Why Every Man Should Take Sildenafil & Tadalafil (even with good erections)

Summary

The video script discusses the importance of considering long-term erectile function, especially for healthy individuals over 40. It highlights the potential for psychological dependency on PDE5 inhibitors in younger individuals and the effectiveness of intracavernosal injections for erectile dysfunction. The script also addresses common errors in injection technique and the impact of prostate cancer treatments on sexual function, emphasizing the need for patient education and informed decision-making.

Takeaways

• 💡 The discussion suggests that men, particularly those over 40, should consider taking steps to protect their long-term erectile function if sexual health is important to them.
• 💊 For healthy individuals, using PDE5 inhibitors regularly is seen as acceptable to protect penile health, but there is a concern about psychological dependency, especially in younger populations.
• 👨‍⚕️ A cardiologist was consulted on the topic, but no specific age was given for when to start taking measures for penile health.
• 📈 There is a high success rate for intracavernosal injections for erectile dysfunction, but there is a significant drop-off in usage over time due to integration challenges into sexual activity.
• ⚠️ There are risks associated with injection therapy, such as priapism, but these are low in a well-organized and monitored program.
• 🚨 The importance of proper injection technique and the dangers of self-adjusting dosages without medical supervision are highlighted.
• 🧊 Some medications used in injection therapy require refrigeration, which can be a practical challenge for some patients.
• 🛑 The rate of erectile dysfunction after prostatectomy is estimated to be around 50-60%, with or without the use of PDE5 inhibitors, two years post-surgery.
• 🔄 Emerging therapies like focused ultrasound and irreversible electrocautery are mentioned, but long-term studies on their effects are lacking.
• 🤔 Ejaculatory distress is a significant issue for some men post-prostatectomy, with a third of them being very bothered by the inability to ejaculate.
• 🌟 Orgasmic function after prostatectomy is preserved for most men, with differences in the quality of orgasms being subjective and variable.

Q & A

What is the recommended age to start considering protection for long-term erectile function according to the cardiologist mentioned in the transcript?

The cardiologist did not provide a specific age but suggested that if you are a healthy 40-year-old, you should start considering actions to protect your long-term erectile function, especially if sexual health is important to you.

What is the concern with a 25-year-old healthy individual starting to use PDE5 inhibitors regularly?

The concern is not about protecting their penis but rather the potential for psychological dependency. There's no physical dependency on PDE5 inhibitors, but a healthy individual might become reliant on them for an erection boost, which could affect their confidence levels.

What is the success rate of intracavernosal injections for treating erectile dysfunction?

Intracavernosal injections have an incredibly high success rate. For example, post-prostatectomy patients have a 92% chance of achieving penetration-hard erections within 6 months of starting injections.

What is the main issue with intracavernosal injections in terms of patient adherence?

The main issue is the difficulty in integrating injection therapy into love-making. It's not very spontaneous, and some patients may find it challenging to carry their injection medicine on dates or during intimate moments.

What is the risk of priapism associated with intracavernosal injections, and how is it managed?

Priapism, an erection that lasts more than four hours, is a concern with injections. However, in a well-organized and monitored program, the risk is very low, at 0.2% in the mentioned program.

Why do some men discontinue using intracavernosal injections over time?

There is a 50% drop in usage over five years due to the inconvenience and the lack of spontaneity associated with injections, as well as the potential for psychological dependency.

What is the significance of nerve-sparing surgery in post-prostatectomy erectile function?

Nerve-sparing surgery is crucial for better recovery or preservation of erectile function after prostatectomy. The better the nerve sparing, the better the chances of regaining function.

How does Androgen Deprivation Therapy (ADT) affect erectile function?

ADT, which reduces testosterone levels to zero, is very detrimental to erectile tissue health. It can lead to muscle atrophy and collagen deposition, significantly impacting erectile function.

What is the estimated rate of erectile dysfunction after prostatectomy or radiation therapy, according to the transcript?

The estimated rate of erectile dysfunction after prostatectomy or radiation therapy is approximately 50 to 60%, with or without the use of PDE5 inhibitors, two years after the procedure.

What are some emerging therapies for erectile dysfunction mentioned in the transcript?

Some emerging therapies include timey frequency ultrasound (also known as Kyu), irreversible electrocautery, and focused therapies like HIFU (High-Intensity Focused Ultrasound) and cryotherapy.

What is the difference between ejaculation and orgasm, and how are they affected by prostatectomy?

Ejaculation is the expulsion of semen, while orgasm is the pleasurable sensation associated with it. After prostatectomy, most men retain their orgasmic function but may experience a change in the intensity or quality of their orgasms. Ejaculation may be affected or lost, depending on the procedure and individual response.