Dr. William Brant joined Fresh Living on KUTV to discuss prostate cancer treatment options and the importance of an early diagnosis. Dr. Brant is proud to be a part of the Granger Summit Urology team who is partnering with Zero Prostate Cancer to help promote early detection and provide support to prostate cancer survivors and their families. You can watch the whole interview on KUTV’s website.
Male sexual arousal involves a complex and coordinated effort among the brain, nerves, muscles, hormones, and ultimately, the blood vessels of the penis. If any physical part of the system doesn’t work properly, it can lead to erectile dysfunction (ED), the inability to achieve and maintain an erection for intercourse. In addition, psychological stressors and mental health issues can cause or worsen ED.
As an example, a physical problem that interferes with your arousal or impairs the ability to achieve an erection may cause you anxiety about your sexual abilities. The anxiety then causes a feedback loop, making you hesitant, slowing your response further, and ultimately worsening your ED.
Urologist and men’s sexual health physician Dr. William Brant understands that talking about erectile dysfunction may make you feel uncomfortable, but he and his staff want to assure you that you aren’t alone — the 1994 Massachusetts Male Aging Study found that about 52% of men experience some form of ED — and it’s nothing to be ashamed about. We offer a number of treatments that can help you regain your sexual function, including cutting-edge shockwave therapy. Here’s what you need to know.
How does an erection occur?
An erection results from increased blood flow into your penis, which can be stimulated either by sexual thoughts or direct contact with the tissue.
When aroused, a man’s penis muscles relax, allowing for increased blood flow through the penile arteries. The blood fills two chambers, one on each side of the penis, stiffening the tissue into an erection. The erection ends when the muscles contract, squeezing the blood out through the penile veins.
What are some standard treatments for ED?
There are a number of options that are commonly used to treat ED.
Medications are typically the first line of treatment for erectile dysfunction. These include Viagra® (sildenafil), Levitra® (vardenafil), and Cialis® (tadalafil). All three are phosphodiesterase (PDE5) inhibitors, which means they block the action of phosphodiesterase, a chemical that prevents you from achieving an erection. The medications increase blood flow to your penis, helping you achieve and maintain an erection suitable for sexual activity.
If psychological or mental health issues are contributing to your ED, talk therapy may prove helpful. During your sessions, you and the therapist can discuss:
- Your stress and anxiety factors
- How you feel about sex
- How you feel about your sexual performance
- Subconscious issues that affect your sexual wellbeing
- ED can take a toll on you and your partner’s relationship, so you might also want to speak with a couples’ counselor to help you reconnect emotionally. With greater openness and trust, you may feel more confident about your performance.
Some medications are injected directly into the penis. These drugs, including alprostadil (edex® and CAVERJECT®), as well as papaverine and phentolamine (TriMix or Bi-Mix), all widen and relax blood vessels, boosting blood flow to the penis.
So, how can shockwave therapy help my erectile dysfunction?
Low-intensity shockwave therapy (LiSWT) is already established as a treatment for healing wounds, bone fractures, and damaged or inflamed connective tissues. But now many doctors, such as Dr. Brant, are incorporating it as a non-invasive treatment for ED.
The treatment goes by several names — LiSWT, Gainswave, Acoustic wave, and True Pulse Protocol — and it can reduce your dependence on oral or injected medications. Dr. Brant and his team use the Li-ESWT (Low-intensity extracorporeal shockwave therapy) system for men who have mild-to-moderate blood flow-related ED and who’ve had success with PDE5 inhibitors.
Dr. Brant uses a wand-like device to deliver low-intensity sound waves into the deep tissues of your penis. The waves clear away any plaque buildup in the blood vessels that prevents flow into the two chambers, without affecting the skin around the treatment area. The waves also stimulate growth factors so that your body can build new, healthy blood vessels, improving the quality of your erections. The treatment requires no anesthesia or medication, is non-invasive, has no side effects, and takes only about 15 minutes per session. The number of sessions you need is customized to your body and your goals, but it’s fair to say that many men need one to two sessions per week for about six weeks for optimal results.
Peyronie’s disease occurs when plaque (fibrous scar tissue) builds up in the penis and causes it to curve during an erection. About six out of 100 men between 40-70 develop the condition; though rare, some men develop it while in their 30s. Symptoms can build up gradually or occur suddenly, but you’re more likely to have them if your blood sugar is high, if you smoke, or if a family member has the disease.
