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Calabro et al 7 reported that treatment with OXC at 1800 mg/d caused retrograde ejaculation in a 35?year?old man with traumatic epilepsy, and the retrograde ejaculation disappeared after switching to other AEDs. However, Calabro et al 30 also reported that 2 young men with epilepsy had loss of libido and a lack of sex appeal after taking LEV, and recovered sexual function after switching to other AEDs. In case studies or sample studies, LTG has not been found to have any adverse effects on sexual function, and it has been shown to have a positive effect on sexual function.

18, 31 A clinical study by Gil?Nagel et al 18 followed 141 patients with epilepsy treated with LTG as initial or replacement therapy for 4?8 months; male patients with epilepsy showed

significant

In this study, the patients with epilepsy had a lower erectile function score than the healthy control group. In patients with epilepsy, premature ejaculation levels have a lower trend, but it was not statistically significant.

These results, to some extent, suggest that epilepsy itself can adversely affect the erectile function score.

The scores of erectile function and premature ejaculation were increased in the OXC, LEV, and LTG groups when compared between before and after treatment, but no statistical significance was found. This may be related to the small case number in this study. We also presume that these 3 AEDs may have effects on improvement of erectile function. In conclusion, this study suggests that seizures may lead to a decrease in semen quality and lower marriage and fertility rates in male adult patients with epilepsy compared to healthy controls, but have no significant effect on erectile function, premature ejaculation, or sex hormones. Treatment with OXC improved the FFMR and survival

rate

Therefore, using these AEDs to treat adult male patients with epilepsy may be a more appropriate choice. None of the authors has any conflict of interest to disclose. We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.

Stember is an Assistant Professor of Urology at Icahn School of Medicine at Mount Sinai in New York City. As a board certified urologist and fellowship trained surgeon, he has a special interest and training in minimally invasive and microsurgical techniques for surgical sperm retrieval in obstructive and nonobstructive azoospermia, microsurgical varicocele repair, vasectomy, vasectomy reversal, erectile dysfunction treatment including penile prosthesis implantation, testis prosthesis insertion, treatment of Peyronie's disease, and testosterone replacement therapy. Stember is a leading authority in the research and treatment of erectile dysfunction.

He is one of a handful of surgeons in the United States who is fellowship trained in both sexual medicine and penile prosthetic surgery (at Memorial Sloan-Kettering Cancer Center) and male infertility and microsurgery (at Weill-Cornell Medical College). Stember has developed several novel medical products and holds a patent for the design of a device to assist with improved outcomes for penile prosthesis

surgery

He is Chair of the Membership Committee of the Sexual Medicine Society of North America. Stember reviews and selects articles for publication in medical journals including the Journal of Sexual Medicine, European Urology, The Journal of Urology, Andrology, Sexual Medicine, and the Asian Journal of Andrology.

He is a member of multiple organizations including the Sexual Medicine Society of North America (SMSNA),

the

Stember is the recipient of the prestigious Scholars in Sexuality Research Grant Award from the Society for Sexual Medicine in 2010. He has authored more than 100 articles, book chapters, and abstracts in the field of reproductive and sexual medicine. His research and discoveries have been presented at national and international conferences and published in leading journals including The Journal of Urology, Annual Review in Medicine, and the Journal of Sexual Medicine . Stember frequently lectures and presents his clinical research at national and international medical conferences.

He has given clinical talks throughout the United States, as well as Canada and South Korea. He teaches and mentors medical students, residents, and fellows, and received the Beth Israel Urology Faculty Teaching Award in 2013.

He has also been a faculty member for surgical skills workshops where he has taught other practicing urologists his technique of penile prosthesis surgery. Bladder Cancer Congenital Kidney Disease Cystoscopy Frequent Urination Hypogonadism Impotence Infertility Neurogenic Bladder Penile Prosthesis Insertion Peyronie's Disease Prostate Cancer Prostate Cancer Screening Vasectomy. Internship, General Surgery Mount Sinai School of Medicine. Fellowship, Microsurgery and Male Fertility Weill Cornell Medical College.

Fellowship, Sexual Medicine Memorial Sloan-Kettering Cancer Center.

2014 Super Doctors - NY Rising Star Urology New York Times.

2014 Center of Excellence - Penile Prosthesis Surgery Coloplast.

2010 Scholars in Sexuality Research Grant Award Sexual Medicine Society of North America.

Pseudo-malfunction of the Coloplast Titan Inflatable Penile Prosthesis One-Touch Release Pump. Is there a rationale for penile rehabilitation following radical prostatectomy?.

