Male Sexual Dysfunction

Sexual dysfunction affects half of adult males over the age of 40. Short term and transient performance problems will affect almost every man, but when the issue does not fade away on its own, physical and psychological issues that affect the quality of life may arise. Medication for erectile dysfunction can, in some cases, offer short term relief, but many men want a long term solution to their problem. This is where the Priapus Shot, or P Shot as it is commonly referred to, provides a solution.

What Is The P Shot?

The P Shot uses a Platelet Rich Fibrin Matrix (PRFM), which is drawn from the patient’s own body to improve sexual performance. The process begins with drawing blood, typically from the arm, in a manner similar to a blood test. A special technique is used to drawplatelet rich plasma from the blood. A fine needle is used to inject the PRFM into the penis. A topical numbing agent is first applied to reduce any pain or discomfort felt from the injection. The total procedure typically takes under 30 minutes and patients can return home, once the procedure is completed.

How It Works and What It Does

The PRFM releases growth factors that cause unipotent stem cells to rejuvenate and grow new tissue. Since the procedure uses the patient’s own blood enriched plasma, it is non-allergenic and free of harmful side effects. The benefits of the P Shot include:

• Increased firmness of erection.
• Increased penile length and girth.
• Increased blood flow and circulation, resulting in improved sexual abilities and enhanced stamina.
• Increased pleasure and sensation.
• Improved appearance.

Some of these effects become apparent almost immediately after the injection, while others will appear a bit later. The nature and extent of the improvements in penis size and sexual performance will vary from patient to patient. Your doctor will be able to provide you with detailed information on the procedure and the results you can expect.

Who Can Benefit From This Treatment?

The P Shot is designed to offer men a lasting increase in their sexual abilities. In particular, it will benefit those whose sexual abilities have decreased due to hardening of the arteries, diabetes, prostate issues, the after effects of surgery and many other conditions. Your doctor, after a consultation and examination, will inform you, if you are a good candidate for the procedure.

Frequently Asked Questions

What are the after effects and downtime? There may be some numbness that lasts for about 60 minutes after the procedure and a small amount of bruising that fades away quickly. Patients generally are able to return to work and resume normal activities (including sex) the same day.

What follow up is required?A follow up consultation a few weeks after the procedure is normal.

Will a second P Shot be required? A second treatment is not normally required although some men may opt for one for various reasons.

To know more about the P Shot, what it can do for you and if you are a good candidate, consult a doctor who specializes in sexual dysfunctional issues. The P Shot is not for all men who have sexual performance issues and is not currently FDA approved.

Are You A Candidate For Perineoplasty?

Post childbirth, many women experience loss of muscle tone, torn or improperly healed muscles and scar tissue, in the muscular / vaginal canal, leading to the exterior, in a woman’s body. This causes:

• Loss of sexual sensation which could lead to psychological issues, consequently impacting sexual satisfaction
• Laxity and looseness of the vaginal canal 

Perineoplasty (also referred to as perineorraphy) is a minor surgical procedure that restores the muscle tone and tightens the perineum. Therefore, this procedure should be undergone, only once a decision has been made to bear no more children, or else laxity will occur once again, post another birth. Weak vaginal walls impaired by childbirth, cannot be remedied by Perineoplasty.

About the Procedure

• This is an outpatient surgical procedure
• Is performed under mild sedation
• Duration of the procedure is usually under an hour
• A V-shaped incision is made in the posterior wall of the vagina, with a fractional CO2 pixel laser or an ElimanSurgitron (uses radiofrequency). Existing scar tissue is removed and the bottom layer of the muscles and tissue, are toned and tightened
• The incision is sutured with soluble sutures

Consult with your gynecologist for more details on the nature of the procedure and the expected results.

How Long Will Recovery Take?

