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Dr. P. Jyoti
Dr. P. Jyoti, Consultant MD
Category: Health
Satisfied Customers: 9126
Experience:  17 yrs experience in treating OPD & Emergency patients.
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I am diabetic for 33 yrs, was caregiver to wife for over 20

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I am diabetic for 33 yrs, was caregiver to wife for over 20 yrs - she was bed ridden and died 2 tears ago. Went to Urologist for ED, tried Cialis for blood flow (4 months) - still no erection, girl friend unhappy. Tried Tri-mix (std mix) and get a very unsatisfying erection (I'd need four times more blood, my guess, to get to the point of being able to consider penetration). Do I have other options or should I consider the multi-piece impact?

Dr. P. Jyoti :

I am Dr. P. Jyoti, MD. I promise to use my full experience and knowledge to provide answers specific to your question. Feel free to ask me anything.

Dr. P. Jyoti :

hello would you like to chat on this?

Dr. P. Jyoti :

hello did the urologist do any tests?

Customer:

Yes, what ae your thoughts to what I have described and tried with my urologist?

Dr. P. Jyoti :

well, there are many causes of ED

Dr. P. Jyoti :

these need to be investigated and ruled out

Dr. P. Jyoti :

since you have consulted a urologist, this will have been done in your case

Dr. P. Jyoti :

do you know if testosterone levels have been checked?

Customer:

I went to a urologist - he ruled out testosterone and my blood sugars are ok - 7.3 A1c

Customer:

testosterone is on normal range for my age

Dr. P. Jyoti :

ok, in that case you are having idiopathic Ed

Customer:

what is that (idiopathic)?

Dr. P. Jyoti :

no direct cause, it is only indirectly related to your age, diabetes, etc

Dr. P. Jyoti :

for this symptomatic treatment is the only choice

Dr. P. Jyoti :

i will briefly describe your options

Customer:

what are my options since tri-mix is not solong my problem, only midly effective?

Dr. P. Jyoti :

the first is durgs like cialis which you have tried already

Dr. P. Jyoti :

the second is penile injections which also you have tried

Dr. P. Jyoti :

these two are the most commonly prescribed ones

Dr. P. Jyoti :

since they have not worked, the other options for you are:

Dr. P. Jyoti :

urethral applications

Dr. P. Jyoti :

some applications are available which are applied within the urethra - these can work better than penile injections

Dr. P. Jyoti :

vaccuum

Dr. P. Jyoti :

vaccuum applicators are available which through creating a vaccuum can cause an erection

Dr. P. Jyoti :

vascular surgery

Customer:

vacuum pump is not going to work - tried that on advice of friend and that stupid band - I just dont have enough blood I guess

Dr. P. Jyoti :

ok

Dr. P. Jyoti :

for you vascular surgery can be promising if you are fit candidate

Dr. P. Jyoti :

in this, first a vascular study is done of the blood flow in the penis

Customer:

what can I expect from vascular surgery? wold I continue ot need drugs / injections or other meds?

Dr. P. Jyoti :

if there is any obstruction or kinking, this can be then corrected with vascualr surgery

Dr. P. Jyoti :

if it works successfully, no you will not need drugs or injections

Dr. P. Jyoti :

all patients may not be suitable candidates, that is, if all the vessels are thinned out

Dr. P. Jyoti :

but in those in which there is partial blockage, this can be like a miracle

Dr. P. Jyoti :

so you must explore this option

Customer:

thank you... how would my urologist determie this (ultrasound or?)

Dr. P. Jyoti :

and lastly, if all these do not work, then implant is the treatment of choice as you have intuited

Dr. P. Jyoti :

yes, thats right, a doppler study

Dr. P. Jyoti :

doppler ultrasound, that is

Dr. P. Jyoti :

i would advise you to meet your urologist again

Dr. P. Jyoti :

discuss these three options - urethral applications, vascular surgery and implant

Customer:

ok, thanks... at least I know now its going to be some kind of surgery next - either corrective or prosthetic

Dr. P. Jyoti :

ask your doctor about doing a doppler study of blood flow in the penis

Dr. P. Jyoti :

thats right

Dr. P. Jyoti :

hope it all works out for you

Dr. P. Jyoti :

Hope that satisfies your query. If so, please choose a positive rating.

If you have any other queries, do ask. Wish you good health and a quick recovery. Bonus is always welcome!

Thank you.
Dr. P. Jyoti

Dr. P. Jyoti :

any further questions?

Customer:

I will and thanks... dont get to see him until September - he insists on limiting my visits to every four months

Customer:

no, you have been helpful, thanks again

Dr. P. Jyoti :

mmm.. thats ok.. not an emergency after all

Dr. P. Jyoti :

glad to help

Dr. P. Jyoti :

wish you the best

Dr. P. Jyoti :

Hope that satisfies your query. If so, please choose a positive rating.

If you have any other queries, do ask. Wish you good health and a quick recovery. Bonus is always welcome!

Thank you.
Dr. P. Jyoti

Customer:

no if it were - I would not be on a web site :)

Customer:

have a blessed day

Dr. P. Jyoti :

:) thats right

Dr. P. Jyoti :

thank you

Dr. P. Jyoti :

good night

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Dr. P. Jyoti :

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Dr. P. Jyoti :

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