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If you’re someone who has had a penile implant, Peyronie’s disease, ED or want to share a story about the men’s health topics we discuss on Below The Belt send us an email or voice note to podcast@drlove.com.au.
Is something not working for you or someone you know below your belt? Are you thinking you might need some help with getting an or maintaining an erection? Join Urologist Dr Christopher Love who explains all there is to know about what causes and how to treat Erectile Dysfunction. In this episode he goes through the causes of ED.
Erectile Dysfunction (ED) is a very common problem that affects millions of men around the world. Approximately 2 million Australian men suffer from some form of ED. ED can occur at any age and at any point in a man’s life. The common thought that ED is an “old man’s problem” is wrong, and young men can suffer too.
Most men have experienced difficulty in getting or keeping an erection at one-time in their lives. This is normal and is often related to anxiety or nervousness, having had too much to drink, tiredness or distraction. This does not indicate a problem but could indicate an issue if the difficulties are ongoing.
Treatment options may include: A Penile Implant procedure, which is the best option in most cases, and is the only way to fix the problem of ED and return the penis to the most normal spontaneous functioning. Lifestyle changes: stop smoking, lose weight, healthier diet, more exercise, control of blood pressure and cholesterol may all help in minimising the risk of ED occurring. Oral medications (PDE5 inhibitors). Injection therapy: self-injection of medication directly into the penis, Penile vacuum pumps and more.
Find out more about ED https://www.drlove.com.au/erectile-dysfunction/:
Do you think that you might have Erectile Dysfunction? Take the quiz here.
If you’re someone who has had a penile implant, Peyrone’s disease or any of the other topics we discuss on Below The Belt and want to share your story, send us an email or voice note to podcast@drlove.com.au.
Visit Dr Christopher Love’s youtube page for videos on ED.
Listen to Below the Belt on Apple Podcasts:
Listen to Below the Belt on Spotify:
Listen to Below the Belt on Google Podcasts:
For more information visit drlove.com.au or email podcast@drlove.com.au for information on urology, penile implants, Peyrone’s disease, prostate, ED or men’s health issues below the belt.
[00:00:00] Welcome to Below the Belt with Dr. Chris Love. We’ve made a series of audio guides about the most common men’s health problems and how you can treat them. You’re gonna find information around erectile dysfunction, penile implants, penile curvature, which is known as Peyronie’s disease. Prostate and other urology [00:00:20] issues that happen below the belt.
[00:00:21] Don’t be embarrassed. Every guy you know has an issue at some point with their penis. On this podcast series, you’ll get the answers and information that you need to know to have a better conversation with your doctor or healthcare professional to be able to treat whatever it is that’s bothering you below the belt, the more information [00:00:40] visit Dr.
[00:00:40] Love, that’s D R L O V. Dot com au. But now below the belt, episode one, why is my penis not working? Erectile dysfunction, ed. Here’s Dr. Chris Love. Hi, I’m Dr. Love. In this audio guide, we’re going to be talking about that topic that men really are scared to [00:01:00] talk about, and that’s erectile dysfunction. Used to be called impotence, that’s an even worse word cause it has all sorts of implications, but doctors now call it erectile dysfunction.
[00:01:08] And as you’ll hear in the next few minutes, it’s a, it’s a very common problem. So, Erectile dysfunction does sound like a fancy medical term, and you know, when we get down to it, what it means is your penis isn’t working the way you want [00:01:20] it to. It’s either not getting strong enough, won’t last long enough, but there’s something wrong with your erection.
[00:01:26] That means you can’t have sex as you used to and as you want to. Whole lot of reasons for it, but when it comes down to it, it just means your penis isn’t working properly. It’s actually a pretty common problem, and it increases in incidence with. [00:01:40] Um, unfortunately, as we get older, no matter how healthy we are, we do run into these sorts of problems, but it can occur at all ages.
[00:01:47] It can be something that happens for a short while and comes good, or it can sometimes be a permanent problem. So if you have noticed a problem like this, you certainly don’t want to ignore it and feel ashamed. [00:02:00] You really should go and talk to a doctor about it, because even if it’s a relatively temporary problem, there are going to be things that are available to help.
[00:02:09] The doctors look after Ed are mainly urologists, but there are also some sexual health specialists around. The first port of call would be to go to your GP and there may be [00:02:20]something simple they can do for you or give you some guidance or order some blood tests or start to investigate the problem. But you really need to go to a specialist to, to look at the full range of treatments that are available because there’s a multitude of things we can do to improve the situation, and particularly if it’s a relatively temporary problem, little bit of guidance and a bit of [00:02:40] help, and, and you’ll be, you’ll be up and running again.
[00:02:45] So if we’re talking about erectile dysfunction, most men have had it for a number of years, whatever the underlying cause is, whether it’s, uh, you know, they’ve had surgery to have their prostate removed or, or whatever. But I rarely would [00:03:00] see someone who hasn’t had the problem for, you know, a number of years and maybe just gradual decline in erections and eventually at a stage where Viagra doesn’t work anymore.
[00:03:09] So they want to look at their options, but it’s not. You. You don’t see people three weeks after they had a problem or not in a specialist practice anyway. Erection problems are actually [00:03:20] more common than most fellas would imagine. Even with men in their twenties or thirties, they’ll sometimes have problems.
[00:03:26] They’re more likely at that age to be what I’d call situational or a bit anxiety associated, and often are temporary, but nevertheless, it’s a problem. In younger men, typically we start off assuming it’s, it’s in their head and I, and I don’t mean that in the [00:03:40] sense that they’re crazy, but if someone’s under stress or they’re anxious, the body produces a whole lot of chemicals in response to stress.
[00:03:48] And those chemicals, things like adrenaline and stuff like that, they actually close down small blood vessels in the body, which is exactly the opposite. We need, if we’re going to have a good erection, you, you can have [00:04:00] stress related to what’s happening in your life. And if you are. Chronically stressed or chronically anxious, you overproduce these chemicals the whole time and that will impact even in times when you’re not at work or you’re not stressed.
[00:04:13] But then there’s the more typical thing of performance anxiety, and that’s often what occurs with a new [00:04:20] partner or you know, a situation that’s been bad and you hope it’s gonna be better. So what’s happening for you is you are worried whether your erection’s going to work. You’ve perhaps it wasn’t so good last time you tried.
[00:04:31] The more you start worrying about that, the same thing happens. You get these chemicals produced, and almost certainly the erection won’t work. So then you’re convinced in your head there’s something [00:04:40] wrong, and that can be a, an ongoing downward spiral. Every time you fail, you’re convinced you’re gonna fail the next time.
[00:04:46] That’s the most common reason younger guys have erection problems. There are a couple of other things I’ll talk about a little later, but for younger men listening to this, the thing to appreciate and uh, understand is it can happen. [00:05:00] Understanding why it happens and may talking to someone’s a great way to solve the problem.
[00:05:04] So who do you talk to? It’s embarrassing. You know, you think you’re the only guy that’s got this problem. You can’t talk to your mates about it. It, it’s, you know, you’re not a man if you can’t get it up. If you have a relationship with your family doctor, possibly they’ve been your gp as you’re a a kid, [00:05:20] it’s pretty difficult to go along and talk to them.
[00:05:22] I’d encourage you to do so, and I think if you’ve gained a little bit of education and understanding about ed, it’s easier to then broach the subject with your doctor because you’re not going in saying, oh, I’ve got this problem. And you know, the, the classic story as you go along to the gp, [00:05:40] Saying, oh, I think I’m getting migraines, and talk about that.
[00:05:43] And then just as you’re about to go out the door, you say, oh, doc, by the way, um, my dick’s not working properly anymore. Somehow you need to sort of get over that and be able to open up to the doctor about it. And, you know, all doctors are medical professionals. They, they listen to this sort of stuff. But I do [00:06:00] understand it’s a very difficult thing.
[00:06:02] So erectile dysfunction is really common. So one way we, we sort of talk about the numbers of men that have got erection problems is to, from the age of 40, we basically say, You’ve got a 40% chance at 40, a 50% chance at 50, a 60% chance at 60. [00:06:20] Now, that’s not entirely accurate, but it’s not inaccurate either, and I think it’s a good way for you to understand that you are not the only man with these problems.
[00:06:29] Probably about 10% of men under the age of 40 have got erection problems also. Sometimes permanently, sometimes intermittently. But as men get older, it’s more likely there are erection [00:06:40] problems related to physical issues. The most common, one of which is poor blood supply into the penis. So unfortunately, as men get older, and it doesn’t matter how fit we all are, the little arteries in the body start to narrow down.
[00:06:54] I think quite ironically, we used to call it hardening in the arteries, which is pretty amusing when we’re talking about [00:07:00] erection problems. But nevertheless, um, it’s really called vascular disease and it’s, uh, where the little arteries narrow. You don’t get enough blood flow. The most important artery that is affected by vascular disease that you will notice.
[00:07:14] Is the arteries into the penis because there’s a visible change. You can see [00:07:20] things aren’t working. It’s also one of the first areas, unfortunately, that is affected by vascular disease. Now, vascular disease gets worse with age, but it’s also worse if you’ve got what we call risk factors. And they’re the things everyone knows that are bad for their heart.
[00:07:35] Smoking, high cholesterol, high blood pressure, diabetes. [00:07:40] Overweight, lack of exercise. All those things that you’ll hear people talk about, protect your heart by treating those things. The reason it’s protecting your heart is cause it’s helping the heart arteries. Well, guess what? The penile arteries are also helped by treating or minimizing those problems.
[00:07:57] So, so what’s really important about [00:08:00] understanding that vascular disease is the common cause of erection problems as men get older is it’s actually the early warning that you are getting vascular disease. And there’s a lot of studies now that have been done that show if a man, perhaps in he’s mid fifties, 60, that sort of age group is having declining erections because.[00:08:20]
[00:08:20] Poor blood flow into the penis. He’s got about a 50% chance of already having coronary artery disease. He just, he just doesn’t know it yet. So specialists in this area that are talking to men about their erections will often recommend they go off and see a cardiologist and have all the, the, the heart testing because, um, There’s one or two [00:08:40] studies that actually show us that if you’ve got erection problems, you’re likely to have a cardiac event within the next eight years.
[00:08:46] So it’s really good if we can prevent that. So when you come and talk to a, an erection specialist, I hope they’re, they’re treating you as a, as a. The whole person, and they’re actually recommending you look at these other factors because there’s a very strong [00:09:00] relationship between them. So apart from vascular disease, which is the most common cause of these problems, as as fellows are getting older, we’ve got a very large group of men who also have erection problems after they’ve had surgery, particularly surgery in the pelvis, and most commonly prostate cancer surgery.
[00:09:18] If you have prostate cancer and you need to [00:09:20] have your prostate removed as you might lose your erections. Unfortunately that is true. Um, it’s important to get the prostate cancer treated cause that’s good for your, you know, your longevity. But, uh, don’t be put off by the fact that you might get erection problems.
[00:09:34] Cuz, cuz we can fix that later on. That’s a little bit different to [00:09:40] vascular disease cuz what happens when you have prostate cancer surgery is that the nerves that take the message from the brain to the penis get pushed and moved around and. All urologists try and preserve those nerves, but sometimes just pushing them around’s a problem and then the nerves don’t work.
[00:09:58] If the nerves don’t work, you don’t get any [00:10:00] erections. Sometimes the nerves will recover and it can take one or two years. But the trouble is, in the meantime, you’re not getting erections. And you’ll probably all be aware of the old saying, if you don’t use it, you lose it. Um, you know, we used to all think that was a joke, but it’s actually true because if you’re not having erections, and that includes.[00:10:20]
[00:10:20] Not waking up in the morning with an erection or having no nocturnal nighttime erections, then you’re not getting fresh blood into the penis. The penis isn’t being stretched and it loses its elasticity and you actually lose penile length. The the penis gets shorter, the tissues inside the penis won’t react.
[00:10:37] So even if the nerves that were [00:10:40] temporarily damaged recover, unfortunately the penis can’t respond any longer, and that’s why erection problems after prostate cancer surgery. Is so common. And then the final, the final group are diabetics. And unfortunately, diabetic men are very prone to develop vascular disease.
[00:10:59] It’s [00:11:00] part of diabetes, be it childhood diabetes are even occurring later in life. And the really, I think the thing that annoy and you know, really, uh, pisses guys off about this is that it doesn’t matter how well your. Been controlled, you may still get erection problems. [00:11:20] They are a group that typically, if they’ve had diabetes for more than about 10 years, probably at least half of them have got erection problems.
