Sexual Medicine
sexual medicine TREATMENTS
Sexual Medicine
Since man has been a man, sexuality has always been present. A large part of our life revolves around it and beyond simple procreation, sexual fulfillment is part of the general well-being and health of people.
In men, sexual motivation is very marked and largely governs behavior and things that are done, the way we relate to others and self-esteem.
However, many physiological alterations and diseases can endanger sexual functions such as erection, penis shape, ejaculation, orgasm and the sexual desire itself, on which everything else depends.
Our Andromedi Clinics in Madrid, Seville and the Canary Islands is a specialist in treating these issues, with responsibility, ethics and high-level professionalism and for this we make available a wide range of therapeutic options aimed at improving sexual health.
Sexual Medicine
Table of Content
Sexual problem
Erectile dysfunction
This sexual problem is more common than is believed, one in five men over 18 years of age suffers from it and is one of the main reasons for consultation.
Erectile dysfunction, also known as male impotence or simply ED, is the difficulty that a man has in achieving rigid penile erections that last for the appropriate time (until ejaculation and orgasm).
Why is it produced?
The erection of the penis depends on many physiological mechanisms including sexual desire (libido), sexual stimuli or arousal, the communication of the nervous system with the penis, the release of substances in the blood vessels of the penis and the dilation of the same so that they fill with blood and the penis becomes hard.
Any problem in them can lead to erectile dysfunction but almost always this is related to vascular, anatomical or psychological alterations such as:
- Endothelial damage due to atherosclerosis, dyslipidemia, hypertension or diabetes.
- Venous leak, when the penis drains its blood before its time.
- Anxiety and stress.
- Low sex drive or low testosterone levels.
How do you know if an erectile problem is real?
In our Andromedi Clinics in Madrid, Seville and the Canary Islands we have specialists in the field and one of the best is Dr. Natalio Cruz.
Patients who come with this problem are subjected to physical examinations and anamnesis, to know how and to what extent the dysfunction in the erection of the penis impacts on their sexual lives. After this initial evaluation and finding the cause of impotence, we proceed to the appropriate treatment for each case.
Treatments we offer
Each treatment for erectile dysfunction depends on the source of the problem. For example, if impotence is caused by diabetes, it is first necessary to control blood glucose and then review which therapeutic option is the best.
Among the treatments for erectile dysfunction are:
- Phosphodiesterase 5 (IPDE5) inhibitor drugs such as sildenafil (better known as Viagra®) that must be prescribed by the doctor and evaluated over time.
- Shock waves.
- Platelet rich plasma.
- Injections of vasoactive drugs into the penis.
- Penile prosthesis (or penile implants) as definitive treatment.
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Enlargement
Penis enlargement
Many men feel that their virile members are not as long or thick as they would like and therefore, they go for this type of treatment.
Size is not a problem
Today, penis enlargement surgeries are very popular. What before had no solution, today can be solved with a simple surgical intervention.
An average penis (in Europe) measures between 13 and 16.5 cm but less than this, it is considered a small penis that may be a candidate for this treatment.
How is the proccess?
First, the man should visit the doctor so that action is taken and he can discuss his expectations. That is, how big and thick would you like to have the penis and evaluate the possibilities.
After this, the man undergoes one of two surgical options:
- Augmentation phaloplasty to cut the suspensory ligament of the penis (which could be reducing the length of the member) and corporoplasty to mold the shape of the penis according to its new size.
- Pubic fat reduction technique, similar to liposuction that removes excess fat that could be covering the penis.
What results to expect?
With penis enlargement, a man can acquire an additional 1.5 to 3 cm, especially when both techniques are combined with the use of a penis extender (a device that keeps the member stretched for a time).
Any andrological center that promises more than this length (and even, they promise an additional 5 cm) could be lying.
Book your appointment in our center by clicking here
Prosthesis
Penis prosthesis
At times, erectile dysfunction can be so severe that it does not respond to common treatments (medications, vacuum pumps, intracavernous injections, shock waves, etc.) that there is no choice but to resort to a new and incredibly effective therapy: the penile prosthesis.
What are they and how do they work?
Also known as penile implants, penile prostheses are high-tech devices that are inserted into the penis through surgery to produce firm, natural-like erections.
The most modern penile prostheses, which we have, have the ability to fill (become hard) when the patient wants it and to induce flaccidity again when the sexual act is over.
What results to expect?
The satisfaction of enjoying a full and active sex life again without having to take blue pills, inject the penis with vasoactive drugs, or put the member in a vacuum pump is priceless.
Studies show that 92% of men with penile prostheses are very satisfied with the results and say that they have an average of 2 intercourse per week after five years, which is amazing.
Each penile prosthesis can last up to ten years with the possibility of being replaced by a new one after this period.
"In our centres in Madrid, Seville or the Canary Islands (Tenerife), we carry out the techniques and treatments with the most modern facilities and the best specialists and equipment to guarantee an effective solution".
