Erectile Dysfunction and Testosterone

On March 21st, 2012, posted in: Blog by

It has only been in the past couple years that a replacement therapy by testosterone for treatment of erectile dysfunction has become more popular. The number of men who are receiving testosterone replacement therapy has been doubled since 2010. It should be remembered that the patients who are suffering from erectile dysfunction should be divided into two categories. One category is erectile dysfunction that is due to lower testosterone, and another category is a lack of adequate erection or premature loss of erection. This quantity could coexist or exist by its own. We should mention that there are people who are having only lower testosterone with no problem with adequate erection. People, who have testosterone levels below 300, however should be treated with replacement therapy. We are mentioning some other reasons for lower testosterone that is causing erectile dysfunction as follow:

  1. Chronic oploid use.
  2. Obesity.
  3. Diabetes.
  4. A metabolic syndrome which is combination of obesity and diabetes.
  5. AIDS and hypertension.
  6. Hyperlipidemia,
  7. Erectile dysfunction itself that can create a vicious cycle.

In recent studies, it has been shown that without treating with PDE-5 medication (Cialis, Viagra, and Levitra) they would not cure the problem of lower testosterone. However, it should be remembered that there are conditions that the people with lower testosterone, if they have a separate condition, should be cured by one of these three agents. It is also important that the level of testosterone be measured early in the morning for the most accurate number. In our Erectile Dysfunction Clinic, we see 10% of people who are referred or come for problem with erectile dysfunction, have testosterone deficiency. After we replace a testosterone level by either a gel or injection, improvement is significant without requiring any kind of PDE-5. There is a significant concern about relation of the replacement therapy by testosterone and prostate cancer. Of course, one should consider that if the patient in high-risk group such as a history of prostate cancer in the family, they should be measured for the PSA level and then if the PSA is in the high side, it should be cautiously administered in either gel or injection form. All people who are above age 60 or 70 and have history of higher PSA should not be given this replacement therapy. The majority of time, especially if seven conditions exist, the treatment by testosterone replacement or a combination of both should cure the situation. Of course, this is a controversial issue. One should consider consulting with the physician prior to using any of these testosterone triple therapy and PDE-5 treatment. Again, we stressed the fact that people who are using testosterone replacement therapy should be concerned about prostate cancer as well if they are in older age group; i.e. after age 55 and older. We will discuss this issue in future communication and I hope this information is adequately referred. If there are have any questions, please call Germantown Urology Center at 301-428-3040.

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Improve Urinary and Sexual Function

On January 22nd, 2012, posted in: Uncategorized by

Many Americans struggle with improper urinary function, sexual function, or both. While it can cause embarrassment and frustration because of an assortment of different reasons, recent research shows that there are some simple ways to curve your problems and reduce your symptoms. These changes for urinary and sexual function improvement come in the form of lifestyle changes. It has been discovered that changes in ones exercise habits and ones smoking habits can drastically affect a person’s urinary and sexual function. It is important for people to keep these facts in the back of their head because they are simple changes that can drastically affect quality of life and number of trips to the doctor.

Here at Germantown Urology, we understand the significance and connection between living a healthy lifestyle and problems with the urinary tract. We always encourage our patients to exercise regularly as well as lay off smoking and poor eating habits. We always strive to give you the best advice and finest tips, but regular exercise along with other healthy lifestyle choices is always a good place to start in relation to any urology matter. Be sure to join our Facebook and Twitter pages for more tips and weekly updates about Germantown Urology!

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Connect with Germantown Urology

On January 22nd, 2012, posted in: Blog by

At Germantown Urology we aim to keep our patients informed and satisfied. When it comes to service, Germantown Urology uses unique strategies to provide you with the most important information and best advice in the urology industry. In a world where quick answers and useful information is key, sites like Facebook and Twitter drastically change how you network with people and with businesses. These relatively new platforms give Facebook and Twitter users a secure and interactive place to view special deals, new photos and videos along with the latest news and updates about Germantown Urology. They even allow people who like the page to post and share their thoughts, viewpoints or suggestions. It is much more interactive and a lot more fun and creative than the simple html webpage. Many ask why they should “like” a page or “follow” a place like Germantown Urology on Twitter. The answer is because you will be given inside information and special access to various parts of that company. This exclusive information should aid you in making intelligent decisions. Facebook and Twitter pages help those with questions and those with and an interest in the industry. It connects patients and potential patients together and promotes a fun and new style of information that is less traditional, but more exciting to view.