At the office of board-certified urologist and men’s sexual health physician Dr. William Brant in Salt Lake City, Utah, we’re quite familiar with Peyronie’s disease and its symptoms, and we understand that your self-confidence can take a real hit if you’re unable to perform in the bedroom. Because of this, Dr. Brant is committed to providing his patients with research-driven treatments to address both their medical condition and their self-esteem. Here’s what he wants you to know about the symptoms of this disease and your treatment options.
Causes and the 5 telltale signs of Peyronie’s disease
Medical researchers don’t fully understand the causes of Peyronie’s disease, but multiple factors seem to be involved. The primary one is repeated trauma to the penis. The trauma can come from a number of causes, including:
- Athletic injury or accident
- Pressure from partner’s pubic bone
- Vigorous sex
However, since there often doesn’t appear to be a specific trauma, doctors speculate that the condition may be linked to underlying health conditions.
If the condition can be linked to trauma, the problem begins during the healing process. Scar tissue develops within the penile tissue in a disorganized manner, causing the development of nodules. On both sides of the penis, there’s a sponge-like tube containing small blood vessels, and the tubes are encased by an elastic tissue sheath that stretches during an erection.
When you become aroused, blood flow increases in the tubes’ vessels, the penis expands, straightens, and finally stiffens into an erection. With Peyronie’s disease, however, the area containing the scar tissue isn’t able to stretch, and the penis curves as a result — the most prominent sign of the disorder. The five telltale symptoms of Peyronie’s disease include:
- Penile curvature
- Pain during erections and intercourse
- Penile lumps
- Erectile dysfunction
- Soft erections (and inability to penetrate)
These symptoms are by no means all the ones you can experience. Peyronie’s disease can also lead to penile shortening and/or narrowing, an “hourglass” indentation, anxiety and stress over performance issues, and an inability to father children.
Treatment of Peyronie’s disease
Treatment choice depends on whether you’re in the acute or chronic phase of the disease. The acute phase occurs over the first two to four weeks, though it can last up to a year; it’s characterized by pain, changes in penis length, and variable curvature. The chronic phase occurs after 3-12 months, when symptoms become stable.
For the acute phase, treatments come in three categories:
- Recommended: Penile traction to prevent loss of length and minimize curvature
- Optional: Oral medication and injection therapies can reduce pain and curvature
- Not recommended: Surgery, since the disease needs to stabilize
For severe cases and chronic Peyronie’s disease, surgery may be your best option. Dr. Brant offers the following procedures.
Dr. Brant inserts stitches on the longer side of your penis to pull it toward a more neutral position. This outpatient procedure takes only about an hour, but you’ll be out of work for a day. You can generally resume sexual intercourse within five weeks.
You should be aware, though, that it can’t correct either indentation or hourglass deformities.
Dr. Brant makes either one or two incisions on the short side of your penis and places a graft (using a vein or other material) to match the long side. A lot of men opt for this procedure because, following surgery, your penis may be up to one inch longer, depending on curvature.
Grafting is done as an outpatient procedure and takes three to four hours. You’ll need to stay home for a few days afterward, and you can generally resume intercourse within about eight weeks.
Dr. Brant places a prosthesis inside your penis to improve erections and straighten the organ. The procedure takes up to 90 minutes. You can usually return home afterward, though sometimes you require an overnight stay.
With a prosthesis, you’ll be out of work for one to four weeks. You can generally resume intercourse within five to six weeks.
Schedule a Peyronie’s Consultation in Salt Lake City
Are you showing any of the telltale signs of Peyronie’s disease? There’s no need to be embarrassed; we have treatments that can help. Call Dr. Brant’s office at 801-207-7922 to schedule a consultation, or book online with us today.
Sexual arousal is a complex process involving a coordinated effort on the part of the brain, hormones, nerves, muscles, and blood vessels. If any part of the system doesn’t function properly, the end result can be erectile dysfunction (ED).
ED is a sensitive subject for most men. But this problem, which causes a persistent inability to achieve and maintain an erection, is more common than you probably think — and it’s treatable. About 5% of men at age 40 have complete erectile dysfunction, increasing to about 15% at age 70. And mild-to-moderate ED affects around 10% of men per decade of life, so that by 50 years, close to 50% of men suffer some degree of dysfunction.
