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Best Urologist for Erectile Dysfunction Treatment Delhi

BEST UROLOGIST FOR ERECTILE DYSFUNCTION TREATMENT

Men who have a problem with their sexual performance may be reluctant to talk with their best urologist, seeing it as an embarrassing issue. However, best urologists are used to dealing with potentially embarrassing issues in private consultations; and, erectile dysfunction is now well understood, and there are various treatment by best urologists available.

Let’s understand this issue in detail.

A Man is considered to have erectile dysfunction if he regularly finds it difficult getting or keeping a firm enough erection to be able to have sex, or if it interferes with other sexual activity.

Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It’s also sometimes referred to as impotence.

There are several forms of Male sexual dysfunction, including poor libido and problems with ejaculation. But ED refers specifically to problems achieving or maintaining an erection. Men with ED often have a healthy libido, yet the body fails to respond.

Sexual dysfunction and ED become more common as Man ages. The percentage of complete ED increases from 5% to 15% as age increases from 40 to 70 years. But this does not mean growing older is the end of your sex life. ED can be treated at any age.

Erectile dysfunction (ED) occurs when a Man has consistent and repeated problems sustaining an erection. Without treatment by best urologist, ED can make sexual intercourse difficult.

What are the symptoms of ED?

You may have erectile dysfunction if you regularly have:

  • Erection that is too soft for sexual intercourse.
  • trouble getting an erection
  • An inability to achieve erections.
  • difficulty maintaining an erection during sexual activities
  • reduced interest in sex
  • Men who cannot get or maintain an erection that lasts long enough or is rigid enough to complete sexual intercourse is considered to have erectile dysfunction.

What causes erectile dysfunction?

Normal erectile function can be affected by problems with any of the following systems:

  • injuries
  • obesity or being overweight
  • increased age
  • stress
  • anxiety
  • drug use
  • alcohol use
  • smoking
  • blood flow
  • nerve supply
  • hormones
  • cardiovascular disease
  • diabetes
  • hypertension
  • damage from cancer or surgery

Diagnosing ED: Physical Exam

The Andrologist examines the patient physically. On the basis of the symptoms and medical history diagnosis is defined. The best urologist conducts a complete physical exam to uncover signs such as poor circulation or nerve trouble. And look for abnormalities of the genital area that could cause problems with erections.

Lab Tests

Several lab tests can help diagnose Male sexual problems. Measuring testosterone levels can determine whether there is a hormonal imbalance, which is often linked to decreased desire. Blood cell counts, blood sugar levels, cholesterol levels, and liver function tests can reveal medical conditions that may account for ED.

What treatment by best urologists are available?

Treatment by best urologist for ED will depend on the underlying cause. You may also need to use a combination of treatment by best urologists, including medication, lifestyle changes, or therapy.

Medical management:

Andrologist recommends medicines to treat ED if mild. If after knowing the history of the patient that the medicines have stopped responding for his case then he is advised for other options like Vacuum devices, penile injections, Penile prosthesis.

Vacuum devices

Vacuum erection devices are a mechanical way of producing an erection for men who do not want or cannot use drug treatment by best urologists, or find they are not working.

The lack of spontaneity with the use of vacuum devices means that many men find other treatment by best urologists for erectile dysfunction preferable.

Surgical treatment by best urologists

There are several surgical treatment by best urologist options:

  • Penile Prosthesis / implants– these are a final option reserved for men who have not had any success with drug treatment by best urologists and other non-invasive options.

There are various kinds of penile implants available in market. Surgeon decides on the grounds of various factors which implant is needed for whom.

Types of implant:

Semi rigid –two piece implant

Inflatable-three piece implant

Advantages of penile implants:

  • These are Easy to use. Surgeon teaches you how to operate the implant after the surgery.
  • Feels natural during intercourse .Implant does not interfere with the natural orgasm means natural orgasm is intact even after the procedure.

  • Eliminates the need for costly pills or shots
  • Offers a long-term solution to erectile dysfunction
  • Your partner will not be able to make out whether there is any implant in your body.

Durability is 10-12 years as per the study and trials.

Dr.Gautam Banga has been performing such cases successfully for the past 11 years. He has treated Males from 22 years to 77 years old.

Dr.Gautam uses AMS implants which are the best implants till date.

It is advisable to abstain from sexual activities for atleast 6 weeks after the surgery.

Success Rate :-about 90%-95% of Penile implants produce erections suitable for intercourse.

  • Vascular surgery– another surgical option for some men is vascular surgery, which attempts to correct some blood vessel causes of erectile dysfunction.

Surgery is a last resort and will only be used in the most extreme cases. Recovery time varies, but success rates are high.

Discussing ED With Your Partner

It’s natural to feel angry or embarrassed when dealing with ED. But don’t forget that your partner is also affected. Talking openly about ED will help your partner understand the diagnosis and treatment by best urologist options. This can reassure a partner that you haven’t lost interest.

For any further enquiry on Penile Implant Surgery please contact:

Dr. Gautam Banga

MBBS, MS, M.Ch (Urology)
Urologist, Andrologist and Genito -Urinary Reconstructive Surgeon
Contact no. : 91- 9886624303 | +91-9999062316 | 011-41041131
Email:- info@urethraandpenilesurgery.com
Website : www.urethraandpenilesurgery.com

Failed Hypospadias Treatment in India

Failed Hypospadias

Failed Hypospadias is a condition that is quite common in young boys, occurring at the time of birth. Complications may occur if it is not treated. Even though Hypospadias has a very straightforward treatment. What could you do about it? Let’s know more about it.

What is Hypospadias?

