Let’s Size it UP: Truth behind penile enlargement

Penis size has always been something that men are preoccupied with. Most men think that bigger is better. It is also directly linked to their self-esteem and self-confidence. Some men get self-conscious when they’re in the changing room comparing themselves with other men who apparently have bigger penises.  Some even feel that if they are not big enough they may not be attractive to the ladies or adequately satisfy their partners. That is why if you search on the internet for penile enlargement, you will get a lot of different products and services listed in order to help you achieve it. The products include things like pills, creams, massage oils, injections and even surgery. The question is do they really work? Or are they just banking on men’s’ fears and obsessions?

In this article, I will explore some of the popular treatment options available and see if it really works or is it just a waste of your money.

What is normal size?

First of all, let us establish what is considered normal. Do some men feel that they are small, but are they really? Many studies have shown that men who think their penises are small actually have normal-sized penises. It is only considered small if the Stretched Penile Length (SPL) is less than 7cm or 2.8 inches. This is measured from the base of the pubic region to the tip of the penis when it’s stretched. Anything longer than this is considered normal size.

Penis enlargement products:

Pills, creams and lotions

These products usually contain herbs or ingredients that manufacturers claim help to increase penile length. Actually most of them only supposed to help to improve blood flow to boost erection. It doesn’t really change the actual penis size or length.

Vacuum pumps

These pumps work by drawing more blood into the penis causing the penis to swell and get engorged. It might make the penis appear bigger temporarily but prolonged use may damage the tissues in the penis and may cause the erections to be less firm.

Exercises

This is similar to penis massage and sometimes are called jelqing. Using both hands to massage the penis to improve blood flow and hoping to increase the length. This technique may be safer but it is not scientifically proven to work. If not done properly may cause pain  or injury to the penis.

Procedures:

Filler injections

Some clinics in other countries offer filler injections using ingredients like Hyaluronic Acid which is typically used to even out wrinkles. A few small scale studies have shown temporary improvements in penile length and size. However bigger studies are required to establish its efficacy and currently it is not a medically approved procedure in Singapore.

Penile surgery

This would be the most extreme method of penile enlargement. There are different techniques done by different surgeons. So far this is the only proven method of penile enlargement. However, there are several potential risks and complications to consider.

Extracorporeal Shockwave Therapy

This procedure works by applying low-intensity shockwave to the penis. This helps to increase blood flow and circulation. Some patients experience bigger girth due to the increased blood flow but no change to the penile length. 

Important things that you can do:

Seek medical consult

Speak to a doctor who can advise you whether you have a small penis and what would be suitable for you.

Talk to your partner

You may feel inadequate but your partner may not have any problems with it. Communicate this to your partner so you can discuss what’s best for you. It may not be about size but could involve certain sexual preferences.

Lose weight

Most of the time, the penis may appear smaller due to excess belly fat. After losing weight especially around the tummy area, your penis will appear longer and more obvious.

Trim your pubic hair

A thick bush may make your penis appear hidden and hence smaller than it actually is. Trimming the pubic hair helps to reveal more of it and make it appear longer or bigger.

Bottom line:

Many men believe that increasing the size of their penis will make them more of a man, more attractive or better in bed. However, it’s highly likely that their penis is within the normal range.

Even if you want to make it bigger, there are no proven ways to do it without risk or complications.

Most of the time it boils down to your own perception about what the size of the penis means to you and your partner. So do speak to a doctor or a healthcare professional to ascertain where you lie with regards to penis size and what is best for you. 

Pain During Ejaculation

What does it feel like?

Pain during ejaculation is also known as dysejaculation, odynorgasmia, post orgasmic pain, dysorgasmia or orgasmalgia. This can range from mild discomfort to severe pain and can occur during or after ejaculation. The usual sites of pain are the penis (along the shaft or at the tip), scrotum, perineal or perianal area.

The pain can last anywhere from a few minutes up to 24 hours. Dysejaculation can be associated with other sexual dysfunctions. It can significantly impair a person’s quality of life and sex life through reduction of the individual’s self-esteem and sexual desire.

Several studies demonstrated its prevalence between 1–10% in the general population, but this may be underreported due as the discomfort may be transient and mild for some people.The prevalence may increase to 30–75% among men who suffer from chronic prostatitis or chronic pelvic pain syndrome. It is also seen in other conditions mentioned below.