Board-certified urologist and men’s sexual health physician Dr. William Brant understands the impact any degree of erectile dysfunction can have on your quality of life, and he provides a number of evidence-based treatments to help you reclaim your health and your sexual confidence. And because ED can be an indication of an underlying disorder, he stresses the importance of seeking prompt medical attention if you experience any symptoms. Here’s what he wants you to know about the condition and its solutions.
Erectile dysfunction basics
In many ways, ED is a blood flow issue. In order for an erection to occur, blood must flow uninterrupted into corpora cavernosa (masses of erectile tissue) and stay there until sex is complete. Anything that interrupts that flow, whether physical or psychological, can lead to some degree of erectile dysfunction.
Physical causes, which includes underlying medical conditions, are responsible for about 90% of ED cases. Atherosclerosis is one of the most common causes, because it narrows or clogs the arteries in the penis, preventing the necessary blood flow.
Other physical causes include:
- High blood pressure or cholesterol
- Hormonal disorders, including thyroid conditions and testosterone deficiency (low T)
- Structural or anatomical disorders of the penis, such as Peyronie’s disease
- Parkinson’s disease
- Multiple sclerosis
- Injuries in the pelvic area
Numerous prescription medications can also cause ED by impacting blood flow, including high blood pressure and heart medications, antidepressants, sleeping pills, chemotherapy or prostate drugs, and illicit drugs and alcohol.
We offer a number of different treatments that help with ED. These include:
Oral medications including Viagra® and Cialis®, which are PDE-5 (phosphodiesterase-5) inhibitors, block a chemical that prevents sufficient blood flow, so you can achieve an erection. Essentially, these medications act to amplify the erections you already have. However, these medications may be ineffective at helping conditions such as low T, Peyronie’s disease, or injury and should not be the only treatment method tried.
Vacuum erection device (VED)
This external device fits over your penis, and as you pump it up, it pulls blood into the penile tissue. A plastic ring placed at the base of your penis maintains the erection for up to 30 minutes.
Some medications that widen and relax blood vessels can be injected directly into the penis, increasing flow.
Penile implants are the most definitive solution, analogous to having a knee replacement for a knee that has failed conservative treatments. If conservative ED treatments yield no joy, a penile implant procedure may be an option. Dr. Brant implants new hydraulic cylinders directly in the penis. This long-lasting solution provides firmer erections in a more natural manner.
Low-intensity shockwave therapy (LiSWT) is already in use to heal wounds, bone fractures, and damaged connective tissues, but doctors are now viewing it as a potential treatment for ED, one that can reduce your dependence on medications.
Dr. Brant and his team use the Li-ESWT system for men who have mild-to-moderate vasculogenic (blood flow-related) ED and who’ve had success with the PDE-5 inhibitors.
Dr. Brant uses a wand-like device to deliver low-intensity sound waves into the tissues of the penis, clearing away plaque that may be blocking the blood vessels and preventing blood flow into the corpora cavernosa. In addition, the waves stimulate growth factors that allow your body to develop new, healthy blood vessels. The treatment is noninvasive and takes only about 15 minutes in-office to complete.
Schedule a Erectile Dysfunction Consultation with D. Brant Today
If you’re struggling with erectile dysfunction, don’t despair; we have solutions that will restore your performance in the bedroom and your self-confidence. Give our office a call at 801-207-7922 to schedule a consultation with Dr. Brant, or book online today.
If you suffer from Peyronie’s disease, know that you are far from alone. This condition, characterized by a bent erection, may not be readily discussed among men in the locker room or at the office, yet it affects six out of 100 males, most commonly between 40 and 70.
Peyronie’s disease can also make erections painful, render sexual intercourse difficult, lead to erectile dysfunction, and cause a shortening of the penis or other penile deformities such as narrowing, indentations, and an hourglass-like appearance. Of course, those are just the physical symptoms. The emotional toll is paramount, as well. Some men notice symptoms suddenly; for others, they may emerge gradually over time.
Urologist Dr. William Brant understands that this issue may be challenging to discuss, but as a specialist in sexual and erectile medicine, he has helped countless men recover from Peyronie’s disease and reclaim healthy sex lives. To start the conversation, he offers the following overview.
Why is my erection bent?
The causes of Peyronie’s disease aren’t entirely understood. Some researchers believe it is a genetic disorder, while others think it is an autoimmune disorder. Among the most common theories is the result of a previous injury that caused internal bleeding in the penis. Even if the injury wasn’t severe enough to have caused significant pain, scar tissue built up in the tissue as it healed. During an erection, when the penis stretches, the scar tissue doesn’t stretch with it, which results in the curvature.
