Man Doing Pushup

#GatekeepersofMen Series

Episode 20

News & Events

How Erectile Dysfunction Affects the COUPLE

Erectile Dysfunction: Physical and Emotional Effect on a man and his partner

 

Erectile dysfunction is a term no man wishes to ever use.  We do not like talking about it.  Even more,  we wish to never experience it.

However….  When a man experiences erectile dysfunction it affects him both physically and emotionally.

 

What is the physical impact of erectile dysfunction?

The penis is linked to your heart.   When aroused, Your heart delivers blood to your penis through the arteries. Your penis then has “the responsibility” of keeping that blood trapped inside the penis in order to keep an erection.  If the penis is unable to bring blood in, or keep the blood trapped, the penis will experience erectile dysfunction.

 

The arteries going to the penis are VERY SMALL, probably smaller than the straw used to stir your morning coffee. When a man has any medical condition that can the decrease blood flow delivery from the heard and the heart is unable to deliver blood to the penis, we call it arterial insufficiency.

 

Now there is another problem that can happen.  The penis also needs to keep the blood TRAPPED inside the penis. Imagine your penis being a bucket of water that needs to stay full to work.  If the bucket has multiple tiny little holes, the water will not be able to stay inside the bucket.  In the penis, we call that “venous leakage”. Venous leakage can happen in both older men and younger men.  I have even seen men who were born with this problem.

 

What is the emotional impact of erectile dysfunction?

ED can crush a man’s confidence, self-worth and lead to depression.  A man with erectile dysfunction may pull himself away from his partner and try to avoid intimacy altogether because he may fear failure in bed.  Those who are single often avoid relationships altogether.   Therefore, if you ask me, the emotional impact of ED weighs heavier than the physical impact.  Erectile dysfunction affects relationships, self-esteem, and even work productivity (yes! There is research on this topic!).

 

Can I overcome ED?

My goal, as a urologist and men’s sexual health expert, is to help men learn about what is going on and how to overcome it.  There are MULTIPLE treatment options and NO MAN should be suffering from ED without finding a solution.  There are pills, injections, vacuum erection devices, psychotherapy, physical therapy and even a penile implant.  We first need to find out what is the cause and then we can find a solution.

 

The HARD Series

Erectile dysfunction is hard.   The journey to overcome it is even harder. This year I was a part of a documentary series that was created to show EVERYONE what men go through and how we can help men overcome it.  This series will show Men with erectile dysfunction that they are not alone.  It will remind you that there are others who have gone through exactly what you are going through now and that there is a solution.  The Hard Series is meant to show us the truth. It is meant to show us that ED is real, that ED is extremely common.  It shows us that as a society, we need to be more open about these topics.  Erectile dysfunction is very common, and it is about time that we start talking about it.

I invite you to watch this episode in which you will see how erectile dysfunction impacted the relationship of a beautiful couple and how a simple procedure helped a man feel worthy of his relationship again.  Enjoy!

Remember….  My goal is to help bring life to your years.

Remember…. We are #gatekeepersofmen.


This article was authored by Dr. Jonathan Clavell. Dr. Clavell is a board-certified urologist who specializes in men’s health including erectile dysfunction, low testosterone, Peyronie’s Disease and BPH. 

Why Gatekeepers of Men? 

Dr. Clavell shares his expertise with Rezum and Penile Implant Surgery

Dr. Clavell was invited to give lectures regarding his specialties in the management of erectile dysfunction and BPH.  He had the opportunity to speak at two American Urology Association (AUA) events, the AUA Southwest section in San Diego, CA and the Puerto Rico Urology Association.

Dr. Clavell speaking at an event. Dr. Clavell speaking at an event.

 

 

 

 

 

 

 

At these events Dr. Clavell shared his experience using Rezum Water Vapor Therapy for BPH and how to manage complications during and after Penile Implant Surgery.

Dr. Clavell Teaches Emerging Implanters Course hosted by Boston Scientific

In the month of June, Dr. Clavell & staff had the opportunity to be apart of the Prosthetic Urology Institute’s, Emerging Implanters Course, hosted by Boston Scientific in San Francisco, California. We had the opportunity to be part of the faculty and continue to teach other surgeons on how to refine their surgical skills and optimize outcomes when it comes to penile implant surgery for men with erectile dysfunction and Peyronie’s Disease.