Causes 

There are a variety of conditions that can result in painful ejaculations, but it can also be an idiopathic problem with no identifiable cause. Sexually transmitted infections, calculi or stones in the seminal vesicles, damage to the pelvic nerves, inflammation of prostate, prostate cancer, benign prostatic hyperplasia, prostate surgery, pelvic radiation, a previous history of hernia repair or rectal intercourse and certain medications such as antidepressants have all been associated with dysorgamia. 

Psychological issues may also be the cause of painful ejaculations, especially if the patient does not experience this problem during masturbation. Other rarer causes include heavy metal or mercury toxicity or ciguatera toxin fish poisoning.

Evaluation

Just with all types of sexual problems, the doctor will start with a thorough medical and sexual history. A history regarding sexually transmitted diseases, relationship issues, psychological or psychiatric issues and drug intake will be taken. The doctor will also be keen to assess any urinary symptoms, prostatic diseases, familial prostate cancer, previous surgical procedures (e.g., hernia repair or prostatectomy) and previous history of radiotherapy. 

Your doctor may do a prostate exam to look for any pain, swelling or nodules which may indicate a prostate pathology. A neurological and musculoskeletal examination may detect a nervous system pathology.

Investigations your doctor might do include a urine or semen culture looking for any infections, especially with sexually transmitted infections. Blood tests for prostate specific antigen (PSA) levels may be raised if it is a prostate issue. Ultrasound scans may also be ordered. No obvious pathology is detected in a significant number of patients. 

Treatment options

Treatment of painful ejaculation should be directed at managing the underlying cause if there is one. 

If an infection is detected, antibiotics will be given. Urological procedures may be done for prostate growth or cancers. If drugs are a suspected cause, changing the medications or stopping it can be considered. Your doctor may prescribe medical treatment such as muscle relaxants, α-blockers, anti-inflammatory agents, certain types of antidepressants and neuropathic pain medications to alleviate the symptoms. Psychotherapy or relationship counselling should be conducted for patients with an underlying psychological issue. Behavioural therapies and pelvic floor exercises have also shown to be helpful. Extracorporeal shockwave therapy (ESWT) can be done for pelvic pain and dysorgasmia which can also alleviate the pain.

If you do experience pain during ejaculation, it is important to seek medical attention and treatment to rule out serious causes and before this issue impairs your sexual function and quality of life. 

Next read: Dysuria (Painful Urination)

Also on this site: hiv test, pep hiv, std test singapore


Dysuria (Painful Urination)

What is Dysuria (Painful Urination)?

Dysuria is the sensation of pain, burning, or discomfort on urination. The pain may be in the lower part of the abdomen, along the length of the penis in males or at the urethral opening in females. It is a symptom which can be due to many different conditions. 


Causes of Dysuria (Painful Urination)

The most common cause of acute dysuria is infection, especially cystitis (infection of the bladder). Other infectious causes include urethritis (infection of the urinary tube) and vaginitis (infection of the vaginal canal). Infections of the prostate may also cause dysuria. These can be due to sexually transmitted infections (STI) or non-STI infections. 

Non-infectious causes can include a foreign body in the urinary tract, certain medication use, urinary tube anatomic abnormalities, trauma, and bladder pain syndrome. Certain autoimmune and psychogenic conditions can cause dysuria as well. 

Dysuria may be accompanied by other symptoms including urinary frequency and urgency, vaginal or penile discharge, pain during sexual intercourse, foul-smelling or blood stained urine, fever and swollen groin lymph nodes.  


Evaluation

The doctor will usually start off with taking a history and performing a physical examination. Crucially, the doctor will also order up some urine tests to be done. These tests can usually tell us the exact organism that is causing the infection. Depending on what the doctor might suspect, other investigations such as radiological investigations (x-rays, ultrasounds or CT scans) and blood tests may be done. If necessary, a urologist may do a scope of the bladder (cystoscopy) as well.


Treatment for Painful Urination

Most of the time, the reason is usually due to a bacterial infection of the urinary tract. For bacterial infections, antibiotics are given to kill off the infection. The type and duration of antibiotics depends on the type of bacteria. Antibiotics in the form of an injection may be given as well. 