[00:11:27] So very, very common problem in diabetics. And there’s a whole lot of other less common causes, hormone problems and other issues. But the, the large groups of of causes are there. The guys that are responding [00:11:40] badly to stress and anxiety. The men that are developing vascular disease, the men that have had prostate cancer surgery, or diabetic men, and that would make up more than 90% of men who have erection problems.
[00:11:53] For more information, visit the website, dr love.com.au. That’s D [00:12:00] R L O V e.com au. In the next episode, Dr. Love will share how to get help online for Ed.
In the second episode of the Below The Belt podcast, Dr Christopher Love is back to share his expertise on a topic that’s close to many people’s hearts (and groins): premature ejaculation. Premature ejaculation affects a lot of men, and it can be a real mood-killer in the bedroom. Don’t worry, Dr Love has tips and advice on what to look for.
There’s no single definition of what “premature” means – it’s different for every person and every sexual encounter. However, if you’re consistently finishing before you or your partner want to, then it might be worth exploring some techniques to help delay ejaculation – from the simple to more advanced techniques like pelvic floor exercises. He also touches on medication and therapy options for those with more severe cases.
So, if you’re tired of finishing too soon, listen to Below The Belt and learn some ways to last longer and enjoy your time between the sheets – and seek help if you think you might need it.
Find out more about ED https://www.drlove.com.au/erectile-dysfunction/:
Do you think that you might have Erectile Dysfunction? Take the quiz here.
If you’re someone who has had a penile implant, Peyrone’s disease or any of the other topics we discuss on Below The Belt and want to share your story, send us an email or voice note to podcast@drlove.com.au.
Visit Dr Christopher Love’s youtube page for videos on ED.
Listen to Below the Belt on Apple Podcasts:
Listen to Below the Belt on Spotify:
Listen to Below the Belt on Google Podcasts:
For more information visit drlove.com.au or email podcast@drlove.com.au for information on urology, penile implants, Peyrone’s disease, prostate, ED or men’s health issues below the belt.
[00:00:00] Welcome to Below the Belt with Dr. Chris Love. We’ve made a series of audio guides about the most common men’s health problems and how you can treat them. You’re gonna find information around erectile dysfunction, penile implants, penile curvature, which is known as Peyronie’s disease, and prostate issues can be embarrassed.
[00:00:19] Every [00:00:20] guy you know has an issue at some point with their penis. On this series, you’ll get the answers and information that you need to know and have a better conversation with your doctor or healthcare professional to be able to treat whatever it is that’s bothering you below the belt. It’s available wherever you get your podcast.
[00:00:37] The more information visit Dr. Love. It’s [00:00:40] d rl o vn com. Now here’s Dr. Chris Love Below the belt, episode two. How to get e d help online.
[00:00:56] Hi, I’m Dr. Love. So if you really can’t [00:01:00] face up to going to your, your family doctor, to your gp, there’s a number of online places you can access this sort of help. Um, there’s. At least two or three, uh, online medical clinics, men’s health clinics available in Australia. And these are the sort of topics they cover.
[00:01:16] Even just looking at, uh, chat sites can be useful, but [00:01:20] please do something about it because the, the longer it goes on and the more you ignore it, the more entrenched that. That behavior’s gonna become in Australia. One of the companies that provides and service, and you can talk to genuine Australian doctors is mosh.
[00:01:33] You’ll find them online and there’ll be a link on my website to them. Uh, and they are very good. All the [00:01:40] information the doctors on Mosh Give you has been double checked by me and, and I basically act as their advisor in these areas. So you’re getting genuine advice from, uh, from someone like Mosh initially with these online companies you make.
[00:01:53] Via a message or an email or before you actually speak to someone and they get you to fill out a little questionnaire so you [00:02:00] don’t have the embarrassment of talking to someone. They then know what the problem is. So when they connect you to a doctor, the doctor already knows why you’re contacting them.
[00:02:08] So I think that helps to get over that initial embarrassment. When you talk to the doctors at Marsh, it’s completely confidential. Your information doesn’t get sold to anyone else. It’s literally like having a consultation [00:02:20] across the desk. It’s just you’re doing it over electronic communication, but the doctors are doctor sitting wanting to help you with your problem.
[00:02:27] And the other good thing about this is you can access them perhaps at times that are more convenient to you, and it makes. Process of getting into the system to get some help a lot easier. And doctors like that can actually help [00:02:40] you with many of the simple causes of Ed. They can, you know, guide you to perhaps talk to a therapist.
[00:02:45] If it’s anxiety related, they can prescribe medication. But if you’re not really happy to go to the doctor, you know, and you’ve known for years, and I would encourage you to do that. This is a more anonymous way of doing it and I think it’s. That anxiety [00:03:00] about approaching the subject For more information, visit the website, dr love.com.au.
[00:03:05] In the next episode, Dr. Love will talk about how your penis might be changing. Is it curved? Have you got urinary problems? Do you have problems getting an erection? That’s on the next episode or below the belt with Dr. Chris [00:03:20] Love.
Below the Belt with Dr. Christopher Love shares how your penis changes, including Peyronie’s disease or penile curvature, urinary problems, and erectile dysfunction (ED) — and in many cases for ED the self-diagnosis is often clear. Are your erections not strong enough, don’t last long enough, or you can’t have sex the way you used to? You likely have erectile dysfunction. Peyronie’s disease can cause a curve in the penis, which can be difficult for many men to deal with. Urinary problems are often related to the prostate and can cause slow flow and the need to urinate more frequently. While these issues can intermingle, we’ll focus on erectile dysfunction. It’s important to note that premature ejaculation can also cause confusion for some men who may mistake it for erectile dysfunction. It’s essential to talk to a doctor who can educate you on what is normal and what isn’t.
One thing that can cause unreasonable expectations in younger men is watching pornography. It can reset the sensitivity of your brain to sexual stimulation, affecting your ability to have sex. This area is being studied by psychologists, and there’s a lot of work being done on it.
If you’re experiencing erectile dysfunction or any other issues related to your penis, don’t be embarrassed. Talk to your doctor to get the help you need to have a better conversation with your healthcare professional and treat whatever is bothering you below the belt.
Find out more about ED https://www.drlove.com.au/erectile-dysfunction/:
Do you think that you might have Erectile Dysfunction? Take the quiz here.
If you’re someone who has had a penile implant, Peyrone’s disease or any of the other topics we discuss on Below The Belt and want to share your story, send us an email or voice note to podcast@drlove.com.au.
Visit Dr Christopher Love’s youtube page for videos on ED.
Listen to Below the Belt on Apple Podcasts:
Listen to Below the Belt on Spotify:
Listen to Below the Belt on Google Podcasts:
For more information visit drlove.com.au or email podcast@drlove.com.au for information on urology, penile implants, Peyrone’s disease, prostate, ED or men’s health issues below the belt.
[00:00:00] Welcome to Below the Belt with Dr. Chris Love. We’ve made a series of audio guides about the most common men’s health problems and how you can treat them. You’re gonna find information around erectile dysfunction, penile implants, penile curvature, which is known as Peyronie’s disease and prostate issues.
[00:00:19] Don’t be [00:00:20] embarrassed. Every guy you know has an issue at some point with their penis. On this series, you’ll get the answers and information that you need to know to have a better conversation with your doctor or healthcare professional to be able to treat whatever it is that’s bothering you below the belt.
[00:00:35] It’s available wherever you get your podcasts. The more information visit Dr. Love, [00:00:40] that’s D R L O V e.com.au. Below the. Episode three. Your penis is changing, discussing curved penis, urinary problems, and problems getting an erection. Now, here’s Dr. Chris Love. Hi, I’m[00:01:00] Dr. Love in Medicine in general, if someone has a symptom, then a doctor’s going to investigate it to find out what’s going on.
[00:01:08] I think erection problems are a lot simpler than that. You, as the patient knows you’ve got a problem cuz your penis isn’t getting hard. It, it’s a medical condition. It’s a medical disease, but it’s not one that needs [00:01:20] a lot of fancy tests or things to work it out. In most cases, if you’ve noticed, your erection is not getting strong enough.
[00:01:27] It’s not lasting you, you can’t have sex the way you used to. And if that’s more than just a one-off thing, because probably over our lives, all, all men have that problem occasionally, and this is a, a problem that’s persist. Essentially you’ve got [00:01:40] erectile dysfunction, so you don’t need to to diagnose in any other way.
[00:01:43] It’s a self-diagnosis, if you like. So there’s a number of other things that can happen in the penis. A condition that occurs called Peyronie’s disease causes a curve in the penis. You may still have a strong erection, but it’s bent and that’s pretty difficult for most guys. Also, we’ll talk a lot more in another, uh, [00:02:00] another audio guide about Peroni’s.
[00:02:02] Some men will develop some urinary problems. It’s pretty common. Flow gets a bit slow. You have to get up at night to have a pee, et cetera. That’s not particularly related to the penis. That’s more related to the prostate. But these things all start to intermingle a little bit, particularly as a man gets older.
[00:02:18] But if we’re just focusing on [00:02:20] erection problems, that’s really a self-diagnosis. It’s not strong enough. It won’t last long enough. Et c. I guess that also goes into this whole area of premature ejaculation and those issues. So it’s normal once a man ejaculates that he loses his erection. Some men will come along thinking they’ve got erectile dysfunction, but they’ve actually got [00:02:40] ejaculation issues.
[00:02:40] And you’ve gotta sort that out and you’ve, and what the doctor needs to say to you is, is well educate you about, is. This? What’s that? How are they interrelated? What’s normal? What’s not normal? Because sometimes really you’ve just got an issue that’s probably relatively normal, but you don’t have the background knowledge to understand what is normal.[00:03:00]
[00:03:00] Just talking about that, one of the things I see quite commonly is younger men who have unreasonable expectations because they’ve been watching a lot of pornography and you know, if you are watching porn and you’re trying to compare yourself to what’s happening there. That’s an unreal world. There’s also a, a thought that if you watch a lot of porn, it can actually reset the, the [00:03:20]sensitivity of your brain to sexual stimulation.
[00:03:22] Possibly you can Overwatch porn and that affects your own ability to have sex because your brain’s got used to watching porn. The sexual stimulus has a change, really interesting area that the psychologists are looking at quite a lot, and there’s a lot of work being done on that. So this term, erectile dysfunction.[00:03:40]
[00:03:40] Is the term a doctoral write down to describe what you’ve got. But if you think about it, it just means your penis isn’t functioning, so dysfunction not functioning. So your erections are not functioning. Erectile dysfunction just means my penis isn’t getting hard enough, staying hard enough, not working the way I want [00:04:00] to, to have an erection and have sex.
[00:04:01] That’s erectile dys. So if this is what you are noticing with yourself, you, you, you shouldn’t be embarrassed about it. If your erection’s not strong and you can’t have sex properly, please do something about it. There are plenty of people that can help you, and sometimes just talking to someone is all you need to get going again.
[00:04:19] And if you are [00:04:20] older and you’ve got other medical problems, well, it’s important that they get investigated and we give you a diagnosis and we give you options for treatment. For more information, visit the website@drlove.com.au. On the next episode, Dr. Love will share some information around the treatments [00:04:40] for Ed.
Welcome to Below the Belt with Dr. Christopher Love, where we discuss common men’s health problems. In this episode, we’ll be talking about treatments for erectile dysfunction (ED) like pills, injections, and pumps. If you’re experiencing ED and need medical help, your doctor will ask about your health, lifestyle, and medical history to identify the cause. They might also suggest tests like blood tests or ultrasounds.
Knowing why you have ED is essential in finding the right treatment. For example, if smoking is the cause, quitting smoking may help. Treatment options range from lifestyle changes to medication and surgery. Doctors usually start with the least invasive treatment and move towards more invasive ones if needed. It’s okay to seek help for ED or other urology issues. Every guy experiences these problems at some point. The more you know about the problem and treatments, the better you can communicate with your healthcare professional and take necessary steps to treat the issue.
Dr Love shares the benefits of talking to a sex therapist to understand stress factors causing sexual problems. The family of medications that help with erection problems includes Viagra, Cialis, Spedra, and Levitra, and they work by opening up the blood vessels in the penis. These drugs only work with sexual stimulation and take time to build up in the bloodstream, so plan accordingly. Lastly, Tadalafil can stay in the bloodstream for more than 24 hours, making it possible to have sex whenever desired.
Find out more about ED https://www.drlove.com.au/erectile-dysfunction/:
Do you think that you might have Erectile Dysfunction? Take the quiz here.
If you’re someone who has had a penile implant, Peyrone’s disease or any of the other topics we discuss on Below The Belt and want to share your story, send us an email or voice note to podcast@drlove.com.au.
Visit Dr Christopher Love’s youtube page for videos on ED.
