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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Urologist
Category: Urology
Satisfied Customers: 35769
Experience:  MBBS MS (Surgery) Vast experience and routinely perform all urology procedures including endoscopy.
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IN MAY 2009 I UNDERWENT A PROSTECTOMY WITH RADIATION. TODAY

Customer Question

IN MAY 2009 I UNDERWENT A PROSTECTOMY WITH RADIATION. TODAY I CONTINUE TO SUFFER FROM INCONTINEST AND ED. I AM 63 YEARS OLD AND WOULD LIKE TO HAVE MY SEX LIFE BACK AS IT IS CAUSING DEPRESSION
JA: Is this your first time reaching out for information about this? In general, how would you describe your overall health?
Customer: YES 1ST TIME. MY GENERAL HEALTH IS FAIR
JA: Anything else in your medical history you think the doctor should know?
Customer: I HAVE DIABETISEA
Submitted: 2 months ago.
Category: Urology
Expert:  Dr. Arun Phophalia replied 2 months ago.

Hello! My name is***** to JustAnswer. I'm reviewing your question now, and will post back with the reply momentarily.

Expert:  Dr. Arun Phophalia replied 2 months ago.

What did the urologist prescribe for incontinence and ED?

Customer: replied 2 months ago.
I was told the incontinence and the ED should return in about 1 year
Expert:  Dr. Arun Phophalia replied 2 months ago.

Thanks for the additional information. I am writing the answer for you and will get back to you in 4-5 minutes. If you get a phone call request, you may ignore it as that is an automated site trigger. Thank you.

Expert:  Dr. Arun Phophalia replied 2 months ago.

Following treatment may be tried for incontinence;

A. Kegel exercises

B. Electrical stimulation:This is a procedure in which small electrodes are placed in pelvic floor. The electrodes produce electric pulses that cause contraction of the muscles of the pelvis and the urethra. This strengthens these muscles to help reduce the incidence of incontinence.

C. Medications:

a) oxybutynin

b) tolterodine

c) propantheline (Pro-Banthine) and

d) dicyclomine

D. Surgical treatments for incontinence; Implanting the InterStim electronic device.

You need urodynamic study to identify the exact cause of incontinence.

Diabetes is one of the commonest risk factors associated with erectile dysfunction (ED). The prevalence of ED is greater in men with diabetes compared with non diabetic population. Many factors can contribute to the development of ED, including organic factors (like vascular disease and neurological disease) and psychogenic factors (anxiety or depression). One of the most common risk factors associated with ED is diabetes. The pathophysiology of ED in men with diabetes is complex, but probably involves vascular and neurogenic components, together with endothelial dysfunction. Associated with the diabetes is a condition, which is called as subclinical late-onset hypogonadism (SLOH) which is suppose to cause erectile dysfunctions. In this there are two hormonal criteria;

1) measurement of testosterone concentration

2) Testosterone / LH ratio (T/LH)

In patients with decrease T/LH ratio, consideration of testosterone replacement therapy should be done, as studies have shown benefit. With this ,hopefully he will have full and sustained erections which should be helpful mutually to you too.

Apart from Testosterone levels and LH estimation following also are advised;

1) Thyroid function tests

2) duplex ultrasonography

3) Ultrasonography of testes

4) angiography

You may need following treatment for ED;

a) intraurethral suppositories,

b) the vacuum device, and

c) intracavernous injection.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Customer: replied 2 months ago.
I have talked to other urologist and was told in my case surgery was my best option
Expert:  Dr. Arun Phophalia replied 2 months ago.

Video urodynamics and investigations for ED are the best to determine about the therapy protocol.

Combination therapies may be recommneded for ED;

a) Sildenafil Plus Intraurethral Prostaglandin E1

b) Oral PDE-5 Inhibitors Plus Intracavernous Injection of Prostaglandin E1

c) Sildenafil Combined with an Oral Alpha-Antagonist

d) Intracavernous Prostaglandin E1 Combined with Oral Alpha-Antagonist

e) Vacuum device and intracavernous injection therapy

f) Testosterone Plus Sildenafil.

InterStim electronic device may be used for ED.

Customer: replied 2 months ago.
THANK YOU
Expert:  Dr. Arun Phophalia replied 2 months ago.

You are very welcome.

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Expert:  Dr. Arun Phophalia replied 2 months ago.

Was this information helpful to you? I would be glad to answer any further questions.

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.
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Wishing you all the very best in life.