Headache-Pill Aspirin Could Be A New Way To Tackle Impotence

Headache-pill aspirin could be a new way to tackle impotence, as almost eight out of ten men were helped by the drug after six weeks of daily therapy of low dose aspirin, according to new research.

The number of men who were able to physically have satisfactory intercourse with their partners more than doubled.

Low dose aspirin, already used to help prevent heart attacks and strokes in people at high risk, by preventing clots and reducing inflammation.

It is thought to work in impotence or erectile dysfunction, by thinning the blood and increasing blood flow to the penis. It may also work by increasing levels of nitric oxide, a gas which widens blood vessels. Viagra also works by increasing levels of the gas.

It’s estimated that erectile dysfunction (ED), which is the inability to have an erection that is satisfactory for sexual intercourse, affects around half of men aged 40 and over to some degree. Although stress and other psychological and social factors can be involved, the main physical cause is vascular problems where not enough blood gets to the penis.

Narrowing of blood vessels as a result of advancing age or associated with heart disease, diabetes, and other conditions, is the main cause. Vascular problems have been estimated to be involved in 90 per cent of cases of ED.

Drugs like Viagra, which works by getting the penile arteries to dilate so that more blood can flow in, can have side effects – headache, back pain and visual disturbance. They also don’t work for all men, and are unsuitable for men with angina. They have to be taken well in advance of sexual intercourse to allow the effective drug concentrations to be reached, which can have an effect on spontaneity.

In the new research, reported in the journal International Urology and Nephrology, doctors looked at the effects of low dose aspirin – 100mg – compare to placebo on men with ED. Aspirin has a number of uses, from relieving pain at high doses (around 300mg) to reducing the risk of serious problems such as heart attacks and strokes at lower dosages.

Nearly 200 men aged 18 to 76 were give aspirin or placebo and treated for six weeks, and ED symptoms and assessments, including sexual intercourse reports and frequency, taken before and after therapy, were compared.

Results show that the number of men who were able to have an erection long enough for successful intercourse increased from 31 per cent to 78 per cent in those taking aspirin..

The number of men with moderate forms of impotence who were able to have a erection hard enough for penetration went up to 96.4 per cent. Almost a third of men with the most severe form of ED were able to have satisfactory sex, nearly double number before treatment started.

But in the men taking the dummy drug there was little change, with only around 40 per cent having satisfactory sex before and after.

“When compared with the placebo group, aspirin-treated subjects showed a significant improvement in all effectiveness measures,” say the researchers from Istanbul Medipol University,

“This is the first clinical study investigating the effect of aspirin in erectile dysfunction,” say the researchers.

Exactly how aspirin could have such an effect is unclear, but one theory is that it makes the blood thinner and less sticky so that more blood can get into the penis. It also helps to stop the blood’s clotting cells, called platelets, from sticking together,

Professor Raj Persad, consultant urologist with Bristol Urology Associates said,

“If these results are confirmed in larger trials, aspirin could be a very effective and inexpensive treatment for erectile dysfunction. We should always be mindful of the fact that in some patients and the elderly, even one aspirin can cause severe gastrointestinal upset and or bleeding.”

Journal Of Sexual Medicine Research Into Topical Glyceryl Trinitrate In The Treatment Of Erectile Dysfunction

Background: Current treatment for erectile dysfunction have some limitations

Aim: This study evaluated the efficacy and tolerability of MED2005 a 0.2% glyceryl trinitrate topical gel, formulated into an enhanced absorbtion topical delivery system (DermaSys) administered on demand, in the treatment of ED.

Read the full article in The Journal Of Sexual Medicine

Visit our South West Andrology erection problems services page to find out how we can help.

New State-Of-The-Art Prostate Diagnostic Service

A new state-of-the-art prostate diagnostic service involving multi-parametric MRI scans is now available at Bristol Urology Associates and South West Andrology.