Listen to Below the Belt on Apple Podcasts:
Listen to Below the Belt on Spotify:
Listen to Below the Belt on Google Podcasts:
For more information visit drlove.com.au or email podcast@drlove.com.au for information on urology, penile implants, Peyrone’s disease, prostate, ED or men’s health issues below the belt.
[00:00:00] Welcome to Below the Belt with Dr. Chris Love. We’ve made a series of audio guides about the most common men’s health problems and how you can treat them. You’re gonna find information around erectile dysfunction. Penile implants, penile curvature, which is known as Peyronie’s disease, prostate, and other urology issues [00:00:20] that happen below the belt.
[00:00:21] Don’t be embarrassed. Every guy you know has an issue at some point with their penis. On this podcast series, you’ll get the answers and information that you need to know to have a better conversation with your doctor or healthcare professional to be able to treat whatever it is that’s bothering you below the belt.
[00:00:38] For more information, [00:00:40] visit Dr. Love. D R L O V e.com.au. But now below the belt, episode four, treatments for Ed Pills, injection, and Pumps.
[00:00:57] Hi, I’m Dr. Love. So [00:01:00] you’ve realized you do have erectile dysfunction and you’ve finally, uh, decided to do something about it, and you’re speaking to a doctor or on mosh, or you’re speaking to your gp or you’ve come to see someone like me. What’s going to happen next? Typically, the diagnosis is a self-diagnosis.
[00:01:17] You know, you’ve got the problem. So what doctors will [00:01:20] do is ask you some questions about your general health and try and establish why you’ve got the problem. Erectile dysfunction, if you like, is the symptom. It’s what the, it’s what the patient notices, but doctors like to understand why you’ve got that symptom.
[00:01:35] And I’m sure you as the, as the person suffering, want to know why you’ve got the problem as well. So [00:01:40] the doctor will start off asking questions to understand, did the problem start gradually? Did it start suddenly? Does it occur all the time? Those sorts of things to try and establish a, a background. The, uh, doctor will want to know about your lifestyle and are you a smoker?
[00:01:56] Do you drink? Would you regard yourself as as fit? Are [00:02:00] you overweight, eating the wrong foods? All those sorts of important lifestyle things. They’ll also want to know about your medical history. Have you had this operation, that operation? Have you had injuries? Is there something that might be, uh, an obvious cause for these problems?
[00:02:15] Often after just taking a history and talking to you about your problem? [00:02:20] The doctor will be able to say to you, I believe your erection problem is due to the factor of smoker, or it’s due to the factor overweight. Sometimes, however, there will need to be other tests done to get a better idea. So blood tests will look at things like cholesterol and look at, uh, blood sugar to make sure you’re not a diabetic.
[00:02:39] [00:02:40] Sometimes we’ll need to measure testosterone, which is male hormone, and sometimes we’ll even need to go on and do special tests like an ultrasound to look at the blood flow in the penis and try and establish if we can, why you have got the problem. So I can talk to you about why most men have the problems having now [00:03:00] come to see the doctor.
[00:03:01] I think it’s nice for you to know why you’ve got the problem if, if we can. Now, to some extent, that doesn’t matter, which sounds a silly thing to say, but. Our treatment options are more or less the same no matter what the cause of the problem is. So I think it’s good for you as the [00:03:20]patient to know why you’ve got the problem.
[00:03:21] And as a doctor, I want to know why you’ve got the problem, and particularly if we think you’ve got vascular disease, cuz we need to talk about your heart. And if we find you diabetic, Great. Let’s get your diabetes treated. We realize you’re smoking 80 cigarettes a day. Well, apart from upsetting your heart, you’re gonna upset your erections.
[00:03:39] We do like to know why [00:03:40] you’ve got the problem, so we can deal with the underlying problem if we can, but really often we’re just moving on to talk about the treatment options that are best suitable for you. I tend to break the treatment options up, like climbing up a ladder. We start on the lowest rung and we work our way up.
[00:03:56] If we are talking about younger men particularly who [00:04:00] have maybe anxiety issues, and we really feel you fall into that category, then I think sometimes just even being confronted with that and being told and that that’s your problem and, and having the mechanism explained that it’s to do with an overproduction of brain chemicals when you’re under stress, and often that goes a long way to helping.
[00:04:18] Knowing a bit about other [00:04:20] lifestyle factors, smoking, recreational drugs. If you’re being honest with yourself and you realize that you’re sitting, watching Netflix at night and having a packet of Tim Tams, that’s probably gonna be great for your health in a lot of ways. If you’re overweight, you know yourself, you’re overweight, you should lose weight.
[00:04:35] If you’re smoking too much, you know that’s not good. I think one of the things any [00:04:40] man can do and at a sort of bottom rung of treatment is to look at the lifestyle factors that they may be able to sort out themselves. So I’d always encourage you if you were sitting across the desk from me to honestly look at those things now, that may or may not help.
[00:04:56] But in, in some cases, particularly just because [00:05:00] you’ve come along to talk to the doctor and you’ve suddenly relieved yourself of that burden of, I’ve got this problem, and you, you understand more about erections and you, you understand how all these things can influence. Sometimes that’s all we have to do.
[00:05:13] Just almost education to you. A bit of self-awareness, a bit of change of [00:05:20] your own lifestyle can be enough to, to make a quite a difference. So the next rung would possibly depend a little bit on what we think is your problem. So if I’m talking to you and I’ve assessed you and I, I think your problem is primarily anxiety.
[00:05:37] Stress about your erection problem? The [00:05:40] sort of self-fulfilling, you know, I think I’ve got a problem. Do you, I have got a problem now. I know I’ve got a problem. You know, the away you go and talking to someone who’s expert in that area is really useful. And there’s a lot of, uh, psychologists with an interest in sexual dysfunction.
[00:05:55] They’re, uh, sex therapists and they’re very good at just getting you to talk about it a [00:06:00] bit, understand what the stress factor is and ways around that. I certainly would not, uh, think that, that that’s something you would avoid because you think, well, gee, I can’t go to a psychologist. It means I’m crazy.
[00:06:12] Not the case. We’re talking about talking to an an expert who can help you work those problems out. Psychologists talk to you [00:06:20] and understand you and get you to understand yourself and work through things that way. Psychiatrists really are medical doctors who treat mental illness by using drugs.
[00:06:30] Typically, although erection issues can be part of depression and other illnesses, typically if we think you’ve got stress causing your sexual problem, [00:06:40] your, your ed, I think the psychology pathway is the way I would direct you. So if I have decided and. Understood that your problem is really one that’s best treated by psychology and therapy.
[00:06:51] I would direct you that way. But the other larger group of men, we will start the the next rung of the ladder, which is the oral medications. [00:07:00] Now, I think just about everyone in the world has heard of the blue pill, Viagra. It’s been around nearly 25 years now, and there’s a number of other drugs in the same family.
[00:07:09] Many men would also have heard of Cialis or S Spedra or La Vira, and these are all brand names. And really we should be talking about the drug name. So [00:07:20] Viagra is Sildenafil. Cialis is Tadalafil. Lavitt. Levitra is fil, and Spedra is Afil. Don’t worry too much about the names, but you’ll notice they all end in Phil f i l and that means they come from the same family of of medication that is, they all work the same way, but there are subtle [00:07:40] differences between them.
[00:07:41] This family of medications work within the penis to open up the blood vessels in the penis and get more blood into the penis, but they don’t do that just by taking the tablet. All they really do is make your own erection better. So if you take Senil or tadalafil, you won’t get an erection unless you [00:08:00] have sexual stimulation.
[00:08:01] A lot of men come along and they don’t actually understand that. They think if they take a tablet, they get an erection. So if you are. Interested in having sex or you’re not having any sexual activity, you can take these tablets and they won’t do anything. What actually happens inside the penis is when you think about sex and get involved in sexual activity, [00:08:20] messages from the brain go down to the penis and they release chemicals in the penis that open up the blood vessels and get more blood to go in.
[00:08:27] There’s also, at the same time, other chemicals in the penis that are starting to try and close the blood vessels. So like most things in the body, there’s a positive and negative force senil and the other drugs block the [00:08:40] chemical that’s trying to close the arteries down. If you’ve had the thoughts and you’re getting involved in sexual activity, the good chemicals are released in the penis, you get more blood flow into the penis.
[00:08:49] And the erection drugs are blocking, if you like, the bad chemical in the penis that’s trying to close the vessels down so you get more blood into the penis. So you do have to be involved in [00:09:00] sexual activity. The other common thing that you may not understand about these drugs is that. When you take them, they have to build up a level in your bloodstream.
[00:09:08] So there’s a time delay from when you take them to when you get any benefit. And that’s actually one of the probably major issues with these and what, what many men will complain about. So you really need [00:09:20] to plan sexual activity because depending on the drug and depending on your own, Metabolism. That’s how your body deals with things.
[00:09:27] It could take anywhere from 30 minutes to 60 minutes before you get a benefit from the medication. Now, that’s not very good for spontaneous sexual activity. There are a few differences between the drugs, however, and [00:09:40] tadalafil, which the brand name used to be Cialis. When you take that medication, it actually stays in your bloodstream for more than 24 hours.
[00:09:48] So we now, for a lot of men say, why don’t you take a very low dose of that every day? And after a few days, you actually have a steady level in your bloodstream, and then you can have sex whenever you like. [00:10:00] And I, I say to you, if you are sitting across the desk from me, think about this like a vitamin for your penis.
[00:10:05] It’s a supplement for your penis. You take it every day. It’s not about erections, it’s about the health of your penis. But what it’s actually doing is giving you a constant level in the bloodstream so you can have sexual activity whenever you. I think a really good way for a [00:10:20] lot of men like you to be treated.
[00:10:21] Most men have heard of disastrous side effects from particularly Viagra when it was first released. Really what was happening is there are some medications for heart conditions that cross-react with the erection drugs, and early days it wasn’t well understood. Men were buying Viagra off the internet and [00:10:40] with no medical supervision.
[00:10:41] And they had drug interactions and some men did die. But if the, the medications you can’t have with the erection drugs are really the medications you take if you’ve got angina or if you’ve got chest pain. Mm-hmm. . Um, and that’s sometimes the sprays that people use or the tablets under the tongue or the patches they wear, unfortunately.[00:11:00]
[00:11:00] If you’ve got that sort of problem that is, you’ve got coronary artery disease and you’re having chest pain angina and you need medication, you are likely to also have erection problems because as I said earlier, it’s all to do with vascular disease. So there, there is this group of men who ideally we could prescribe an erection drug for them, but they’re taking an [00:11:20] angina medication regularly and, and we can’t.
[00:11:24] That, that’s becomes a bit of an issue in how, how I would treat you if you’re in that situation. If you’re taking any of the erection medications, there is a chance you might have some minor side effects you might find you have a slight headache, a bit of flushing of the face, a bit stuffy in the [00:11:40] nose.
[00:11:40] Um, tadalafil. Different to the other ones you might find you get a bit of just achiness in the muscles. Now sometimes that’s significant enough not to take the medication, but the great majority of men can take these medications with minimal side effects and with safety, because we only are going to [00:12:00] prescribe the medication if we know there’s no, no risks and they’re not on other medications that would, uh, which would clash with them something.
[00:12:09] Maybe 65% of men with erection problems will actually respond really well to to oral medication. If you’ve got fairly mild problems, your doctor can [00:12:20] treat you very simply. And the next treatment group that most men will at least consider and. You. You may or may not when I talk about it, but that’s learning to inject a drug into the penis yourself, so we can inject on the medication into the side of the penis.
[00:12:38] That actually opens the [00:12:40] arteries up. It actually causes an erection. Oral medications only help your erection if you’re having an erection. The injected medications give you an erect. But it means sticking a needle into the side of your dick every time you want to have an erection. And a lot of guys are not, not super keen on that idea.
[00:12:58] There’s a little bit of discomfort. There’s [00:13:00] a risk of bruising and bleeding. Uh, you can even develop scar tissue inside the penis because of the injections, and that scar tissue can affect the shape of the erection. And the worst potential complication if, if this sort of treatment’s not supervised properly, is you can actually get a prolonged direction that won’t go down, and that [00:13:20] might sound like fun for the first hour or three.
[00:13:22] After a few hours when it’s hurting and painful and clearly not going to go down, it can then permanently damage the penis. So if you are going. Use self-injected medication. You need to be prepared that there could be a prolonged direction and you’d need to go to the emergency department. You need [00:13:40] to very strictly follow the instructions the doctor’s given you when they prescribe the medication.
[00:13:45] You don’t use double the dose because you’re gonna get into trouble. And things like that. So it’s certainly a treatment that can be very useful, but has to be controlled and supervised by, by your doctor. I, I’ve talked about moving [00:14:00] up the treatment ladder up each rung. The next thing I’m going to tell you about is not going up a full rung.