Hypospadias is a birth defect that only occurs in Males. The Urethra, responsible for carrying urine outside of the body, develops abnormally instead of the usual location (tip of the penis). Most of the times, the opening of the urethra develops on the underside of the Male genital. However, there are many variations to it, and sometime it can also develop near the scrotum. The further it is from the usual position, the more severe the case could be.

Causes

Like most birth defects, causes of Hypospadias are not exactly known. Abnormal hormone production during pregnancy could alter the development of the reproductive system of the male fetus, which might sometimes result in Hypospadias. Physical damages have been shown to have no correlation with this condition.

Complications

Although there are no dangers to the people suffering from Hypospadias, there are still many complications that could arise in the patients. Some of them include:

  • The irregular location of the urethra opening often leads to difficulty in urination. While it is manageable, it becomes very difficult for the young boys to learn doing it.
  • More often than not, a person suffering from hypospadias has an abnormal penis, mostly with a curvature larger than usual. Not only does it pose problem with erection, it also might lead to low self-confidence of the individuals.
  • Again, the abnormal shape of the penis and the location of the tip of urethra can affect ejaculation, sometimes making it impossible to achieve it. If not treated, it could lead to a problematic sex life and many psychological issues.

Failed Hypospadias Treatment

One has to understand that hypospadias is a condition for which surgery is the only treatment.

In most cases, a single surgery is enough to solve the issue. The urethra is adjusted so that it now points towards the tip of the penis and can work normally.

However, in the more complicated cases, multiple surgeries (in stages) may be required. Tissue grafts might be needed to reconstruct the urethra significantly.

Failed Hypospadias

The primary factor behind the success is the age of the individual. Children are known to have a success rate of about 95%, while it is lower in adults undergoing the same procedures.

The second major factor is the type of surgery undertaken. Repositioning of urethra is almost always successful, as it requires no additional procedure. However, creating a flap or grafts could be tricky and may often lead to complications.

Failed hypospadias surgery can be a major setback for the patients. The complications arising from the surgery may require multiple subsequent surgeries and hence, can impact the patient both psychologically and physically. Psychosexual analysis shows that Men with successful Hypospadias repair always have a better score than Men with failed hypospadias repair.

 

Steps to be taken before repair

The initial evaluation is very critical before carrying out the repair for hypospadias. The past failure has to be analyzed to understand the cause behind it. The most basic step, usually, is to view the complication that occurred with the failure. It could be a stricture, chordee, fistula or persistent hypospadias. Records of previous treatments are a great help in understanding the reason behind the complications, but often the failure occurs many years earlier and records are hard to obtain.

In any case, certain observations must be recorded. These include:

  • Record of urine flow and any obstacles in it whatsoever
  • Penile curvature
  • Difficulty in intercourse and/or ejaculation
  • Any infections in the urinary tract or stones in the urinary bladder

Hypospadias repair

There are many ways failed Hypospadias could be repaired. Let’s take a look at them:

Stricture repair

People suffering from urethral stricture after a failed Hypospadias operation could get it corrected surgically. A lot depends upon the length and location of the stricture itself. People having stricture that are small and/or located on the outside may require only a single surgery, while people with long and/or inside stricture may require staged urethroplasty along with grafting.

Excision and primary anastomosis

EPA is a very effective technique in dealing with stricture that are short and usually on the outside. While EPA is very successful in cases of urethroplasty, it must be used in case of Hypospadias with caution. Hypospadias is known to alter blood supply to the urethra, so it must be kept in mind using EPA. The doctor must ensure that the blood flow from the penile arteries must not be affected.

Preputial skin flap

While use of skin flap is common in most surgeries, it is rarely adopted in cases of Hypospadias repair. The reason is the lack of enough foreskin due to previous Hypospadias surgery, among other issues. For this reason, use of preputial skin flap has a high failure rate. However, if you have enough foreskin for creating skin flaps, then this technique could be used.

Single-stage buccal graft repair

In cases of long strictures, EPA is quite ineffective. Hence, buccal graft repair seems like the best option. Grafts are created from the buccal mucosa and used in the repair of strictures. However, even this method has only limited success, with strictures often recurring after some time. However, any method to repair long strictures in a single-stage surgery has high failure rate, and use of buccal grafts are the most effective among them.

Staged urethroplasty

For patients that have suffered multiple failed hypospadias, staged urethroplasty is the best chance. There are many considerations to be taken while undergoing staged urethroplasty. For instance, the choice of grafts has to be considered carefully before applying. Removal of urethral plate is another decision that must be taken wisely. In most of the cases, two stages are enough to repair any damage caused by a failed hypospadias operation. It must be noted that most men quit after the first stage itself, considering the second stage of urethroplasty closure as unnecessary.

 

Chordee Repair

Ventral penile curvature is another complication caused by a failed hypospadias surgery, though there are many ways to treat it. The most effective method is to induce an artificial erection. Things get complicated when both chordee and strictures are present in the patient. Removal of the urethral plate itself may seem like the best approach, but it rarely works. Instead, it would be better to perform staged surgeries while dealing with the two complications one-by-one.

Urethrocutaneous fistula

Urethrocutaneous fistula is one of the most common complications caused after a failed hypospadias surgery. Like strictures, the treatment depends heavily on the size of the fistula. Smaller fistula could be repaired easily with additional catheter drainage. Longer fistula could be repaired by first excising the fistulous tract, then closing the urethra. Closure of fistula is the most prudent way of repairing it.

Conclusion

Hypospadias is a defect that can cause you a lot of inconvenience, or may not cause any discomfort at all but repairs are necessary after a failed hypospadias surgery, preferably as soon as possible.

TO KNOW MORE ABOUT URETHROPLASTY SURGERY REACH OUT TO :

Dr. Gautam Banga at

91-9999062316, 011-41041131,
Email : gautambanga@gmail.com