What is Electro Shock Wave Therapy (ESWT) for Erectile Dysfunction (ED) ?
What is Erectile Dysfunction?
Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It is also sometimes also referred to as impotence.
Occasional ED is not uncommon. Many men experience it during times of stress. However, frequent ED can be a sign of health problems that need treatment. It can also be a sign of emotional or relationship difficulties that may need to be addressed by a professional.
How does ESWT work for ED?
One of the causes of Erectile Dysfunction is the poor flow of blood into the penis caused by unhealthy blood vessels.
By shooting multiple low-intensity shockwaves into the penis, new and healthy blood vessels develop. This is known as neo-vascularization.
Who will benefit from ESWT?
Since this treatment is specific for blood vessel problems, only people with ED due to unhealthy blood vessels will benefit. These are usually old patients (40 to 70 years old) and may have chronic diseases such as Diabetes, High Blood Pressure or High Cholesterol.
If your ED is due to other factors such as stress or side effects of medicines, then you will not benefit from this treatment.
ESWT can potentially cure patients with mild to moderate ED. For patients with severe ED, it will make them respond better to ED medicines.
What is the success rate?
Studies have shown that 76% of patients will have an improvement in their IIEF score by more than 5 points. Another study showed that 21 out of 29 patients treated had an improvement of their Erection Hardness Score from 2 to > 3.
In very severe cases of ED where the patient could not get an erection even with medicines for their ED (i.e. PDE5 inhibitors), after the ESWT treatment, 72.4% of them were able to get an erection with their medicines.
Overall, it is fair to say more than 70% of people will benefit from this treatment. Of course 70% is not a 100% and this success rate has to be balanced against the cost of the treatment.
Videos on ESWT for ED
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Sexual Transmitted Infections: The Causes Symptoms and Treatment
STIs are caused by viruses, bacteria and other micro-organisms that you can catch if you have sex with someone who is carrying one of these infections.
Symptoms can be classified into urinary symptoms, skin symptoms and general symptoms, and it can start to appear as early as 3 days after sex or can take weeks to months. Some people get infected but never develop any symptoms.
Treatment depends on the type of STI you have. Some can be treated by antibiotics and some such as Herpes and HIV are lifelong infections that have to be managed. STIs such as HPV and Hepatitis can be prevented with vaccines.
Remember, as long as you are having sex, you can have an STI. Most STIs can lead to serious complications if left untreated.
See your doctor for regular screening tests and treatment if necessary. Talk to him about getting vaccinated against Hepatitis and HPV.
Speak to our doctors if you suspect that you have had any high risk exposure to HIV.
Be safe. Be nice.
The UN has reached its goal to treat 15 million people living with HIV.
According to an article written by BBC news, the UN has achieved its target of treating 15 million people living with HIV as of March 2015 – 9 months before the planned schedule end. This landmark target has been reached thanks to global efforts to get anti-retroviral drugs to those who need it most including those living in the poorest parts of sub-Saharan Africa.
The UN first started their plan in 2000, where fewer than 700,000 people living with HIV were receiving adequate treatment.
A recently release UN Aids report states that the global response to HIV as prevented.
30 million new HIV infections and just short of 8 million AIDS related deaths since the year 2000. Over the last fourteen and a half years the number of new HIV infections has fallen from 2.6 million per year to 1.8 million. AIDS related deaths have dropped from 1.6 million per year to 1.2 million. UN Aids still feels that this is too high but it is a substantial step to reduce the impact of HIV and AIDS.
Part of this improvement has been due to greater money investment which sat at US$4.8 billion in 2000 and has now increased to US$20 billion as of 2014.
UN Aids is optimistic that continued effort may be able to end the AIDS epidemic by 2030 but the next 5 years will be vitally important.
Vineeth, 7 months old male kid, reported HIV-positive lying at an orphanage in Madras, India, Tuesday 29th November, 2005. Vineeth abandoned by his parent at Guild of Service and transfered to Community Health Education Society (CHES), an orphanage for HIV/AIDS infected, affected and Vulnerable Children, funded by Family Health International, Washington D.C. More than 40 million people worldwide are living with HIV/AIDS, according to latest figures from UNAIDS. World Aids Day will be observed on Dec. 1. (AP photo/ M.Lakshman)
Area for improvement
Despite all the good news there have been certain areas that lag behind. One such area is the awareness of HIV as people who do not know they are infected are not going to seek treatment.