[00:14:05] It’s going up half a rung on the ladder. Vacuum erection device, and many men would know that as a penis pump or penis enlarger or, or similar things. Essentially, you’d have put a, a plastic tube over your penis. It’s got a little [00:14:20] pump attached to it, and when you press on the pump, it creates suction within the plastic tube and your penis basically gets sucked up into an erection by, by negative pressure, by suction.
[00:14:29] And when it’s where you want it to be, you can put a rubber ring around the base to keep it like that. Now the problem. For a lot of men is that you won’t get a really rock hard erection. It’s not very [00:14:40] spontaneous for you. Again, if you’re in the middle of wanting to have sex and you again, hang on, pump, pump, pump, pump, pump, pump, you know, it’s not necessarily what people want to do, but for many men, and particularly for some older men, it gives them enough erection to be to be happy.
[00:14:55] The rubber ring can get a bit uncomfortable. The penis goes a bit a bit blue [00:15:00]because there’s no blood getting into it because you’ve got this constrictive ring around the penis. And if you don’t get the ring far enough towards your body, you’ll have a penis that’s a bit firm further away from the body and it’s, it’s floppy towards the body, and it’ll just be like, it’s got a hinge.
[00:15:14] So, If you want to use that, it’s safe as long as you’re careful with it. It’s cheap, but you have to [00:15:20] know how to use it and practice a bit to get a good result with it. And, and to be honest, I find that most of the men I talk to probably are not interested in trying that. They want their erection to be as good as it can be.
[00:15:31] But you should understand that is an option for you possibly and certainly for some men. So if you’re going to use a vacuum erection device and, and practice with it [00:15:40] and, and know how it works for you, great. But I, I suspect you’ll be coming back to talk to me or someone like me because. Most men find that they just don’t get a good enough erection to continue to use that long term.
[00:15:53] On the next episode of Below The Belt, what is a penile implant and how can it fix my erection? Have a [00:16:00] listen, and if you hear something that sounds familiar, visit dr love
In this episode of Below The Belt, Dr. Christopher Love explains that penile implants or prostheses are the best way to restore erections in any man, no matter what the cause of his erection problem. Unlike other treatments that only enable an erection, penile implants fix the underlying problem. A penile implant is a device that goes inside the penis, just like an inner tube in a car tire. It can be filled with fluid and pressure, which builds up to give a hard penis. The cylinders are connected to a little reservoir of fluid inside the body near the bladder and a pump inside the scrotum, between the testicles. When you pump the device, the fluid flows into the cylinders, and it gets harder. Once you have learned how to use it, you can have a rock-hard erection within 20 or 30 seconds. It is almost like the real thing and stays up until you release the little valve, which allows the fluid to come from the penis back to the reservoir.
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[00:00:00] Welcome to Below the Belt with Dr. Chris Love. We’ve made a series of audio guides about the most common men’s health problems and how you can treat them. You’re gonna find information around erectile dysfunction, penile implants. Penile curvature, which is known as Peyronie’s disease, prostate, and other urology issues that happen [00:00:20] below the belt.
[00:00:20] Don’t be embarrassed. Every guy you know has an issue at some point with their penis. On this podcast series, you’ll get the answers and information that you need to know to have a better conversation with your doctor or healthcare professional to be able to treat whatever it is that’s bothering you Below the belt, the more information visit Dr.
[00:00:39] [00:00:40] Love, that’s D R L O V. Dot com.au. But now below the belt, episode five, what is a penile implant and how can it fix my erection? Hi, I am Dr. Love. I have no doubt from my experience and my own patients and everything I’ve done over the [00:01:00] years that the best way to restore erections in any man, no matter what the cause of his erection problem is to put a penile implant or a penile prosthesis inside the penis.
[00:01:10] It doesn’t matter whether your erection problem’s due to blood flow or nerve damage or leaky veins, we can restore your erection with a penile. In fact, it’s the only [00:01:20] treatment that fixes erectile dys. All the other treatments enable you to have an erection, but they don’t actually fix the underlying problem.
[00:01:27] So the concept of a penile implant is, it’s a bit like putting an inner inner tube in a flat car tire. If you imagine you’ve got a flat tire, we can put an inner inner tube inside it. We can fill the inner inner tube with air. So the pressure is in the inner tube, [00:01:40] but the inner inner tube’s in the tire.
[00:01:41] So the pressure gets quite high and it looks and works like a. If you imagine, we put cylindrical inner tubes inside your penis, inside the natural cavities. We can fill those up with fluid. The pressure builds up and it looks like a car tire. That was the joke. No, no. [00:02:00] Okay. , sorry. So in the penis you’ve got two tubes that get full of blood and one on each side on the top of your penis, and that’s where the blood pressure builds up.
[00:02:10] And that’s why you, why you get a hard penis. That’s why you get an erection if we. That’s not working for any reason. Okay, let’s put something inside those two tubes [00:02:20] that will give you an erection. Just like we put the inner inner tube in the car tire, if we put inner inner tubes inside the natural tubes in your penis, then they can be filled up.
[00:02:29] The pressure builds up and it will look and work just like a penis. So it’s really a way of replacing the blood flow. Mechanism with another fluid mechanism that does exactly the same job, and [00:02:40] that’s why it works so well. Because it doesn’t matter how bad your erection problem is, it doesn’t matter what the cause of your erection problem is, this will fix it.
[00:02:48] Now these involve surgery, which I’ll speak about in a moment, but we can open up the penis inside these natural tubes, which normally fill with blood. We just put a pair of [00:03:00] penile implant cylinders and. Uh, made the length and the size of your penis. They go inside the penis, they get connected up to a little reservoir of fluid.
[00:03:10] It’s inside your body, near your bladder, and they’re all connected with little internal tubes to a pump that sits down in inside your scrotum, between your balls. So [00:03:20] basically everything’s inside. When you want an erection, you feel the pump between your balls, between your testicles, and as you pump on it, the fluid comes from little reservoir that’s inside you, goes to the two little inner inner tubes we’ve put inside your penis.
[00:03:34] And then that fills with, with fluid gets harder and it basically is an erection. And [00:03:40] the really good thing about a penile implant or a penile prosthesis is once you’ve learned how to use it, You can pump it up and have a really good rock hard erection within 20 or 30 seconds. So it’s really spontaneous.
[00:03:52] It’s almost like the real thing in that regard. You can make it as hard as you want it to be. In fact, if you pump your penile implant [00:04:00] really hard, you’ll have a probably the hardest erection you’ve ever had, and it stays up as long as you want to because even after you’ve, you’ve come and had an orgasm, it won’t go down until you release the little valve, which is.
[00:04:12] On the pump in the scrotum, and that allows the fluid to come from the penis back to the reservoir. Next time you wanna pump it up, the fluid’s in the reservoir, [00:04:20] you pump it up with the little pump between your testes, you get your erection again. So you can use it as often as you want to make it as hard or soft as you want it to be.
[00:04:28] So it really restores your erection. So the thing about penile implants or penile prosthesis is not a lot of people even know about them. So in terms of a treatment for Ed, This might be the first [00:04:40] time you’ve even heard about that, and that wouldn’t surprise me because it’s not talked about. You wouldn’t know if someone had a penile implant in.
[00:04:47] They’ve got a device inside their body when the implant is deflated, the penis is flacid. Probably not as flacid as it used to be cuz it’s got the device in it, even when the device is flat. You can wear normal [00:05:00] clothing when you pump it up. It’s a good hard erection, but you wouldn’t necessarily know someone had one.
[00:05:05] I think there’s been a reluctance to talk about it like there is on all of these things, but also even a lot of gps don’t necessarily know about implants, and yet in many ways it’s the best treatment cuz it will fix your erectile dys. The [00:05:20] really good things about a penile implant are that it will always work.
[00:05:23] You pump it up, you’ll always get an erection. There’s no, take the tablet. I hope it works. There’s no stick a needle in my penis. Hope it works. This will work, and that’s why I think it’s a great solution for you. You get a hard erection, stays up as long as you like. You could even say it’s better than the real thing in that.[00:05:40]
[00:05:41] Now, there’s obviously some negatives. It requires an operation, which we’ll briefly talk about in a moment. It is a mechanical device that goes inside the body. So in theory, something could go wrong with it. They’re very reliable, very robust devices, and if we put an implant into you, you’ve got a 95% chance.
[00:05:59] It’s [00:06:00] still working fine. 10 years from now and even 20 years from now, you’ve got about a 60% chance. It’s still working. So they’re pretty reliable device. If something did happen to it, it’s usually fluid leaks out because the material deteriorates a little bit in the body and you gotta pump it up one day and it won’t pump.
[00:06:17] So if it fails, we then have [00:06:20] choices. If you’re of an age or health issues where it’s not that important to you anymore, we can just leave the device inside the body. It doesn’t have to be removed, or it is a small risk of infection with any operation, more so in diabetics, but anyone can get a surgical infection if you’ve put a foreign material in the.
[00:06:37] And here we’d be talking about hip [00:06:40] replacements or cataracts or any of the things we do. If you get an infection and there’s a foreign material in the body, it’s harder to get rid of the infection. So there’s a whole lot of stuff we do, and I’ve got a particular surgical technique that I’ve developed over the years and call it the minimally invasive no touch.
[00:06:56] But basically we do this operation through a little three [00:07:00] centimeter hole. We have all the skin isolated, and my infection rate for these is less than half a percent. So it’s not quite zero, but it’s very low infections. The thing we, we all try and avoid because it may lead to needing to remove the implant, but it’s a very low risk.
[00:07:15] The other two negatives come to your expectations about what a penile implant will [00:07:20] do for you. It’s unfortunately not gonna make you more attractive. It’s not gonna suddenly increase your appeal to the world, but it will enable you to have penetrative sex. The head of the penis, the glands of the penis, the knob is a separate area to the shaft of the penis.
[00:07:35] So the implant goes in the shaft and it makes the shaft thick and [00:07:40] hard, but the head of the penis does not get filled up by the. So some men will pump the implant up and go, oh, it looks a bit funny. Or My penis isn’t as long as it used to be. Uh, and some of that’s because the head’s not engorging. Many men, when they start sexual activity, they’ll pump their implant up, they’ll start sexual activity, they’ll then get some [00:08:00] engorgement of the head of the penis.
[00:08:01] After that, some won’t, but, but many will. And this brings us to this question of length. So you might be wondering, like many patients do, how long’s madic gonna be Doc, right? You’re gonna make it longer for. If I put an implant into you, I’m putting it into the natural tubes that normally get full of blood.
[00:08:19] So we’re opening [00:08:20] those tubes, we are measuring the inside, and we are putting an implant in that fits into those tubes. You can’t put an implant in that’s bigger than the tubes, cuz it just literally won’t go in. Now one of the problems is when you’ve had erection problems for a long time, doesn’t matter what’s caused them, the fact you’re not getting regular erections, you’re not having erections overnight, et cetera.
[00:08:39] The [00:08:40] penis loses length, it loses elasticity. Cause all the erections we have during our sleep, and whether you know it or not, you are having four or five erections every night during sleep and you’ve been doing that your whole life. They’re not to do with having naughty dreams, , they’re actually a normal body function to keep the penis healthy.
[00:08:57] So if we are not getting those [00:09:00] nighttime erections or not getting any erections, guess what your penis isn’t as. And the main thing that happens if your penis isn’t being stretched regularly is it loses length and it loses elasticity, so we can’t stretch it. So before we even put an implant into you, you’ve lost some length of your penis.
[00:09:16] Now I can make it as long as possible. [00:09:20] By several techniques we have during surgery and putting cylinders in that are slightly longer than the space we’re putting ’em into. So we can help a bit, but you can’t put a cylinder in that will make the penis the length it used to be. So the common, I think, misconception that you might have and, and you wouldn’t be alone in this, is that great.
[00:09:38] I can have an implant in and my [00:09:40] penis will be 50%. I wish it was true, but we can’t do that. We get good length, great rigidity. It works really well. All the other aspects of sex are the same, so touch and feel, and orgasm, and ejaculation, warmth, all that’s exactly the same. What you get is a guaranteed hard dick, and that’s what [00:10:00] most guys want when it comes down to it.
[00:10:02] If you’re worried about length, the first thing I would say to you is that what’s more important is having a penis that works. It gets hard, gets thick, it lasts as long as you like. Implants give really good girth and, and. That works for you. That works for you and your partner length is not what necessarily what it’s [00:10:20] all about.
[00:10:20] It’s not how big it is, it’s how you use it. And you know, I think that’s probably quite important in this context also. So with a penile implant, the way I do the operation is a little incision just above your penis, just on the pubic hair area. It’s just a little three centimeter incision done under a general anesthetic.
