Penile arterial insufficiency

[superchevy]

Dr tan can help to answer this issue ..what is it to be done ..ie ultra scan or....

Blood test for testosterone is normal..but can't get a stiff erection......

Can help to explain why....and the fees of the above mentioned is how much.....and what cause that,

Thank you.

[jitaokenaburn]

Why you assuming penile arterial insufficiency straight away? Besides low testosterone there are many other causes.

Either you see a endocrinologist to run more hormonal tests (the blood tests can cost $600 and above depending on how through).

Or see a urologist to check for any other lying structural issues, prostate problems and also to do the ultrasound penis examination where they will inject your cock and scan it (probably <$200 for the ultrasound itself and <$100 for the carveject injection). He might also rent you noctournal penile rigidity test to bring home (this one i don't know how much).

Best if you see both. Then depending on the outcome, refer elsewhere for more exotic causes.

Actually, you can also just see Doctor Tan as your principal GP regarding your ED. He has a new clinic dedicated to men's health only and he is manning the clinic. He can run all the blood tests for you that the endocrinologist can run, and can also give as good of advise (most endocrinologist specialists I've met are actually more behind the times then younger GPs in regards to men's health and endocrinology). And for any other tests like the ultrasound etc. he should be able to refer you for external appointments.

That's pretty much what you should do.

[DoctorTan]

You basically have ED and a normal serum Testosterone.

You need to find out what is causing your ED. Common causes include:
- Arterial Insufficiency
- Enlarged Prostate
- Medication side effects

Less common causes include:
- Psychological
- Chronic Medical Illnesses
- Other hormonal problems aside from Testosterone deficiency
- Venous Leak

To give you an idea of the costs:

Full Hormonal Profile is about $300
Ultrasound Doppler Penis is about $500
Caverject injection which you need for the USS is $30+

You should not be making your own conclusions about what is causing your ED. See a doctor.

The most economical way of going about is will be to see the Polyclinic and get referred to a government hospital. Unless you are not Singaporean than it makes no difference. In fact, as a full paying patient, sometimes our government hospitals cost even more than private hospitals.

[kgbkgb]

Originally Posted by DoctorTan

You basically have ED and a normal serum Testosterone.

You need to find out what is causing your ED. Common causes include:
- Arterial Insufficiency
- Enlarged Prostate
- Medication side effects

Less common causes include:
- Psychological
- Chronic Medical Illnesses
- Other hormonal problems aside from Testosterone deficiency
- Venous Leak

To give you an idea of the costs:

Full Hormonal Profile is about $300
Ultrasound Doppler Penis is about $500
Caverject injection which you need for the USS is $30+

You should not be making your own conclusions about what is causing your ED. See a doctor.

The most economical way of going about is will be to see the Polyclinic and get referred to a government hospital. Unless you are not Singaporean than it makes no difference. In fact, as a full paying patient, sometimes our government hospitals cost even more than private hospitals.

Dr Tan, you have listed quite a bit of possibilities. However, I think most doctors simply prescribe the blue pill once the patient complains of ED. We don't normally get to be tested for all those listed possibilities. Why is that so?

[DoctorTan]

Originally Posted by kgbkgb

Dr Tan, you have listed quite a bit of possibilities. However, I think most doctors simply prescribe the blue pill once the patient complains of ED. We don't normally get to be tested for all those listed possibilities. Why is that so?

I think I gave you the wrong idea. I also normally do not test my patients for all those possibilities unless there is a need to do so.

For example he has symptoms suggestive of an underlying illness or he is keen to establish a firm diagnosis.

Usually from the history and physical examination alone, we can get an idea of the cause of the problem. And most of the time PDE5Is (Blue pill) works anyway. The patient may also not be keen to address other issues.

For example if a patient sees me for ED and I find out he also has symptoms of low Testosterone, the patient may decide he does not want to investigate or treat his Testosterone issues and only take the blue pill to get an erection. We will obviously respect the patient's wishes.

In this thread, the discussion took this turn because he was asking me for a cause of his ED.

[jitaokenaburn]

Originally Posted by kgbkgb

However, I think most doctors simply prescribe the blue pill once the patient complains of ED. We don't normally get to be tested for all those listed possibilities. Why is that so?

The blue pill is first line treatment so they will give it to you regardless. The follow up investigation is another story.

Some people are lazy and can't be fucked. Including doctors and patients. Here are some scenarios

1) Doctor is jaded and apathetic, medically uneducated patient takes his word and opinions as gold

2) Patient is too lazy about his health, Doctor sees no need to proceed with possibly costly and long drawn tests and procedures that patient is apathetic about

3) Both doctor and patient can't be fucked

The best healthcare exists when both patient and doctor see eye to eye about their healthcare objectives. Doctor and patient chemistry!