Treatment for children has also faltered but is showing signs of improvement. Children receiving antiretroviral treatment increased from 14% in 2010 to 32% in 2014.
Those most in need
Sub-Saharan Africa has suffered the most with regards to HIV and AIDS accounting for 66% of all new worldwide HIV infections in 2014. When last checked 25.8 million people in this area were confirmed as living with HIV – that is almost five times the total population of Singapore! Also something to bear in mind is that the worldwide number of people living with HIV is estimated at 36.9 million so we can see that Sub-Saharan Africa makes up a staggering 70% of worldwide infections.
So the UN Aids report is strikingly positive showing that globally we are making huge strides to reducing the burden of HIV and AIDS but as with any battle we must not be complacent.
Should you have any concerns on HIV or AIDS you can always speak to one of our doctors at any of our clinics here.
"The world has delivered on halting and reversing the Aids epidemic” - Ban Ki-moon, Secretary General of the United Nations
COPYRIGHT © 2015. DR TAN & PARTNERS (SINGAPORE). ALL RIGHTS RESERVED.
Haze – new general advisory guidelines
COPYRIGHT © 2015. DR TAN & PARTNERS (SINGAPORE). ALL RIGHTS RESERVED.
It is an established fact that men who are exposed to pesticides in their work or in the environment they live in have a higher risk of sub-fertility. But what about the pesticides found on the fruits we eat?
A recent study on 155 men detailed exactly how much and what kind of fruits and vegetables they ate. This data was then compared to the US Department of Agriculture's data on how much pesticide residue is found on particular produce. For example peppers, spinach, strawberries, apples, and pears tend to have high levels of pesticide residue, whereas peas, beans, grapefruit, and onions have low-to-moderate levels.
It was found that the men who ate at least 1.5 servings of high-pesticide produce per day had about half as many sperm in their semen, and two-thirds as many normal-appearing sperm, as men who ate less than half a serving of high-pesticide produce per day.
Although this does not necessarily mean these men are less fertile, it would be logical to assume there is some impact on their fertility.
Also logically, this should not be surprising as pesticides are designed to harm pests reproduction so it should have sort of impact or effect on human reproduction also.
This study did not specify or differentiate which kinds of pesticides are worse.
So if you are struggling with fertility, one thing you may want to do is to switch to organic fruits and vegetables. Or at least choose fruits and vegetables that are known to have less pesticide residue.
COPYRIGHT © 2015. DR TAN & PARTNERS (SINGAPORE). ALL RIGHTS RESERVED.
Hey guys, if you're not lasting as long as you would like in bed, it could be only be due to 2 reasons:
1. You cannot get hard. Or you can get hard but it gets soft very quickly. Maybe even before you can penetrate your partner. Or you can get hard but its not as hard as you would like it to be. This is called Erectile Dysfunction.
2. You have absolutely no problems getting hard but you ejaculate much sooner than you would like to. This is called Premature Ejaculation.
Of course, these 2 issues are not mutually exclusive. You could be suffering from both at the same time. Also, one problem can lead to the other.
It is not surprising that this can lead to a lot of distress not only for you but also for your partner.
In this article, we are going to talk about certain things you can do to help with Erectile Dysfunction. We will discuss Premature Ejaculation in a separate article.
Do you have Erectile Dysfunction?
Well, this really should be rather obvious. If you cannot get hard enough to enjoy sex then you have Erectile Dysfunction. There are 2 questionnaires that attempt to semi-quantify the severity of the problem. These are the International Index of Erectile Function (IIEF) and the Erection Hardness Score. They are both rather self explanatory. Basically the lower the score you have, the bigger a problem you have.
What are the possible causes?
Not being able to get an erection can just be due to stress or can be due to more serious problems. Some of the possible common causes are listed here.
1. Stress and Anxiety
I have seen many fit young men with absolutely no problems at all until their wives start stressing them about getting a baby. Then out of the blue, they cannot get an erection. Although they do not conciously feel stressed or anxious, subconciously this could be affecting their erections.
