MEN'S HEALTH
SURGICAL MANAGEMENT OF ERECTILE DYSFUNCTION
AUTHOR Kellen Choi, DO, FACOS
A
s a fellowship trained reconstruc-
tive urologist at a large academic
center, I treat a diverse group of
patients who struggle with erectile
dysfunction (ED) due to numer-
ous causes. Despite the different
causes, situations and diseases that
result in ED, all my patients have one true
desire: to reconnect intimately with their partner again.
Approximately 20% of people over the age of 20 and 50% of
people over the age of 40 suffer from erectile dysfunction (1,2). That
makes up 30 million people in the United States (3).
I am grateful to be able to help the wide range of patients that
suffer from ED. These patients span all different generations, eth-
nicities and backgrounds. They can range from the very young man
in his 20s who suffers from sickle cell disease to the elderly prostate
cancer survivor. Throughout my training, one patient particularly
stood out which reaffirmed my passion to help those suffering from
ED. It was a young man in his early 20s who suffered from sickle
cell disease. His sickle cell disease was extremely difficult to control,
and he would often end up in the emergency room for priapism.
With each sickle cell crisis, he grew increasingly despondent and
discouraged about ever being intimate with his partner and having
children. On Thanksgiving Day, he was sitting on the side of the
bed with a river of tears streaming down his face after I had again
treated his priapism. Through his tears, he hopelessly asked, “Will
I ever be able to father a child?” Every crisis and resulting priapism
caused him to fear getting a natural erection which led to erectile
dysfunction. As with everyone else I see, I assured him there are
many medical interventions, including surgical options, to help him.
When I see patients with ED in my practice, I make sure other
underlying cause for erectile dysfunction are ruled out. This includes
patients with depression, those taking medications that could affect
their sexual function, and those with uncontrolled medical condi-
tions. ED has been found to be a sentinel sign for cardiovascular
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JULY 2019
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