Hi Michael-Thanks for your site. Last year I had my prostate removed due to localized cancer. I am now very well. Nerves around the penis get damaged or destroyed during surgery in order to remove the cancer. On average they take 18months-2 yrs to regenerate. The Doctor has put me on injection therapy which works fairly well and I think my nerves may be regenerating. Standard medication is not effective at this stage. My question is: Do you know any way to speed up this process of regeneration and also is it true that lots of squatting either with weights or without, will help erections at any age? I am 66 yrs and keep fit.One finds it hard at times to do without this great gift which one always took for granted. Any info you can provide will be greatly appreciated.
John
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You’re at the forefront of urology. Until this century, urologists thought that nerves damaged during prostatectomy could not regenerate. But that view is slowly changing as urologists’ experiments with various drugs suggest that some nerve regeneration is possible. Of course, after 60, most men’s erections are iffy even if they have intact prostates. So I can’t promise you a future of erections without injections. But I urge you to work with your urologist and try some of the approaches that show promise. For an excellent review of post-prostatectomy nerve-regeneration possibilities, visit this link from the journal Reviews in Urology. It mentions a half-dozen drugs that might help. Work with your urologist to see if any might be appropriate for you. And please let me know what happens. As I mentioned, this is the forefront of urology, and if the nerves can be regenerated, that could improve the quality of life for millions of prostate cancer survivors. Good luck!
Many thanks Michael.
, he ( a pathologist) auidts his urologists’ biopsy practices.Other commentators have already mentioned reasons why Mitchell’s study is weak, so I will not revisit that issue.A pathologist sharing a small portion of his fees with a fellow physician is not much different, from a purely economic perspective, from a non-partner pathologist (many of whom never reach partnership status for a host of reasons) sharing fees she billed/earned with partners in her pathology group. Is this an instance of a partner extorting money from his non-partner for the sake of maintaining employment? The specialties may be different but the ultimate act transfer of monies is the same. Sure the end does not justify the means but these are voluntary activities in a democracy. Everyone makes trade-offs that fit their situation. Do not pathologists with captive patient populations at hospitals split fees with the hospital (professional for the doctor and technical for the hospital; sometimes there are also trades made between these parties regards these fees); does not the hospital split Medicare Part A fees with the pathologist or keep all of the Part A fees in exchange for the pathology group’s contractual privilege of billing Part B professional services (something the CAP has alleged for years and complained about to the OIG); are pathologists therefore held hostage by the hospital; name a hospital that gives a pathology group the actual Part A fees due to pathologists; does not the hospital (a non-physician partner of pathologists) benefit the more special stains or molecular studies the pathologist orders when the hospital collects the technical fees; do not hospital contracts incentivize pathology groups to meet financial goals and give them a percentage in some cases?Perhaps you are naive that a clinician sends his patient specimens to the best consultant he knows or that there is no give and take ( kickbacks) between primary care doctors and specialists. These are not overt but compensation of primary or secondary care physicians and the overall financial success of a multispecialty group or hospital system-owned physician practice depends significantly on incentives or compulsions for referring to their own multispecialty/hospital-owned group. Practice long enough and you will realize there has always been an implied you scratch my back etc in many medical transactions such as patient referrals between physicians, private labs, surgery centers and hospitals. I believe that physicians in general, as opposed to other business interests in medicine, put patients first, money second. Most, not all. Irrespective of specialty. Physicians of all specialties often push the envelope as a result of the distorted payment system for healthcare services we have in this country. Whether that is right or wrong is up to each and everyone of us. A Wall Street mentality has slowly insinuated Healthcare because, as Willie Sutton said, that is where the money is (The AMA is not a paragon of virtue either; further the AMA membership represents only a third of all physicians in the country, including myself. The AMA is opportunistic like any other organization; it signed on to ObamaCare because they made a backdoor deal and want their CPT system to be the only billing codes used as they make millions in royalties every year from CPT usage. Same with the CAP and its promotion of SNOMED codes; it is a very good system for healthcare and the CAP wants to benefit financially from its use. Nothing wrong with that as that is the way the quality healthcare and the economy is supposed to work.)