If the cause of dysuria is due to a STI, it is imperative that we ensure the bacteria is eliminated completely, and that your sexual partners are tested and treated as well. It is also recommended to screen for other STIs. 

Other symptomatic treatment for dysuria can include medications to ease the discomfort on urination or the other symptoms like urinary frequency and urgency. While these medications do not clear the bacteria by itself, when used in conjunction with the antibiotics, they can provide much needed relief for symptoms that can otherwise be very uncomfortable.

If you do experience dysuria, do not hesitate and seek medical attention and treatment early.

Next read: Vaginal Piercings

Also on this site: hiv test, pep hiv, std test singapore


Penile Discharge – Video

Penile discharge

Penile discharge is any substance (other than urine) that comes from the urinary tube, also known as the urethra.

Normal discharge includes pre-ejaculate, or pre-cum, and semen ejaculate. These are usually produced during sexual stimulation.

Abnormal discharge can range from clear to pus-like and usually produced in the presence of an infection. In males, the infection is usually due to a sexually transmitted infection.

This may be accompanied by symptoms such as pain on the passing of urine, ulcers, urinary frequency and urgency.

The most common 2 causatives STI organisms are Chlamydia and Gonorrhea, but there are a variety of other microorganisms that can cause similar symptoms. Read more: STD symtopms

Non-STI organisms that cause urinary tract infections can also present with discharge. These are usually accompanied by urinary frequency, urinary urgency and foul-smelling or cloudy urine.

Similar organisms may infect the prostate causing prostatitis which may present with discharge, fever, urinary symptoms, pelvic pain and even blood in the semen.

If there has been any instrumentation of the urethra, for example with a catheter or after a procedure at the urologist, a discharge may also be produced due to the trauma.

Balanitis

Balanitis is inflammation of the foreskin and head of the penis that can cause some discharge under the foreskin. It may present with a rash, itching or pain, a foul smell and ulcers. The inflammation may be due to infections or irritation. While it is not a true penile discharge as it does not come out of the urethra, it may be confused with true penile discharge by some people.

If you do not clean your foreskin and head of the penis regularly, a layer of dead cells and sebum may build up. This is known as smegma and may also be confused with true penile discharge. While this is not harmful, it is advised to wash this area properly so smegma does not build up as a dirty head of the penis predisposes you to balanitis.

If you do have any of the symptoms that we have mentioned, please visit us at DTAP clinic so we can evaluate your condition.

Penile Piercings

Common types of penile piercings.

Penile piercing is a general term and there are actually many different ways and styles a man can get a piercing on his manhood.

Apadravya: This is a piercing that passes through the glans vertically. It can go from top to bottom or vice versa.

Ampallang: This piercing goes through the glans horizontally. It can go from left to right or vice versa.

Deep shaft: This piercing goes through the penile shaft. It can be pierced like Apadravya or Ampallang and goes through the shaft.

Dydoe/king’s crown: This piercing passes through the ridge or corona of the glans and on to the head of the penis itself. It usually comes in pairs.

Foreskin: This piercing is done through the foreskin of an uncircumcised penis. It is equivalent to a clitoral hood piercing in females.

Frenum: Frenulum is the skin that attaches the foreskin to the head of the penis. A frenum piercing is one that goes through the frenulum horizontally.

Guiche (perineum): This piercing is on the perineum. Perineum is the area between the anus and the scrotum.

Hafada (scrotal): This is a surface piercing done anywhere on the scrotal skin. It does not penetrate deep into the scrotum.

Lorum: This piercing is done horizontally on the underside of the penis at its base.The position is where the scrotum meets the penis.

Magic cross: This piercing is basically an Ampallang and Apadryava combined together. Making it appear like a cross.

Prince Albert: This is one of the most popular penile piercings. It is a ring type of piercing that goes along the underside of the glans from the urethral opening to the part where the glans meet the shaft of the penis.

Pubic: consists of a piece of jewelry through any part of the area around the base of the penis

Reverse PA: the opposite of Prince Albert, with jewelry entering the urethra and exiting through the top of the shaft



Sexual benefits to penile piercings

  • Some men chose piercings to enhance sexual pleasure for him and or the partner. It can increase pleasure during masturbation or sexual intercourse
  • Depending on the type of piercing, some can stimulate the partner more than others. Especially during vaginal or anal intercourse.