Of course Erectile Dysfunction can also be related to more serious Psychological Illness like Depression or Post-Traumatic Stress Disorder (PTSD).
2. Unhealthy Blood Vessels
Having unhealthy blood vessels can impede blood flowing into the penis. It can also lead to blood leaking out of the penis. Both of which can lead to ED. Unhealthy blood vessels can be related to Chronic Diseases like Diabetes and High Blood Pressure.
3. 'T' Deficiency
As men age, the main male hormone known as 'T' will drop. Sometimes, it drops to such a low level as to start causing problems. Being overweight and having chronic diseases like Diabetes can cause the 'T' to drop faster and further. Having a low 'T' can lead to many issues including ED.
4. Trauma or Injury
Surgery to the Prostate can injure nerves in the pelvic region leading to problems with erection. Surgery to the brain or spinal cord can also injure nerves leading to the penis.
Of course any trauma or injury to the pelvic / genital region can lead to ED issues. Even an activity as benign as cycling can injure the prostate and pelvic nerves. Some bicycle seats these days are specially designed to minimze this problem.
5. Chronic Diseases
Erectile Dysfunction could be the first sign that you have a more serious problem. Medical illnesses that are commonly associated with problems with erection are Diabetes, High Blood Pressure, High Cholesterol and Thyroid problems. So when you see a doctor for ED, he/she will usually screen you for all sorts of general heatlh issues.
6. Prostate Enlargement / Benign Prostatic Hyperplasia (BPH)
All men, as we age, our prostate gets bigger. This can lead to urinary problems like poor flow, leaking, dribbling, getting up lots of times at night to urinate etc
BPH also causes problems with erection.
Smoking causes blood vessels to close up. This reduces the blood flow into the penis and can lead to erectile problems.
Many types of medicine can cause Erectile Dysfunction. Common ones are:
- Medicines for High Blood Pressure
- Medicines for Gastritis and Stomach Ulcers
- Medicines for High Cholesterol
- Medicines for Male Pattern Hair Loss
- Medicines for Depression
A simple home test you can do is the so-called "Nocturnal Penile Tumescence Test".
Basically you want to know if you are getting erections while you are in REM sleep. If you can, this means your ED is more likely psychological then organic. What you do is buy a string of stamps and stick them around your penis before you go to sleep. The stamps should have perforated links. If you find the string of stamps broken apart in the morning, you probably had some erections during your sleep. Of course the other easy thing to do is to ask your partner sleeping with you if you get erections in the middle of the night.
Deciding on which treatment you need depends on what the underlying problem is.
There are now many medicines available for the treatment of ED.
Collectively they are known as PDE5 inhibitors. They work by increasing a chemical called Nitric Oxide in the blood vessels of the penis. This causes the blood vessels to dilate and brings more blood into the penis leading to a stronger erection.
2. 'T' Replacement
If your 'T' is low (this is determined with a blood test), you might benefit from 'T' Replacement Treatment. This can be done with injections, gels or pills.
3. Change of Medicines
If you are on medicines that can cause ED, you can consider alternatives that will not cause ED. Of course this should not compromise the treatment of your other medivcal problem for which you were taking the medicine in the first place.
Recently, there has been a lot of research into using ESWT in the treatment of ED. This treatment involves sending shockwaves into the base and shaft of the penis. This stimulates the penis to make new and healthy blood vessels thereby curing the ED.
5. Vacuum Devices
Vacuum devices work by mechanically drawing blood into the penis. The blood is then kept in the penis with a constricting device at the base, usually a rubber band.
6. Surgical Implants
Surgical implants have come a long way. One of the newest techniques involves placing silastic plastic tubes within the shaft of the penis. The reservoir is placed near the bladder and the pump is placed in the scrotum. Pressing the pump in the scrotum will create an erection.
We have 4 locations conveniently located at Robertson Walk, Bencoolen Street, Novena and Scotts (Pacific Plaza).
Robertson Walk 6238 7810
Bencoolen Street 6884 4119
Scotts 66942348 (Opening April 2015)
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We are now Open on Weekends.
You can also visit our free STD, HIV and Sexual Health Forum.
Read our earlier blog entry on Erectile Dysfunction.