Dr. Clavell participates in the Emerging Implanters Course

Houston Mens Health at Emerging Implanters Course

Dr. Clavell speaks at Emerging Implanters Course

 

Dr. Clavell Hosts Men’s Health Prosthetic Course for Experienced Physicians

Dr. Clavell was invited and served as faculty for the Men’s Health Prosthetic course for Experienced Physicians in Phoenix, Arizona on May 21-22, 2022. This course was hosted by Coloplast and was focused towards Urologists already in practice who are seeking to master advanced skills and management of complications that relate to penile implant surgery. Dr. Clavell shared insight on the prevention and management of infections and led a hands-on course where he shared surgical techniques for the management of complications that may be encountered during penile implant surgery.

Prosthetic Course with Dr. Clavell

Schedule a Penile Implant Consultation in Houston, TX

Dr. Clavell is experienced in advanced Men’s Health Prosthetic Course for Experienced Physician surgical skills and techniques that are able to optimize outcomes related to penile prosthesis surgery. If you have erectile dysfunction that is not responding to medications, we encourage you to call our office at (713) 652-5011 and schedule your appointment today!
Remember: We are Gatekeepers of Men!

Dr. Jonathan Clavell Introduces New Surgical Technique at SMSNA Meeting

At this year’s Sexual Medicine Society of North America (SMSNA) Annual Meeting annual scientific meeting, board-certified urologist Dr. Jonathan Clavell had the privilege of presenting his novel approaches and techniques for the management of Peyronie’s Disease and how to manage Non-Infectious Complications related to Penile Prosthesis Placement. We congratulate Dr. Clavell for being a pioneer in the field of Urologic Sexual Medicine!

Dr. Clavell presents at SMSNA annual scientific meeting

Dr. Clavell presents at SMSNA annual scientific meeting

 

If you missed out on this presentation, don’t worry, he will be presenting this new technique at the International Society of Sexual Medicine in Tokyo, Japan (November 2021). This seminar is virtual and will be available on-demand, so even though most will not be able to attend it live, you can still watch all sessions at your convenience

For more information about all upcoming Sexual Medicine Society of North America meeting and how you can attend, please visit the link below:

Sexual Medicine Society of North America

For more information about the International Society of Sexual Medicine’s virtual conference and how you can attend, please visit the link below:

International Society of Sexual Medicine

Schedule an Appointment With Dr. Jonathan Clavell

At Clavell Urology, you can have the certainty you will be evaluated by one of the experts in the field of Men’s Health. If you have Peyronie’s Disease or Erectile Dysfunction, call us at (713) 652-5011 and schedule an appointment with Dr. Clavell today!

Dr. Jonathan Clavell Leads Prosthetic Course Training

Throughout the months of June and July, board-certified urologist Dr. Jonathan Clavell led multiple Surgical Skills Workshops on Penile Implant Surgery across the state of Texas. Dr. Jonathan Clavell hosted the surgical skills workshops in the following locations:

  1. University of Texas Medical Branch in Galveston, TX
  2. Austin, TX
  3. Texas Tech University in Lubbock, TX

As an expert in the field of Urologic Sexual Medicine and Prosthetics, Dr. Clavell shares his expertise with residents and other urologic surgeons on how to perform the surgery and increase efficiency in order to maximize patient outcomes. He is committed to research, innovation, and sharing techniques in order to provide better care for patients.

dr. clavell does one-on-one training with workshop attendees

Workshop attendees watch procedure

penile implant workshop attendees

dr. clavell presents to workshop attendees

Have Any Additional Questions?

If you are interested in learning more about penile implant surgery or when Dr. Jonathan Clavell will host his next workshop, call our Houston urology office today at (713) 652-5011 to schedule an appointment!