Germantown Urology is proud to introduce their new Facebook and Twitter pages. Here you will be able to navigate through pictures, videos, special information, and much more! Connecting and being the first to know has never been easier. Simply like our Facebook page or Follow us on Twitter. The links are provided below! The benefits are widespread so do it today and connect with us!

Facebook Page: Center/174845875884511

Twitter Page:!/GermantownU

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Happy New Year!

On December 29th, 2011, posted in: Blog by

Germantown Urology has had an amazing past year and is very much looking forward to serving new and returning patients in 2012. We have made some progressive changes in 2011 and will continue to improve our efforts and service in the New Year. During this past year we have assisted and treated many new patients who were suffering from everything from erectile dysfunction to prostate cancer. Our patient care and services are second to none and we look forward to continuing this care in the New Year. At Germantown Urology, we have also launched a brand new social media campaign. In the New Year, along with continuing our superior service, Germantown Urology will focus on informative blogs, reports and news about everything in the Urology Industry. If you are a returning or even potential patient, platforms like Facebook and Twitter can be of great use so please join and notify others to as well.

In the New Year, you will see more updates, more fans and more interaction, will greatly improve your Germantown experience. Germantown is always trying to make your visit better. We have big plans and new ideas in these changing times so get ready for new deals and special offers along with more stories and helpful hints. We at Germantown are very thankful to have you as our patients and take great pleasure in assisting you. We love to hear from our patients and take all comments, suggestions and inquiries into careful consideration. We wish you a wonderful Holiday season and a very happy New Year!

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Spreading the Word Together!

On December 20th, 2011, posted in: Blog by

The Great Prostate Cancer Challenge, which is the premier men’s health event series in America, raised nearly 2 million dollars in 2011 which will go to prostate cancer research, advocacy, and awareness.  According to the event manager ZERO’s CEO Skip Lockwood, 240,000 men will be diagnosed with this disease, 34,000 of which will die from it.  Partnering with urology groups from all over the country and with their sponsors, ZERO focuses on reducing the diagnosis and fatality numbers by putting on events such as the Great Prostate Cancer Challenge to raise money for research and education about this disease.  The goal of the GPCC event is to end prostate cancer by gaining a huge number of participants to help raise awareness.  The GPCC event uses tactics similar to the Susan G. Komen Foundation, which is a group that is doing the same thing for women’s health issues, especially breast cancer.

Back in 2007, one of the largest urology practice groups known as the Chesapeake Urology Associates hosted an event in the greater Baltimore area, which had more than 1,100 participants and raised over $135,000.  The event consisted of a 5K race or a 1 mile fun walk which was held in September during National Prostate Cancer Health Month, and was the most successful event of its kind in Maryland.  Other Urology groups began joining the GPCC to help raise money and awareness after the success of the 5K race in Baltimore.  By 2011, the GPCC exploded by hosting more than 12,000 athletes in 27 cities across the United States.  The funds from all of these programs go to national and local efforts to save lives that have been affected by prostate cancer.  Additionally, national funds from ZERO increase federal funding for prostate cancer research and provide free testing for high-risk men. ZERO is committed to end prostate cancer, and to help cure those who have been diagnosed with it.  To help reach their goal, ZERO increases federal funding to search for new treatments and they fund local grants to end prostate cancer through the GPCC.  They also conduct free testing via the Drive Against Prostate Cancer mobile testing program and strive to educate those diagnosed or at risk and their families.

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Female Sexual Dysfunction

On October 31st, 2011, posted in: Blog by

Female sexual dysfunction has been described in medical literature but the four most commonly known stages of sexual function in females include: platue, arousal, orgasm, and the resolution stage.  According to World Health, the definition of FSD includes lack of sexual desire, failure of genital response and orgasmic dysfunction, vaginismus or dyspareunia  (pain during intercourse).  Any combination of all stages may be physical or psychological.  Consequently there are three different types of problems in three different stages of dysfunction: Desire, Arousal and Orgasm.

Caplets medical and sexual history is crucial in making a diagnosis about whether a physical desire problem in a younger age group could be temporary or prolonged.

Desire: Loss of interest or lack of desire can trigger lack of orgasm or vaginismus. A long list of medications such as Antihypertention drugs, sedatives, trycyclic antidepressants, cancer medication or even depression itself can create a lack of desire. It is clear that after menopause women have significantly lower desire, but it is important that some women can still maintain their sexual function but with slower pace.  After menopause, many factors play important roles in maintaining sexual function, such as utiftre. Some of these factors include menopausal life styles with a prior or present sex partner and other psychosexual factors, along with an individual’s general health condition.  Lack of vaginal lubrication (lowpr estroc, prog), diabetic, arthritis, kidney dysfunction and metabolic disease also can disturb both pre and post menopausal sexual function in women.