• As with any surgical procedure, the body will need time to heal
• Painkillers will be prescribed to overcome any pain or discomfort that may be experienced
• Soaking in warm water and Sitz baths, a few times a day, will help to ease any discomfort
• Post-surgery, during the first week, activities are limited, due to post procedure swelling and tenderness
• Vigorous physical activity can normally be resumed after about two weeks or when there is no discomfort. The time varies from patient to patient. Women involved in sedentary office work, will normally be able to return to work, after a week. If your occupation involves any physical activities your doctor will be able to advise you, when you may be able to resume work
• Abstinence from sexual activity for about six weeks is normally advised
• Regular and ongoing kegel exercise is recommended to enhance the functioning of the vaginal walls 

What Are The Risks?

There will only be, the normal risks of bleeding, infection, bruising and temporary scarring that accompany all surgical procedures. Your surgeon will brief you about any possible issues and how they will be dealt with, if they should occur.

Do you qualify for a Perineoplasty Procedure?

Yes, you will, if you:

• Have had a normal delivery (given birth vaginally)
• Are experiencing looseness or itching in your vaginal canal
• Are experiencing decreased sexual sensation
• Have any changes in your bowel habits

Women need not necessarily have experienced childbirth to have vaginal flatus or decreased sexual satisfaction. Excess weight and the pressure, can sometimes overstretch and damage the structure of the perineum, leading to a feeling of looseness and laxity.

DermaSweep the New Age Skin Rejuvenator

DermaSweep is the latest development in the field of skin rejuvenation. DermaSweep offers a greater degree of exfoliation because it gently lifts the surface of the skin as it sweeps away the layers of dead skin. This increases blood flow, which results in improved collagen formation, and firmer and more toned skin. In addition, the enhanced exfoliation, works to polish the skin and improve its glow. DermaSweep works with a range of customized products to offer better results than other similar techniques. It is safe to use it on sensitive skins and on skin conditions like rosacea. This is an advanced medical grade procedure and is available only to, licensed doctors and licensed aestheticians. 

Type of Skin Conditions  DermaSweep Treats

DermaSweep is customizable so it can safely and effectively be used on all types of skins, ranging from the most fragile to the most resilient. The treatment is customized depending on the skin type and the specific condition to be treated.  These conditions include:

• Wrinkles, crow’s feet, fine lines and other age related skin conditions
• Skin that has suffered damage due to sun exposure
• Acne
• Stretch marks
• Regular brown patches and age spots – Hyperpigmentation
• Irregular brown patches – Melisma
• Uneven skin texture
• Surgical and other scars

When Do You See Results?

A DermaSweep treatment takes about 45 minutes. You will see the results, in terms of a clearer complexion, fewer lines and stretch marks and fewer blemishes after the first session. The normal course of the complete treatment, runs from 4 to 6 sessions, with intervals of 10 to 14 days. There will be a continued, significant and visible improvement, after each session. You will be given a daily post treatment routine to follow, through the duration of the treatment to enhance its effectiveness.

Side Effects

For all practical purposes there are none. You will be able to have the treatment done at any convenient time during the day and return to your normal activities immediately thereafter. You could even have the procedure done during your lunch break. You may feel a slight tingling after the exfoliation is done. You skin will feel smoother than before and there will be no soreness or redness that will be visible. 

Special Treatments

Along with the highly effective microdermabrasion, DermaSweep can also be combined with the delivery of specific topical solutions to treat a range of skin conditions. These include:

• Hyperpigmentation – DermaSweep exfoliation is combined with a skin brightening solution containing kojic acid, azelaic acid and hydroquinone to remove excess and uneven pigmentation of the skin.
• Acne – This is often treated with salicylic acid solution. When it is combined with the DermaSweep process, the solution is able to enter the clogged pores of the skin more effectively and the improvement on the acne treatment is significant.
• Dehydrated skin – DermaSweep is combined with hyaluronic acid with added aloe vera and chamomile to hydrate the skin most effectively.
• Chemical Peel Infusion – Combining DermaSweep with tested chemical peel agents, results in the microdermabrasion becoming even more potent in treating pigmentation issues and aiding skin rejuvenation.