Diagnosing Peyronie’s disease
A physical exam is often enough to identify scar tissue in the penis and diagnose Peyronie’s disease. An ultrasound might also be ordered. Before testing, you’ll likely receive an injection directly into the penis that causes it to become erect. Ultrasound tests use sound waves to produce images of soft tissues.
Treatment recommendations depend on how long you’ve had symptoms and severity. First-line approaches include:
- Penile traction therapy to stretch the penis
- Vacuum devices
If your curvature is acute or prevents you from having sex, Dr. Brant may recommend one of the following surgical solutions.
Stitches are placed along the longer side of your penis to pull it toward a more neutral position. This is an outpatient procedure that takes about an hour, but you’ll need to rest the remainder of the day. Sexual intercourse can typically be resumed within five weeks. This procedure, however, can’t correct either indentation or hourglass deformities.
This surgery requires Dr. Brant to make one or more cuts in the scar tissue, allowing the sheath to stretch out and straighten the penis. He may also remove some of the scar tissue. A piece of tissue, called a graft, may be sewn into place to cover the tunica albuginea holes. This surgery, generally used in men with more-severe curvatures, is also an outpatient procedure. It takes three to four hours and requires several days rest afterward. Sexual intercourse can be resumed in about eight weeks.
A prosthesis is surgically placed inside the penis to straighten it and improve erections. This procedure takes up to 90 minutes and requires about four weeks of downtime. Sexual intercourse can be resumed within five to six weeks.
Schedule a Peyronie’s Disease Consultation with Dr. Brant Today
Don’t ignore a painful and or bent erection. You can resume a healthy sex life with the proper diagnosis and treatment from Dr. Brant. To schedule a consultation, call the office at 801-207-7922, or request an appointment online.
Erectile dysfunction, defined as the inability to maintain an erection sufficient for sexual intercourse, is a sensitive topic, one which many men are reluctant to discuss, even with their doctor. However, ED is also a common problem. Mild-to-moderate ED affects approximately 10% of men for each decade of life (i.e., 60% of men in their 60s, 70% of men in their 70s), and treatments are available that can give you back your sex life.
Board-certified urologist and men’s health physician, Dr. William Brant provides research-driven treatments for erectile dysfunction to his patients in Salt Lake City, Utah. He understands that ED can often be a symptom of an underlying medical condition and that prompt medical intervention is important so that you can regain your full sexual health. One condition that’s particularly linked to erection problems is diabetes. Here’s what you need to know about the problem — and the solution.
The 411 on diabetes
Diabetes is a metabolic disease that causes high levels of sugar in the bloodstream. In a healthy individual, the hormone insulin moves sugar (glucose) from the blood into the body’s cells, either to be stored or to be used for energy. With diabetes, however, the body has a problem with insulin, so the sugar builds up in the blood.
There are two main types of diabetes. Type 1 is an autoimmune disease in which the immune system mistakenly attacks and destroys the beta cells in the pancreas, where insulin is produced. Without the cells, there’s no insulin available to regulate glucose. About 10% of diabetics have this type.
Type 2 occurs when your body becomes resistant to the insulin that’s produced, leading to a buildup of sugar in your blood. Being overweight or obese and not exercising are two primary causes of type 2 diabetes. Carrying extra weight, especially around your waist, makes your cells more resistant to insulin’s effect on your blood sugar.
The 411 on erectile dysfunction
Achieving an erection involves proper functioning of many different body systems, including the brain, nerves, hormones, muscles, and blood circulation. If there’s a problem with any of these systems, you may be unable to achieve or maintain an erection. Psychological factors such as stress and anxiety can cause or worsen the problem, as the brain plays a key role in sexual desire and controlling the body systems responsible for an erection.
What’s the diabetes-ED link?
It’s estimated that between 35-75% of men with diabetes will experience at least some degree of ED during their lifetime. In addition, diabetic men tend to develop ED 10-15 years earlier than men without diabetes, and the numbers only increase as the men age.
