The following is a guest opinion article from Doc Martyn. His opinions and advice are entirely his own and may not necessarily be those of The Pattaya News Company Limited. His contact information can be found at the end of the article.
- In July last year, Joseph, not his real name, an intelligent young man in his thirties, sustained trauma to his ph@llus during a romantic interlude with his girlfriend of 2 years. He experienced acute pain and discomfort on the upper left side of the shaft of his ph@llus. Since the injury, he had experienced er$ctile dysfunction, ED.
- He visited three doctors:
-The first prescribed Viagra and an analgesic, with the diagnosis of Peyronie’s disease.
-The second gave him a Testosterone injection, yet his level was within normal limits.
-The third recommended Cialis and Synaflex, a Cox-2 Inhibitor (a next-generation NSAID).
None of these therapies were effective and his ED persists.
- He consulted me last week. He told me his story. I reassured him that his trauma was relatively minor. We discussed the concept of a fractured ph@llus, a highly traumatic event involving rupture of the Tunica Albuginea, TA, see photo 1. The TA supports the Corpus Cavernosa, the ‘spongue’ of the ph@llus which fills with blood causing tumescence, identified as CC in photo 1.
To reassure him, I described the case of an older patient of mine in his sixties: One morning he woke with morning glory when, suddenly, his two granddaughters jumped on him. He felt a sudden severe pain at the base of his ph@allus. His Tunica Albuginea, TA, had ruptured and his corpus cavernosum was damaged. It took many months to heal, leaving a significant degree of ED: When aroused, the shaft would engorge with blood but the ruptured, and now scarred, base of his ph@llus remained narrow. When engorged, the patient referred to his member as a balloon on a stick, an apt description.
- My examination of Joseph seven months after his initial trauma indicated that the 3 small horizontal lesions on the upper right side of his ph@llus had healed well. With such a minimal amount of damage to his member, it was difficult to understand his ED, for which he was using the prescribed Cialis. Further, he complained that; since the trauma his relationship with his girlfriend had not been the same.
- In older men, ED is usually a complication of dotage. This is a significant problem. About 30 million men in the U.S. and over 100 million men worldwide suffer from ED. In addition, men with diabetes are three times more likely to have ED.
Pfizer realized the potential profit from age-related ED and gained FDA approval for Viagra in 1998. In 2019 Viagra sales worldwide generated about US$ 500 million.
- Unless a young man has a significant physical illness, psychological dysfunction is generally the cause of ED. A young man who suffers ED subconsciously, and frequently also consciously, feels inadequate as a man.
I quizzed Joseph about his ED and his relationship. He and his 31-year-old girlfriend live separately. He professed that he cared for her.
But in-depth questioning revealed the following:
-They engage romantically about 3 times/week, mostly in the missionary position. —–Frequently, the Cialis did not produce an adequate tumescence.
-During their recent vacation together, she was happy to remain in the hotel room on her mobile, to watch movies and sleep, which he found a little boring.
-Generally, they did not engage in foreplay, neither oral nor manual.
-Sometimes, he was unable to climax.
- I talked to Joseph about their traditional approach to romance. I suggested that his ED was most likely due to their mundane approach to intercourse. I suggested that he should ‘spice up’ their relationship, encouraging her to engage in more adventurous behavior. He was reluctant to ask her.
- Finally, I suggested that he seek another girl, preferably a bar girl, to determine if he would lose his ED in the hands of someone more lithesome and adventurous. His response; “I already have, and I did.” And ‘therein lies the truth’.
Addendum: Over the past 6 years, as a retired medic living in Buriram I offered second opinions on any medical issue. I recently moved to Pattaya. As in this case, if you reside outside of Pattaya, telephone consultations are provided. For assistance; please contact me, Doc Martyn, on Facebook or call Dao on 095 414 8145.