Risks associated with penile piercings

  • Increased risk of UTI (Urinary tract infections)
  • Infection at piercing site.
  • Increased risk of STI
  • Injuring your partner’s genitals during intercourse.

Common signs & symptoms of STIs

Genital piercings are getting more exposure and interest nowadays. Before you decide to get one I suggest you make the necessary research before deciding. When choosing to pierce, I would suggest going to a reputable body piercing specialist. One who has experience and also maintains high standards of cleanliness and hygiene. I highly discourage you from doing it on your own. It’s definitely an acquired taste, so make sure you make the right decision.

Next read: Vaginal Piercings

Also on this site: std screening



Congenital Penile Curvature (CPC)

Congenital Penile Curvature

Congenital Penile Curvature, or CPC, is a relatively uncommon condition. It can be noted early in life by parents during diapering and dressing of their infants. Others do not discover the problem until sexual maturity, where they notice the curvature themselves. Often, the penile curvature is only observed in the erect state. CPC can sometimes occur together with hypospadias. This is a urethral abnormality whereby the opening of the urethra is on the underside of the penis instead of the tip. 

The cause of CPC is not known, but is thought to result from excessive elasticity in one aspect of the penis as compared to the rest of the penis. For example, if there is more tissue elasticity on the top of the penis, it expands more than the rest of the penis during erection, resulting in a downward curve. The curve in CPC is typically downwards. 

The degree of curvature ranges from mild to severe. There can be discomfort experienced during sexual intercourse. Men may find that they are only able to have sex in one particular position. Other positions may not be possible due to the nature of the curve. Unlike Peyronie’s disease, which is another cause of curved penis, CPC does not cause painful erections or erectile dysfunction, and there is no fibrous scar tissue that can be felt.

Medical literature suggests that CPC can only be treated surgically by a method known as plication, which involves removing tissue and stitching the opposite side of where the curvature is. 


ESWT – Extracorporeal Shock Wave Therapy

There are no evidence-based non-surgical treatments described. However, from our experience at DTAP, we have observed that Extracorporeal Shock Wave Therapy, or ESWT, is also able to treat CPC with favourable outcomes. We have treated a considerable number of CPC patients with ESWT alone and achieved either full resolution or significant improvement in curvature. 

Therefore, at DTAP we offer ESWT as a treatment option for CPC. We would like to re-emphasize that this is not based on the medical literature, but rather from our personal experiences with patients. It is always recommended to visit a doctor for a detailed consultation, medical examination and assessment of treatment options before making an informed decision on which treatment to undertake.

Also on this site: STD Screening, STD Check Up Singapore

7 Things You Need To Know About Anal Cancer In Men

Anal cancer is a rare disease and the understanding of its natural history is evolving. While it is the 26th most common cancer in the USA annually, the incidence rate is increasing at 2% per year over the past decade. Further underpinning its importance in recent times is that it is also one of the cancers that has devastatingly poor outcomes in the late stage while being relatively easy to detect and treat in the early stages.


What is Anal Cancer?

Anal cancer like all cancers start when the cells lose the ability to maintain their original form. Precancerous changes such as aberrant growth soon occurs as these cells no longer serve their original function and a tumor develops. 

The anal canal is a 4 cm structure that continues from the rectum. Embryologically, this canal develops from 2 distinct stem cells that originate from different parts of the body. As the embryo develops into a fetus, these 2 stems cells develop into either Squamous Cells (outside of canal) or Columnar Cells (inside of anal canal). These 2 cells meet and develop into the anal canal. This is important because the junction at which these 2 cells converge while forming your anal canal all those years ago is also the most susceptible site for developing anal cancer. 


Although not entirely analogous, anal cancer shares many similarities with cervical cancer in women. Both cancers occur most frequently at the junction where 2 normally distinct cells meet and majority of both tumors are found to be co-infected with Human Papilloma Virus (HPV) sub-type 16.

Men who have sex with Men (MSM) and immuncompromised patients (transplant, cancer patients and HIV patients) are more prone to this cancer. Compared to the general population, MSM with no HIV have 2 times the risk of developing anal cancer, MSM with HIV have up to 25 times the risk while transplant patients have 5 times the risk and a patient with previous colon cancer has 20 times the risk. Other risk factors include previous ano-genital warts, previous STD infection and high risk sexual activity.

