Sexual well-being continues to be a hot topic in the field of aesthetic medicine. One of the main reasons for this is that many of the non-invasive treatment options available are generally not included in other specialties, as they are often not covered by insurance.
Within our practice, the field of sexual medicine is developing rapidly, because patients suffering from sexual dysfunctions want alternatives to surgical procedures. Often oral medications are not tolerated or appropriate due to side effects and / or lack of effectiveness.
More specifically, erectile dysfunction (ED) affects more than 50% of men in their fifties, and this number increases by 10% every 10 years.
Erectile dysfunction is a physiological deficit in adequate blood flow, associated with venous and arterial insufficiency due to disease, medication or a psychological cause. A history of hypertension, specific blood pressure medications, and underlying hormonal dysfunctions is often associated with ED. Anxiety, depression and medications to treat psychological disorders can also be associated with sexual dysfunction. Therefore, during the patient’s visit, a full health history and assessment should be completed to determine the cause of the problem.
This health history and this evaluation are completed by one of our highly qualified nurse practitioners who then creates a care plan for the patient, which is examined and approved by a doctor.
We have now entered an era where there are energy-based treatments that use sound waves to improve and sometimes cure the problems of erectile dysfunction.
Low intensity extracorporeal shock wave lithotripsy (LI-ESWL) uses sound waves to break damaged arteries and veins, causing microvascular damage and ultimately angiogenesis. Although this technology has been around for over 20 years, recent studies have shown an approximately 80% success rate in improving erectile function. Once the practitioner obtains specific training, he can execute the treatment correctly to optimize the results.
There are a number of brand names for these types of devices, but we use Zimmer Medizinsystems’ Big D Wave ™ for our emergencies. Although this is a more recent addition to our office’s treatment offerings, patient demand for this procedure is increasing at an accelerated rate. Treatments are quick and only take about 15 minutes, painless. The most effective treatment for our emergency detox treatment includes ten Big D Wave treatment sessions, with a recommended frequency of twice a week for five weeks. Each visit lasts approximately 15-30 minutes and consists of applying a specific energy protocol via the sound wave transmission rod. We also recommend that patients use a penis pump for at least ten minutes each day, as well as a low daily dose of a PDE5 inhibitor, in order to increase circulation in the penile tissues, which allows increased blood flow favoring angiogenesis.
We also recommend an injection of platelet rich plasma into the penile tissue, also called P-shot®, and a review of the treatment with hormonal optimization. The addition of P-shot allows further regeneration of penile tissue because cytokines and growth factors create a kind of “healing bath” for arteries and veins.
The P-shot procedure consists of taking the patient’s blood and centrifuging the platelets of red blood cells. The resulting PRP is then injected into specific areas of the penile tissue, according to the protocol. Patients are prepared with a topical anesthetic anesthetic before the procedure with minimal discomfort or bruising.
Thanks to this precise and patient-centered protocol, our practice has successfully helped several men suffering from severe erectile dysfunction. Before treatment, these patients were unable to maintain an erection with the maximum dose of PDE5 inhibitors. They had to use intercavernosal injections with an insulin syringe, which are painful and often “wiping out”, in order to maintain their erection.
Generally, a patient can expect at least a gradual reduction in treatment. For example, if a patient needs a maximum dose of Viagra before rehabilitation, he should, after treatment, obtain a realistic result: take only the minimum dose of PDE5 inhibitor if necessary, which is a promising result. . PDE5 inhibitors are less likely to cause unwanted side effects at a lower dose.