[00:10:39] Keeps you in [00:10:40] hospital one night. All the parts of the implant, the reservoir and the, the tubes inside the penis and the pumping, the scro and all put in through that. And when that incision heals up, you literally don’t see it. What a lot of men then ask me, it might be something you are thinking about is, does my partner need to know about this?
[00:10:58] Can I, can I hide [00:11:00] it? Can I disguise it? The answer is yes and no. The things inside you, if I’m looking at you, can’t see it. Sometimes you might just see slight bulge for the pump in the scrotum, but we try and make them as disguised as possible for you when you’ve pumped it up. And if your partner’s not feeling around your scrotum or your balls or they wouldn’t know any different, [00:11:20] they’d say, wow, this is a good, hard erection.
[00:11:22] But just like you can feel the pump in the scrotum to pump it up. Your partner, if they’re feeling around that era, will feel that there’s something there. So it depends a bit on what you’re doing when you’re having sex and you know your relationship and you know, techniques and all sorts of things like that.
[00:11:38] Yes. No one [00:11:40] needs no, but it’s pretty hard to disguise it completely from an intimate partner. So if you want to try and make it, you know, something you know about, but your partner doesn’t, what many men will do, and you might think of this yourself, you could just go to the bathroom and pump it up and come back and say, Hey, look, look what I’ve got, uh,
[00:11:59] Once [00:12:00] you’re proficient at pumping it up, and that’ll be something you’ll learn fairly quickly. Uh, my, my nurse will instruct you on how that works and, and she’s a great resource for if you’ve got any problems. Still also been an audio guide available as part of this series, which you can quickly refer to if you need to, just to remember how to pump it up.
[00:12:19] So what [00:12:20] some, some people might do, and it might be what you decide to do is particularly with a new partner, and if you haven’t already spoken to your partner about it, is you could go to the bathroom and pump it up and then you can come out, you’ve already got your erection, or you, you may well be able to.
[00:12:37] Somewhat, uh, without being observed, pump it up just while [00:12:40] you’re in bed so you can get away with your partner not knowing. But I’d always encourage you, uh, and particularly if you’re in an established long-term relationship, then, then you know, your partner should know. I think the issue comes to people at a single and a.
[00:12:54] It’s got different partners and what I hear from a lot of my patients is that it is a little bit [00:13:00] awkward first up, but their partners actually appreciate the fact they’ve got a really hard penis that lasts as long as they like. So it actually, I think, becomes a positive that you’ve got an implant rather than negative for, for, for lots of men.
[00:13:13] Rather than try and hide it, I think you just need to be upfront and say, look, I’ve got this device in me. It, it’s not [00:13:20] mechanical. Or you know, I’m not a robot, it’s it, but I’ve now got a really great erection and we’re both gonna really enjoy that. Most people and most of their partners that that’s the right thing to do.
[00:13:31] I’d always suggest. You’ve tried several times yourself before you’re involved with the partner. Cause you do need to become proficient and you need to [00:13:40] practice a little bit and you will, you’ll become really expert at it cuz you’ll exactly feel how your pump feels and you’ll know how much pressure to apply.
[00:13:48] Ideally, you practice yourself. You can masturbate, you can see that it all works. Before you have sexual activity with your partner, but I think you’re better to be pretty open about it and say, look at this great device [00:14:00] I’ve got. This is cool, isn’t it? I mean, well look, it’s strong and it’ll stay up and you want to go again and you know it’s, they’re pretty good devices.
[00:14:09] On the next episode of Below The Belt, why is my Penis curved and what is pei’s disease? Have a listen, and if you hear something that sounds familiar, visit dr love.com au for [00:14:20] more information.
On this episode of Below The Belt… why is my penis curved? Peyronie’s disease is the most common cause of penile curvature, and it occurs when scar tissue builds up in the penis due to injury or trauma, leading to a bent penis. Join Dr. Christopher Love as he discusses various conditions related to men’s health, including erectile dysfunction, penile implants, penile curvature or Peyronie’s disease, and prostate issues.
Some men may have a genetic tendency towards the disease — normal wear and tear during sexual activity can also cause a bent penis. However, many men with Peyronie’s disease may not even realize they have it. Dr. Love explains that this condition is common, and it can occur suddenly, leading to a lump in the penis or a bent erection. Overall, the episode offers valuable insights into men’s health issues and the importance of seeking medical help when needed.
Find out more about ED https://www.drlove.com.au/erectile-dysfunction/:
Do you think that you might have Erectile Dysfunction? Take the quiz here.
If you’re someone who has had a penile implant, Peyrone’s disease or any of the other topics we discuss on Below The Belt and want to share your story, send us an email or voice note to podcast@drlove.com.au.
Visit Dr Christopher Love’s youtube page for videos on ED.
Listen to Below the Belt on Apple Podcasts:
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For more information visit drlove.com.au or email podcast@drlove.com.au for information on urology, penile implants, Peyrone’s disease, prostate, ED or men’s health issues below the belt.
[00:00:00] Welcome to Below the Belt with Dr. Chris Love. We’ve made a series of audio guides about the most common men’s health problems and how you can treat them. You’re gonna find information around erectile dysfunction, penile implants, penile curvature, which is known as Peyronie’s disease and prostate issues.
[00:00:19] Don’t be embarrassed. [00:00:20] Every guy you know has an issue at some point with their penis. On this series, you’ll get the answers and information that you need to know to have a better conversation with your doctor or healthcare professional to be able to treat whatever it is that’s bothering you below the belt.
[00:00:35] It’s available wherever you get your podcasts. The more information visit Dr. Love, [00:00:40] that’s D R L O V e.com au. Below the belt, episode six. Why is My Penis. And what is pei’s disease Now? Here’s Dr. Chris love, it’s Dr. Chris Love again. I suspect you didn’t necessarily enjoy listening to our, our audio guide on erectile [00:01:00] dysfunction.
[00:01:00] It might have been a bit confronting, but I hope you nevertheless got some information from it and you know more about the problem, and I hope if you’ve got the problem, you’ll seek some help for it. What we’re gonna talk about in this guide is another condition that sometimes exists when you’ve got erectile dysfunction.
[00:01:16] And that is a bent penis. Now that may be something we’ll all [00:01:20] go. Oh, bent penis. Aha. But it’s actually quite a common condition. So what we are talking about is when a man gets an erection, it curves, or it’s got a kink in it, or it’s got a kink, both sides. So it looks like a, an hourglass. And by far, the most common cause of that is a condition called pe.
[00:01:39] Welcome to [00:01:40] Below the Belt. Was a French surgeon, Jillian, back in the 18th century, first described this condition and it since had his name attached to it. And when it got translated from French to English, it was called disease. And it’s, it’s not a disease, it’s a condition. Welcome to Below the Belt. It’s not something you’ve called podcast someone else.
[00:01:59] The other reason you [00:02:00] can have a, a bent. Direction is you can be born with below the belt direction and that’s called I talk to Chris love Core D and a contend podcast Meanings. You were born with it. That’s less common, but that’s where a man has always had a curved direction. So I’ll have patients coming along who are maybe in their twenties this week, a [00:02:20] couple of fellows in their thirties belt say, look, I’ve always had it, Peter.
[00:02:24] I thought it was normal, and I realized it wasn’t. I finally decided to get some advice. Peyronie’s disease is where the curve occurs later life. The belt, a podcast series stand. There are two ary for it to occur happen. One is the belt. Some men seem to [00:02:40] have within their own genetic makeup, they’re more likely to get this condition.
[00:02:44] So there’s probably some genetic factors, some hereditary factors to below the belt with doctors, and we know it’s associated with it of common curling, which is called jus Co. Typically the finger and the ring finger curl in won straighten. [00:03:00] So you might want to just stretch your fingers out now and make sure they’ll stretch out and if they won’t have a little feel in the palm of your hand and see if the tendons, but so that’s where the finger becomes the palm of the hand.
[00:03:12] If they feel a bit thick or ropey, because that’s the start of trons contractor the belt. Now that doesn’t mean we’ll get disease, but it [00:03:20] suggests you’ve got the genetic tend. The second thing you need to get Peron’s disease, and this sounds a bit dramatic, is trauma to the peace. And there are two types of trauma or injury if you like.
[00:03:33] In the great majority of men that get Peron’s disease, they don’t remember an incident. They don remember [00:03:40] any trauma and that’s absolutely true. And prostate, there is also a group of men where their erection has been venturing into course, and sometimes they’ll remember that they’ll have pain, bruising, swelling, or sometimes.
[00:03:51] Vitamin men just described, they hear something crack when they’re having intercourse. That sort of trauma or what I would call wear and tear [00:04:00] trauma, it can lead to peons. Now, wear and tear trauma is as men are getting older and erections aren’t what, as firm as they used to be, just having normal sexual activity.
[00:04:10] The penis just flexes and bends a little bit. It’s not rock hard anymore, so it flexes. It’s just like flex, flex, flex. You get a little wear and tear, which [00:04:20] you wouldn’t even call an injury. You don’t even know it’s an injury. But that can be enough to initiate peons. So what PEs is, is the body responds to that injury by causing too much scar tissue to fall.
[00:04:33] So it’s trying to repair the injury, overdo it so you get scar tissue in the beans, which you can [00:04:40] feel is a. Sometimes it’s tender cause there’s inflammation. The problem with scar tissue in the penis, the scar tissue contracts, so the penis will shorten a bit, but more importantly, scar tissue won’t stretch.
[00:04:51] So when you have an erection, the rest of your penis is filling with blood and the bit that’s got the scar tissue can’t. So it’ll curve in that direction and upwards, downwards, [00:05:00] sideways, whatever, indentations, basically due to the physical effect. You’ve got scar tissue in, in your penis now, and scar tissue doesn’t work the same as the normal tissue.
[00:05:10] Peroni’s disease is actually relatively common. We think if we go looking for it and not literally looking for it, but if we ask our patients, if noticed a [00:05:20] change in their penis or if they noticed a little lump, or if we’re examining a patient and we can feel something, if we really actively look for peroni’s disease, we think about nine or.
[00:05:29] 10% of men actually have it. You may not even know you’ve got it because you might think a little curve, normal or a little lump you can feel is normal, or you might even be worried. You can feel a little bit of lump and you [00:05:40] think it’s a cancer and you won’t even come along and get someone to check it for you.
[00:05:43] Or maybe your erections are not working well enough for other reasons. To not even know you’ve got a curve, but you’re not the only man with peyron. And I think when I talk to you about this, you’re gonna be surprised how common it is. So what happens with it? Typically it starts occurring and often the [00:06:00] change comes on quite suddenly and men come along saying, look, I felt a lump, and then two weeks later, my erection was bent.
[00:06:06] Or some just come along and you might say to me, or my erection got bent. I don’t know why, but it often, it’ll come on quite quickly. The first question most of you will have is, What happens? Does it get better? Does it go away? [00:06:20] Unfortunately, there’s a very small number of men only where the condition goes away, and just as we don’t really understand why it starts, we don’t really know why it goes away.
[00:06:29] Perhaps around 5%, 10% of patients, the condition will improve over time and maybe not complete the go away the bill of a lot better. It’s also a very small group where it gets worse and [00:06:40] worse no matter what we do, but most of you that have got Peroni’s disease, Will have had a fairly typical course that is, it starts, it gets a bit worse for maybe six months, maybe 12 months, and then it gets to what we call a stable stage.
[00:06:54] We need to wait until it’s at the stable stage before we can use those treatments early on. [00:07:00] When it’s first starting now, it’ll be great to think we could give you medication to fix it. And if you look on the internet, you’ll see that people talk about vitamin E and all sorts of other things. The problem is all those things you might investigate on the internet, and people swear that it helps when you do medical studies to try and prove if they [00:07:20] help, there’s no evidence that these things really help.
[00:07:23] So maybe we’ve got men who are going to get better anyway. They take their vitamin E and they go, wow, this is great, and they put it on the internet. Here’s the cure. A lot of these things are safe and you can try them, but unfortunately there’s virtually no oral medication that will make any difference.
[00:07:38] The only oral [00:07:40] medication you might want to take when you first start getting perrons. Is actually the erection drugs that may sound funny, but well as opening up blood vessels on the penis and helping with erections, we think these drugs also have an effect within the penis on some other chemicals, nitric oxide, and some other things [00:08:00] inside the penis that can soften the scar tissue.
[00:08:03] So I think if you’re going to take any oral medication early on, Actually the erection drugs will more likely to help you than vitamin E or anything else you might read on the internet. So if you’ve got a problem with the shape of your erection guides. Another important part of [00:08:20]Peyronie’s disease and something I think a lot of men don’t talk about, and I want to just tell you about it now, is.