Anal Cancer In The Early Stages

In its early stages, anal cancer does not produce any symptoms. The early signs of of developing anal cancer is pre-cancerous cell changes. This is detected by direct visualization and sampling of the area. The core principle of screening for anal cancer is hence looking for these pre-cancerous changes. This can be done through a variety of methods depending on the expertise available, each method has different levels of specificity in detecting anal cancer. 

Anal Pap Smear & HPV Testing

Currently, the Anal PAP smear and HPV testing is considered to be the most practical means of screening for anal cancer. This involves a swab inserted into the anal canal and cells from the area are sampled and looked under a microscope for any pre-cancerous changes, further processing of the sample via HPV DNA PCR is also used to detect any presence of HPV in these cells. Once the patients with potential risk of developing anal cancers are pick out with this screening, a further diagnostic test is required. The current diagnostic standard is High Resolution Anoscopy where a high magnification scope is used to examine the tissue. Different reagents are also used to differentiate normal tissue from pre-cancerous tissue. 

There are no established guidelines for how frequent screening should be carried out but current expert opinions recommend every 1 – 2 years for MSM with HIV and 2 – 3 years for MSM without HIV. 

Treatment of Anal Cancer

Treatment of anal cancer can be considered in 2 categories – Pre-cancerous treatment and Cancer treatment. Precancerous changes, once detected by screening and diagnosed with Anoscopy can be treated with either Topical Therapy such to eradicate the precancerous tissues. Local Ablative Therapy that involves Radiofrequency Ablation can also be used to destroy the any precancerous tissue. Cancer treatment for pre-cancerous changes that have progressed to cancer, on the other hand requires surgery.

In both situations, close monitoring post treatment is essential as the recurrence rates are significant especially in high grade pre-cancerous changes. 

Preventing pre-cancerous changes is essential to the approach of reducing anal cancer rates. HPV vaccination is shown to reduce pre-cancerous changes with a recent study showing 75% reduction in both Low and High grade changes in MSM population. There is also data suggesting that vaccination after precancerous changes have been detected is also able to reduce the rate of recurrence by approximately 20%.

In summary, anal cancer is disease in which majority of the tumors are driven by the HPV virus and in which pre-cancerous changes in the patients can accurately predict the chances of developing cancer especially in high risk populations. This makes screening and detection of early disease together with vaccination essential to reducing the rates of anal cancer.

Next read: PENILE CANCER – 7 THINGS YOU NEED TO KNOW!

Anal Douching – 7 Things You Need to Know!

Anal douching is the act of cleansing the anal canal and can be done in a variety of ways with a range of products. Many use anal douching to prepare for receptive anal intercourse, however, while it does help with cleaning the area, it is not strictly necessary for anal intercourse.

The anal canal is situated just beyond the rectum, its surface is lined by mucosa layer that amongst other functions, prevents the entry of infective agents such as bacteria into the underlying tissue. Another important structure of the anal canal are the anal sphincters, these muscles line both sides of the canal and maintain fecal continence (keeping your poop in).Tears in the mucosa layers can become infected very quickly, as these wounds further develop into abscesses, they ulcerate through the deeper layers of the anal canal and if the sphincters are damaged, can result in fecal incontinence. 

Overzealous cleansing – too hard or with harsh chemicals results in the mucosal lining of the anal canal to dry out. Dry tissue is “friable” meaning it breaks apart easily thus pre-disposing the anal canal to infection. Therefore, much like how scrubbing your hands with steel wool can give you blisters, anal douching is not entirely bad but must be done in a measured and safe way.

Is douching necessary for Anal intercourse?

No. Clearing your bowels before anal intercourse is useful in keeping your sheets clean and because most bowel movements are able to clear the rectum (the body’s poop storage pouch), gentle cleaning of the external anal canal will suffice in most cases. 


Are laxatives recommended when preparing for anal sex?

Not generally. Laxatives are designed to clear the entire colon which is approximately 1.5 m long. Generally, anal intercourse involves the anal canal (~4cm) and rectum (~15cm), which works out to approximately 20 cm of length or 10 inches (the law of averages would suggest that it enough space for most anal intercourse). A downside of using laxatives is that it can dehydrate you because it pulls water from your body into the colon to give “soften” the contents of the colon. 