 

Dr. Jonathan Clavell presents the Effectiveness of the Proximal Extracapsular Tunneling Technique

Board-certified urologist, Dr. Jonathan Clavell, recently published an article with Science Direct presenting the effectiveness of the Proximal Extracapsular Tunneling technique. Through his research, Dr. Clavell discodoctor working on computervered that this approach is a viable technique that may help treat distal cylinder impending erosion and floppy glans syndrome, among other corporal dilation-related complications, with minimal operative time or complexity.

This technique is simple and can be safely performed by both high and low-volume surgeons. It avoids the need for additional counter incisions on the penis and, therefore, theoretically decreases the risk of infection.

Take a deeper look into his research, and learn more about proximal extracapsular tunneling, by checking out his article on Science Direct.

For more information about how Dr. Clavell can help you treat distal cylinder impending erosion & floppy glans syndrome, contact our office in Houston, Texas, at (713) 652-5011 today!

 

Penile Implant: The Solution for ED?

Is the Penile Implant the “last resort” or “best option” for ED?

Lea el Artículo En Español


Every day in clinic I meet men who complain that their erection is weaker. I repeat: every single day.  Erectile dysfunction is very common and occurs to approximately 40% of guys above 40 years old.  These men often come in to see me after they‘ve done their research online to know what their options are.  They find many alternatives which include oral medications, injections, urethral gels, vacuum therapy, shockwaves, PRP, stem cells and the penile implant. Unfortunately, some of these are experimental and have not been proven to work. Without knowing the pros and cons of each treatment option, it is hard to know what is the best option for each individual.

“My erection is getting weaker, what can I do?”

I first wish to clarify that ED is NOT an “on and off switch”.  What I mean by this is that many people think that men either have a VERY STRONG ERECTION or NO ERECTION at all.  However, those who suffer from it know that it is a spectrum. Think of it as a scale or grading system.  The erection can be anywhere between 0% (completely flaccid) and 100% (hard as a rock).

Happy couple in nature


That said, every man who notices that he is having problems with either gaining or maintaining an erection should consider going to see his primary care doctor.  They should first make sure that there is no medical condition that could be contributing to his sexual impotence.  If you are diagnosed with Diabetes, heart disease, high blood pressure, thyroid problems, low testosterone, etc : these medical conditions could be the cause of your weak erections.  The second thing they should do is:  visit a specialist!  Visit someone who knows all the treatment options and can help guide you to what is best for you.

 

What is the best treatment for ED?

This is a difficult question to answer because there are different causes of erectile dysfunction.  For example, men with “hormonal ED” will benefit from Testosterone Replacement Therapy. Men with psychogenic ED benefit from behavioral sexual therapy. However, men with vascular erectile dysfunction, that is problems with blood flow in the penis will not necessarily respond to Testosterone or behavioral therapy.  This is why it is important you go visit a SPECIALIST who can help guide you towards the best treatment specifically for you.

“My doctor told me the penile implant is the last resort”

Another thing we need to clarify is that the penile implant is probably the MOST EFFECTIVE therapy for ED, no matter the degree or severity of erectile dysfunction.   Multiple research studies have shown that men with penile implants are more satisfied with their sexual function than those taking pills, injections or vacuum therapy.  If you wonder, treatment satisfaction rate after the implant is more than 95% for BOTH patients AND partners.  That is more than 30% more than pills, injections and vacuum therapy!


So… why do some consider it the “last resort”?

Most of the time we offer the penile prosthesis for men with severe ED that do not respond to medications or other therapies. The inflatable penile implant is a device that is placed inside the penis. It will occupy the space and disrupt that space within the erectile tissue.  If the implant needs to get removed; then, other therapies (like Sildenafil, Tadalafil or injections) will not work. This is the reason some doctors consider it as the last resort. “….because once you have the implant there is no going back”.  However, I do not think this way and I will explain why…

Does the Penile Implant need to be replaced regularly?

There is a big misconception regarding penile implants.  Many men think that it needs to be replaced regularly, but the fact is that it does not.  In 5 years, 95% of implants still work.  Research studies have gone up to 15 years, and 70% of penile prostheses were still working!  I have seen men 18 to 20 years after their original surgery who still have a functional implant that helps them gain and maintain the erection they want.

Happy couple outside camper van


Is the penile implant the best option for me?