[00:08:25] What it does to men’s image of themselves and what it does to our self-esteem and our feeling of being a man. And nearly all of my patients, when I talk to them and I ask them about that, will say something like, I just don’t [00:08:40] feel so good about myself. I don’t feel like I’m the man I used to be. And interestingly, I hear that more from men with Peyronie’s disease than I do with erectile dysfunction.
[00:08:49] So there’s something about you look down and your penis isn’t the way it was that seems to have. Direct effect, and I think it’s very important that I talk to you about that because you’re not the only one [00:09:00] feeling it and that loss of. Manliness, if you like, that self-esteem issue can then become a bigger problem.
[00:09:08] You can become depressed and you can actually develop a erectile dysfunction because you’re so worried about the shape of your penis that the strength isn’t any good. So remove the belt. Don’t feel that if you’ve got this condition and you’re [00:09:20] feeling. Strange about yourself, and you’re not even feeling like having sex, et cetera, et cetera.
[00:09:25] They’re all normal things that can occur with peroni’s disease. It does have quite a mental effect on many men. So generally when you are observing yourself and realizing you’ve got a problem, either you or your partner’s going, hang on, there’s something wrong here. It’s [00:09:40] the wrong shape. It’s got a bend, or it’s got a little kink in it or something.
[00:09:44] So it’s not about color of penis or anything, it’s really about the shape of the penis. Sometimes your partner might comment that it’s hurting them and it might be hurting them, cuz if it’s bending a fair bit, it’s gonna cause discomfort. How many, sometimes you might find you can’t penetrate because it’s got a bend, it might [00:10:00] even have a hinge in it.
[00:10:01] So it’s really to do with the shape of the erection. That’s what Peroni’s disease does to you below the bell. So it’s pretty easy to know cause you can look at yourself, my above, look in the mirror, ask your partner what they think, and the erection’s no longer straight. So if you have noticed that there’s a change in the shape of your erection, [00:10:20] you’re not the only one with the condition.
[00:10:23] There are ways to fix it. It shouldn’t be embarrassing to talk to a doctor about it, and you really need to, because it most likely won’t get better by itself when the condition becomes stable, most commonly we’re going to talk about surgery to fix it. Pills. And if it’s [00:10:40] affecting your life, then it ought to be fixed.
[00:10:42] Some men might say, look, it’s a little bit of a bend. All I want to know is what’s wrong with me. I’m happy to leave and that’s fine. So not everyone needs treatment, but you should at least talk to someone who knows about the condition and can. Discuss the options with you. So one way you might be able to help the [00:11:00] problem with the shape of your erection yourself without any medication or surgery is what’s called penile traction.
[00:11:07] Now, penile traction means gently stretching the penis outwards from the body and doing that fairly consistently for several months to get an effect. Many of my patients assume that we are stretching the scar tissue. [00:11:20] You can’t stretch scar tissue. What happens when we pull the penis out points is it makes the body produce new cells.
[00:11:28] So you’re actually making your body remodel with the penises. Good for that cuz it’s a nice stretchy organ to start with. Tissue produces new cells and a change of the shape of the erection. So [00:11:40] if you use attraction device and you do need to use it, it very conscientious. I’ll speak about in a moment, you’re probably gonna get at least 50% improve in your curvature.
[00:11:50] Probably gonna gain a little bit of the length. You’ve lost maybe a couple of centimeters, and that might be enough if you’ve got a bit of length back and, and the curve’s only 50% of what it was. Maybe that’s [00:12:00] all we need to do. So what we’ve got are devices that you can now, these problems put over the penis, will stretch the penis outward from your body.
[00:12:07] So it’s not something, you’re not holding it yourself. We’re talking about a device that does that, and it’s applying a gentle stretching to the penis for a long period of time. That’s what traction is. It’s not, let’s put five kilograms on the end of [00:12:20] your deck and stretch it. That’s not what we’re talking about.
[00:12:22] We’re talking about gentle stretching, using a device for a period of time, and depending on. Device you’re using, that could be the need to use it for three or four hours every day for six months, or maybe only needing to use it for an hour a day for three months because there are some different devices and some work better than [00:12:40] others.
[00:12:40] So it takes a fair bit of time and devotion and really work at it. But for a man who’s prepared to do that, they may well improve their erection enough to avoid surgery. And if you can improve your erection shape enough to avoid surgery, that might well be something you want to do, and it’s [00:13:00] safe and it’s a conservative therapy.
[00:13:03] If it works, great. If it doesn’t, we haven’t really lost anything. We’ve still got some other options. Many men with this condition do eventually come to surgery, and the way I would talk to you about surgery is first of all, is your erection strength. Okay? So can you get a [00:13:20] strong erection? Either naturally or maybe helped by oral medication, or if you can’t get a strong erection or haven’t got a strong erection, that would take us on on a different pathway.
[00:13:31] So if your erection is strong or you take tablets and it’s strong, our only concern then is the shape of it. And the way I like to talk to you [00:13:40] about it is, Because most men have an upward bend that’s most common. Might have a little indentation, but I say to you think that you’ve now got a short side of the penis and alongside of the penis.
[00:13:52] When you have an erection, one side’s shorter than the other. That’s why it bends. So I can make your penis straighter by doing [00:14:00] something to the short side or doing something to the long side. The simplest way I can get your erection straight is to actually slightly shorten the long side to make it the same length as the short side.
[00:14:11] So therefore, your penis will be straight. But as soon as I say to you, I’m shortening the longside, you’re gonna go. You’re not shortening him a dick, mate. Come on. What’s happening here? Maybe [00:14:20] not those words, but it’s a common response. One side’s already shortened, so you’ve already got a shorter penis. I can balance the two sides and what you end up with if, if we do that operation, which is very simple, it’s a 30 minute operation in outta hospital in the same day, virtually no complications.
[00:14:38] What you’re getting with that is a [00:14:40] penis that’s dead straight and not as long as it used to be, but the length. You can judge for yourself if you grab your penis and stretch it out from your body as far as you can, just with your fingers, almost to the point of it hurting. That’s the length your erection will be if we shorten the longer side to make the penis straight.
[00:14:58] So I’d, I’d have you stretch your [00:15:00] penis out and say, okay, if that’s now my erection length, but it’s now straight, am I better off than I am the way it is? Nearly always. The answer’s yes. When I’m talking about shortening the longer side, I’d probably prefer to use the term, I’m balancing the length of the two sides.
[00:15:16] Now, depending on how bad your curve is, [00:15:20] how much do I need to shorten or balance the other side? If your bend is. Say 30 or 45 degrees, which is pretty common, sort of bend. I’m only shortening the other side of your penis around six or eight millimeters. And for many men, they will answer the question, is this gonna be better than the way you are?
[00:15:39] Now, they’re gonna [00:15:40] answer by, yes, of course it is, cuz it’s usable. And the trouble with Peroni’s disease is once you’ve got it, you’ve got it. We can’t cure it. We can only make the penis better than it is now. I’m trying to make your penis more functional. I’m trying to make it function better for you. The other surgical option is we can do something on the short side that is try and make the short [00:16:00] side longer to make your penis straight, and that sounds very attractive cause we’re correcting the problem.
[00:16:06] The difficulty is in most men. Their penis is gonna bend upwards. That’s common with perrons. And if you want to operate on the top surface of the penis, which is where the, the fibrous tissue is, first of [00:16:20] all, you have to move nerves that run along that part of the penis. So you have to move the nerves out of the way without damaging them.
[00:16:26] And if you damage them, you can have numbness of the head of the penis, which is not a good. And the second thing I have to do is I have to cut into the scar tissue to enable it to open up to straighten the penis, and then the little gaps in the [00:16:40] penis have to be filled in with a little graft. And I like a little patch graft to make the penis waterproof.
[00:16:45] Now that’s all very complicated surgery and things can go wrong. So generally we are talking about improving the length of the short side by only about two centimeters compared to the [00:17:00] simpler operation, which is reducing the long side by about eight millimeters. So we can make the penis a bit longer on the top surface, but the risks are we might end up with numbness of the head of the penis and we might end up with a less rigid erection because the little graphs we put in may not hold the pressure of the P, the erection as well [00:17:20] as the original tissue did.
[00:17:21] And that has to be discussed with you quite openly before we decide to go down that pathway. No more than one centimeter. So simple operation, one centimeter at the most shorter on the longside. Versus a more complicated operation with more risks because of the nerves and because of the [00:17:40] grafts on the short side to gain maybe two centimeters.
[00:17:45] I do a lot of both operations. I’m happy for you to do what is right for you, but it’s very important. We’ve discussed that and you’ve understood the risks. So if you think you’ve got Pei’s disease or you think your penis has changed, next time you have an [00:18:00] erection, just have a good look at it from above or maybe look sideways in the mirror and take a photo if you want to and have a look at it and just see, okay, is my penis straight?
[00:18:08] Have I got a bend? How much is it bending? Has this been there for ages? Have, is this something that’s just started because the earlier you talk to someone about it and the earlier you come and see someone. Our [00:18:20] options for what we can do are more, for instance, traction. I was talking about maybe if you start using traction when you first get a bend, the bend won’t end up as bad as it would otherwise end up.
[00:18:30] Give yourself the options for different treatments by coming along early. There are a group of men with severe Peyronie’s disease who have also got severe [00:18:40] erectile dysfunction. So that is, they’ve got a really bad bend, a lot of shortening, and the erection’s not strong. So that group of men can have a different operation and that is we’ll put a penile implant in the same as we do if they’ve got erectile dysfunction, as well as cut a lot of the scar tissue away.
[00:18:58] And because they’ve already [00:19:00] got the implant in, we know we are not going to. Your erection any weaker, so I can actually be a bit more extensive in cutting the scar tissue away and potentially give a result. That does increase the length a little bit. Still some risks, but in some ways a combination of an implant and.
[00:19:18] Exci or [00:19:20] cutting into the scar tissue can give a better result, but I would only recommend that if you had erectile dysfunction, not just because you’ve got a bend. So there’s a number of things we can offer for peonies and because it’s not a condition that’s discussed very often, like most of these below, the belt issues aren’t.
[00:19:36] Um, if you think you’ve got this problem, please make contact with someone [00:19:40]and, and find out what’s going on and get expert help on the next episode of Below. Peeing is a struggle. It’s happening too often and it’s too slow. What’s my prostate? And are these problems? Cancer? Have a listen and if you hear something that sounds familiar, visit dr [00:20:00] love.com au for more information.
Dr. Christopher Love discusses common men’s health issues — and in this episode of Below The Belt, we focus on the prostate. The prostate is a gland that sits below the bladder and produces fluid that is part of semen fluid, which helps with fertility. As men age, the prostate gland gets bigger, which affects the way the bladder works, resulting in slower urine flow, a delay in getting started, increased frequency of urination, waking up at night to urinate, and an urgent need to urinate. These are common symptoms of bladder outflow obstruction caused by the enlargement of the prostate, known as benign prostatic hyperplasia (BPH). Dr. Love highlights the other causes that may lead to these symptoms, and men should seek advice from their healthcare professional.
If you’re experiencing Erectile Dysfunction (ED) or any other issues related to your penis, don’t be embarrassed. Talk to your doctor to get the help you need to have a better conversation with your healthcare professional and treat whatever is bothering you below the belt.
Find out more about ED https://www.drlove.com.au/erectile-dysfunction/:
Do you think that you might have Erectile Dysfunction? Take the quiz here.
If you’re someone who has had a penile implant, Peyrone’s disease or any of the other topics we discuss on Below The Belt and want to share your story, send us an email or voice note to podcast@drlove.com.au.
Visit Dr Christopher Love’s youtube page for videos on ED.
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For more information visit drlove.com.au or email podcast@drlove.com.au for information on urology, penile implants, Peyrone’s disease, prostate, ED or men’s health issues below the belt.
[00:00:00] Welcome to Below the Belt with Dr. Chris Love. We’ve made a series of audio guides about the most common men’s health problems and how you can treat them. You’re gonna find information around erectile dysfunction. Penile implants, penile curvature, which is known as Peyronie’s disease and prostate issues.
[00:00:19] Don’t be [00:00:20] embarrassed. Every guy you know has an issue at some point with their penis. On this series, you’ll get the answers and information that you need to know to have a better conversation with your doctor or healthcare professional to be able to treat whatever it is that’s bothering you below the belt.
[00:00:36] It’s available wherever you get your podcasts. For more information, visit [00:00:40] Dr. Love. That’s D R L O V. Dot com.au. Below the belt. Episode seven. Peeing is a struggle. It’s happening too often and it’s too slow. What’s my prostate? And are these problems? Cancer? Now. Here’s Dr. Chris Love. Hi, it’s [00:01:00] Dr. Chris Love again.