Enemas for anal douching?

Enemas for emptying out the rectum and anal canal. It can be seen as a more focused means of cleaning out the area compared to Laxatives. There are however several concerns with enemas.

Firstly the solution used in the enemas can change the chemical balance in that area of your body. This can dry out the mucosa and predispose to damage. The tip of the enema should be soft and insert gently, this will prevent inadvertently tearing the mucosa with the tip of the enema. And lastly, do not share your enemas, studies have found that sharing enemas is a risk factor for the transmission of Sexually Transmitted Infections.


Is using water the best option to clean out your anus?

Yes. Water is generally pH neutral and is not as caustic to the mucosa as some of the chemicals in enemas. Again be careful when inserting anything into your anal canal!


Does over-douching cause you to poop?

Depending on how you do it but generally no. Douching itself is different from laxatives in that it only clears the poop in your anal canal and rectum. 


How long should anal cleansing take?

Anal cleansing should take about 5 – 10 minutes. Again, like washing your hands, overzealous washing can damage the tissue and make it friable. A good bowel moment and gentle washing if the area with water should suffice in getting the area clean.


Does anal douching increase the risk of HIV/ STDs?

Potentially. As mentioned, sharing enemas is a risk factor for contracting STDs even after washing the tip. Because most STDs infect by entering the body through a break in the mucosa, any damage to that layer either by overzealous washing changing the chemical balance of the tissue making friable or mechanical damage with a pointed enema tip create entry points for infective agents that cause STDs to enter the area. To further minimize the transmission of STDs during Anal Intercourse it is hence best to wear a condom.

Also Read Vaginal Douching


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Penile Cancer – 7 Things You Need to Know!

The mere mention of penile cancer conjures up much fear and uncertainty among public imagination, especially among grown men. It is not a common cancer in Singapore, hence it is not well known to the public. We shall explore more details in this article about this little known cancer.

What exactly is penile cancer?

Penile Cancer happens when the normal cells of the skin and tissue of the penis turns malignant and grows beyond control, forming a tumour. Penile cancer may eventually spread to other parts of the body including other glands, lymph nodes or organs.

Penile cancer is typically a disease of older men, with most patients around the age of 60 when diagnosed. In developed countries like the USA, Europe, Singapore, penile cancer is rare, accounting for less than 1% of all cancers diagnosed. This is in contrast to less developed countries like South America, Parts of Africa and Asia where penile cancer can account for 10 to 20% of all cancers diagnosed.


Signs and Symptoms of penile cancer

The majority of penile cancers arise from the head of the penis or from the foreskin. The most common findings on examination is a painless lump or an ulcer. The symptoms may include bleeding, rash or balanitis. 30 to 60 percent of patients also have swollen lymph nodes in the groin as well. 


What is the cause of penile cancer?

The majority of penile cancers are squamous cell carcinoma (SCC) and its many variants. Other cancers which can affect the penis include basal cell carcinoma (BCC), Kaposi Sarcoma (KS), melanomas and other lymphomas.


Who is at risk for penile cancer?

  • Patients with previous known medical condition of the penis. This would include warts, infections, previous injury, tears or strictures
  • Phimosis. Uncircumcised males sometimes have a thickening and scarring of the foreskin. This is a condition known as phimosis, which is a difficulty in retracting the foreskin over the head of the penis. 
  • Human Papillomavirus infection (HPV). HPV can be found in 30% to 50% of penile cancers.
  • Smoking and Tobacco Exposure
  • Human Immunodeficiency Virus (HIV) Infection
  • Patients with previous Ultraviolet treatment for psoriasis.

Who to prevent penile cancer?

  • Patients who have phimosis can consider getting a circumcision
  • Vaccination against HPV early can also be useful in preventing infection and possible penile/anal cancer. Screening for High Risk HPV through a swab can also be useful in patients who have risk factors.
  • Patients who are smokers should definitely stop smoking not only to prevent penile cancers but other forms of cancers as well.

What are the treatments for penile cancer?

Treatment of penile cancer depends on the type and staging of the cancer. If disease is limited, organ preserving treatment options include topical medications, lasers, radiation therapy or micrographic surgery. If the cancer is advanced and locally extensive, a partial or even full amputation of the penis might be required.


