Memorial Day

Thanks to all the men and women who gave their lives serving our country, then and now.

The right way to take "those pills"

Drugs like Viagra, Levitra and Cialis are often prescribed for men with erectile dysfunction. Unfortunately, sometimes you don't get the "owner's manual" with them that tells you how to take them correctly. To maximize success with these medicines here are a few pearls of wisdom and a few tips to follow:

1. These pills are not "after dinner" mints. They work best if taken on an empty stomach. Empty like the first thing in the morning, not empty like one hour after eating Chinese food. Food in the stomach interferes with absorption of the drug. High fat foods delay stomach emptying - so even waiting the recommended four hours after eating may not guarantee that your stomach is empty.

2. It takes time for the drug to be absorbed from the stomach and into your bloodstream. If you take one of these pills and have a nice erection 5 minutes later, it's YOU, not the drug. In some ways this can be very reassuring... the equipment works on its own. It may just be having temporary technical difficulties for some other reason. Absorption takes 30 to 45 minutes.

3. You must have some kind of stimulation to help get an erection. These pills are not magic. They do not result in an instant flawless erection. The stimulation can be anything that you find arousing: touch, visuals, fantasy... the list is endless.

4. If the quality of the erection you are able to get with the drug is not satisfactory, talk to your doctor. You may need a different dose. You may have better success with a different drug.

5. Remember that it may take 6 or 8 tries before you have the success you want. Don't give up if the first time doesn't work.

6. If you have an erection that lasts more than 4 hours after you have an orgasm or ejaculate, call your doctor. This condition is called "priapism" and although rare, needs to be treated to avoid lasting damage.

7. As with everything else, if you are using these pills with a partner, communication is key. Many men are nervous or anxious when trying these drugs for the first time. Make it shared experience with your partner. Maintain a sense of humor. Set aside time when both of you are not rushed or have another commitment.

8. Relax and enjoy!

Erectile Dysfunction

Erectile dysfunction (ED) means the penis does not get erect or stay erect long enough for satisfactory sexual function. It is safe to say that nearly every man will experience erectile dysfunction at some time in his life. It may be transient and due to anxiety or anger, certain medications, fatigue, overconsumption of alcohol or drugs (especially cocaine and valium) or idiopathic which means unexplained.

An evaluation for erectile dysfunction includes a careful history and physical exam as well a review of medications and a thorough discussion about medical problems and social or relationship problems.

Sustained ED is usually due to medical problems such as diabetes, injury to the blood vessels to the penis, vascular disease, heart disease as well as smoking. Diabetes and smoking are two of the worst things for erections. Smoking causes small blood vessels to constrict which makes it difficult for the penis to fill with blood, which is what makes it hard. Diabetes causes damage to small blood vessels so if you are diabetic, do your very best to keep your blood sugar under control.

ED can lead to all kinds of issues with self confidence, self esteem and relationship problems. Men may be very upset by an episode of ED and lose confidence in the ability to get or sustain an erection. The partner may feel that the ED is their fault (I'm not sexy enough, I've gained weight, he doesn't find me attractive any more) or that it is a sign that the man is seeing someone else. The man may feel like a failure and then not want to try again.

Communication with your partner is an essential part of treating ED. This is not an easy thing to do. Your partner may have problems with vaginal dryness or pain with intercourse. These are things that can be treated as well. Dr. Roesel sees many women with this type of problem.

The treatments for ED vary from medicine to injections and/or mechanical devices to surgery. In order to determine what is the right treatment for you, it's important to find out what is causing your particular problem. Don't be afraid to discuss ED with your doctor. We are here to help.

Saturday appointments now available!

If you are like a lot of people these days... you are BUSY. All the time. Every day. Work. School. Home. Time gets away from you and it's easy to put off getting things done that you would probably rather not do. Like go to the doctor. Especially if it's a urologist you need.

In an effort to make things a little easier for those of you who are busy, or who hate weekday traffic, or have long work hours during the week, we are now offering Saturday appointments once a month. The office hours will be shorter, from 9 AM until 3 PM but all regular office services including cystoscopy, prostate biopsy, vasectomy, urodynamics and ultrasound will be available.

Dates for future Saturdays are May 23, June 6 and July 11. Call 271-2862 for your appointment and we'll see if we can help you get just one more thing off your "to do" list.