RE: ED and incontinence treatment resourc es in the US.

May 17, 2004

--

Well normally, both partners do report a high degree of satisfaction with

the penile implant. It helps couples regain the spontenaity they enjoyed

prior to prostate cancer treatment which is one of the advantages it has

over mechanical devices like t

Re: ED and incontinence treatment resources

in the US.

Thanks Donna, you are a gem.

I suppose I should try an implant if only for my wife's sake <grin>

Regards

In a message dated 17/05/2004 16:15:28 GMT Standard Time,

dpoglian@... writes:

--

You're right. Prostate cancer is BIG business. It takes a truly caring

physician to honestly tell a patient that he doesn't need treatment or that

he can postpone treatment, perhaps indefinitely. There's not alot of money

in monitoring alone.

Regarding treatment for ED:

Dr Tom Lue is the most renowned ED specialist that I know of. He's in San

Francisco. Here's the contact info that I got from my friend who has had a

consultation with him and lives in San Francisco. If you decide to go, I'll

put you in touch with her. Dr. Lue should be able to counsel you as to

which problem you should tackle firstbou or whether you need to develop a

total plan before doing anything so that if surgery is involved it can be

co-ordinated with other treatments. If you decide on an AUS and a permanent

penile implant, I'm not sure if both surgeries could be done at the same

time. It would be something you could ask about.

Lue, Tom F MD - UCSF Urology Faculty Practice

400 Parnassus Ave # 610

San Francisco, CA

Email: tlue@...

http://urology.ucsf.edu/clinicalRes/CRneuroMale.html

<http://urology.ucsf.edu/clinicalRes/CRneuroMale.html>

Tom Lue also has written a book about ED, " A Patient's Guide to Male Sexual

Dysfunction " . This is where I found it on amazon:

http://www.amazon.com/exec/obidos/tg/detail/-/1884065821/qid=1084805345/sr=1

-1/ref=sr_1_1/104-5039543-5122312?v=glance

<http://www.amazon.com/exec/obidos/tg/detail/-/1884065821/qid=1084805345/sr=

1-1/ref=sr_1_1/104-5039543-5122312?v=glance & s=books> & s=books

Ralph and Barbara Alterowitz also have a new book coming out called

" Intimacy with Impotence: The Couple's Guide to Better Sex after Prostate

Disease " . I found it at this very long URL at amazon where it can be

pre-ordered.

http://www.amazon.com/exec/obidos/tg/detail/-/0738207896/qid=1084805039/sr=1

-1/ref=sr_1_1/104-5039543-5122312?v=glance

<http://www.amazon.com/exec/obidos/tg/detail/-/0738207896/qid=1084805039/sr=

1-1/ref=sr_1_1/104-5039543-5122312?v=glance & s=books> & s=books

The doctor that my friend saw, who will do a double cuff artificial urinary

sphincter to control high volume incontinence rather than insisting on a

trial period with a single cuff and then a second surgery if it doesn't work

is in Cleveland at the Cleveland Clinic. Dr. Drogo K. Montague. You can

see a whole lot of information about him here:

http://www.clevelandclinic.org/reproductiveresearchcenter/staff/montaguedk.h

tml

<http://www.clevelandclinic.org/reproductiveresearchcenter/staff/montaguedk.

html> and here:

http://www.clevelandclinic.org/reproductiveresearchcenter/staff/montaguedk.h

tml

<http://www.clevelandclinic.org/reproductiveresearchcenter/staff/montaguedk.

html>

The Cleveland Clinic is in Cleveland, Ohio at 9500 Euclid Avenue,

Cleveland, OH. 44195.

Phone number is .

I see that he also does prosthetic surgeries of other types, including

penile implants, so perhaps he can help you with both problems. I hope this

helps you. Men who suffer depression as a result of their impotence and

incontinence often lack motivation to do something to resolve the problem.

Sometimes a spouse's support is interpreted as a demand to make her life

return to normal instead of a push for the guy to get off his duff and

tackle his physical problems aggressively. So sometimes it's difficult for

the partner of an impotent or incontinent man to know exactly what to say,

but communication between husband and wife and a willingness to tackle the

problem as a team are key ingredients in the formula for success. These

problems, although very personal in their nature, can be handled just like

any other problem. By investigating the options and making a determination

regarding the degree of intervention necessary to achieve the sort of

lifestyle that you demand as a human being. Either of these fine doctors

could help you regain more normalcy in your life. If you are so unhappy

with your life as it is, I would consider a phone call to one or both to be

a great first step.

Hugs --

Donna

May 17, 2004

....as I was saying...advantage over mechanical devices like the VED or over

injectables, or over even oral medications that take some time to work.

Cialis may be an exception because it says in the bloodstream for days. But

if you've had no nerves spared or if they are so damaged that they won't

function, oral medications are unlikely to help much. Some patients are

able to positively impact their erectile ability by using a therapeutic 25

mg dose of Viagra nightly at bedtime. This can help to encourage the return

of nocturnal erections which are natures way of keeping the blood flow to

penile tissues healthy. Stimulating regular erections during the recovery

period after prostate cancer treatment is encouraged because damage to

penile tissues can result if the penis is allowed to be in the flaccid state

for too long. Sometimes a single injection can help jump-start the recovery

process. Like cleaning out a clogged pipe. Dr. Lue has mentioned this to

my friends and they did try injectables, eventually finding a combination of

oral and injectable medications that worked fine for them. It's a matter of

manipulating the combination of injectables and finding the right dosage of

any oral medication that is also being used to find the right formula

sometimes. There's some experimentation and patience involved. With

surgery to do a penile implant, there is a surgical recovery period involved

which isn't particularly pleasant, but not unbearable either. And then the

devices provide many years of worry-free use. The newer ones are more

reliable and last longer before they need new parts. They used to say a

penile implant could be expected to last ten years before another surgery

was necessary to replace or repair it, but I believe the new devices are

said to last longer because of better components and engineering. That's

another question to ask the doctor.

I forgot to mention that you can shop for VED's at phoenix5, but Caren told

me today that the site is down again at http://www.phoenix5.org

<http://www.phoenix5.org> so you might need to wait until she gets it

fixed. There's a site search engine you can use and a whole bunch of

first-person stories from men and women about their ED experiences and some

of the techniques and tips for dealing with ED that are shared. One of

them is about my friends in San Francisco who were also friends of our dear

Young, who was the inventor and webmaster of Phoenix5. He died of

prostate cancer almost a year ago. His story is a good one if there's any

doubt left in anyone's mind about the value of screening. He thought that

the reason he couldn't walk anymore was osteoarthritis because his mother

had both hips replaced. Turned out he had stage D prostate cancer with a

PSA of over 1000. The VA wouldn't pay for the test to see what his real PSA

was. He beat all the odds for longevity, diagnosed in November, 1999 and

finally after getting pneumonia and suffering a probable eschemic stroke

which robbed him of the most important thing in his life, his ability to

communicate, he died on June 15th, 2003. His wife, Caren, whom he married

the previous fall, now maintains the website.

Doctors will often want patients to try other less-invasive options before

opting for a penile implant because it is major surgery. But if no other

option proves effective or satisfactory, a penile implant is definitely an

option.