What are the complications of penile cancer?

After treatment, patients might be faced with complications depending on the kind of treatment. For organ preservation treatments, issues with cosmesis, erectile dysfunction and reduced sensation are common. For surgical treatments, for example a penile amputation, patients might require an external opening known as a urethrostomy for urination. Patients might also require a surgical reconstruction of the amputated organ for cosmetic issues.


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“Cheap” Viagra

From time to time, there has been reports on the news about people suffering ill effects after taking unlicensed, unverified health products which claim to boost the “virility” and “sexual prowess” of men.

In fact, these illegal products often contain different pharmaceutical compounds. In 2008, 10 people died after taking them for sexual enhancement. Diabetes medications were found in these tablets, resulting in people experiencing low blood sugar, dizziness and fainting, cold sweats and eventually loss of consciousness. 

Furthermore because the compounds of the drug are unknown, many have also experienced side effects such as loss of hearing, strokes and extremely painful erections. Not the outcome one would be looking for when wanting to boost their own libido. In fact if left untreated, these painful erections caused by the engorgement of blood can lead to Permanent Impotence.

Image taken from Immigration & Checkpoints Authority Facebook.


These illegal products are often bought from street peddlers, online pharmacies or even from other countries with no prior Health Sciences Authority (HSA) Singapore approval. That being said, here are the top 5 reasons why “Cheap” Viagra may end up costing you so much more than just the money you think you might be saving.

1. You can get severe side effects from unknown doses or what is in the drug

The tablet may contain any combination of medicines to boost erections, other medications that may have adverse side effects such as the diabetes medications i described above. Ultimately leading to organ damage and eventually  death.

The main way medications boost erections are by enlarging the blood vessels in the penis, allowing more blood to flow in. If these engorgement of blood is not regulated and the blood flow is not reversed after a while, it can lead to priapism (engorgement of blood in the penis), painful erections and ultimately impotency. 

Without medical supervision, the penis may eventually have not enough new oxygen from new blood, and after a few hours, critical damage to the penis can start to occur. This is dangerous and is a medical emergency.

2. You could be paying for a dud

Don’t be fooled by catchy packaging names such as King Power, Black Gorilla, Tiger King. Many times, for the sake of selling the tablet, the peddler has no idea what goes into it.

You would be lucky to have avoided an adverse health event, and in this case, have completely no effect at all after taking the tablet. In fact, the scary thing is you might end up taking an additional one or two to get a better effect and end up overdosing on the toxic components of the tablet as well. 

3. You have no idea how these drugs are made

Because there is HSA approval of these illegal drugs, there is no guarantee they are made under the proper conditions. This means you might think you are buying a new Ferrari, but after getting the keys, you realize that either there is no engine or that they have given you a Toyota engine instead. Worse still, they could have given you a spoilt ferrari engine, and after driving for 5mins, the engine explodes and you get caught in the explosion.

4. You may not be getting to the root of your problem

You might also think that these sexual enhancement medications may address your poor erections, but instead there are other root causes or even more effective and safer treatments available that need to be addressed. Testosterone Deficiency Syndrome | Andropause

ESWT For Erectile Dysfunction

This is a novel mode of treatment for Erectile Dysfunction which uses low-intensity shock waves directly to penile tissues to help stimulate the growth of new blood vessels. It has been shown to be safe, painless, and effective for the treatment of vasculogenic Erectile Dysfunction (caused by blood vessel problems such as in people with diabetes and high blood pressure).

If you think you may have Erectile Dysfunction, the first step is to speak to your doctor. There are many safe and effective treatments now available for Erectile Dysfunction, but recommended treatments may vary depending on the underlying cause, age and comorbid conditions such as heart disease.

5. You might think it is very difficult to see a doctor and get real HSA approved medications

With DTAP Teleconsult, we are one call away from addressing your erection concerns in full privacy, medical supervision and support with 3 breezy steps. Furthermore, you do not even need to leave the comforts of your own home to receive the medications you require with DTAP Delivery. All within the same span of the day. This convenience and assurance should be no excuse for you to put your health and life at risk by taking “Cheap” Viagra.

With 15 years of caring, our doctors at DTAP clinic will support you through your men’s health journey professionally, discreetly, and effectively.