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Tag: erectile dysfunction

can hernia surgery cause erectile dysfunction
2Apr

People with hernias often come to the doctor with complaints of heavy and enlarged balls (scrotum) while standing. The scrotum and penis form the external genitalia of males. The scrotum is essential for proper reproductive function. Any disease or procedure involving it can affect fertility, making procreation the primary concern for the patient.

Hernia surgery is a common medical procedure to repair a weakness or gap in the abdominal wall, where internal organs may protrude. While the surgery is generally safe and effective, like any medical intervention, it carries some risks and potential complications. One question that has intrigued both patients and healthcare professionals is whether complications of hernia surgery can lead to erectile dysfunction (ED).

Understanding Hernia Surgery Complications:

Hernia surgery, whether performed using traditional open techniques or minimally invasive methods like laparoscopy, aims to reinforce the weakened abdominal wall and prevent organ protrusion. While the majority of patients experience successful outcomes, complications can arise, including infection, bleeding, or issues related to anesthesia. It’s crucial to note that these complications are relatively rare and often treatable.

Can hernia surgery cause erectile dysfunction?

A not uncommon complication after hernia surgery is sexual dysfunction, warranting consideration in preoperative risk discussions. According to a study, about 5% of people experienced difficulties with sex, such as trouble finishing, and around 9% experienced pain during sex after getting hernia repaired.

This study was done on almost 5,000 patients who had hernia surgery. On average, these patients were around 52 years old, and they were followed up for about 10.5 months.

When comparing two types of surgery – one with smaller cuts (minimally invasive) and one with bigger cuts (open) – they found that about 8% had sex problems after the minimally invasive surgery, and about 4% had issues after the open surgery. For pain during sex, around 7% had issues after the minimally invasive surgery, while about 13% had problems after the open surgery.

The Role of Nerve Damage:

One potential connection between complications from hernia surgery and erectile dysfunction is related to nerve damage. The surgical procedure involves manipulating tissues and organs, and this can unintentionally harm nerves responsible for sexual function. The critical nerves in question include the ilioinguinal, iliohypogastric, and genitofemoral nerves. If these nerves suffer damage or become trapped during surgery, it could result in various sensory and motor impairments, potentially impacting sexual function. Patients may report symptoms such as pain during sex.

Postoperative Pain and Psychological Factors:

Complications such as chronic pain after hernia surgery (a result of nerve entrapment) can have a psychological impact on patients. Persistent pain may contribute to anxiety and stress, which are well-known factors associated with erectile dysfunction. The fear of experiencing pain during sexual activity can also create a negative feedback loop, exacerbating the problem. Patients need to communicate openly with their healthcare providers about any postoperative pain or psychological distress to address these issues promptly.

Preventive Measures and Patient Education:

To minimize the risk of complications and potential effects on sexual function, it is crucial for healthcare providers to thoroughly educate patients about the surgical procedure, potential risks, and postoperative care. Emphasizing the importance of early detection and intervention for complications can contribute to better outcomes.

Patients considering hernia surgery should communicate openly with their healthcare providers to fully understand the potential risks and benefits. In the event of postoperative complications, early detection, and appropriate management can help mitigate any adverse effects on sexual function.

Dr Imtiaz, an endovascular surgeon and interventional radiologist, is an expert in answering these queries. His areas of expertise are male and female infertility issues.

Here are answers to some common questions related to hernia surgery.

Can a hernia cause low testosterone?

While hernias can impact sexual health in various ways, there is currently no study supporting the idea that hernias directly affect testosterone levels.

How long after hernia surgery can I have intercourse?

There are no specific periods to suggest when you can have intercourse after hernia surgery. The scenario varies for each person. Generally, it is advisable to wait for at least one week after surgery. However, you can resume intercourse as long as there is no pain or discomfort.

Can you get a hernia from ejaculating?

A hernia is a defect in the abdominal wall that allows abdominal contents to protrude and slide into the scrotum. Risk factors include chronic constipation, coughing, and weight lifting. Essentially, any factor causing increased abdominal pressure can lead to a hernia. It’s important to note that ejaculation plays no role in the development of a hernia.

For further queries email us at info@drimtiazahmad.com. Follow us on Instagram @Profdr_imtiaz_ahmad for daily updates.

venous leak erectile dysfunction
29Mar

Erectile dysfunction (ED) is a big issue in various populations worldwide. Erectile dysfunction is defined as a situation or inability to achieve and/or maintain penile erection that is sufficient for satisfactory sexual performance. It’s been observed that around 52% of the male population is affected with ED amongst which over 30% of young males are suffering from this condition. Scientific investigations have observed that the prevalence of ED is strongly associated with increasing age, making it a major health problem since with the increase of the aging population, the worldwide prevalence of ED has been predicted to reach 322 million by 2025.

