Heart of the matter

A new procedure may help men suffering from erectile dysfunction, but the real problem is getting men to speak up, writes Michael Murty

A NEW procedure gives hope to men suffering from erectile dysfunction. It employs the stent, or an artificial tube similar to those used in heart arteries, which can be used in the internal pudendal artery, opening the vessel and allowing better blood flow to the penis.

Relatively unknown around the world and still in the research phase, the new procedure is described as a “viable option” to treat ED.

University Malaya Medical Centre consultant cardiologist and internal physician Dr Ramesh Singh Veriah says that should doctors be able to use angioplasty to treat ED, it would be a major breakthrough.

He says so far there have been two trials with the method — Zen trial and Impassed trial — that found benefits and also, differences and hindrances.

“The problem right now is that the blood vessels in the pelvic region vary greatly and differ from men to men.

“The procedure will take a lot of planning, money and we need to screen patients too. We hope to collaborate with Medtronic,” he adds.

Medtronic Inc. is a manufacturer of pacemakers, heart stents and spine products.

Dr Ramesh says doctors should screen patients regularly for ED when they show signs like diabetes, hypertension, obesity and cardiovascular disease as well as those who smoke and drink.

SPEAK UP
These, he says, are signs that a patient may be suffering from ED.

“ED should also be addressed in the medical history of patients as it may be a symptom for early atherosclerosis,” he says, adding that men should look at ED as a risk factor just like they do high blood pressure, high blood sugar and cholesterol.

Dr Ramesh says the hypothesis here is that the penile blood vessels are significantly smaller than the coronary artery vessels, which makes it easier to be blocked first. (See diagram).

“This is why ED precedes coronary artery disease as the smaller vessels clog up first,” he says.

He points out that many men with ED symptoms go to general practitioner or urologist and get prescribed with drugs.

But when these drugs solve their ED problem, the patients don’t show up anymore for follow-up checks, which keep the cardiovascular disease untreated.
 
TABOO TOPIC
Dr Ramesh says ED is still considered taboo among many patients. He says most choose to downplay the problem because of ego and frustration.

He asks: “Why is seeking help for infertility normal but checking for ED still a taboo? It is crucial that the mindset of such people change,” he says.

He adds that family doctors and general practitioners have a very big role to play in ED.

“The family doctor is usually the front line. They may receive complaints, hints or see signs of ED. Patients tend to open up when they feel secure and comfortable to talk, so doctors should pick this up,” he says.

Dr Ramesh says the treatment of ED is not limited to one doctor. It is a multidisciplinary management.

“It involves the patient, spouse, multiple doctors, like the family physician, the endocrinologist, cardiologist, urologist, psychiatrist and psychologist,” he says, adding that doctors should not work individually but as a team to help the patient.

EVADING ISSUES
Damai Service Hospital clinical andrologist Dr Mohd Ismail Mohd Tambi says men tend to be evasive when it comes to their virility.

“The data I collected was from an intensive study done 12 years ago,” he says.

The study, Epidemiology Of Erectile Dysfunction In Four Countries: Cross-national Study Of The Prevalence And Correlates Of Erectile Dysfunction, measured the prevalence of ED in community-based populations in Brazil, Italy, Japan and Malaysia. It studied the connections with the demographic characteristics, medical conditions and health-related behaviours.

A random sample of approximately 600 men aged 40-70, were interviewed using a standardised questionnaire. The outcome found that the prevalence of ED was 34 per cent in Japan, 22 per cent in Malaysia, 17 per cent in Italy and 15 per cent in Brazil.

 

 

 

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