.
01:31
So there are two forms of penile prosthesis.
01:35
One type is called hydraulic expandables and the other type is called malleable rods.
01:42
Let's deal with the simple one first.
01:45
Malleable rods essentially are the rods that surgeons put into the penis so that it can
01:51
create an artificial erection.
01:54
That itself is actually very effective.
01:56
However, obviously it's more invasive and less natural.
02:02
The other form, which is the expandable hydraulics, essentially there are three components.
02:08
There are two hydraulic cylinders that's been put into the erectile tissues of the penis.
02:14
There's a pump that's hidden in the scrotum and there's a reservoir of saline that will
02:20
deliver to the actual erectile cylinders whenever the pump is switched on.
02:27
Although this is the most effective form of prosthesis, however, sometimes the device
02:36
itself might become faulty because after using it for a long time, it may be defective.
02:42
So therefore, sometimes this might get infected and defective and may need change.
02:48
So therefore, we don't necessarily need this to be inserted in all patients, especially
02:55
the patients are responding to injections or medication, then prosthesis is not necessary.
03:01
However, if truly patients do suffer from non-oral or injectable treated conditions
03:11
of erectile dysfunction, penile prosthesis perhaps give the hope to patients to revive
03:18
their sex life despite the treatment of difficult prostate cancer.
03:24
Next week, we start fresh in the month of December, obviously over festivity, we want
03:30
to make it slightly more humorous and we're going to talk about various piercing in genitals
03:37
and also in other parts and we'll start talking about piercings around the nipples.
03:43
Let's find out in next week's Putting Dr. G on the Spot.
03:46
[music]
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