DermaSweep is one of many cosmetic and rejuvenation procedures that are available. Before making any decisions on what you should opt for, it is important to obtain the advice of an expert who will be able to analyse the nature of your skin, the conditions that affect it and decide on what treatment will produce the best results. If you want to know more about this or the other options available to you contact a doctor that specializes in this field and offers a wide range of skin treatment and rejuvenation services. That will ensure that you get both the best guidance and the ability to choose the technique that is best for you.

Exilis and Thermage – How They Are Different

Among the two most popular and widely used systems of wrinkle reduction and reshaping of targeted fat deposits are Exilis and Thermage. To be able to make the right choice in what is right for you, you need to know what they both involve and the kind of results you can expect. While they may appear to be similar at first glance, there are differences that enhance one procedure over the other.

Thermage

Thermage is a non-surgical procedure that uses radio frequency energy to stimulate the collagen in your body. The procedure causes the area of application to contract, resulting in tighter and firmer skin. The treatment is done using a hand held device that is applied to the skin surface. The device emits the radio frequency energy that penetrates the surface of the skin to reach the collagen deposits underneath. Although the system works to cool the top layer of skin while delivering heat to the lower layers, you will feel varying sensations of heat while the treatment is in progress. The procedure typically lasts from 45 to 90 minutes, depending on the part of the body being treated.

The drawback with Thermage is that it does not work on wrinkles and deep lines.  On the positive side, it can be used on darker skin tones, unlike Intense Pulsed Light and Laser Resurfacing. It also works on lighter skin.

Thermage treatment does not require any down time and you should be able to resume all you normal activities immediately after the procedure is completed. In some cases, there may be mild transient redness which will disappear in a short time. Post treatment exercise and regular hydration is necessary to maximize the results.

Exilis

Exilis is an FDA approved procedure that also uses radio frequency energy to tighten skin on any part of the face or body. Exilis uses radio waves to safely target fat cells. This thermal energy strengthens and stimulates the collagen to improve laxity and texture. The simultaneous cooling action of Exilis allows for the deep layers in the tissue to be treated. This, along with the sophisticated monitoring system, ensures that you will be comfortable and relaxed while the treatment is underway.

There is no downtime after the procedure and you will be able to resume all your activities once it is over.  Here too, exercise and hydration will maximize the benefits of the treatment.

Differences

The main differences between Thermage and Exilis are:

• Thermage applies the energy in a pulsed form, so that each pulse applies a large amount of heat. Exilis delivers the heat continuously and builds it up gradually.
• Thermage treatment takes about 45 to 90 minutes. Each Exilis treatment requires about 30 minutes.
• Thermage is effective on the face and smaller body areas. Exilis is effective on not just the face but on all parts of the body, including the arms, legs, thighs, abdomen, chest and neck.
• The Exilis treatment is more tolerable and is less inexpensive in comparison to Thermage.
• It is cost effective as maintenance is much easier after an Exilis treatment.

Making a Choice

If you need to decide upon the type of treatment you need to undergo, then consulting an experienced doctor, would be advisable, as the doctor can guide you after taking into consideration the various aspects of your requirements and the apt treatment that will provide optimum results.

Doctor Speak

From many reviews, many doctors who have used Thermage, both the old and new devices and despite the great marketing support from the Thermage Company itself, many doctors have graduated into using the Exilis process, as it is longer lasting, is very comfortable on the patient, has better maintenance outcomes and is less expensive.

Novasure Endometrial Ablation – A Simple Solution to Heavy Periods

It is estimated that about 20% of women suffer from heavy and painful periods. Heavy bleeding does not mean that there is a medical condition that requires treatment. However, the effects on a woman’s lifestyle can be devastating.  The pain and discomfort are bad enough; what is often worse is the interruption to everyday life and feeling of isolation during those days. There is now a simple, quick and permanent solution to this problem – one that does not involve on going medication and unwanted hormonal side effects. It is called Novasure Endometrial Ablation.

What is Novasure Endometrial Ablation?