Medical research has identified several likely causes for ED in patients who have diabetes. These include:
Blood vessel damage
With high levels of glucose in the bloodstream, microvascular disease — damage to the small blood vessels — occurs. This is what leads to kidney damage, neuropathy, and loss of vision, among other things. To achieve an erection, blood must flow into the corpora cavernosa — healthy masses of erectile tissue in the penis — and stay trapped inside. In the presence of microvascular disease, though, blood flow is weak or impeded, leading to ED. Men with both diabetes and high blood pressure can also see an increased risk of ED because of further damage to the penile vessels.
High levels of glucose may also cause nerve damage, especially in the nerves farthest away from the body. Many diabetics have foot problems, but they often have problems with their hands and penis. This can manifest as ED, loss of sensation, inability to climax, and other sexual issues. Having good glucose control may prevent this from worsening but typically once the damage is done, it does not spontaneously get better.
Low testosterone (T) levels
About 25% of men with diabetes have low T. Testosterone plays a role in sexual function in men, so low T can be responsible, in part, for ED.
Depression and anxiety
It can be anxiety-provoking or depressing to have to manage a difficult disease like diabetes, and depression is known to lead to various issues with having an erection. Depression can cause a lack of sleep, which itself results in a loss of morning erections, a natural occurrence in healthy men. And as we’ve seen, psychological factors can cause men to have difficulty achieving an erection or maintaining it during sex.
Medication side effects
Many men with diabetes depend on multiple medications to reduce complications from their disease and also their risk of heart problems. Some of these medications lower blood pressure or have physical and/or psychological side effects that make an erection difficult.
If you have diabetes and are also struggling with ED, there are treatments. They range from lifestyle choices like losing weight, exercising, lowering your blood pressure and cholesterol, and quitting smoking; to hormone replacement therapy, ED pills that increase blood flow to the penis, penis injections, and even penile implants.
Urinary incontinence (UI) — the inability to hold in urine until you make it to a bathroom — is uncomfortable and embarrassing. It affects both men and women, and especially for men, the number of people who develop it increases with age. Approximately 11-34% of older men have some form of the condition, while 2-11% of older men deal with daily symptoms.
Urinary incontinence isn’t a disease, but rather, it’s a symptom of some underlying medical issue that causes loss of bladder control.
At the offices of urologist and men’s sexual health physician Dr. William Brant, located in Salt Lake City, Utah, we understand how difficult it can be to live with UI, and we offer several innovative treatments for it, including minimally invasive sling surgery. The first step, though, is knowing where to go for help. Your best option is coming into our office for a men’s sexual health exam. Here’s why.
The types of urinary incontinence (UI)
There are four primary types of UI:
- Urgency incontinence: a sudden, urgent need to urinate, followed by leakage
- Stress incontinence: leakage brought on by sudden pressure or quick movements, such as sneezing or coughing
- Overflow incontinence: an inability to empty your bladder fully, so it “overflows”
- Functional incontinence: an outside obstacle, such as a physical disability, prevents you from reaching the toilet on time
What are the risks for and causes of urinary incontinence?
The most common risk factors for men developing UI include:
Muscles, including the bladder muscles, weaken with age, which makes holding in urine more difficult. In addition, loss of bladder control may be a symptom of certain diseases or conditions that are more common in older men.
Lack of exercise/obesity
Physical activity can increase stress incontinence, but lack of activity can weaken muscles and increase the risk of weight gain. The pressure of extra weight on the bladder can cause leakage.
History of certain conditions
Diabetes can lead to urine leakage, so can an enlarged prostate, the gland responsible for producing semen, which sits next to the bladder (called benign prostatic hyperplasia or BPH).
Stress or urge incontinence can also be related to untreated prostate cancer, but UI is most often a side effect of prostate cancer treatment.
Diseases that interfere with your brain’s ability to effectively signal your bladder muscles, including Parkinson’s disease, Alzheimer’s disease, and multiple sclerosis, can also lead to UI.
Other causes of UI in men include:
- Urinary tract infection
- Urinary tract obstruction
- Weak bladder or pelvic floor muscles
- Loss of bladder sphincter strength
- Chronic cough
- Excessive alcohol use
Because the urinary tract is connected to the reproductive system, we can evaluate your issues with a sexual medicine evaluation.
How can a sexual medicine evaluation help UI?
Sexual medicine is a medical field that addresses common issues affecting men’s health, including urinary conditions such as incontinence. Dr. Brant specializes in both urology and men’s sexual health, so he’s well-suited to diagnose and treat such conditions.
