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7 Things You Need To Know About Anal Cancer In Men

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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!

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“Cheap” Viagra

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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.

 
 
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What happens if you tear or injure your Frenulum?

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The frenulum is the piece of skin that attaches the foreskin to the head of the penis (glans penis). In some men, this part may be short or tight. During intercourse it may be at higher risk of getting torn. 

I feel pain and there is bleeding, did I injure or tear my frenulum?

One of the most common symptoms of a torn frenulum is pain with or without bleeding. It may appear very shocking or scary as blood may be dripping or it may cause a very messy situation in the bedroom.

Common causes for Frenulum injuries/ tear

These tears or injuries are basically caused by a sudden or strong pulling back the foreskin. This causes a strong tension in the frenulum causing it to tear or get injured. This usually occur during intercourse or aggressive masturbation.

How long does it take for it to heal?

Generally if left alone, it takes around 1-2 weeks for it to heal completely. Rate of healing varies between men. If there is any bleeding, it usually stops on its own. If still bleeding, one may need to apply pressure for a few minutes to stop the bleeding.

Treatment options

Conservative: It can heal on its own but will take some time. Even if healed, it will develop a scar and this causes thickening of the frenulum. When thickened, it will become even tighter and hence higher risk of it tearing again. Most of my patients who came to see me report the tears happening several times.

Medical treatment: There is no medical treatment for a torn frenulum. Antibiotic cream may be applied to prevent infection.Surgical: In some cases, pain or bleeding may not stop on its own. In certain instances it may repair with sutures by a medical doctor. This depends on the severity and anatomy of the injury.

How do I avoid getting a Frenulum injury/ tear?

Men with short frenulum or frenulum breve are at higher risk of renulum tears. So the key here to lengthen the frenulum

Conservative: Can try regular stretching of the foreskin and frenulum but this is usually not very useful or successful.

Frenulectomy: This is a simple procedure where the frenulum is cut to release the tension and lengthen the space between the foreskin and the head. The remaining tissue is then stitched together to avoid bleeding and promote faster healing. After this procedure is done, the foreskin can easily move back and forth without risk of tearing the frenulum.

Circumcision: For some men, a frenulectomy procedure may not be enough. They may also have tight foreskin (phimosis) on top of a tight frenulum. This procedure will be able to solve both problems of phimosis and tight frenulum. Circumcision in adults is a simple procedure and can be done at any age. There is no age limit to this procedure.

 

So if you experience any torn frenulum or pain and or bleeding at the frenulum, do consult your doctor. He will have to first do an assessment and physical examination so that he can advice which more of treatment is best for you.

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How To Apply Testosterone Gel (Androgel)?

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https://youtu.be/Q-nn9x4RJ5s

What is Testosterone Gel (Androgel)?

This medicine contains testosterone, a male hormone produced naturally in the body. This medicine is used in adult men for testosterone replacement to treat various health problems caused by a lack of testosterone such as male hypogonadism. 

What do you need to know before you use Androgel?

Do not use this medication if:

 If you are allergic to testosterone or any of the ingredients of this medicine (listed in section 6),

– If you are suffering from prostate cancer,

– If you are suffering from breast cancer.

How to apply?

The recommended dose is 5g of gel (i.e.50 mg of testosterone) applied once daily at approximately the same time, preferably in the morning.

The daily dose may be adjusted by your doctor, on an individual patient basis, not exceeding 10 g of gel per day.

The gel must be gently spread onto clean, dry, healthy skin as a thin layer on the shoulders, arms or stomach.

After opening the sachet, the entire contents should be taken out of the sachet and applied immediately onto the skin.

Allow the gel to dry for at least 3-5 minutes before dressing.

Wash your hands with soap and water after applying.

Do not apply to the genital areas (penis and testes) as the high alcohol content may cause local irritation.

Possible transfer of testosterone

During close and relatively long periods of skin contact testosterone may be transferred to another person unless you cover the treated area and could result in the other person showing signs of increased testosterone such as more hair on the face and body and a deepened voice.

It may cause changes in the menstrual cycle of women. Wearing clothes covering the application area or washing the application area before contact protects against such transfer.

The following precautions are recommended:

For the patient:

– wash your hands with soap and water after applying the gel,

– cover the application area with clothing once the gel has dried,

– wash the application area before making close contact with another person.

If you believe testosterone has been transferred to another person (man, woman or child), this person should:

– wash the affected area of skin immediately with soap and water,

– report any signs such as acne or changes in the growth or pattern of hair on your body or face to your doctor. You should preferably wait at least 1 hour before showering or bathing after applying this medicine.

How to store Androgel

This medicinal product does not require any special storage conditions. Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the box.

 
 
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Avanafil For Erectile Dysfunction

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Phosphodiesterase 5 Inhibitors (PDE5i) are a class of medications used to treat Erectile Dysfunction. They are the first line of therapy in men who are present with symptoms of having poor quality of erections. As mentioned in our previous articles, a healthy erection is one of the cornerstones of male reproductive health. – Men’s Health Clinic Singapore

Not all PDE5i are made the same, understanding how each one works will allow better discussion with your attending physician when deciding which medication will work best for your situation. In general, inhibition of PDE enzymes in the body results in the dilatation of blood vessels throughout the body. Consequently, medications such as PDE5i that enhance erections can lead to unwanted side effects of headaches and back pain. Medical research therefore has been focused on creating ED medications that are more focused on inhibition PDE5 only in order to enhance erections with minimal side effects.

Avanafil is an example of a highly specific PDE5i and has the potential benefits of providing good quality erections with minimal side effects. Studies done on the molecular binding of Avanafil have shown that it is 110-fold more selective to PDE5 than other PDE5 inhibitors. The additional benefit of Avanafil is the faster absorption of the medication compared to the other PDE5i. A faster absorption translates to faster onset of the medication, therefore with an absorption of 30 to 45 min makes it the fastest acting PDE5i at the moment. One of the largest clinical studies for the medication involving 600 patients showed a significant improvement in erection quality at 100mg and 200mg doses.

Although more specific than other PDE5i, Avanafil does still result in the common side effects of the medication class albeit to a lesser extent. These side effects include headache, flushing and nasal congestion. Absorption of Avanafil is affected by fatty food with a 20% decrease in absorption which translates to a 1 hour delay in onset. 

Avanafil is a good addition to the PDE5i class of medications that help men suffering from ED. Avanafil is only available with a Doctor’s prescription. Discussing your concerns with your attending physician can help you create a treatment plan to include Avanafil or the other PDE5i medications can help you achieve better quality erections and enhance your reproductive health.

Speak to our doctor today to find out if Avanafil is suitable for you.

Avanafil is available at our clinics.

References:

  1. Mehrotra N, Gupta M, Kovar A, Meibohm B. The role of pharmacokinetics and pharmacodynamics in phosphodiesterase-5 inhibitor therapy. Int J Impot Res. 2007;19:253-264
  2. Goldstein I, McCullough AR, Jones LA et al. A randomized, double-blind, placebo-controlled evaluation of the safety and efficacy of avanafil in subjects with erectile dysfunction. J Sex Med. 2012;9:1122-1133

Sclerosing Lymphangitis

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Sclerosing lymphangitis is a skin condition that manifests as a firm cord-like structure encircling the coronal sulcus, which is the circumference of the base of the penile head.

Sclerosing lymphangitis is observed usually in the second or third decade, although cases as young as 18, and as old as 66 years of age have been reported. The condition is thought to be fairly common, but significantly under-reported because it is usually asymptomatic and resolves spontaneously, therefore most patients do not visit a doctor.

Various other terms have been used for this condition, including non-venereal sclerosing lymphangitis of the penis, circular indurated lymphangitis of the penis, lymphangiosclerosis and sclerotic lymphangitis.

Causes

Sclerosing lymphangitis is thought to occur from prolonged or frequent vigorous sexual intercourse or masturbation. The resulting microtrauma leads to obstruction of a large lymphatic vessel. 

Signs and symptoms

Sclerosing lymphangitis presents as a skin coloured, serpiginous cord-like thickening encircling the coronal sulcus of the penis. It can feel like a hardened, almost calcified vein. There are no signs of inflammation, and the lesion is painless. It usually develops within a few days to a week after the sexual activity. 

Treatment

Sclerosing lymphangitis can cause anxiety and embarrassment due to its genital location, alarming appearance and association with sex. However, it is self-limiting and does not require treatment aside from reassurance and advice to restrain from vigorous sexual activity until the condition subsides. In most cases it resolves spontaneously after 2 to 3 weeks, but can last up to 6 weeks or longer. Investigations such as ultrasound scan or biopsy are not necessary. In recurring cases, surgery can be performed to excise the affected vessel.

Although the condition is by definition not associated with sexually transmitted infections (STIs), patients are advised to consider basic STI screening.

Next read: COMMON CAUSES OF BUMPS & WHITE SPOTS ON PENIS & FORESKIN

 
 
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Circumcision Reduces Bacteria And Risk Of STDs

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What is Circumcision?

Circumcision is a procedure where the excess foreskin is removed. This ritual has been performed on boys for thousands of years. It is currently practised by many faiths and culture. In the states, it is usually done within the first few days of life. Among Muslims and Jews, it is highly encouraged for boys to be circumcised. In fact, it is highly encouraged because it promotes better hygiene among other benefits. 

Male circumcision reduces the abundance of bacteria living on the penis and might help explain why circumcision offers men some protection against HIV, according to a study led by the Translational Genomics Research Institute (TGen).

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Are circumcised men less likely to contract HIV?

One of the most interesting benefits of circumcision is the finding that circumcised men are less likely to contract HIV, the virus that causes AIDS. In 2005, a study of South African men found that circumcised men who had sex with an HIV-positive woman were 63 percent less likely than uncircumcised men to contract the virus. Other than HIV, Circumcision has also been shown to reduce the risk of contracting HPV, or human papillomavirus. 

HPV is a virus that can cause cervical cancer in women. Another sexually transmitted virus is the herpes simplex virus type 2, better known as genital herpes. The risk of transmission of genital herpes is also reduced in men who were circumcised.

Bacteria and Sexually Transmitted Diseases (STDs)

Other than viruses, bacteria also are responsible for some of the common Sexually Transmitted Diseases (STDs). Circumcision has been proven to reduce incidence of Chlamydia Trachomatis infection. Interestingly, circumcision doesn’t just protect the men, but also protects the women as well.

In a study published in 2005 in American Journal of Epidemiology, there’s an 82% reduction of Chlamydia infection among women whose partners were circumcised as compared to women whose partners were uncircumcised.

A study of women in Kenya and Uganda enrolled in an RCT and followed up for 3 years found circumcision of their male partners was associated with a 59% reduction in incident syphilis among the women. A prospective study in Kenya by the same authors found that those with circumcised male partners had a 58% lower risk of incident Trachomatis vaginalis than did women with uncircumcised partners.

One of the main possible reasons behind lower risk of infection is the recent finding where there is a significant shift in the bacterial flora of the penis after circumcision. This was according to a study published by the online journal mBio. This international collaboration focused on 156 men in Rakai, Uganda — part of the world’s largest randomized-controlled trial on male circumcision.

Researchers showed that men who were circumcised as part of the study had 33.3 percent less bacteria on their penis than those who remained uncircumcised one year after the study began. Researchers further showed that the decrease was primarily found in 12 types of bacteria, most of which were intolerant to oxygen.

At the same time, understanding the mechanisms that underlie the benefits of male circumcision could help to identify new intervention strategies for decreasing HIV transmission, especially for populations with high HIV prevalence and in places where male circumcision is culturally less acceptable, the study says.

“We know that male circumcision can prevent HIV and other diseases in heterosexual men, but it is important to know why,” said Dr. Lance Price, the Director of TGen Center for Microbiomics and Human Health and the study’s senior author.

“We think that these dramatic changes in the penis microbiome may explain, at least in part, why male circumcision is protective, ” said Dr. Price, who is also a Professor of Environmental and Occupational Health in the School of Public Health and Health Services at the George Washington University.

HIV

In heterosexual transmission of HIV, the virus on the foreskin needs to reach its target cells, the CD4+ T-cells, which reside primarily in blood or the lymph nodes.

Researchers hypothesize that penis bacteria may facilitate this process in two ways: by both recruiting more HIV target cells to the foreskin and by triggering another set of immune cells, the Langerhans cells, to deliver the virus to susceptible T-cells. Without this trigger, the Langerhans cells will simply destroy the virus.

“Our findings are interesting from two perspectives. From a public health standpoint, we were finally able to detail the bacterial changes associated with male circumcision,” said Dr. Cindy Liu, Adjunct Professor at the Pathogen Genomics Division at TGen, and the study’s lead author.

“From an ecological perspective, our study shows how phenomena from the macro-world actually scale to the micro level. When you change a macro environment, such as clear cutting a forest, you affect the animals that live there. That’s intuitive. Here we show that changing the penis environment affects the microbes that live there as well.” said Dr. Liu, who also is a member of the Department of Pathology at the Johns Hopkins School of Medicine.

Currently circumcision among adults is carried out in Africa as a part of the campaign to fight HIV and AIDs. With increasing evidence of health benefits from circumcision, I am seeing more men coming forward to get circumcised voluntarily. These are men who have no medical problems that warrant a circumcision. They simply want to have better hygiene and reduce their risk of infection.

Also read: What Are The Top 7 Reason Men Undergo Circumcision?

At Dr Tan & Partners, we use the Shang Ring Method of circumcision. With this method, there is no need for injections and the procedure is very quick, simple and painless. Only numbing cream is used and after 30 minutes of application, the procedure can commence. The procedure itself takes only 10-15 minutes. Our patients are usually surprised at how painless and quick the procedure is. Most importantly they like how the results look at the end of the day.

Also read: How Does Sutureless Circumcision​ Technique (Shang Ring) Work

Next read: How Is The Adult Circumcision (Foreskin Removal) Procedure Done?

Speak to your doctor if you have any questions regarding circumcision.

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How Do You Inject Caverject?

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Caverject

Caverject is a medication that is used for Erectile Dysfunction (ED).

Also read: TOP 7 MYTHS AND FACTS ABOUT ERECTILE DYSFUNCTION

What’s in Caverject?

The main ingredient is Alprostadil. This medication increases blood flow into the penis and dilates the blood vessels. By so doing, it will improve erection in the penis.

Unboxing Caverject

What is included in a box of Caverject?

  • One bottle of powder – the medication
  • Two needles, one big and one small
  • A paper manual to refer to
  • A syringe that contains the diluent which will be used to dilute the medication powder
  • 2 packets of alcohol swabs
https://youtu.be/hwvV72MMHeE

Dr Taufiq, Resident Doctor, DTAP Clinic, will be sharing on how to properly administer Caverject.

How do you inject Caverject?

Step 1: Open the vial of the powder and use an alcohol swab to clean the top of the vial.

Step 2: Break open the seal for the syringe with diluent

Step 3: Open the packaging for the large needle and attach the large needle to the syringe. Make sure it’s sealed tightly together. Pull off the cap of the needle and be careful, the needle is very sharp, do not accidentally poke yourself.

Step 4: Inject the needle into the vial and fill the vial with the diluent.

Step 5: Remove the needle and slightly shake the bottle, mixing the solution with the powder.

Step 6: Once the diluent and powder in the vial is mixed, draw out the liquid and put back the cap of the large needle in order to remove it. When putting on the cap, make sure you hear a cap sound before proceeding to turn it anticlockwise to remove it.

Step 7: Remove the smaller needle from the packaging and attach the syringe turning it clockwise until it fits. You will need to remove the excess air inside the diluent.

To do so, remove the cap of the needle, make sure the liquid goes up to the top and the air goes all the way up. Put back the cap and check with your doctor for the right dose. Inject the right dose by looking at the measuring lines at the side of the syringe.

Step 8: Preparing for the injection.

The area of injection is the top and side of the penis. Do not inject directly into the top but slightly to the right into the muscle of the penis. Clean area of injection with an alcohol swab and inject at a 45 degree angle towards the cleaned area. Go in directly and inject and once it is complete, remove it.

Step 9: After the injection you are advised to press on the injection wound and massage the medication upwards to distribute the medication into the penis muscle.

[Always dispose of sharps into a sharps box or in a container or plastic bottle.]

Potential risks or side effects?

Potential risks or side effects from using Caverject includes bleeding and pain in the penis. The risk of pain can be alleviated by pressing onto wound. If you are allergic you are advised not to use it, do speak to your doctor before using this medication.

When should I use Caverject?

Caverject is to be used 15 minutes before sexual intercourse.

Watch next: CAUSES OF ERECTILE DYSFUNCTION & TREATMENT OPTIONS (VIDEO)

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Weak Erection & Erectile Dysfunction? – Improve Erection without pills

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One of the main reasons why men have weaker erections is due to poor blood flow into the penis. Blood flow may diminish due to chronic diseases like diabetes and hypertension. Other contributing factors include smoking, stress or the effects of ageing. With poorer blood flow, the erections becoming weaker and may not be able to sustain as long as before.

Typically, men will be popping pills or medications that help to increase blood flow to the penis like Sildenafil or Tadalafil. However, these medications do have their side effects and it can be a bit troublesome to have to rely on them for results.
With Extracorporeal Shock Wave Therapy (ESWT), it gives men hope for better erections without having to rely on pills.

How Does Extracorporeal Shock Wave Therapy (ESWT) work?

ESWT involves the use of painless, low-energy shockwaves to improve tissue and blood vessels in the body.
The handheld device is applied to the penile muscles and gentle shockwaves are sent to the treatment area.
Delivery of these shockwaves causes new blood vessels to form and thus improving blood flow and circulation to the penis. This, in turn, will improve erection in terms of strength, hardness, and also sustainability.
For men who do not have erectile issues, they may benefit from a single session as well. This is called Penile Rejuvenation.

FAQs:

Is it safe?

Yes ESWT is safe, painless, no downtime and no recovery needed.

How many sessions do I need?

If you have erectile dysfunction, you will need 6 sessions. If you just need a booster or enhancement, you only need a single session.

How much does each session cost?

Each session costs $400.

Are there any criteria for this treatment to be effective?

There are no specific requirements for this treatment. As long as you want a better and stronger erection, you will benefit from ESWT.
Do speak to your doctor to find out if ESWT is suitable for you.

ESWT is available at our dedicated DTAP Men’s Health clinics, please call us or email us at hello@dtapclinic.com.sg for an appointment.

Take Care!

Also, Read:

  1. Things to do to maintain your penis health
  2. Weak Erection: Does Penis Size Matters?
  3. 8 Things You Didn’t Know About Your Penis
  4. 10 Ways to Improve Sexual Performance for Men
  5. An Overview of STD by an STD Doctor
  6. Sexual Health Advice for Travellers
  7. Penile Rejuvenation
  8. Electroshock Wave (ESWT) Treatment for Erectile Dysfunction in Singapore
  9. What you need to Know about Erectile Dysfunction 
  10. What You Need to Know about Premature Ejaculation Treatment
  11. What you need to know about Testosterone Deficiency Syndrome
  12. What is HIV / AIDS Signs and Symptoms
  13. Paraphimosis – My Foreskin is Stuck

 

Is Premature Ejaculation a Problem?

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Too Fast? Too Slow?

Premature ejaculation or PE occurs when a man reaches orgasm and ejaculates with minimal stimulation or within a very short period of time.
There is no uniform cut-off timing for what constitutes as PE, and in the past, most experts would agree that last less than one minute is a cause for concern.
However, newer guidelines suggest that any man who feels they do not have control over when he ejaculates and that it causes distress to him and his partner can be considered to have premature ejaculation.

Is Premature Ejaculation a Problem?

Of course, Premature Ejaculation is a real problem if:

  • It is causing or arising from inter-personal relationship problems.
  • It is causing or arising from psychological issues like anxiety and depression.
  • It is a sign of hidden erectile dysfunction (ED).
  • It is due to a low serum Testosterone level.
  • It is a sign of an underlying medical disease.
  • It is due to stopping a drug.
  • It is severe enough to affect fertility.

Sometimes premature ejaculation may be caused or worsened by other conditions, such as anxiety and depression, erectile dysfunction, prostatitis and testosterone deficiency.
These conditions will be assessed with a clinical history and may need further investigation if appropriate.

Is there any treatment for Premature Ejaculation?

There are several options for treatment of premature ejaculation, although a combination of certain medication and non-pharmacological treatments often give the best results.

If you think that you or your partner may be suffering from premature ejaculation, please visit our DTAP Clinics for a thorough evaluation and discussion on Premature Ejaculation Treatment options.

Take Care!

Related Read:

  1. STD Risk for Receptive Unprotected Anal Sex in Men
  2. 10 Ways to Improve Sexual Performance for Men
  3. Weak Erection? Erectile Dysfunction? Improv Erection with Pills
  4. Weak Erection: Does Penis Size Matters?
  5. Pearly Penile Papules (Bumps On Penis)
  6. Phimosis – Unusually Tight Foreskin 
  7. An Overview of STD – From an STD Doctor
  8. What are the Signs & Symptoms of HIV and AIDS?
  9. What Causes Men’s Pattern hair loss (Androgenic Alopecia)
  10. Pills That Prevent HIV – HIV PrEP & HIV PEP
  11. What are the Causes of Foreskin Infection?