As previously mentioned, the inflatable penile prosthesis has been scientifically proven to be the BEST treatment option for ED and the therapy with the highest satisfaction rate. Even though it is mostly reserved for men who do not respond to medications or other therapies, there are men that get the procedure done for other reasons.  Here are some examples:

  1. Some men do not want to go through EVERY… SINGLE.. THERAPY before they find a solution.
  2. Some men do not want to take medications even though they work.  Oral medications like Sildenafil or Tadalafil are known to have side effects like headaches, back pain, flushing of the face, etc.  To be honest…. Men don’t have to “settle” for a treatment that is causing them side effects.
  3. Other men find injections and vacuum therapies are not good for their lifestyle.  Injections require timing and preparation.   Most of these injectable medications, like Trimix, need to be refrigerated and can cause long-lasting painful erections, scar tissue, among other side effects.  Vacuum therapies need lubrication and a rubber band to “keep the blood trapped” inside the penis which can cause pain and discomfort.  These inconveniences can decrease the spontaneity of the sexual encounter and be a “turn-off” for most couples.
  4. Some men have already failed everything. They still fear the penile implant because someone told them “there is no going back”.  I usually answer them with..   “you’ve already failed everything. What is it you ‘would be going back to, injections or pills that you already know don’t work?’.  Immediately, they understand that it is time to take the next step if they wish to recover their sexual life back.
So… is the penile implant the best option for guys with ED? In most cases, it actually is! Think about it.  The inflatable penile implant is inside your body, completely concealed. It will be there on demand, every.. single.. time you need it.  After you recover from the surgery, it is unlikely you will have pain or discomfort.   It will take you 30 seconds to achieve an erection and it will remain erect until YOU make it go down.

Happy couple on boat

The sexual encounter lasts exactly the amount of time you (and your partner) want it to last. 


In Summary…

Although erectile dysfunction is very common, there are many causes and severities that make treatments to be different for each individual.  Goals are very different for every man and every couple.  My goal as a specialist in Urological Sexual Medicine is to help you reach your goals.  If you think a penile implant is an option for you, come visit us.  You do not have to FAIL everything and all other treatment options to be a “candidate”.   If you have erectile dysfunction, I have great news for you:  You ARE A CANDIDATE for the penile implant. It is not the last resort. In most cases, it is the best resort and solution for ED.   We can help you reach your goals!   Call us!  I would be honored to help you.   Remember we are….  GatekeepersofMen!


This article was authored by Dr. Jonathan Clavell. Dr. Clavell is a board-certified urologist who specializes in men’s health including erectile dysfunction, low testosterone, Peyronie’s Disease and BPH. 

Why Gatekeepers of Men? 

Implante de Pene: La solución para la disfunción eréctil?

El implante de pene: la última opción para la Disfunción Eréctil, o la mejor opción?

Lea el Artículo En Inglés


Todos los días veo a hombres que presentan a mi clínica con la preocupación de que su erección está “más débil”. Repito:  TODOS LOS DIAS.  La disfunción eréctil, o impotencia sexual, es bien común y ocurre en 40% de los hombres mayores de 40 años.  Muchos hombres que sufren de impotencia sexual llegan a mi clínica luego de haber investigado en el internet acerca de sus opciones de tratamiento.  Estas opciones incluyen: medicamentos orales, inyecciones, terapia de vacío (Vacuum), terapia de shock, inyecciones de plasma, células madres y el implante de pene.  Desafortunadamente, algunas de estas alternativas aún se consideran experimentales y no son recomendadas por la academia de Urología Americana o la Sociedad de Medicina Sexual.  Por lo tanto, es difícil saber cual es la mejor opción para cada individuo si no conocemos los beneficios y riesgos de cada terapia.

“Mi erección está más débil. ¿Qué puedo hacer?”

Antes que todo, quisiera clarificar una cosa:  La Disfunción Eréctil no es un encendedor que prende y apaga.   Muchas personas (hombres y mujeres) piensan que solo dos cosas ocurren en los hombres en cuanto a sus erecciones:  UNA ERECCIÓN BIEN FUERTE o CERO ERECCIÓN.  Sin embargo, aquellos hombres que sufren de impotencia sexual saben que es un espectro.