During an evaluation, Dr. Brant checks urinary function. He also performs an examination of the prostate gland. If the prostate is enlarged, as in BPH, it can squeeze the urethra, affecting the urine flow. The symptoms vary from person-to-person, but the most common are a hesitant, interrupted, or weak stream; more frequent urination, particularly during the night; urgency, leaking, or dribbling; and urge incontinence.
These lower urinary tract symptoms (LUTS) associated with BPH rarely occur in men under 40, but more than half of men in their 60s, and up to 90% in their 70s and 80s, have some LUTS.
No matter what the cause, Dr. Brant can provide effective treatment. If the symptoms are mild, lifestyle changes, such as avoiding caffeine, alcohol, and spicy food — which all stimulate the bladder — can reduce the frequency of urine leaks.
If the cause is weak pelvic floor muscles, he may recommend you perform Kegel exercises to strengthen these muscles, as they help control urination. They are particularly useful for stress incontinence, but they can also help urge incontinence.
For more severe cases, he may recommend one of two surgical procedures, a sling that wraps around your urethra and bladder neck to help keep the urethra closed, or an artificial urinary sphincter (AUS), a fluid-filled ring around the bladder neck that keeps the urethra shut until you’re ready to void.
Testosterone is a sex hormone produced mainly in men by their testicles, although it’s present at low levels in women, too. A lot of men think of it as a pure “sex” hormone, meaning that it’s only function is to improve erectile function. However, testosterone has much more widespread effects. Testosterone affects facial and body hair growth as well as sexual development, including stimulating sperm production and supporting a man’s libido, or sex drive. It also helps build muscle and bone mass to produce the characteristic “male” appearance. Additionally, it is involved in mood, brain health, heart health, and so on.
Testosterone production usually decreases with age, and according to the American Urological Association, about two out of 10 men over age 60 have low testosterone levels (low T), while three out of 10 men in their 70s and 80s have low T. Low T, though, can happen at any age and for a variety of reasons from diet to blood pressure to thyroid problems.
According to the Food and Drug Administration, a normal T range is typically 300-1,000 ng/dL, which is determined by a serum testosterone blood test. If the level drops below 300, men can experience a wide range of symptoms. The testing for low T is a bit more complicated than this range, and those numbers are often not quite accurate, but they are a good starting point.
Here at the office of urologist Dr. William Brant, we specialize in men’s health issues, including low T, and we can provide you with the treatment you need to feel like yourself again. Here’s what you need to know about recognizing the signs and symptoms of the condition.
What are common symptoms of low testosterone levels?
There are a number of symptoms of low T in men. Some of the most common include:
Testosterone plays a large part in a man’s sex drive. Though men can experience a lowered libido as they get older, someone with low T will experience a more noticeable drop in their desire to have sex.
Testosterone not only supports sex drive, but it also helps to achieve and maintain an erection. It’s only one of many components to do so, but it works by stimulating brain receptors to produce nitric oxide, a molecule that triggers a series of chemical reactions required to produce an erection.
With low T, men can have difficulty achieving an erection before sex or having spontaneous erections, though it’s only one component in the process. Research, however, is inconclusive about the value of testosterone replacement in treating ED.
In a review of studies, nearly half showed no improvement in erectile problems with testosterone replacement. That’s most likely because other factors, such as obesity, diabetes, thyroid problems, stress and anxiety, and high cholesterol and blood pressure, also play a role.
Male pattern baldness has a strong genetic component, and it’s a natural part of aging for most men. Testosterone is converted to another hormone, which is responsible for the loss of hair on the head. Some men with very low T may experience a loss of body and facial hair.
Loss of muscle mass
Testosterone plays a key role in building muscle, so men with low T might might experience a decrease in muscle mass, or a new inability to gain muscle at the gym. Studies, however, have shown that although low T does decrease muscle mass, it may not necessarily affect muscle strength or function.
Decreased bone mass
Osteoporosis and osteopenia, the thinning of bone mass, is a condition normally associated with women — especially small, white women of European descent. However, men with low T can also develop osteoporosis since testosterone helps produce and strengthen bone. That means they have lower bone volume and are more prone to bone fractures. Bone density can easily be measured with a DEXA test, and there are medications available to treat the condition, although it’s preferable to get testosterone levels back in the normal range.
Increased body fat
Men with low T not only experience increases in body fat, they can also develop gynecomastia, or enlarged breast tissue. Current understanding pegs this as an imbalance between testosterone and estrogen (the female hormone, which men have in small quantities), since the testosterone level is no longer where it should be. It is important to not just check T in these cases, but also the estrogen level.