[00:01:01] What we’re gonna talk about in this audio guide is another below the belt problem. In fact, a very common one, and that’s trouble with your bladder, usually related to your prostate. Most men have heard of prostates. They worry about prostate cancer, but most men don’t even know what the prostate is. So the [00:01:20] prostate’s a gland that sits below your bladder, it produces fluid.
[00:01:23] That’s part of the semen fluid. And what’s important about the prostate is it helps your fertility. Unfortunately, as you get older, your prostate gets bigger, and that’s just a part of aging. We don’t really have any way of preventing that. So all of us men get [00:01:40] enlarged prostates as we get older. The position of the prostate is such that as it gets bigger, it’s going to affect the way the bladder works.
[00:01:47] So what you’ll notice is your urine flow gets slower. You sometimes have a bit of delay in getting started. You might find you have to go to the toilet more often. You might find you’re waking up at night to go. [00:02:00] You might find it’s urgent when you need to go. All those sort of things, which are. Common symptoms of what we call bladder outflow obstruction.
[00:02:08] That is something is causing blockage to the bladder, so the bladder starts to behave this way. So if you’ve noticed any of those sorts of symptoms, and particularly if you’re a man getting a bit older, [00:02:20] it will be your prostate causing this. There are some other causes which I’ll briefly mention, but it’s very likely to be your prostate and you certainly should get some advice on that.
[00:02:30] What I’m talking about there is not prostate cancer. I’m talking about enlargement of the prostate, which is called bph, benign prosthetic hyperplasia. It’s just the [00:02:40] prostate getting bigger, so some younger men also get those symptoms, and I’m talking perhaps about men under the age of 40 or 50, because typically prostate enlargement doesn’t start to cause problems till we’re above 50 or 60.
[00:02:53] Some younger men have the same problem, and it could be due to something else. The outlet of the bladder is called the bladder neck, [00:03:00] and it’s a circular muscle. And some younger men have tightness of the bladder neck for reasons we don’t know. And that also causes obstruction to passing urine. So it gives exactly the same symptoms as an enlarged prostate does, but it’s in a younger age group so they can have hesitation getting started, slow flow, all those same things.
[00:03:19] [00:03:20] So even if you’re a younger man with, with what I would call plumbing problems, you ought to seek some advice on it because it’s not normal. The third thing that can cause these symptoms is a narrowing in the water tube itself. That’s the urethra of the tube from the bladder to the outside world. And some men can develop scar tissue in the urethra, the water [00:03:40] tube that narrows that.
[00:03:41] But usually if you’ve got these symptoms, we’re talking about an enlarge prostate, most commonly in an older age group and possibly a tight bladder neck muscle. In a younger age group, the two things sit right next to each other, so the symptoms are identical. The. The doctor’s normally going to investigate it is to [00:04:00] ask you questions about it and understand when it started, do some blood tests such as the psa, which is the prostate blood test, which is a useful test to help us understand whether you might have prostate cancer.
[00:04:12] It doesn’t tell us you do, but it might give us a clue that we should investigate that. We usually would do a urine test to make sure [00:04:20] there’s no infection. We might do an ultrasound to get a picture of the bladder and the prostate, or we might do what’s called a urine re flow test where we get you to pee into a special toilet that measures the speed of passing urine, and then we’ll measure how much you’re leaving behind.
[00:04:35] We’ve even got some questionnaires we can get you to fill out, which put your symptoms in a, and we [00:04:40] sort of allocate a number to each symptom to see how bad you are. And that’s useful to do because then later on when we’ve treated you, we can do the same questionnaire again. One of the other symptoms probably related to these conditions and is a bit of a.
[00:04:54] Bother Cause we don’t have a great way of treating it is dribbling after you finish passing urine. And the [00:05:00] medical term for that is post mcri dribbling. Urian is passing urine. That can be related to prostate or bladder neck problems. But there’s also a group of men that probably get this condition cause urine stays in the water tube and doesn’t completely drain away.
[00:05:16] So they’ve passed urine. And normally the water tube gives [00:05:20] a bit of a squeeze, a bit like milking a cow and, and squeezes the last few drops out, but sometimes that mechanism doesn’t work. So if a man’s dribbling is his only symptom and not poor flow and other things, it’s maybe more likely to be that condition.
[00:05:34] But again, These are all intermingled and we need to really sort out what’s what and how we can help you. [00:05:40] So the treatments we can offer you for these sort of problems. I would broadly break up into medication treatment and surgical treatment. There’s a few things we can do before that, such as perhaps learning to improve the strength of the pelvic.
[00:05:54] Floor muscles and if some men’s main problem is they’re going too often, we can [00:06:00] encourage them to try and hang on and ignore the urge to go and retrain their bladder. But definitive treatment is really gonna be medication or surgery. With medication. There are actually some herbal agents which you can buy across the counter, which probably do help a little bit.
[00:06:15] Specific medications are medications that either relax the [00:06:20] prostate and bladder neck, or medications that shrink the prostate. Or in combination of both. So we can put you onto a daily tablet that works by relaxing the prostate and the bladder neck, and a lot of men will get a really useful benefit from that.
[00:06:33] Major problems with it is it can occasionally cause lightheadedness and it will often cause backward [00:06:40] ejaculation. So when you come, the semen fluid goes back into the bladder, which in itself is not a problem. But some guys don’t like that and it doesn’t cause any harm. It just washes out when you next pee, both of which go away if you stop taking the tablet.
[00:06:52] The other medication actually shrinks the prostate, and that takes several months to work. And the combination of the two is actually very [00:07:00] effective. The shrinking medication, however, can cause some other side effects. The most important one is that some men get a decrease in their interest in sex, their libido, and we don’t really know why that occurs.
[00:07:13] But the concerning thing about that is if we say about 10% of men lose their sex drive, their [00:07:20] libido, about 10% of them, which is about 1% overall, it never returns even if you stop the medication In my practice, and I think a lot of urologists now, we are less enthusiastic about using that medication, particularly in a younger age group of men, but it’s still a useful medication.
[00:07:38] So if you are sitting across the [00:07:40] desk and you are telling me, well, look Doc, I’ve tried this tablet and it sort of helps, but you know, I don’t like the backward ejaculation or the lightheadedness or the tablet’s not helping me, then we need to look at a procedure and I’d, I’d like to sort of work backwards on procedures from the most invasive to the least.
[00:07:56] Don’t say nearly all men, particularly older, have probably heard of a [00:08:00] rebar or a what’s called a T U R P, where we basically look down the eye of the penis with a telescope and we cut the middle out of the prostate to open up the caliber. Been around for, you know, probably 70 or 80 years that operation.
[00:08:13] Still a very good operation, really improves the bladder. But it involves a couple of days in hospital, [00:08:20] probably up to a month of restricted activities cause of the risk of bleeding. You can get some erection problems because of it, and nearly every man will get backward ejaculation from that operation, which is then permanent and can’t be reversed.
[00:08:33] So because of that, there are lesser procedures. There’s laser treatment where we can do much the same [00:08:40] thing as we do with a rebar, but using laser that’s less time in hospital, less risk of bleeding, but still has a risk of backward ejaculation. And then we’ve got two fairly new procedures. Both in the last six or seven years, which can help without some of those side effects.
[00:08:55] The two of them are what’s called Euro lift, which is where we look with a telescope. [00:09:00] We push the prostate open to open up the passageway, and we fire little staples into the prostate with a special instrument that just basically. Opens the prostate up if you’ve got your curtains at home and we’re just going to tie your curtains back with a tie on each side.
[00:09:14] That’s sort of what we can do with your prostate as well. And the beauty of that is it’s day surgery. It’s about [00:09:20] three, four days recovery and virtually no risk of any sexual side effects. So that’s a very attractive option for a lot of men. And then the other simple treatment we have is what’s called water vapor or.
[00:09:32] Therapy goes by the brand name resume. Again. We look with a telescope where the prostate’s enlarged. We put a little needle into the [00:09:40] prostate and we inject steam, and the steam heats the prostate enough to damage the prostate tissue. And over the next three months, the body absorbs that damage prostate tissue and the prostate actually opens up naturally.
[00:09:51] So we’re not cutting anything away like we do with a. Again, day surgery takes a bit longer to get the benefit, but you are generally over the [00:10:00] operation in terms of general effects by a week. And then over the next three months, your plumbing gets a lot better. Also very low risk of any sexual side effects.
[00:10:08] So these days, if we’re talking to men about prostates, not prostate cancer, we’re talking about prostates. What I always would say to you, We all get enlarged prostates. That happens sometimes. The enlarged [00:10:20] prostate’s going to affect your bladder enough that you are gonna complain about it. You’re not gonna like what’s happening.
[00:10:25] And if that’s the case, we’ve got ways of treating it. Yes. We wanna make sure you haven’t got prostate cancer. But if you come along and say, look, doc, you know, I’m four times up every night. You know, what the hell are we gonna do? Okay, we might talk about the tablets, we might talk about these new [00:10:40] techniques.
[00:10:40] We might talk about a rebo. There’s a number of options we can offer, and they all help. What I hear from a lot of men is, ah, it’s just normal when you get old. You know, when I’m an old man, I expect to have a dribble and I expect to be up at night. Well, yes, you might expect that it is normal in that, you know, it happens as we get older, but they don’t just put up with these sort of symptoms.
[00:10:58] Get rid of that myth [00:11:00] that old men have dribble problems, cuz yes they might, but we can fix it. If you think you’ve got this problem, please make contact with someone and, and find out what’s going on and get expert help.
[00:00:00] Welcome to Below the Belt with Dr. Chris Love. We’ve made a series of audio guides about the most common men’s health problems and how you can treat them. You’re going to find information around erectile dysfunction, penile implants, penile curvature, which is known as Peyronie’s disease, prostate, and other urology issues that happen below the belt.
[00:00:22] Don’t be embarrassed. Every guy you know has an issue at some point with their penis. On this podcast series you’ll get the answers and information that you need to know to have a better conversation with your doctor or health care professional to be able to treat whatever it is that’s bothering you below the belt.
[00:00:39] For more information visit Dr. Love That’s D R L O V E
[00:00:47] Hello, it’s Dr. Chris Love. In the Below the Belt series, we’ve been talking a lot about men’s health issues and particularly penile implants as the best treatment for erectile dysfunction. There’s a lot of questions that men are worried [00:01:00] about and they don’t necessarily want to ask. So we get a lot of email questions, a lot of inquiries, which I thought it’d be good to answer a lot of those questions.
[00:01:09] here on the podcast. So here’s an episode about frequently asked questions about penile implants. Patients who come along to see me to discuss penile implant surgery often have questions that they think may not be terribly important, but I think all questions are. One of the very common questions I get from ejaculate and have an orgasm if they have a penile implant.
[00:01:34] The simple answer is yes, the penile implant gives you good penile rigidity. But the other aspects of sexual function should continue as they are now. So if you have a penile implant, it’ll give you a really good stiff penis, so you’ll have no problems with firmness. And if you’re now able to have orgasm and ejaculation, that will continue.
[00:01:53] Some men lose those functions, particularly if they’ve had prostate cancer surgery, and we can’t easily [00:02:00] replace those. But certainly a penile implant will enable you to have normal sex with normal touch, feel, sensation, orgasm, ejaculation. Another question that’s very common is penile length. And I think everybody has a perception or a belief that they’ll have a bigger penis if they have an implant in.
[00:02:19] I wish that was true, but unfortunately it isn’t. When you’ve had erection problems for a while, you tend to lose penile length because The penis is not being stretched regularly, the elastic tissues in the penis change and most men will find their erection is shorter when they have not had good quality erections for a while.
[00:02:38] Now when we put an implant in we can do everything possible to get the best length we can but you can’t put an implant in. That’s longer than the penis itself. What I like to do for patients is make sure they understand that and then talk to them about maximizing the length. Some men, for instance, if they use a vacuum device or a penile traction device [00:03:00] before surgery can increase their length.
[00:03:02] And there are steps that I can take as the surgeon to give the patient the best length. And that includes putting injections into the penis when the patient is. The sleep to relax the muscles in the penis, stretching the penis with fluid that we inject into it, and also selecting a penile implant that’s a little bit longer than the penis.
[00:03:23] Knowing the patient will get some stretching over the first probably 6 to 12 months. Another question that some men will ask or perhaps are even a bit embarrassed to ask is whether their partner will be able to inflate the implant for them. Now, obviously that’s absolutely fine and yes, the partner can.