Arousal problem: Lubrication may exist alone or with a combination of two stages. Less vaginal blood circulation and lack of lubrication due to low hormone rates (due to lack of estrogen vaginal flora) has a higher PH, infection and decrease vaginal folds and even length, therefore vaginal dryness, atrophy (become smaller) pelvis surgery and other systemic diseases (cancer ms medication are just a few causing fambulatory).

Orgasmic Problems: Most women are able to reach orgasm with stimulation. Dysfunction of women who cannot reach orgasm without clitoral stimulation are a very small percentage. Nevertheless though, a small percentage cannot get orgasm even with stimulation, postmenopausal women have lower genital contraction and even if orgasm occurs, it may be painful. Psychological causes may include medicines like serotonin  reuptake and almost all antidepressant, although these patients need to take their antidepressant but research is going on to use of oral sildenafil (Viagra) for these group of patient and result are promising, since nitrate oxide has significant role on both and women: other causes of lack of orgasm are cardiovascular deficiency. Hysterectomy and multiple sclerosis and spinal cord injury are few of many reasons that cause a lack of orgasm.

The scope of FSD is so wide that we cannot brief it in this short and narrow space, we hope we will describe the issue in future however if you have any questions of related issues please call 301 428 3040 Dr. Allen Farsaii MD.

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Urinary Incontinence

On October 30th, 2011, posted in: Blog by

Urinary incontinence (loss of urine control and overactive bladder) is any condition of the bladder that is described as dysfunctional bladder in which the bladder has the problem of storage or voiding.  It could be temporary or permanent, mild to moderate.  Some medications or illnesses can cause temporary urine loss however, in chronic types victims have no underlying disease and a mechanical cause such as bladder prolapsed due to pelvic surgeries, multiple vaginal deliveries, hysterectomy, or even a C-section can cause overactive and urinary incontinence. Overactive bladder may coexist via incontinence of the urine urgency and the urgency frequency condition.  The estimated number or prevalence of this disease varies between 10 to 12 million cases, with the vast majority being women ages 35-75 years.  However, younger women may also be victims of the disease.  This disease is usually under-diagnosed due to the patient’s embarrassment and lack of knowledge about the disease.  Consequently, more than 50% of the cases are under reported.  Whether it is reported or not to a medical provider, overactive bladder/incontinence has a profound negative effect on the patient’s daily life and socioeconomic value to society including psychological suffering through loss of social activity, loss of independency, lower quality of life, and isolation.  Control of these conditions of overactive/urinary incontinence cost more than 10 billion dollars annually in the United States.

While advances in treatment of overactive bladder and incontinence are encouraging, advances in non-surgical treatment such as medications are so promising that the number of surgical treatments is dramatically declining.  In our daily practice, we see a wide range of bladder dysfunction ranging from sudden onset of urine leak with or without frequency and urgency and/or total urinary incontinence.  We often see lack of urinary tract infection; however, if we do observe the urinary infection, we treat that first and hopefully, that will take care of the urgency incontinence or frequency by itself.  If it the condition becomes worse, it is associated with the incontinence.

In our clinic, there is a significant improvement in the number of patients who are gaining dryness to pre-incontinence condition, meaning that the number of patients traveling to the bathroom or using diapers is being reduced from 8-10 to almost zero.  We have been able to control the patient’s urinary symptoms up to 90% of the time using oral medication combined with behavioral modification such as bladder training or timed voiding.  Providing no anatomical changes such as bladder prolapsed exist in the remaining 10% of the cases, non-surgical methods such as collagen injections can be used to avoid surgery.  Should non-surgical methods fail to resolve this issue, new outpatient procedures including the Gynecare TVT, a 30 minute procedure are available.  Please do not let yourself suffer from unnecessary urinary urge or incontinence or embarrassment of diaper change and social isolation.  If you have any questions, please call the Germantown Urology Center at (301) 428-3040 and ask for Allen Farsaii, M.D.  I can help you.


Dr. Allen Farsaii, Urologist with more than 30 years of experience, is the Medical Director at Germantown Urology Center.  He is a graduate of New York Medical College, a Resident and Fellow at the University of California and was Chief of Urology at Veterans Hospital, Los Angeles, and a Clinical Instructor at the West Virginia School of Medicine.

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