Men with low T can have a hard time falling or staying asleep. They also have an increased risk of sleep apnea, a potentially serious disorder in which a person temporarily stops breathing. This not only disrupts sleep, but it can also cause a wide range of physical problems, including heart disease.
Decreased energy levels and mood changes
Low T can reduce energy levels and lead to fatigue, even after adequate rest. And according to some evidence, this may also be paired with mood alterations, including a lack of focus, irritability, and depression.
As any guy who’s worn a jockstrap can tell you, the testicles are incredibly sensitive parts of the male anatomy, and pain in that region is nothing to sneeze at. But testicular pain comes from many causes and presents in a number of different ways; it’s important to know when you have a problem.
Board-certified in urology and men’s sexual health, Dr. William Brant has extensive knowledge of testicular pain and its causes, and he’s an expert in its treatment. He’s put together this guide to help you understand what might be at the root of your pain and what you can do about it.
What are the causes of testicular pain?
Testicular pain is discomfort felt in the testicles (testes) or the scrotum, the sac that surrounds them. It may start mildly, building in strength, or it can come on suddenly, depending on the cause. It’s caused by many different things, ranging from blunt trauma to infections to neurological disease to torsion. Let’s examine a few of these.
The large majority (85%) of testicular injuries are caused by blunt force trauma, such as would be sustained by a direct kick or punch to the groin, sports injuries, and straddle injuries. Such a blow to the testicles can cause sudden, excruciating pain that may linger, as well as bruising and swelling. In addition, the testicle may rupture or develop a hematocele, where blood pools around the testicle and presses on it. Any disruption to blood flow can be serious, so if you’re experiencing pain and swelling after direct force, seek medical attention as soon as possible.
Epididymitis is an infection of the epididymis, the organ in which sperm mature before leaving the body. The infection can come from a number of sources, such as sexually transmitted diseases, including chlamydia and gonorrhea, and urinary tract infections.
Symptoms may include:
- Pain that increases gradually
- A scrotum that’s hot to the touch
The doctor will usually treat the infection with antibiotics.
Kidney stones are hard balls of calcium that get lodged in the organ responsible for excreting liquid waste, and they can cause pain that radiates to the testicles. This is known as referred pain — pain that occurs beyond the region causing the problem.
Some common symptoms of kidney stones include:
- Blood-tinged urine
- A burning sensation when urinating
- Pain at the top of the penis
- A sharp, cramping pain that radiates from the back to the groin
- Frequent urination
- Nausea and vomiting
If the stone is small, it may pass on its own. If the stone doesn’t pass, though, and you begin to experience symptoms of an infection, such as a fever or discharge, seek medical treatment as soon as you can. Treatment options usually include surgery to remove the stone, or shockwave lithotripsy, where shock waves aimed at the kidney break up the stones, which are then excreted.
Testicular torsion is a serious medical condition that’s most common in men under 25 years old. It occurs when the testicle twists around the spermatic cord, the duct that carries sperm from the testicles to the urethra. According to the American Urological Association, testicular torsion happens on the left side more so than on the right.
Symptoms that accompany torsion include:
- Sudden, severe pain on one side of the scrotum
- A red or darkening color on the scrotum
- Swelling in the scrotal sac
- Nausea and vomiting
The pain from the torsion may be sudden, but some men experience a pain that worsens slowly over several days.
Torsion is a life-threatening condition, as it cuts off the blood flow to the testicles and may result in testicular loss. Treatment almost always involves surgery to undo the twisting, but if the surgeon cannot repair the damage for some reason, he may have to remove the testicle. Since torsion usually affects just one testicle, removing it doesn’t impact the man’s fertility.
A hernia is an event in which tissue pushes through a weak spot in the abdominal muscles. An inguinal hernia can push its way into the scrotum, causing testicular pain and swelling. Surgery to repair the hernia can lead to lingering pain, and the doctor may treat this with an anesthetic injection.
Schedule an Appointment Testicular or Scrotal Pain in Salt Lake City Today
Are you experiencing testicular or scrotal pain, with or without knowing its source? If your pain is a life-threatening emergency, dial 911, or go to your local emergency department. Otherwise, contact Dr. Brant to learn more about your condition and your treatment options, by phone at 801-207-7922, or by booking an appointment online today.