[00:03:41] They’ll need the same training that patients get, which is really a session with myself and my prosthesis nurse. Perhaps 20 minutes or half an hour to make sure the patient and if the partner wants to, the partner can be trained in how the implant inflates and deflates. And I think it’s [00:04:00] great if both the man and his partner can do that.
[00:04:02] But the devices I use are all very reliable. They’re very well tested and very well manufactured. And I expect 90 to 95 percent of implants to still be in the patient working fine after 10 years. Even up to 20 years, most of them are still going to be working. But realistically, by 20 years, perhaps 30 or 40 percent of implants have failed.
[00:04:26] And the reason they fail is they develop a little hole in them, the fluid leaks out, the fluid’s just salt water, so it does no harm. But then you go to pump the device and it’s got no fluid and it won’t pump up. If that happens, you can have the device replaced. It’s a smaller operation to replace the device.
[00:04:44] Then it is to put it in initially, the recovery is quicker, et cetera. I’m really disappointed for any patient whose implant doesn’t last at least 10 years. And I think that’s a pretty good outcome for most things we put in the body. Not everything will last forever, and I think if you can [00:05:00] look forward to 10 years of normal sexual activity, that’s a good reason to have an implant.
[00:05:04] A very common concern that many men have is their ability to disguise the implant. They ask questions like, well, other people know I’ve got an implant. That’s an interesting question and it’s not really a straight yes or no answer. So when you’ve got an implant in your penis and you’ve got a pump in the scrotum to inflate it, it’s all internal.
[00:05:24] You can be standing naked, no one would know. However, your penis won’t look the same when it’s flacid, as it did beforehand. The penile implant is in the penis all the time, so when the cylinders are empty, the penis is soft, it will hang down, but it won’t actually retract back into the body. So it will look as if they’ve got a longer penis, even when it’s soft.
[00:05:46] And some of the devices when they’re empty also get a little bit of a fold in them when it’s placid, and that can be. A little obvious if you make it in terms of things like wearing shorts and wearing bathing costumes and whatever it looks [00:06:00] like you’ve just got a reasonable size flaccid penis. So I guess the answer, as I said, is not yes, and it’s not no, it’s.
[00:06:08] Yes, you can disguise it. Virtually no one would be aware you have an implant in normal clothing. It’s not an issue at all. But in, in tight gym gear, swimming gear, et cetera, it looks like you’re fairly well endowed, but it’s not like you have an erection the whole time. So a question I hear a lot is, Will an implant affect natural sensation or orgasm?
[00:06:29] It won’t affect in a negative way those things at all. Once an implant’s in your penis, you can have a stiff penis, you can have penetrative sex. The touch, the feel, the sensation on the skin and sensation on the head of the penis should all be completely normal. Indeed, some patients, because they’re now More confident with their ability to have sex, more confident in the bedroom, might even have enhanced sensation and a more intense orgasm, but on a purely physical basis, putting an [00:07:00] implant in will not cause a problem with any of those things.
[00:07:04] If you can have an orgasm, you’ll have an orgasm. If you can have ejaculation, that’ll occur. So it’s just a great way of having, and putting it in very blunt language, it’s a great way of having a stiff dick and that’s what it does. And everything else works fine. More so than that, when you have sexual stimulation, most men get a bit of blood flow into the penis over and above the firmness they get from the implant.
[00:07:30] So most men will tell me that they can feel blood filling the penis a bit, the head of the penis fills with blood, with sexual stimulation, so you’ve really got the guaranteed. Rigidity from the implant, the guaranteed stiffness, and then with sexual stimulation, you get a more normal, natural blood flow feeling around the implant.
[00:07:52] And it won’t happen in all men, but the majority of men will get further enhancement of their erection, sexual [00:08:00] stimulation. So what should you do if you notice a change in your penis? That might be a bend, it might be pain, it might be an indentation or some other change in how your penis looks. Obviously, the first thing most men will be concerned about is how serious it is and is it a sign of something nasty.
[00:08:19] And I think it’s natural enough to be worried about that, but I’d certainly encourage you to go along to your doctor and talk about it. It’s not an embarrassing issue. Doctors are trained to listen to all these things. It’s most likely to be Peyronie’s disease, which is a scar tissue that develops in the penis.
[00:08:34] But it could be something else. And certainly if there’s discomfort or inflammation associated with it, you want some treatment anyway. Certainly go along to your doctor. Get reassured about that. For more information, visit the website drlove. com. au That’s d r l o v e dot com dot au.
A patient shares his experience with getting a penile implant.
If you’re experiencing Erectile Dysfunction (ED) or any other issues related to your penis, don’t be embarrassed. Talk to your doctor to get the help you need to have a better conversation with your healthcare professional and treat whatever is bothering you below the belt.
Find out more about ED https://www.drlove.com.au/erectile-dysfunction/:
Do you think that you might have Erectile Dysfunction? Take the quiz here.
If you’re someone who has had a penile implant, Peyrone’s disease or any of the other topics we discuss on Below The Belt and want to share your story, send us an email or voice note to podcast@drlove.com.au.
Visit Dr Christopher Love’s youtube page for videos on ED.
Listen to Below the Belt on Apple Podcasts:
Listen to Below the Belt on Spotify:
Listen to Below the Belt on Google Podcasts:
For more information visit drlove.com.au or email podcast@drlove.com.au for information on urology, penile implants, Peyrone’s disease, prostate, ED or men’s health issues below the belt.
A patient shares his experience with getting a penile implant.
If you’re experiencing Erectile Dysfunction (ED) or any other issues related to your penis, don’t be embarrassed. Talk to your doctor to get the help you need to have a better conversation with your healthcare professional and treat whatever is bothering you below the belt.
Find out more about ED https://www.drlove.com.au/erectile-dysfunction/:
Do you think that you might have Erectile Dysfunction? Take the quiz here.
If you’re someone who has had a penile implant, Peyrone’s disease or any of the other topics we discuss on Below The Belt and want to share your story, send us an email or voice note to podcast@drlove.com.au.
Visit Dr Christopher Love’s youtube page for videos on ED.
Listen to Below the Belt on Apple Podcasts:
Listen to Below the Belt on Spotify:
Listen to Below the Belt on Google Podcasts:
For more information visit drlove.com.au or email podcast@drlove.com.au for information on urology, penile implants, Peyrone’s disease, prostate, ED or men’s health issues below the belt.
[00:00:00] Welcome to Below the Belt with Dr. Chris Love. We’ve made a series of audio guides about the most common men’s health problems and how you can treat them. You’re going to find information around erectile dysfunction, penile implants, penile curvature, which is known as Peyronie’s disease, prostate, and other urology issues that happen below the belt.
[00:00:21] Don’t be embarrassed. Every guy you know has an issue at some point with their penis. On this podcast series, you’ll get the answers and information that you need to know to have a better conversation with your doctor or healthcare professional to be able to treat whatever it is that’s bothering you below the belt.
[00:00:38] For more information, visit drlove. com. au Hi, I’m a 70 year old single heterosexual male who has had a history of vascular disease causing my ED. And I had, I had decided to have a penile implant. [00:01:00] It’s been a great success. The surgery went extremely well without any problems. And the result has been nothing short of a miracle.
[00:01:08] Well, I was, uh, approximately 50 when I started having ED problems. Um, we’re talking about in the, uh, mid to late 90s. The problem I have is vascular ED. It wasn’t widely, widely known, but I knew I had a problem because I couldn’t get a sufficient erection, uh, to have sex. And I realized You know, with a lot of reading that maybe this was the problem, you know, a little arteries, fine arteries and arterioles clogging up, you know, if you, if you can’t get an erection, you feel miserable.
[00:01:40] You know, you’re not, you’re a lesser man than you were and, uh, you know, you’re lacking confidence and you start to dread, I’m single and it’ll stay that way. Um, you know, you meet some lady and, uh, You know, you know that you may not be able to perform and you find all these excuses and it affects any, any [00:02:00] long term in depth relationship because you, uh, you know, you can’t literally rise to the occasion.
[00:02:07] Um, so it’s quite, it’s quite, uh, emotionally debilitating. The only thing around at the time was, uh, penile, penile injections with, uh, uh, three mix chemicals and you had to inject into the side of your penis and, uh, it did give a very, well, within a few minutes, instantaneous erection which lasted, gosh, I think probably about an hour, hour and a half.
[00:02:29] However, there is a downside to these and it causes scarring in the corporal bodies resulting in Peyronie’s. And it gave me a deformity called an hourglass deformity, which, uh, with an erection and it was like a hinge in the middle of the penis, it was just, just useless. So in 1999, it was suggested having an implant.
[00:02:50] Um, I felt at the time it was pretty radical. Um, there wasn’t a lot of information around. You know, it’s a one way street. Once you have the [00:03:00] implant, you, you don’t go back. Um, so I was a little reluctant. I did have the Peyronie’s corrected with a, uh, what’s called a Nesbit plication surgery, which did straighten things out.
[00:03:12] It did remove the hourglass deformity. However, one of the downsides is it gives you a little bit of shortening. Um, not markedly, but noticeably. Anyway, uh, so Viagra burst on the scene and, uh, it was very good. Uh, no two ways about it. Gave me back my confidence, uh, elevated my mood because they work. They, they actually worked.
[00:03:34] The efficacy does diminish with time. We’re talking about the mid to late 90s. Um, ED, there was a suspicion that it might be indicative of coronary artery disease, but nothing definite. Now, well, it’s pretty well established that erectile difficulties certainly are a harbinger of further, uh, coronary artery problems.
[00:03:59] Um, and that [00:04:00] is, that’s, you know, confirmed. It stands to reason, it’s sort of common sense, if the little vessels start to clog up, um, all vessels are starting to clog up. I’ve had five stents put in my coronary arteries as a result. Um, with three minor heart attacks and I want to keep the minor, I don’t want any major ones.
[00:04:17] And, uh, that’s why in the end I decided to, uh, go with the implant and I’m so happy about it. Probably the, the best thing that I’ve ever done for myself, health wise. I was very happy with the staff and the doctor involved. I’ve done a lot of research and found that he was a very well practiced implanter.
[00:04:40] And I felt very confident with him and his reputation. And the night before I was to be implanted, I set off and I walked from my house to the private hospital. And I had my music playing in my AirPods and, um, I got there [00:05:00] nice and relaxed, I was admitted that night. I’d taken advantage of being off work for the preceding two months, um, to do some physiotherapy, penile physiotherapy with a vacuum device, uh, doing that four times a day, for I think it was about 15 minutes each time, and also a little stretching device, um, that I managed to get.
[00:05:24] So, I thought I’m going to have everything in my favor, um, and for two or three days before surgery, I was making sure I was washing with, um, uh, disinfectant soap to pull my skin bacterial count down. The major problem. As I see it with implants or with anything implanted in the body is infection and I tried to minimize, it’s a risk assessment, and I tried to minimize any infection.
[00:05:51] Anyway, I got to the hospital, I checked in, and the following morning, uh, I went off to surgery and I had the… Implant [00:06:00] done. It was, it was really nowhere near as daunting as I thought. It’s perfectly, it’s perfectly normal to be nervous about any form of surgery. Um, especially this one. I mean, it doesn’t come more personal than, than this.
[00:06:13] I think, you know, you, you weigh up whether you wanna spend a life of having ed and making excuses and not feeling like the man you were, uh, or risking. And it is a risk, and risking having it corrected and living a, uh, an amazing new life. It’s like a, a total, uh, new start to your life. You feel terrific about it, um, and it’s got some, it has some actual advantages over a normal, over a normal erection in that you can have it any time you want, doesn’t matter how much alcohol you drink.
[00:06:48] It really is quite, Uh, uplifting. It’s, uh, no pun intended. And after coming out of surgery, I checked and everything was still there, uh, very battered and bruised. And I followed to the letter, [00:07:00] uh, what the instructions were to, for the next week. I stayed in for two nights and, uh, caught a taxi home and, um, I, as I said, I observed everything, uh, all the instructions.
[00:07:11] And I’ve had a, Really, what I consider a perfect outcome. I couldn’t really hope for better. No infection. Uh, I went back, I think it was a week later for the checkup, and uh, the doc was very happy with the result. I did everything, the re inflating of everything, I followed it to the letter. What I would recommend, uh, do a lot of homework, there is so much information to get.
[00:07:35] On the net, bear in mind, in every field there are always cowboys. People are out for a quick buck and they can have very average skills. It’s in your interest to find people who really know what they’re doing. They’ve done a lot of them. Look at reviews online from people who are happy with their results, like myself, and people who are unhappy with their results.
[00:07:56] And you get a feel for the various [00:08:00] surgeons. Get onto YouTube. You know, you can do a lot. I couldn’t. I really couldn’t be happier. For more information, visit the website dr love.com au. That’s D R L O V e.com au.
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