Happy couple in nature

Tómelo como si fuera una escala o sistema de notas:  la erección puede ser de 0% (completamente flácida) a un 100% (fuerte como una roca). 

 


Ahora bien, todo hombre que haya notado que tiene problemas con obtener o mantener una erección debe visitar a su médico primario. Usted debe de asegurarse de que una condición médica esté contribuyendo a su impotencia sexual.  Si usted tiene diabetes, la presión arterial alta, problemas de su tiroide, colesterol, baja testosterona, etc.: estas condiciones pueden ser la causa principal de sus erecciones débiles.  Lo segundo que esos hombres deben de hacer es: ¡visitar a un especialista!  Visite a alguien que conozca a fondo las opciones de tratamiento y que pueda guiarlo y proveer una solución para usted.

¿Cuál es el mejor tratamiento para la disfunción eréctil?

Esta pregunta es difícil de contestar porque hay diferentes causas para la disfunción eréctil.  Por ejemplo, los hombres con “disfunción hormonal” responden a terapia de Testosterona.  Los hombres con “disfunción psicogénica” se benefician de terapias de comportamiento sexual.  Sin embargo, los hombres con disfunción eréctil VASCULAR, eso es problemas con el flujo sanguíneo sanguíneo hacia el pene no necesariamente responderán a la Testosterona o terapias de comportamiento. Por eso es que es bien importante que visite a un ESPECIALISTA que pueda guiarlo a usted hacia el mejor tratamiento específicamente para usted como individuo.


“Mi doctor me dijo que el implante peneano es la última opción.”

Otro argumento que debemos de clarificar es que el tratamiento más eficaz para la disfunción eréctil es el implante de pene. La prótesis hidráulica de pene es el mejor tratamiento para la impotencia sexual sin importar la severidad de la disfunción.  Múltiples estudios investigativos han demostrado que los hombres con implantes de pene están más satisfechos con su función sexual que aquellos hombres que son tratados con pastillas, inyecciones y/o la terapia de bomba de vacío.  Para ser más específico, la taza de satisfacción para los pacientes con implantes peneanos y sus parejas excede un 95%.   Esto es 30% más que las pastillas, inyecciones y la bomba de vacío!


Entonces… ¿por qué algunos lo consideran el último recurso?

La mayoría de las veces nosotros ofrecemos el implante peneano a los hombres que sufren de disfunción eréctil SEVERA. Eso es, aquellos que ya no responden a otras terapias o tratamientos.  La prótesis hidráulica, conocida como “la bombita”, es un dispositivo que se inserta dentro del pene. El implante ocupa y destruye el espacio dentro del téjido eréctil del pene.  Por lo tanto, si el implante se remueve, otras terapias como las pastillas o las inyecciones intracavernosas NO van a funcionar. Por esa razón muchos doctores consideran el implante peneano como la última opción.  Muchos dicen “…una vez te pongan el implante, no hay vuelta atrás.”  Sin embargo, te explicaré porque yo no pienso de esa manera…

¿El implante de pene tiene que re-emplazarse regularmente?

El concepto más equivocado que escucho en cuanto a los implantes peneanos es el siguiente:  Muchos hombres piensan que el implante tiene que cambiarse regularmente, cuando realmente esto no es cierto.  En 5 años, 95% de los implantes aún funcionan.   Los estudios investigativos demuestran que 70% de los implantes funcionan más de 15 años!  Yo he visto hombres 20 años luego de su cirugía que aún tienen su bombita funcionando.

Happy couple outside camper van


¿La mejor opción para mi sería el implante de pene?