Blood vessels play a prime role to keep erections firm. Under normal physiological circumstances, during sexual arousal nerves release chemicals that increase blood flow into the corpus cavernosum (erection chambers in the penis), the arteries in the penis expand to allow the inflow of blood which makes the erection firm. However, to keep the erection rigid, blood needs to stay in the penis until the man ejaculates. For this, penile veins constrict to trap the blood inside, which is known as veno-occlusion. At the end of sexual stimulation, the veins widen and blood flows back into the body. If the veins do not constrict enough, blood leaks back into the body, which results in softening of the erection, this phenomenon is known as a venous leak in which the erection gradually loses its firmness. Therefore, venous leak is a defect where a male is unable to have strong erections even with sufficient blood into the penis as a result of abnormal venous drainage in the penis corpora cavernosa, thus retarding the typical erectile capability of men. Venous leak is often listed under erectile dysfunction causes in younger men. Surveys have found that about 70% of the affected population by ED does not get treated therefore, men suffering from this condition experience shame and choose to be secluded in sexual relations. If you have concerns regarding being affected by this condition, contact your urologist, and get an early treatment since venous leakage is treatable. Although there are quite a few causes of erectile dysfunction, nonetheless, many non-invasive remedial options are available for such patients that will improve fertility and its progression.

Erectile Dysfunction Causes

There are many different underlying factors that can qualify as erectile dysfunction causes. Based on etiology, erectile dysfunction is divided into three major types: psychological (such as depression, stress, and anxiety), organic (related to vascular system, nervous system and endocrine system) and mixed.

When we talk about organic causes, defects in the physiology of vascular system are a common occurrence, in patients with venogenic erectile dysfunction, veno-occlusive dysfunction is recognized as underlying cause in most cases which can be due to either aging or injury related changes to the tunica albuginea, cavernosal smooth muscle dysfunction or excessive adrenergic input or shunts created during priapism episodes. There are several potential risk factors such as age, diabetes, obesity, cardiovascular disorders, hypertension, atherosclerosis, prostatectomy, pelvic radiation, Peyronie’s disease (development of scar tissue inside the penis), and androgen deprivation therapy that appear to be associated with organic ED.

Diagnosis and Treatment

In order to diagnose venous leak erectile dysfunction, your doctor will take your personal history, would likely do a physical examination, and recommend some tests such as Penile doppler ultrasound,certain male hormone and routine blood tests along with urine tests to rule out any doubts.

It is advisable for patients with venous leak erectile dysfunction to make lifestyle modifications and prevent physiological stresses to overrule these conditions and take adjunct medications. Furthermore, for patients suspected with ED are commonly prescribed phosphodiesterase type 5 inhibitors (PDE5Is) therapy which is not a curative treatment but rather symptom-relieving treatment and loses its effect in in a few months. There are surgical interventions also available in the market such as penile implant(recommended only in elderly and patients who had radical prostate surgery) and venous ligation surgery, which aims to repair the leaking veins(discouraged by surgical fraternity for recurrence and high failure rates).

Moreover, an interventional radiological approach that is endovascular treatment is a promising approach to treat patients with erectile dysfunction or venous leakage. Endovascular therapy with 3D precision-guided embolization of venous leak is a minimally invasive procedure and a safer alternative to surgical methods. For endovascular embolization, administration of local anesthesia followed by real-time fluoroscopic monitored puncture of a venous access is performed to reach the leaking veins and periprostatic venous plexus under sonographic and 3-D precision guided fluoroscopic guidance.

The non-invasive endovascular treatment can be performed by two different approaches, such as antegrade approach via deep dorsal penile vein and retrograde transfemoral venous approach via internal iliac veins. Although both approaches aim to embolize the periprostatic venous plexus along with other unusually shaped or abnormally functioning veins due to valvular incompetence, antegrade endovascular treatment is preferred since it provides a more direct route for catheterization of the periprostatic venous leaks.3D Precision guided fluoroscopic guidance helps the catheter reach the specific veins, following a diagnostic venogram embolization is performed using N-butyl-2-cyanoacrylate and ethiodized oil mixed in specific ratios depending on proximity, size and extent of venous leaks under continuous fluoroscopic control in neutral projection with optional oblique projection for precison guided embolization of incompetent pelvic veins.

This non-surgical treatment- 3D precision-guided embolization of venous leak is a complex and challenging procedure which requires high expertise in the said field. Its treatment in Pakistan was introduced by Dr. Imtiaz Ahmed in 2019, making him a pioneer. Dr Imtiaz Ahmad is an endovascular surgical specialist and an interventional radiologist who treats men suffering from venous leakage, erectile dysfunction and infertility issues that may have little hope left otherwise. His expertise in the field speaks volume for itself, which can be inferred by the accolades of his treated patients.