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RATED ONE OF THE NATION'S TOP PHYSICIANS FOR PATIENT SATISFACTION IN 2015, GREGORY LOWE, MD, UROLOGIC SURGEON AND SEXUAL MEDICINE SPECIALIST AT OHIOHEALTH UROLOGY PHYSICIANS, MERGES HIGH"LEVEL EXPERTISE WITH STATE"OF"THE"ART DEVICES AND TECHNIQUES TO TREAT ERECTILE DYSFUNCTION ¡ED¢ AND MALE URINARY INCONTINENCE ¡UI¢. ED AFFECTS AS MANY as 30 million men in the U.S., according to the Urology Care Foundation. "Older men typically develop ED due to complications from diabetes, heart disease, and past prostate surgery or prostate cancer treatment," Dr. Lowe says. "For younger men who develop ED, some of it relates to stress and some to anxiety. For others, their hormone panel might be a bit o•." In more than 80 percent of cases, ED is related to physiological rather than psy- chological conditions, Dr. Lowe explains. However, a menta l component of ten develops following the onset of ED, as it can have a profound impact on self-esteem and personal relationships. "Furthermore, ED won't resolve 'with time,'" he adds. "Left untreated, it typi- cally worsens." UI affects up to a third of older men, according to the National Institute of Diabetes a nd Digestive a nd K idney Diseases. The chief causes are similar to those of ED, with the exception of heart disease. Like ED, UI markedly diminishes quality of life, and the conditions have considerable overlap. "The No. 1 cause of both is diabetes," Dr. Lowe notes. "And as ED worsens, men are more likely to develop incontinence." ASSESSING ED TREATMENTS Ora l medications such a s si ldena f i l citrate are e•ective ED treatments for about 70¡percent of men who are otherwise healthy, according to Harvard Medical School. However, e¢cacy is limited among men in whom cardiovascular disease, prostate surgery or diabetes has damaged arteries or nerves, and for some, oral medi- cations are not e•ective at all. They also cannot be taken by men who take nitrates. Intracavernosal injection yields only about a 40 percent patient satisfaction rate, according to a study published in Andrology, and Dr. Lowe points out that another treat- ment, intraurethral suppositories, is not frequently chosen because of high cost and an aching sensation many men experience when they use the suppositories. A vacuum erection device frequently reduces sexual sensation and partner satisfaction, he adds. In contrast, Dr. Lowe finds his patients have high success rates with penile pros- thetics, the gold standard for treating ED for the past 40 years. These implants have a patient and partner satisfaction rate greater than 90 percent. "The procedure takes less than an hour," he says. "Patients return home the same day or early the next morning and can begin using the prosthesis four to six weeks fol- lowing surgery." About 95 percent of penile prosthetics used in the U.S. are inflatable; the remain- der are semi-rigid and simply bend into position, Dr. Lowe adds. He most often BY BRITTAIN WHITESIDEGALLOWAY DELIVERING LEADING-EDGE TREATMENTS FOR ED AND MALE URINARY INCONTINENCE Gregory Lowe, MD: 0 4C O V E R F E A T U R E

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