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Posted by HFHS M.D.-MS on March 17, 1998 at 23:35:50:

In Reply to: TESTICULAR CANCER & IMPOTENCE posted by NANCY on March 16, 1998 at 15:41:06:

: My husband had testicular cancer 1 year ago where they removed a malignant tumor and a testicle.
  Six months ago, he started experiencing erectile dysfunction, whereby he has been unable to maintain an erection.
  His urologist prescribed an anti-depressant & some other medication (can't remember the name) - both of which he cannot take legally or he would lose his job during random drug testing.  (They would produce a false-positive for narcotics.)
  Friday, we tried the Muse injection - it didn't work.  I hear there's a new pill due out on the market that you take orally?
  What is it called and when will it be available?  Also, would appreciate any suggestions you have.
  Thank you in advance for your time!
Dear Nancy;
Thanks you for your questions.
It is doubtful that there is a physical cause for erectile dysfunction directly related to the treatment except if testosterone production were affected . Certainly an an emotional cause needs to be considered. I would talk to your doctor  regarding a full evaluation for impotence with hormonal levels, liver function, renal function and blood sugar levels as well as a complete physical examination. Nocturnal penile tumescence testing and possibly a formal emotional evaluation by a sex therapist  may be required.
There is several options available for treatment of erectile dysfunction.  The most none invasive is the pump is  the vacuum erection device( VED).  This cylinder is placed over the penis and helps it fill with blood by creating a vacuum. A comfortable band is used at the base of the penis to keep the blood trapped in. Muse is another possibility and goes up to 1000 mcg dose.  Try a higher dose before giving up on this product. They also have a tourniquet that keeps the medicine in the penis.  Injectable agents are very effective with minimal pain for most and are fairly easy to learn to use.  
Oral medication are supposed to  be out in May but I would not hold my breath.  FDA approval  a Viagra is still pending as of today.  Other oral medications are on the way in the near future. There is also a surgical option which invloves placing a device in his penis to allow him to have erections. Such is unlikely to be needed. There is little question that he can regain his erectile ability, the question is what is the cause of his difficulty and what is the best way to help him. It is important throughout all of this that he continue with his scheduled visits and x-rays/lab tests regarding his cancer.        
More individualized impotence and testicular cancer care is available at the Henry Ford Hospital and its satellites.  Drs. Keoleian, Liroff, Farah and Holloway are our impotence specialists. They can be reached through I-800-653-6568.  We can also arrange local accommodations through this number if this is your need. Please bring any physicians
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