Men with suspected prostate cancer could benefit from less invasive testing

Following a recent Internationally reputed study it has been revealed that men with suspected prostate cancer could benefit from less invasive testing. The PROMIS (Prostate MRI Imaging Study) found that up to a quarter of men could avoid undergoing an invasive biopsy if they had an MRI scan first. There are no signs and symptoms in early prostate cancer and currently there is no test to diagnose it.

A multi-parametric MRI (MpMRI) scan is able to create an incredibly detailed picture of the prostate and the tissue that surrounds it. This scan also helps to provide useful information about the size and location of any suspected tumours to enable more accurate targeting, doubling the detection rates of any aggressive cancers, if present.

Professor Raj Persad, Consultant Urologist at North Bristol Director of Bristol Urology Associates, said that,

“these findings mean that a group of patients will be able to have one simple, painless scan and avoid need for a biopsy while in others we will be able to better target biopsies in those who still require the procedure to diagnose prostate cancer.’ This is a major advance that goes hand in hand with all the other technologies we are developing to make cancer diagnosis and treatment more precise.”

Prof Persad continued,

“patients who may be suitable for an mpMRI scan usually have an elevated PSA or another cause for worry such as a strong family history of prostate cancer. They need to be referred to a Consultant Urologist, who specialises in fdetermining who needs an mpMRI and who doesn’t, as there is further clinical information needed before planning a scan”.

The MRI scanner we use in Bristol is a powerful and accurate one and appointments are available with no waiting list and rapid turnaround of scan results. These results will be interpreted by Prof Persad and his colleagues to determine the necessity of biopsies of the prostate and any follow-on treatment that may be necessary. Using this scanning technique we will be able to reduce the number of unnecessary prostate biopsies by up to 30%.

If the MRI shows an abnormality in the prostate this can be accurately targeted with safe and sophisticated transperineal (through the skin of the perineum) biopsies which produce less pain and less risk of sepsis and sexual dysfunction than traditional transrectal biopsies.

The traditional pathway was ‘blind’ biopsy of the prostate using transrectally guided prostate biopsy needles

Until the recent PROMIS trial in which Professor Persad was one of the main investigators, the standard pathway was ‘blind’ biopsy of the prostate using transrectally guided prostate biopsy needles, for anyone with an elevated PSA. This type of biopsy was recognised to cause a significant chance of pain, infection and intra-prostatic trauma and bleeding whilst being poor in accuracy in diagnosing the main index lesion. The greater trauma involved with type of biopsy can also cause marked sexual dysfunction. Now we are generally able to do less but more accurately placed biopsies. The consequence is less trauma and sexual dysfunction, more accuracy in diagnosis and the ability to avoid biopsy in a significant number of patients with unsuspicious MRI scans of the prostate.

For more information contact South West Andrology or Bristol Urology Associates 0117 980 4118

What is Robotic Surgery?

Raj Persad, Director and Consultant Urologist, talks about using robotic surgery at Southmead Hospital and how new wearable robotic systems could improve access to robot-assisted keyhole surgery in other areas.

A team of researchers led by the University of the West of England (UWE Bristol) is developing a robotic system that can be worn to carry out minimally invasive surgery, also known as keyhole surgery, that will offer surgeons natural and dexterous movement as well as the ability to ‘sense’, ‘see’, control and safely navigate through the surgical environment.

Read more

Da Vinci Robotic Prostatectomy

A minimally invasive surgical procedure, called robotic prostatectomy, uses finely controlled robotic instruments to perform the prostatectomy safely, while enhancing patient recovery and outcome.

The da Vinci Surgical System, surgeons operate through just a few small incisions. The da Vinci System features a magnified 3D high-definition vision system and tiny wristed instruments that bend and rotate far greater than the human hand. As a result, da Vinci enables your surgeon to operate with enhanced vision, precision and control.

Watch the video to find out more about the benefits of this surgery.

Inflatable Penile Prosthesis – How Does It Work?