About 10 million women in America suffer from heavy menstrual bleeding. In many cases the problem begins in their 30s or 40s, as the approach menopause, but it can begin much earlier. Novasure Endometrial Ablation is a safe simple procedure that can stop heavy bleeding without side effects. It has been proven to be effective for 90% of the women who have opted for it. If you are a premenopausal woman suffering from heavy periods and are past the age of child bearing or have taken a decision not to have any more children, Novasure Endometrial Ablation may be right for you. Novasure is not sterilization so the decision not to have children must be a firm one as getting pregnant after the procedure can be dangerous. It is also not recommended for those who may have uterine cancer, a pelvic or urinary infection, an IUD or a metal uterine implant. 

If these are not issues that concern or affect you, Novasure Endometrial Ablation offers a quick solution that can be completed in 5 minutes in a doctor’s office. No general anesthesia is required and in most cases patients experience mild or no pain during and after the procedure. A women can typically return to normal activities a day or two after the procedure.

Heavy bleeding is caused by the endometrium (the lining or coating of the uterus). The Novasure Endometrial Ablation procedure works by removing the endometrium in a quick and effective manner. During the procedure your doctor will open the cervix slightly and insert a slender wand specially designed for the Novasure process. Once inserted the wand will extend a triangular mesh device into the uterus. The mesh will expand to accurately fit the exact size and shape of the uterus. The mesh is then used to deliver precisely measured radio frequency energy for a period of 90 seconds. The mesh then retracts into the wand which is removed from the uterus. That is all there is to it. No incisions are made and no other procedure is required.

After The Procedure

There may be some minor discomfort or nausea after the procedure. In some cases there may be mild pain, cramping and bloody or watery discharge. These are all normal and no cause for worry. Your doctor will brief you about any possible post procedure issues and if required, prescribe medication to deal with them. In general, there is no reason why you should not be able to resume your normal life within a day or two days, knowing that you are free from the pain and discomfort you have been suffering from and that heavy periods will no longer interrupt your life . Many women report that after they have undergone Novasure Endometrial Ablation they find that their energy levels have improved and that their PMS issues are greatly reduced.

Is It For You?

Every woman’s body is different. The right way to know if Novasure Endometrial Ablation is the correct solution to your heavy period problems is to consult a medical practitioner who specializes in women’s health issues and who is familiar with and offers Novasure Endometrial Ablation as a standard service. While Novasure Endometrial Ablation is the best solution for heavy period problems for most women, if for any reason, it is not for you, the doctor will advise you of other suitable alternatives.

What Is Essure Tubal Ligation?

Birth control is more than just a matter of preventing pregnancy. The method of control that you choose must be compatible with your body and your lifestyle. If your family is complete or if you know you do not want any more children permanent birth control must be considered. In the good old days, this meant a trip to an operating room,a general anesthetic and 1 to 2 incisions on your belly so that your tubes could be cut, burnt or clamped. Not only is this method inconvenient, it is also painful, risky and made you miss work.

Today, the Essure procedure is a method of non invasive permanent birth control that has replaced the above. It is done in the comfort of the doctor's office, with no general anesthetic or incisions. After the procedure you can resume normal activities that same day without the need for post op pain medications.

How Essure Works

The Essure procedure consists of 2 small inserts that are placed in the fallopian tubes by a doctor. Since they are inserted through the vagina and cervix, no surgery is involved. Once these tubes are in place, the procedure is completed. The inserts are designed to be flexible so that they can bend and conform to the shape of the body while remaining securely in place. These inserts are made from the same material that is used of a variety of medical devices like heart stents and are proven to be safe. They do not contain any hormones so the question of any hormonal reactions does not arise. Once in place these inserts form the core of a natural barrier that develops over them which acts to prevent sperms from reaching the ovum.