Corpora cavernosa rotation surgery
Curvature technique
Penis curvature
Congenital curvature of the penis is a common problem and can make erection and intercourse difficult, but some surgical techniques can improve this picture.
Why is there a curvature of the penis?
Generally, men with this problem have a smaller corpus cavernosum than the opposite and for this reason, when the member becomes erect, it curves to one side.
Corpora cavernosa rotation surgery
Why is it causing so much trouble?
Those who suffer from it say they feel discomfort in the penis, pain and even numbness when they have sex. Not to mention that it could complicate many positions during sex.
The solution
The solution to this anatomical and sexual problem is nothing more than surgery.
This correction surgery aims to equalize the size of both corpora cavernosa (responsible for erection) so that the penis can become straight when erect.
Peyronie
Peyronie's disease
Peyronie’s disease is a curvature of the penis (similar to the previous one) that appears at any point in adulthood, and can make sexual intercourse very difficult.
Where is it from?
On occasion, the penis can develop points of fibrous, hard and little elastic tissue in the layer that covers the corpora cavernosa and when this occurs, the penis curves during the erection.
And the cure for all this?
The treatment of this disease can be conservative such as the injection of plasma rich in platelets and growth factors (PRPFC) directly into the fibrous plaque or surgery.
The latter is the most definitive of all and has proven to have excellent results in penis correction. There is also surgery.
Shockwave Technique
Shock waves
Shock waves are a very effective treatment for erectile dysfunction with minimal side effects. A few sessions of this therapy are enough to begin to see positive results.
What are those waves?
Shock wave therapy involves applying low-intensity vibratory waves to the injury site (in this case, all over the penis from base to tip).
These waves have the ability to:
- Increase blood flow to tissues, which is helpful in repairing cells and nourishing them.
- Improve the elasticity of the capillaries of the corpora cavernosa of the penis, so that they can hold more blood during erection.
- And promote angiogenesis, which means, the creation of new blood vessels.
When is this therapy indicated?
Shock waves are indicated as a treatment for the most common type of erectile dysfunction, that of vascular origin.
And this makes perfect sense, because shock waves improve the integrity of the injured capillary endothelium, the site where the problem occurs.
Venous leak
Venous leak
Venous leakage is a common problem and is related to erectile dysfunction, fortunately, it has treatment.
When is ED due to venous leak?
The dorsal vein of the penis plays an important role in draining blood after orgasm and ejaculation have occurred (when the man finishes), but sometimes this vein can do this during sexual intercourse, causing the penis to get flabby ahead of time.
Treatment
Venous leakage can be solved by a short and simple surgery in which the vein in question is blocked (occluded).
This means that, during erection, the penis can maintain rigidity until the last moment of sexual intercourse.
Blood supply to the penis with venous leakage
Normal blood supply of the erect penis
Problems delaying ejaculation
Premature ejaculation
Premature ejaculation is a very common problem in which the man has difficulty delaying the right moment of ejaculation, causing him to suddenly lose his sexual desire.
Causes of premature ejaculation
Until some time ago, it was believed that this problem only occurred due to emotional factors such as anxiety, or depression, but today it is known that other alterations can stimulate its appearance such as:
- Low levels of testosterone in the blood or high levels of thyroid hormones (hyperthyroidism).
- Inflammations of the prostate such as BPH, prostatitis or cancer.
- Pelvic floor muscle problems.
- Obesity.
What is the treatment?
The clinical management of ejaculation should include psychotherapy combined with some other treatment such as the use of drugs with anesthesia for the penis (usually in the form of sprays), antidepressants or phosphodiesterase inhibitors.
Lack of sexual desire
Lack of sexual desire
The lack of sexual desire affects many men (as do some women) and therefore, the quality of their love relationships.
How is low libido?
This condition is characterized by low motivation for any sexual activity, anxiety about sexual performance, feelings of disgust for sexual relations, relationship problems, omission of thoughts related to sex and little desire for masturbation.
Causes and treatments
The causes of low libido have to do, almost always, with emotional factors (such as stress or relationship problems) and hormonal factors such as the decrease in testosterone (or estrogen in women).
Treatment should include medical management of the underlying condition and psychological and couple therapy.
Orgasm problems
Orgasm problems
Orgasm problems (dry orgasm or total absence of it) can greatly impact the quality of life of those who suffer from it, their partners and the ability to have children.
Why do they cause so much trouble?
Orgasm is the highest point of erotic arousal of the entire sexual relationship, for this reason, if a person develops dry orgasms (especially in women), delayed or anorgasmia (absence of orgasm), sexual desire will decrease as well as their yield and fertility.
Treatment
Medical management will depend on the type of problem, its severity and the causes that originate it, but this is often based on psychological therapy (to assess expectations and desires) and couples therapy (to build trust and seek ways to innovate sexuality).
Este contenido médico ha sido actualizado y revisado por en la siguiente fecha: 18 May 2022
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