Katz BF, Gaunay GS, Barazani Y, Nelson CJ, Moreira DM, Dinlenc CZ, Nagler HM, Stember DS. Use of a preoperative checklist reduces risk of penile prosthesis infection.

Reproductive sequelae of diabetes in male patients.

Endocrinology and metabolism clinics of North America 2013 Dec; 42(4). Lifestyle, environment, and male reproductive health.

The Urologic clinics of North America 2014 Feb; 41(1). Outcomes of abdominal wall reservoir placement in inflatable penile prosthesis implantation: a safe and efficacious alternative to the space of Retzius. Concordance between patient and physician assessment of the magnitude of Peyronie's disease curvature.

Tal R, Stember DS, Logmanieh N, Narus J, Mulhall JP.

Erectile dysfunction in men treated for testicular cancer. Preoperative buy viagra with prescription erectile function is an independent predictor for decision to spare cavernous nerves during radical prostatectomy.

Sullivan JF, Stember DS, Deveci S, Akin-Olugbade Y, Mulhall JP. Ejaculation profiles of men following radiation therapy for prostate cancer. Defining the aetiology of erectile dysfunction in men with chronic pelvic pain syndrome.

Microsurgical epididymal sperm aspiration: indications, techniques and outcomes.

Management of ejaculatory disorders in infertile men.

Perioperative prevention buy lady era tablet of penile prosthesis infection: practice patterns among surgeons of SMSNA and ISSM. The concept of erectile function preservation (penile rehabilitation) in the patient after brachytherapy for prostate cancer.

Options for fertility preservation in men and boys with cancer.

Advances in experimental medicine and biology 2012; 732.

A retrospective analysis of risk factors for IPP reservoir entry into the peritoneum after abdominal wall placement. International journal of impotence research 2017 Sep; 29(5). Margolin EJ, Mlynarczyk CM, Mulhall JP, Stember DS, Stahl PJ. Three-Dimensional Photography for Quantitative Assessment of Penile Volume-Loss Deformities in Peyronie's Disease. Gross MS, Phillips EA, Carrasquillo RJ, Thornton A, Greenfield JM, Levine LA, Alukal JP, Conners WP, Glina S, Tanrikut C, Honig SC, Becher EF, Bennett NE, Wang R, Perito PE, Stahl PJ, Rossello Gaya M, Rossello Barbara M, Cedeno JD, Gheiler EL, Kalejaiye O, Ralph DJ, Kohler TS, Stember DS, Carrion RE, Maria PP, Brant WO, Bickell MW, Garber BB, Pineda M, Burnett AL, Eid JF, Henry GD, Munarriz RM.

Multicenter Investigation of the Micro-Organisms Involved in Penile Prosthesis viagra online no prior prescription Infection: An Analysis of the Efficacy of the AUA and EAU Guidelines for Penile Prosthesis Prophylaxis.

Gaffney CD, Pagano MJ, Kuker AP, Stember DS, Stahl PJ. Osteoporosis and Low Bone Mineral Density in Men with Testosterone Deficiency Syndrome.

Onyeji IC, Sui W, Pagano MJ, Weinberg AC, James MB, Theofanides MC, Stember DS, Anderson CB, Stahl PJ. Impact of Surgeon Case Volume on Reoperation Rates after Inflatable Penile Prosthesis Surgery.

The sildenafil 25 mg buy Patient Experience Star Rating reflects our patients’ perception of how well their Mount Sinai physician communicated with them during an office visit. The Star Rating is based on patient responses to three questions on the Clinician & Group CAHPS (CG-CAHPS) Survey, a standardized questionnaire developed by Medicare.

Responses are measured on a scale of 1 to 5, with 5 being the best score. Don’t want a penile implant or lifetime of dependence upon PGE penile injections?

Morganstern’s ExoSurge® Technology utilizes a patented tandem of buy sildenafil cvs mostly FDA-approved devices that represent the first notable treatment innovation to resolve chronic erection issues since introduction of the first penis prosthetic device in 1973.

We’re now able to completely heal men in our Atlanta erectile dysfunction clinic who suffer from chronic and severe ED issues – supplanting the need for penile prosthetic surgery or penile injections – in almost 90% of cases. Morganstern, a board-certified urologist was recognized as one of the Best Urologists in Georgia by 3-Best Rated. Chronic erectile dysfunction is best defined as a condition in which the patient isn’t improving from traditional urologic treatment ED paradigms including Phosphodiesterase-type 5 inhibitors (Viagra, Cialis, Levitra, etc.), shockwave therapy, hormone therapy, penile injections or vacuum pumps.

