Clinical Surgeries

Nanotechnology may revolutionise the way we undertake healthcare in the 21st century. Within just a few years, it may be possible for us to monitor our own health from home using just a mobile phone and what is known as sensing technology. This ‘lab-on-a-chip’ technology also looks promising when it comes to global health – particularly with regard to providing precision tools for diagnosing diseases, providing illusive possibilities in the future of healthcare technology.

Sensing possibilities in the future of healthcare technology

This new nano-chip technology offers a variety of possibilities, including:

PSA stands for prostate specific antigen – a protein produced by the male prostate gland which plays a role in nourishing the sperm. A PSA test is a blood test to determine if PSA levels in the blood are elevated – which may indicate prostate cancer or alternately another problem with the prostate gland.

Prostate diseases

While prostate cancer may be the disease of the prostate that we tend to hear the most about, other non-cancerous prostate problems can also occur. These include:
•    Prostatitis – acute or chronic bacterial infection of the prostate.
•    Chronic non-bacterial prostatitis.
•    Sterile pyuria – elevated white cells in the urine.
•    Non-cancerous enlargement of the prostate.

So as you can see, prostate cancer is not the only concern. However, when having a PSA test done, the aim is usually to detect if cancer might be present.

How common is prostate cancer?

This cancer is rare in the under-50s, even though it is the commonest type of cancer in Australian men apart from certain skin cancers. According to the federal government, approximately 20,000 men are diagnosed with the disease each year in Australia, and this is expected to rise over time. The most common risk factors are advancing age and genetic predisposition. Around 60% of men with the disease are older than 65.

What can a PSA test show?

Normally, only small amounts of PSA enter the bloodstream. Where the PSA reading is higher than 4ng/ml, a follow-up might be recommended.

A PSA test is not enough on its own to determine if prostate cancer is present – often a digital rectal examination (DRE) is performed as well for confirmation. Other tests may include a biopsy, MRI, and / or a CT scan.

For older men – those over 70 – testing and treatment is not always recommended, especially if it is considered they are likely to die of other causes within a few years. Prostate cancer treatments can have a number of side effects – including damaged nerves and muscles, urinary incontinence, erectile dysfunction and reduced libido. For an older man who is asymptomatic, it may not be worth the risk involved.

What treatments are available?

The type of treatment recommended will depend on the age and health of the patient and how advanced the cancer is. Treatments include surveillance, radiotherapy, surgery, androgen-deprivation therapy, chemotherapy, brachytherapy, and high-intensity focused ultrasound. With some patients, surveillance or watchful waiting may well be the main course of action recommended – especially for older men or where the cancer is low-grade and do not appear to be advancing.

Should all men have a regular PSA test?

As indicated earlier, PSA levels can become elevated for any number of reasons. In addition, testing can sometimes result in false positives, which can lead to undue anxiety and even unnecessary treatments or procedures that do not necessarily improve the patient’s quality of life.

The current guidelines for men without symptoms recommend testing every two years for men aged 50-69, and only for those that genuinely want the test and who understand all the risks and benefits involved. PSA testing is not recommended for men who are likely to die from any cause within seven years.

So in a nutshell, broad-based PSA for men is not recommended. However men with symptoms such as an increased need to urinate especially during the night, difficulty urinating, or a feeling of the bladder not being completely emptied after going to the toilet, should speak to their medical practitioner about their symptoms and about the options that are available to them.

The best and most effective long-term treatment for erectile dysfunction is to find the underlying cause of the problem, and treat that. This applies whether the cause is physical, psychological, emotional, or all of the above.

In the majority of cases, the cause is physical and frequently relates to conditions that affect the blood vessels and blood flow, such as diabetes or heart disease. Many sufferers of erectile dysfunction may benefit from lifestyle changes including weight loss, quitting smoking, reducing alcohol consumption, and improving overall health through diet, exercise and reduction of stress.

In some cases of erectile dysfunction, the condition is temporary and may resolve itself over time. For instance, temporary illness, anxiety or tiredness can cause short-term erectile dysfunction that goes away when the cause is treated through medication, therapy or rest.

Surgical or non-surgical treatments?

In more serious cases of erectile dysfunction, following prostate cancer treatments for example, surgery involving penile implants may provide an effective and successful long-term solution. Surgery is not for everyone however – some sufferers do not need surgery, and some prefer to choose non-surgical treatments.

Effective non-surgical treatments

Fortunately, there are some very effective non-surgical treatments available. These include:

Medication

Medications such as Viagra, Levitra or Cialis are known as PDE-5 inhibitors, and work by increasing blood flow to the penile tissue in order to create an erection. It’s important to note that these drugs are not a hormonal treatment, nor are they designed to increase libido.

Some drug treatments need to be taken just prior to intercourse, while others should be taken on a daily basis. They are generally safe, but should not be used without medical supervision, especially by men who are taking nitrate drug treatments for heart disease.

Injection therapy

Penile injections open the blood vessels and increase blood flow to the penis, creating an erection within minutes which lasts for up to 30 minutes. Side effects may include penile scarring, or prolonged erections – especially if the dose is too high. Injection therapy must be done under medical supervision, and when proper care is taken this treatment can be very effective.

Vacuum constriction device

This device – also sometimes called a vacuum pump – can be used to produce an erection within a few minutes. The erection can last for up to 30 minutes.

The device is made up of a cylinder and pump, either hand or battery-operated, with the vacuum effect being created through pumping air out of the cylinder.

As for the other treatments mentioned, vacuum pumps are designed to increase blood flow to the penis. It can be a very effective treatment for men who have a physical erectile dysfunction problem, and who do not wish to take the surgical option. It is also relatively inexpensive.

Some men report a cold feeling and a loss of sensation in the penis, or a loss of spontaneity. Some bruising may also occur, although it is usually not painful.

Linear shockwave therapy

This is a new treatment that uses low-intensity shockwaves to reverse vascular dysfunction in the penis. It involves having four or five treatments over several weeks in a day clinic. Treatment is usually pain-free.

This treatment may suit men who cannot take PDE-5 drugs or those who have undergone prostate cancer treatment.

Psychological treatments

Psychotherapy and counselling may be helpful on their own where the cause of erectile dysfunction is psychological. They may also be used in conjunction with physical treatments, particularly for men who are struggling with anxiety and loss of self-confidence as a result of erectile function problems.

Contact us if you would like information on erectile dysfunction treatment in Sydney.

Erectile dysfunction is defined as the inability to attain an erection or to sustain one long enough for sexual intercourse. As you might imagine, this can seriously affect a sufferer’s self-esteem and interfere with his intimate relationships.

Occasional erectile dysfunction is not something to worry about. If a man is tired from working long hours, has just had a bout of the flu, or been to hospital for surgery, for instance, he may experience some temporary dysfunction while his body recovers. It could also happen when he’s just had too much of a good time and a few too many beers!

Isn’t it really just psychological?

It’s often thought that erectile dysfunction is mostly a psychological condition, perhaps caused by factors such as anxiety, overwork, or emotional distress. While these can certainly be contributing factors in some cases, as a rule, the more serious cases of erectile dysfunction have a physical cause.

Causes include: