Information on Erectile Dysfunction
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Causes of Erectile Dysfunction (Impotency)
In a normal erection, blood flows into two special chambers of the penis, and blood is prevented from flowing out. The chambers, therefore become distended and firm, and thus, an erection. Inability to achieve erection occurs when either not enough blood enters the chambers or blood leaks out of the chambers. In either case, there is not enough distension of the chambers and, therefore, no erection is possible.
Inadequate inflow of blood can be the result of general poor health, medical conditions that result in poor circulations such as diabetes, hardening and narrowing of the lumens of blood vessels and many others. Neurological conditions such as multiple sclerosis and Parkinson’s disease and loss of sensation to the genital areas due to trauma result in lack of arousal and therefore no stimulation to increase blood flow.
Lifestyle involving drug use, smoking, high alcoholic intake, lack of sleep are all detrimental and can contribute to erectile dysfunction.
At the offices of Victor Liu MD, we are a one-stop center with a comprehensive approach to the management of erectile dysfunction ranging from enhancement of “normal” sexual function, with or without medications, to those who has no erection even with any available non-surgical means. They can only be helped by surgery (penile implant).
The objective of non-surgical treatments is to increase the blood flow into and to decrease the blood flow out of the erection chambers of the penis.
How do we know whether the ED is due to inadequate inflow of blood or due to leaking of blood or both? Dr. Liu uses a very specialized study, offered by very few doctors, called ultrasound duplex of the penis. This test will tell the adequacy of the blood inflow and whether there is venous leak. The test is done by Dr. Liu himself. See picture of ultrasound duplex.
Dr. Liu's Routine for Erectile Dysfunction Treatments
Dr. Liu and his staff are very conscious of the sensitivity of this matter. The privacy of the patient is fully respected. Any communication regarding this must only be with the patient and no one else. There is no exception to this rule.
To treat the fundamental causes of erectile dysfunction
When first seen, a thorough history, physical examination and blood tests are done. These findings will be fed into an artificial intelligence software (Sottopelle) which will in turn print out what hormonal replacement the patient needs. In men, many of them are low in male hormone (testosterone). The hormones are given as pellets.
The program suggests what hormones need to be given and by how much of each.
2. Priapus ManWave Treatment
A proprietary treatment combining Extra-corporal Low-Intensity Shock Wave (ECLISW) and an enhanced PriapusShot.
ECLISW is a treatment utilizing low-intensity shock waves that goes through the skin deep into the chambers of erection (corpus carvernosa) of the penis, to dislodge plaques, thereby unblocking the blood vessels. They also stimulate new blood vessel formation. The total effect is to increase the circulation in the penis. The treatment is completely painless without the need of any type of anesthesia and has no down-time. The machine used is made in Germany by Zimmer. This type of treatment has been done in Europe for many years, reporting success in over 75% of the patients. There have not been report of any type of complication.
PriapusShot is invented by Dr. Charles Runels. It uses the patient's own platelet-rich plasma (PRP) which contains high concetration of growth and regenerating factors, which when introduced into the penis, helps to increase new blood vessels formation, and help to repair any defects present. Dr. Liu enhanced this treatment with high concentration of PRP and occasionally re-enforce it with amnion (obtained from human placenta, sterilized of all possible contaminants, and ready for injection) The advantage of using amnion is that it is obtained from the placenta, which contains "young and potent" growth factors and regenerative factors.
Dr. Liu uses special settings, number of treatments, dosage of PRP and other regenerative cells including stem cells. It has been reported that with either ECLISW or PriapusShot alone
more than 75% of the patients will have improvement of their ED.
Dr. Liu likes this treatment because it aims at the root of the problem and that is to improve the blood circulation into the penis.
THE SEVERITY OF THE ERECTILE DYSFUNCTION AND THE PROGRESS OF TREATMENT CAN BE APPRAISED BY DETERMINING THE ARTERIAL BLOOD FLOW INTO AND THE VENOUS FLOW OF BLOOD OUT OF THE ERECTION CHAMBERS (CORPUS CAVERNOSAE) OF THE PENIS USING THE ULTRASOUND DUPLEX.
ABOUT 20-30% OF PATIENTS WITH ED WILL NEED SURGERY.
3. Surgery for Erectile Dysfunction.
Penile implant is one of the most successful surgery. It has over 90% patient satisfaction rate and is a life-changing experience for many. See Video of interview
It enables the patient to have sex on demand, the erection can last as long as desired, the patient has normal sensation, and can maintain ability to have orgasm and impregnating his partner. See Video of demo.
This type of implant has been used for over 20 years and has been improved significantly over this period of time. The latest ones consist of 2 cylindrical rods one on each side in the penis. It has a small reservoir put behind the pubic bone and a small pump inside the scrotum.
Every part is inside underneath the skin and is completely invisible. When the patient wishes to have an erection, he simply squeezes on the pump inside the scrotum to fill the shafts. When finished with sex, he presses on a small knob in the scrotum and the cylinders will deflate and the penis softens.
For those patients who have severe arthritis and cannot use their hands to pump, they can have a non-inflatable, malleable implant.
Complication rate is low, generally reported to be about 3%. These include infection, implant malfunction and extrusion.
Other surgeries for treatment of ED include (a). arterial bypass: brings in adjacent blood vessels to improve circulation. The success rate is low because of build-up of blocks in the smaller blood vessels beyond the new arterial supplies; and (b). remove or tie up some of the veins leaving the penis to decrease the blood flow out of the penis. This works for a short period of time and fails because new veins will open up and blood outflow will increase again. These two are not good options.
IF INTERESTED, DR. LIU WILL BE HAPPY GIVE YOU A FREE CONSULTATION TO DISCUSS IN PRIVATE THE PROS AND CONS OF PENILE IMPLANTS.
Options that Treat the Symptoms (To Get an Erection but Not Treating the Disease)
Penile suction pump
forms a vacuum and causes blood to flow into the penis. The blood is then prevented from flowing out by means of a constricting band at the base of the penis, thus resulting in an erection.
The vacuum pump by itself works well as an accessory in conjunction with the Priapus ManWave and other treatments, but not well accepted by the patient as a primary treatment.
20-30 minutes before sex, direct injection into the shaft of the penis or intra-urethra placement of circulatory dilating drugs (such as tri-mix) which increase the blood flow into the penis, resulting in an erection.
This works for a while but is not well tolerated by the patients and most of them discontinue after a few months.
They also do not treat the basic circulatory problem.
such as viagra and cialis have different modes of action, are popular and work well as a temporary aid but do not treat the basic problem of ED.
About Doctor Victor Liu
Dr. Liu is a board-certified plastic surgeon with more than 25 years experience. He is also board-certified in general surgery, and is certified in regenerative medicine as well. He is a Fellow of the American College of Surgery (F.A.C.S.) and a Fellow of the Royal College of Surgeons of Canada --F.R.C.S. (C) He has specialized in cosmetic surgery for more than 25 years and believes that in order for the patient to look well, being healthy is most important. One important aspect of good health is to have adequate and well-balanced hormones in the body. He uses the Sottopelle system to acheive this in his patients.
He also has a special interest and training in the field of sexual enhancement for both men and women.
For women, he uses the O-Shot, ALMI Shot and RF treatment for vaginal rejuvenation, tightening and relief of stress urinary incontinence; and vaginoplasty surgery for tightening as well as correction of damages resulting from childbirth and changes after menopause. As a plastic surgeon, he specializes in improving the appearance of the genital area doing labiaplasty and other procedures to acheive his results.
For men, he gives the Priapus Shot, extra-corporal shock wave and other treatments for erectile dysfunction. When indicated, he puts in penile implants.
I had prostate cancer at 65...and cannot achieve erection after a prostatectomy...I had the penile implant done...my recovery had some soreness, nothing serious...I was back in the gym after 7 weeks...when you were impotent, you have a gradual withdrawal from your wife. When I kissed her, then what happens? Nothing when you have ED...you feel guilty...now you have your life back after your implant...
I would trust Dr.Liu with all of my cosmetic needs. Dr.Liu is a true artist able to achieve exactly what you desire&able to make you look beautiful &NATURAL. His artistic sense and level of knowledge were very impressive. He was very honest and upfront with the pros and cons of each type of procedure. I highly recommend Dr Liu.
To All People looking for a good plastic surgeon, you can stop looking any further. Victor Liu has 25+ years of experience and is so good at what he does that it will never look like you had work done. You will look natural, well rested and a much younger version of yourself. Once the word gets out about how talented this man is, he will put all SF, Burlingame, Redwood City, and Mountain...
Dr. Liu is very nice and professional. The first time consultation I got all the information I need. I feel very comfortable to put myself in his hand. It had been 4 months after the surgery. Everything goes very well. I am very happy about the turnout! Defenitely will recommend him to anyone I know...
I wish I could see him much earlier. He is so sophisticated, efficient. My forehead had a big dent and scar which have bothered me for years. I went to see him April 19th, 2017, it only took Dr. Liu a few seconds to look and touch the area before he told me with a great confidence that he can do it with a very reasonable price. I had a small procedure 3 hours later, Now even though the stitches have not been removed, I touch the area with my hand and look into the mirror, both the scar and the dent is gone. The front desk lady was also very helpful and friendly, English might be her native language, the big plus is that she is also very fluent in both Cantonese and Mandarin. The nurse was very gentle and nice. Overall I had a very pleasant experience. Thank you so much, Dr. Liu!1 person voted for this review
Anthony R. :
Dr. Lui is amazing at what he does. You can barely see I have a scar after the removals. And compared to anyone else in the area, he is the best.
I have known Dr. Liu for many years and had multiple surgeries performed by him. I would not trust any other plastic surgeon to work on my face or body. His office staff is friendly, courteous and very professional and provide a caring enviorment for all of my visits. I highly recommend this skilled surgeon
A couple of years ago, I had an automobile accident and had severe neurological problems and ED. I sought out viagra and cialis...didn't work...use MUSE, didn't work...then I had a penile implant...I am a 100% glad I had the implant done and would do it again...