Until now, a penile prosthetic was the only other option for such patients.

Erectile Dysfunction Solutions Born from Comprehensive Testing. The underlying causes of male erection issues vary;

sometimes

It’s a combination of more than one of these typical root causes. A key component of our success is rooted in the fact “we don’t guess” when it comes to what’s wrong or attempt to stamp a “one size fits all” solution upon your case.

A big part of why we excel is the degree of testing and evaluation we perform during your initial visits.

Unlike many, we don’t guess regarding the reasons behind your lack of performance. We examine every detail and come up with a pathway that will enhance your life. During your firs t visit we’ll gather and review all your health history indicators, collect information on any prior treatments you might have explored, perform a physical exam related to your complaints and order tests that will help us narrow in on exactly why things aren’t operating up to par.

Your next visit usually involves detailed testing that will help us discover the root cause of any deficiencies and to what degree they are causing problems.

At your third visit we are able to provide a complete diagnosis regarding the origins of your troubles: what’s not working and why – along with treatment options to repair the problems.

We look forward to serving you and getting you performing at levels you need and deserve. Blood Work Analyzes blood components looking at the presence of various Macronutrients and in what quantity they present themselves in your body.

Sometimes our bodies have the bare minimum macronutrients to function from.

This test allows us to check these numbers and supplement what is needed to get the body into optimal operational and healing range prior to treatment. Vascular Study Looks at the blood flow of the penis. Checks for any plaque or calcification build up in the penis. *This may reveal the need for any combination of the treatments* If blood flow is poor in or to the penis then a treatment pertaining to increasing blood flow may be required.

(RejuvaHeart™) If flow is not retained in the penis then a treatment pertaining to increasing blood retention will be required. (Neosonic™) If there is plaque of calcification in the penis then the treatment for breaking down this plaque and calcification is required. (EndoStim™) Endograph *if

blood

If it is not isolated then a treatment pertaining to increasing blood flow is required. (RejuvaHeart™) Most Comprehensive Blood Testing for ED.

Every doctor takes blood; it provides the clearest immediate roadmap about what ails you beyond what you can verbalize. Our blood draws are twice as intensive as seen at typical urology practices and five-times more detailed than at a family physician or men’s health center. Simple: Remember this is not an “ending” diagnosis – but a symptom of another problem. Tracking down that underlying cause starts with blood work. Our urologists provide a unique and detailed Doppler ultrasound of the penis to unlock the keys to healing plus we perform an endothelial test to evaluate healthy blood flow throughout the rest of your body.

Most issues are sourced from problems within the penis.

However, 40% are rooted from challenges outside the groin area. What happens without this tandem of detailed analysis? Doctors are just guessing – throwing out treatment ideas on what might be wrong.

This uncertainty leaves the patient facing less than ideal treatment paths, a lifetime of dependency on treatments like

injections

We will be looking at how the blood flows through the

penis

Most men recall life at 16 years of age – when mere thought of sexual excitement could cause immediate arousal.

That was because the blood flowing into and through the penis was working perfectly.

Our urologists also closely

analyze

Problems in this regard are classified as Arterial Insufficiency – and we can now fix that without surgery! After all that blood pumps into a penis: we need it to stay in order to maintain an optimal engorged erection.

If there’s a leaky-valve from disease, aging or damage?

Blood seeps out and the erection weakens – like a tiny pinhole slowly deflates a balloon.

In these situations, a man can get excited and erect – but somehow – keeps losing erection.

This is known as Venus Leakage – we can now non-invasively repair that if faulty. Built-up plaque is a common challenge in penile health. In severe cases, you could be dealing with Peyronie’s Disease – which requires an exclusive treatment paradigm.

However, it’s not uncommon to have bits of hardened plaque in spots around the penis or an inordinate amount of “diffuse plaque” hampering blood flow & performance within your penile tissue.

Diffuse plaque can be likened to heavy salt water – the plaque has not scaled and hardened to edges of the penis – buts its density and weight and causing the pipes to operate less efficiently and more cumbersome.

Endothelial analysis provides a detailed analysis of blood flow rates throughout your body.

It doesn’t do any good to improve blood flow within the penis if the providing resource isn’t offering adequate pressure and quality to support penile function. We can’t begin to tell you the number of patients we treated who had seen countless doctors who found nothing wrong with their penis and suggested they pursue a lifetime dependency on penile injections or an implant when in reality – the erection problems was actually stemming from the body vs.