Orlando Premature Ejaculation

Premature Ejaculation

Premature ejaculation (PE) can be classified as lifelong or acquired.

According to the International Society of Sexual Medicine, lifelong premature ejaculation is defined as male sexual dysfunction characterized by ejaculation that always or nearly always occurs before or within about 1 min of vaginal penetration and the inability to delay ejaculation on all or almost all vaginal penetrations, which results in negative personal consequences, such as distress, bother, frustration, and/or avoidance of sexual intimacy.

Acquired PE occurs at some point in a man’s life after having experienced normal ejaculation experiences in the past.

If a patient feels he is experiencing PE and would like treatment, it is important that he be assessed by a physician experienced with identifying the condition, considering if PE is lifelong or acquired, and devising an optimal treatment plan. Prior to treatment, a thorough history and physical exam should be conducted. All the treatment risks and benefits should be addressed before initiating treatment.

Treatment can include an on-demand oral medication that is taken several hours before sexual activity and one that is taken daily.

There are additional topical medications that can be applied to assist with delaying ejaculation.

In addition, there are behavioral techniques that can be used to delay ejaculation.

If you find you are experiencing this type of condition, please contact NV Medical Orlando for a personal and confidential consultation with our Board-Certified Urologist today.

Orlando Erectile Dysfunction Treatments

Erectile Dysfunction Treatments

Erectile Dysfunction (ED) is defined as an inability to achieve and or maintain an erection sufficient to perform satisfactory sexual intercourse. The spectrum of Erectile Dysfunction can also include premature ejaculation.

Erectile Dysfunction may result from psychological, neurological, hormonal, and vascular conditions. In addition, ED can be caused by disruption or impairment of the smooth muscle function of the penis.

Treatments of Erectile Dysfunction are variable and should be prescribed while taking the primary cause of ED into consideration.

Lifestyle Modifications may be recommended which can include weight reduction, regular exercise and smoking cessation.

Medication adjustment can be done with coordination of the original prescribing provider. Medications for depression, anxiety, psychological disorders and chemical imbalances, as well as medications for enlarged prostate can contribute ED. Thus, adjustment of the medication may improve the patient’s ability to obtain and maintain an erection.

Treatments for ED:

Oral Treatments:

Phosphodiesterase 5 Inhibitors (PDE5-I)

These medications require sexual stimulation to be efficacious. They are taken 30 mins- 1 hour prior to sexual activity. They cannot be taken if patient is also taking Nitrates which are medications for chest pain.

Intracavernosal Injections:

Often used for patients who do not have a satisfactory response to the oral treatments, this a very successful form of treatment for men with severe ED, including those with Diabetes Mellitus, and those who have had Prostate Cancer treatments including radiation and surgery.

Intraurethral Suppositories

This is a suppository that is placed in the urethra to improve the ability to obtain and maintain an erection

Hormonal Therapy:

If Men with ED are identified as having hormonal abnormalities, these should be identified and addressed as part of the treatment for ED

Vacuum Erection Device

This treatment is done by suction of blood into the erectile bodies of the penis. The blood is trapped in the penis with aid of a constriction device at the base of the penis.

Stem Cell/Platelet Rich Plasma Therapy

This procedure involves removing the patient’s blood, processing the blood and injecting platelet rich plasma into the cavernosa, also known as the erectile bodies of the penis. Several studies have demonstrated that PRP injection improves ED, including the quality, and firmness of the erection.

Low Intensity Extracorporeal Shockwave Lithotripsy

Currently under clinical investigations, this treatment has been shown to be efficacious in improving ED in patients who have not responded well to traditional therapies.

Surgical Treatments:

Penile Prosthesis

This procedure involves placing cylinders in the erectile bodies of the penis. There are 2 primary types, which are malleable or inflatable. The patient satisfaction for this procedure is >85% in  studies. This is suitable for patients who have not had success with less invasive ED treatments.