Even though 1 out of every 2 men over the age of 40 suffers from ED, not many men ever wants to talk about it.

Prescription pills are usually the first course of action for treating erectile dysfunction, but often they aren’t an instant fix. When pills aren’t an option, a penile implant can offer real hope.

A penile implant (or penile prosthesis) is a medical device that is custom-fit and surgically placed into a penis to produce a natural-looking and natural-feeling erection.

There are two penile prosthesis types; the flexible rod implant (the Genesis) which produces a permanently firm penis, and the inflatable prosthesis (the Titan) produce a more natural erection. Watch the videos to find out more about the inflatable prosthesis.

The Titan® Touch inflatable penile prosthesis


Peyronie’s Disease Surgery: The Length Preserving Technique

Peyronie’s Disease: This is a condition in which patches of scar tissue (fibrous plaques) develop along the shaft of the penis. This can result in changes in the shape (bending or deformity) of the penis, painful erections and difficulties with having sex (intercourse).

The traditional Nesbit operation can lead to penile shortening. Penile shortening does not only have negative effects on the aesthetics of a penis, but also on penetrative ability and also on the psychological well being of a man. Studies have shown that patients who have undergone a Nesbit procedure have higher depression rates and are more frequently dissatisfied with the outcome of surgery.

The length preserving techniques is more complex, but at the same time a more effective treatment option. It is an incision and grafting technique based on geometric principles. This technique straightens the penis without penile length loss, because it tackles the curvature at the short unhealthy side of the penile curvature (concave side of the curvature). Based on special geometric principles the exact point of the incision on the tunica as well as the length and width of the graft needed to cover the tunical defect are identified. View the video to see how it works.

Would you like more information? View our Peyronie’s Diesease services page for more information about how we can help.

Raj Talks To The Mail About A Urine Test That Can Help Doctors Spot Signs Of Prostate Cancer

Prostate Cancer is the most common form of cancer found in men in Britain, with 50,000 new cases diagnosed every year.

In Britain, prostate cancer claims 10,000 lives each year. The disease is difficult to spot early on, as symptoms tend to develop only when the tumour has grown large enough to put pressure on the urethra – causing pain when urinating and frequent, urgent trips to the lavatory. This is when men may first go to their GP with a problem.

Scientists claim that the simple but highly accurate urine test for prostate cancer could prevent 41 per cent of unnecessary invasive biopsies. Men become eligible for the test if they have been identified as being at risk

Professor Raj Persad, consultant urologist at the North Bristol NHS Trust, Bristol Urology Associates and South West Andology, says:

‘The challenges in prostate-cancer diagnosis include finding a test which is accurate enough so that only patients with potentially significant disease go forward for biopsy.’

‘If a non-invasive liquid biopsy can help minimise biopsies, this will be a great contribution.

‘If this new test is more accurate at picking up clinically significant cancers, it could be offered as a screening test for prostate cancer.’

He added:

‘This will need more rigorous clinical testing.

Read the full story on the Daily Mail

View our services page about how we can help men with prostate cancer.

The UroLift System for treating an enlarged prostate

The UroLift® System treatment is a minimally invasive approach to treating an enlarged prostate, or BPH (Benign Prostatic Hyperplasia), that lifts or holds the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue.

The UroLift System is an alternative for patients looking for something other than drug therapy or more invasive surgery.

Watch the video for more information about how it works. Please view our prostate services page for how we can help with prostate disease.

UroLift, Nick’s story & interview with Raj Persad on ITV

ITV News covers the story of Nick, a man with an enlarged prostate which caused him to ‘to-and-fro’ to the loo many times during the night, meaning he never got a good night’s sleep.

The UroLift system was the answer to his problem. Brought to the UK by South West Andology Consultant, Raj Persad, this new treatment means that surgery for this condition is now much less invasive. A treasury tag style clip lifts or holds the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue.

Please watch the video to find out more about Nick’s story.