The Benefits of Essure

• The procedure typically takes about 10 minutes and can be performed in a doctor’s office without the use of general anesthesia.
• In most cases women are able to go home within an hour of the procedure being completed and are able to return to normal activities within 1 or 2 days.
• The inserts do not contain any hormones that could be released into the body.
• Essure has been proven to be 99% effective in preventing pregnancy.
• Essure has been available for over 10 years and is FDA approved.

Safety Issues

As with any medical procedure that is permanent, there are various safety factors that must be taken into consideration.

• Essure Tubal Ligation is a permanent form of birth control. You must be sure that you do not want to have any more children. If you would like to keep the possibility of conceiving again open, Essure is not for you.
• It takes about 3 months for the natural barriers to form over the inserts and so prevent conception. During this time some other form of birth control must be used.
• In a few cases mild pain, cramping, vaginal bleeding and pelvic or back pain may be experienced for a few days. If it does, your doctor can prescribe medication to deal with the problem.
• The Essure procedure does not offer protection against HIV and other sexually transmitted diseases so precautions must be taken to prevent infection.

Is It Right For You?

While Essure Tubal Ligation offers a safe, convenient and effective form of permanent birth control, it may not be right for everyone. If you are looking for a permanent method of birth control, you should talk to your OB /GYN about Essure and the various options available to you. Once you have the information you need, you and your doctor can take a decision on what is best for you. In many cases, it will be Essure Tubal Ligation.

Essure Tubal Ligation

Tubal ligations were a big deal in the past but this has changed drastically in the last 7 years in my practice thanks to a procedure that has been around for at least 5 years prior to that.

The Essure procedure is a prime example of the recent trend towards minimally invasive procedures.

This is an in-office procedure done with a local anesthetic and involves minimal down time..

What's even better is that you undergo another simple minimally invasive test to confirm that it succeeded before you abandon your current birth control

We’ve been very happy with the modern methods we use in our office for more and more procedures that used to require going to the hospital and having major surgery with general anesthesia. It’s amazing that we do procedures every day that did not exist a few years ago. Our practice is much better as a result. One of the greatest improvements has been in permanent birth control, or what we used to call “having a tubal.” The previous procedure used to cause pain as we inserted a scope through the patient’s navel, and there was some risk involved with hitting a blood vessel or a hidden abdominal structure. Then there would be cauterizing the patient’s tubes, with the risk that the cautery could be too much or too little, which could result in an injury or a pregnancy, respectively. While a permanent birth control method is not for those who are still planning to have children, there are many people who are definitely not planning to ever become pregnant in the future and don’t want to have to depend on birth control pills or other methods that require  a lot of effort or cost.

Today we are pleased to offer and perform the Essure in-office procedure which accomplishes the same objective in a better, safer, quicker, and less painful way. The Essure is a tiny insert made of a flexible nickel-titanium polyester alloy that we place inside the uterus where the tubes are attached to it. This area is very narrow, only about 1-2 millimeters in diameter (see the picture). To accomplish this we give the patient 4 kinds of oral pain medication (which we call a cocktail) that is taken before coming into the office. We then give additional pain medication as a shot and also we give local anesthesia for the cervix. A tiny instrument which is the insertion device is gently placed through the cervix. So there is no cutting, no scar, and hardly any pain or bleeding. This gives us a view from within the uterus, and we look up to see the tiny openings at the top where the tubes meet the uterus. We place the tiny device in first one side, and then the other. The procedure is done. It usually takes about 15 minutes total time for both sides to be completed and does not hurt more than having a period.The opening of the right tube seen as it enters the uterus.

During the next 3 months each tube where the device has been inserted becomes blocked. We confirm this by doing a tubal dye test, and we get a report that shows a successful placement and successful blockage of both tubes. Not only is the procedure easy to do, but the results confirm it has worked before we advise patients to stop using birth control. The end result is a very convenient, safe, and effective method of having a permanent birth control with no cutting, no scar, and very little cost. As it is done in the office, there are no hospital charges for the person or for the insurance company.

We have been performing the procedure in our office for several years now, and the results have been great. If you are done having children, you should definitely consider having a permanent method that is so safe, easy and effective as this.