Como mencioné anteriormente, los estudios científicos han demostrado que el implante hidráulico de pene es la MEJOR opción de tratamiento para la disfunción eréctil y la terapia con la mayor taza de satisfacción.  Aunque se ofrece mayormente a hombres que han fallado otros tratamientos, hay hombres que se hacen la cirugía por otras razones. Aquí algunos ejemplos:

  1. Algunos hombres no quieren intentar TODAS… LAS.. TERAPIAS antes de encontrar una solución permanente.
  2. Algunos hombres no quieren tomar medicinas aún si éstas funcionan.  Las pastillas como Sildenafil y Tadalafil tienen efectos secundarios como dolores de cabeza, dolores de espalda, palpitaciones en el pecho, enrojecimiento de la cara, etc. Para serte honesto….  Los hombres no tienen que conformarse con un tratamiento que le esté causando efectos secundarios.
  3. Otros hombres encuentran que las inyecciones y la bomba de vacío no son la solución debido a su estilo de vida.  Las inyecciones funcionan en un tiempo específico y toman preparación.  La mayoría de las inyecciones tienen que mantenerse refrigeradas y pueden causar erecciones dolorosas, tejido de cicatriz, entre otros efectos secundarios. La bomba de vacío  necesitan lubricación y un anillo de constricción para “atrapar la sangre” dentro del pene que puede causar dolor e incomodidad.  Estas inconveniencias pueden disminuir la espontaneidad del acto sexual y le “quita las ganas” a muchas parejas.
  4. Algunos hombres ya han intentado y fallado todo.  Aún así temen el implante de pene porque alguien les dijo “no hay vuelta atrás”.  Sin embargo, mi contestación a ellos es la siguiente “ya has fallado todo.  ¿A qué irías de regreso? ¿Inyecciones y pastillas que ya sabes que no funcionan?”.  Inmediatamente ellos entienden que es tiempo de tomar el próximo paso hacia la recuperación de su vida sexual.
Por lo tanto, la contestación a la pregunta “el implante peneano será la mejor opción para mi?” En la mayoría de las ocasiones, sí lo es! Piénsalo.  La prótesis hidráulica de pene está escondida dentro de su cuerpo. Va estar listo para uso en… todo… momento y SIEMPRE que usted lo necesite. Luego que usted se recupere de su cirugía, es poco probable que usted tenga dolor o incomodidad.

Happy couple on boat

Le tomará 30 segundos obtener su erección y se mantendrá firme hasta que USTED lo baje. El encuentro sexual entre usted y su pareja durará exactamente el tiempo que USTED quiera que dure. 


En Resúmen…

Aunque la disfunción eréctil es bien común, hay muchas causas y severidades que hace que los tratamientos sean diferentes para cada individuo. Tanto cada hombre como cada pareja tienen metas distintas.  Mi meta como especialista en Medicina Sexual Urológica es ayudarlo a usted llegar a sus metas.  Si usted cree que el implante de pene es una opción para usted, visítenos! Usted no tiene que fallar todos los otros tratamientos para ser un “buen candidato” para el implante.   Si usted tiene disfunción eréctil, tengo excelentes noticias para usted: Usted ES CANDIDATO para el implante de pene. La bombita no es el último recurso.  En la mayoría de los casos, es el mejor recurso. ¡Nosotros podemos ayudarlo a llegar a su meta! ¡Llámenos! Sería un honor poder ayudarlo.  Recuerde que somos… GatekeepersofMen!


El autor de este artículo fue el Dr. Jonathan Clavell. Dr. Clavell es urólogo diplomático y certificado por la Academia de Urología Americana y es especialista en Salud Sexual Masculina que incluye disfunción eréctil, baja testosterona, Enfermedad de Peyronie’s y problemas de prostata agrandada. 

Why Gatekeepers of Men? 

Congenital Penile Curvature

Congenital Penile Curvature

Are all curves the same?

Curved or bent penis. This is the ONE condition in Men’s Health that generally NO ONE talks about.  Some men even wonder “can that really happen?” and, those who suffer from it think “Am I the only one with this?”.  Many years ago, men with penile curvature suffered in silence and, fortunately, now we even see it in commercials and realize we are not alone.

Penile curvatures are very common.  The penis can bend upward, downward or to the sides.  In most occasions, the curvature is mild and does not cause any problems. However, some men have more complex curves that make them more self-conscious.  Most often, a penile curvature is due to normal differences in penis anatomy, but sometimes scar tissue or another problem causes a bent penis and painful erections.

younger man playing sports

Continue reading “Congenital Penile Curvature”

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