Penile implants may sound like an extreme solution for erectile dysfunction, but is it? Often, for men with ED, implants offer a safe option for regaining satisfaction in your sex life and have higher satisfaction rate than more conservative methods.
Based in Salt Lake City, Utah, urology specialist William Brant, MD, FACS, FECSM is an expert at identifying the causes of erectile dysfunction and designing a personalized treatment plan to help restore your ability to have an erection. Dr. Brant and our knowledgeable team are here to explain more about the pros and cons of penile implants, so you can decide if it’s right for you.
What are penile implants?
Penile implants is a general term that covers a wide array of implants designed to help you get and maintain an erection. If you’re worried that penile implants may be difficult to conceal under clothes, don’t fear — the most common implants only harden your penis when you’re ready to have an erection, otherwise, your penis will remain in a normal, flaccid state.
Some of the most popular types of penile implants include:
- One-piece implant – This device is made up of semi-rigid cylinders that are placed in the area of your penis responsible for erections. This is the least complicated kind of prosthesis and easiest to use; however, it offers the least natural-looking and natural-feeling erection as compared to the other implants.
- Two-piece implant – This implant adds a pump in your scrotum to fill the cylinders in your penis with fluid, creating an erection. You can drain the fluid out by bending your penis in a certain direction. Although it’s effective, this device is not the best at maintaining total flaccidity. It may not be a good option if you’re thin or have a larger penis.
- Three-piece implant – This device involves the same mechanism as the two-piece, but the pump can both inflate and deflate the penis. The pump pulls the fluid from a reservoir placed in the lower abdomen area in order to create the erection and sends it back to the reservoir ro return your penis to a completely flaccid state. These are, by far, the most commonly used implants in the U.S.
Dr. Brant typically recommends the three-piece penile implant to his patients, unless there is a safety or medical concern that prevents you from getting it. The three-piece device offers great rigidity and flaccidity, and most importantly, gives you total control over your erection as well as allowing you to be totally discreet about having an implant.
What should I consider before getting a penile implant?
Penile implants offer amazing benefits, but there are a few drawbacks you should consider before getting one. Here is the breakdown of the pros and cons.
Some of the pros for getting a penile implant include:
- Allows you to control your erection
- Long-lasting, good for up to 20 years, although this depends on a combination of use and luck
- High patient satisfaction rate
- Returns your penis to a flaccid state when not in use (by deflating for the two or three-piece or bending the semirigid cylinders for the one-piece)
- Easy to use
- Best solution for ED that either doesn’t respond to medication or other treatment, or if those treatments are unsatisfactory.
Each device also comes with its own added benefits. As previously mentioned, the three-piece implant creates the most natural-looking erections, offering both excellent rigidity and total flaccidity. The one-piece device has a very low chance of malfunction (due to its simple construction) and is great for patients with limited dexterity.
Cons of penile implants
The biggest drawback to penile implants is its permanence. In most cases, once you receive a penile implant, you will no longer be able to achieve an erection by natural means. This also applies if you were to have the implant removed.
Other cons of penile implants include:
- Outpatient procedure, which involves recovery time at home
- Higher chance of malfunction with the two or three-piece device
- Less rigid erections (with the one-piece)
- Constant pressure on the penis (with the one-piece), which may cause injury in certain kinds of patients
- Slight risk of infection (very rare, as many modern implants come with an antibiotic coating to prevent this from happening). Using modern techniques and protocols, Dr. Brant’s rate of infection is less than 1% (outside of unusual circumstances).
Dr. Brant takes the time to explore all nonsurgical treatment options for your ED, including medication and therapy, before suggesting penile implants. If you have concerns about penile implants, he answers all your questions and makes sure you understand both the pros and cons of penile implants before proceeding.
The procedure itself only takes about an hour, and you’ll be able to go home afterward. During the procedure, Dr. Brant makes a very small incision on the upper area of your scrotum to be able to insert the implant. The incision heals in about a week, and you’ll be recovered and able to resume having sex after two to six weeks (depending on the procedure and type of implant).
Schedule a Penile Implant Consultation in Salt Lake City
If you’ve been struggling with erectile dysfunction that just won’t respond to treatment, you may be a good candidate for penile implants. Contact our Salt Lake City, Utah, office by calling 801-207-7922 or by sending a message on our website to schedule a consultation with Dr. Brant.