Author: Washington Heights Urology

Testosterone plays a vital role in the body, impacting everything from bone density and muscle mass to mood and energy levels. While it’s commonly associated with men’s health, testosterone is essential for both males and females.

When testosterone levels drop—a condition often referred to as Low T—it can have significant physical, emotional, and social impacts, affecting overall life quality. Let’s explore how low testosterone affects your health, the symptoms to watch for, and available treatment options.

The Role of Testosterone in the Body

Testosterone is a hormone produced primarily in the testes in men and the ovaries and adrenal glands in women. It regulates key functions, including:

• Development of muscle mass and strength
• Maintenance of bone density
• Red blood cell production
• Fat distribution
• Libido and sexual function
• Mood and cognitive performance

Optimal testosterone levels help maintain a healthy, active lifestyle. When levels decline, either due to aging or medical conditions, the effects can be profound.

Common Symptoms of Low Testosterone

Low testosterone can manifest in various ways, including:

• Physical Symptoms: Fatigue, reduced muscle mass, increased body fat, and decreased bone density.
• Emotional Symptoms: Irritability, depression, anxiety, and difficulty concentrating.
• Sexual Symptoms: Reduced libido, erectile dysfunction, and decreased sexual satisfaction.

These symptoms can lead to a diminished sense of well-being, affecting confidence, motivation, and social relationships.

How Low Testosterone Impacts Health

Muscle Mass and Strength

Testosterone plays a key role in maintaining muscle mass. Low T can lead to muscle loss and reduced strength, making physical activity and daily tasks more challenging.

Bone Density

Low testosterone contributes to reduced bone density, increasing the risk of osteoporosis and fractures, particularly in older adults.

Cardiovascular Health

Studies suggest that low testosterone levels may be linked to an increased risk of cardiovascular disease. Maintaining healthy testosterone levels can support heart health and circulation.

Mood and Cognitive Function

Low T can lead to feelings of depression, anxiety, and brain fog, significantly impacting mental health and daily functioning.

Treatment Options for Low Testosterone

Fortunately, Low T can be managed effectively with the right treatment plan. Options include:

Testosterone Replacement Therapy (TRT)

TRT involves administering testosterone via injections, gels, patches, or pellets to restore hormone levels. This treatment can improve energy, mood, libido, and muscle mass while reducing symptoms like fatigue and depression.

Lifestyle Changes

Adopting a healthy lifestyle can naturally boost testosterone levels. Key strategies include:

• Regular exercise, particularly strength training
• A balanced diet rich in healthy fats, protein, and essential nutrients
• Stress management and adequate sleep

Regular Monitoring

It’s important to monitor testosterone levels regularly, especially if you experience symptoms of Low T. Regular check-ups can help tailor treatments to your individual needs and ensure long-term health.

Low Testosterone Treatment in NYC

Low testosterone can significantly impact your health and quality of life, but with early detection and proper management, you can regain vitality and well-being.

If you suspect you may have Low T, contact Robert Valenzuela, MD at (212) 781-9696 to explore treatment options and take steps toward a healthier, more fulfilling life.

When a man discovers that he has erectile dysfunction, there are several treatments. Many times medications will work for a time, but it is estimated that 40% of men discontinue their use within one year due to a number of issues. Injections are the next line of treatment, but if these do not prove to be satisfactory, most men decide on a penile implant. We will discuss implants here including the two types, their benefits, plus the question: how long do penile implants last?

Continue reading “How Long Do Penile Implants Last?” →

Maybe you first learned about Peyronie’s Disease from TV ads, but the multitude of men who have this condition already knew about it. It comes on fairly quickly and can cause pain and sometimes shame. Peyronie’s Disease: signs and treatments you should know.

Continue reading “Peyronie’s Disease: Signs And Treatments You Should Know” →

Is erectile dysfunction permanent? We are here to tell you E.D. can be treated in almost all cases. More importantly, the biggest barrier to restoring full sexual function is a man’s reluctance to seek treatment. If you are living with some erectile dysfunction issues, now is the time to get some answers.

Continue reading “Is Erectile Dysfunction Permanent? What You Should Know.” →

If you want an active sex life and you have Peyronie’s Disease, there is help. Maybe you are also dealing with erectile dysfunction and all the issues that revolve around that stubborn problem. Can a penile implant correct Peyronie’s Disease? Keep reading to discover how.

Continue reading “Can A Penile Implant Correct Peyronie’s Disease?” →

PENILE PROSTHESIS REVISION OR EXCHANGE FOR LENGTH, GIRTH RESTORATION AND IMPROVE AESTHETIC APPEARANCE.

Over 25,000 penile implants are placed annually in the United States. This procedure has demonstrated a satisfaction rate of up to 93%. Despite this high level of satisfaction, a subset of patients remains dissatisfied with surgical outcomes due to multiple factors. These may include loss of penile length and girth, poor esthetic outcome, poor rigidity, hypermobility of the glans (tip of the penis) herniation of reservoir.

Patient and Partner Satisfaction

Satisfaction is largely due to perception and attitude towards the medical encounter and procedure. This is driven by parameters such as patient expectations, comorbidities, surgical complications or premature device failures and partner’s response to the procedure. Therefore, it is very important to consult a specialist doctor for an accurate diagnosis. Only with specific exams, carried out during the consultation, it is possible to evaluate the presence of fibrosis, loss of size, thinning and curvature.

The function of the implant is to restore rigidity to the penis. Often the placement of the prosthesis is performed without concerns of length preservation or restoration. As surgeons we are concerned with the treatment of the medical condition. The surgeon’s focus is the surgical correction of erectile dysfunction. After the surgery, patients may present with complaints that may lead to decreased satisfaction. These conditions may not be apparent until the patient has recovered and is ready to resume sexual activity.

In this article we will review some of the causes of patient dissatisfaction and the treatment options.

PENILE PROSTHESIS REVISION OR EXCHANGE FOR GIRTH AND LENGTH RESTORATION.

LOSS OF LENGTH (SHORTENING OF THE PENIS)

A common complaint after penile prosthesis implantation is loss of penile length. This has been shown to have a negative impact on overall patient satisfaction. Some studies have shown that the subjective feeling of loss of penile length occurred in over 15% patients.  In fact, the loss of length has been reported to be 1” to 1.75”.

If you have noticed significant loss of length and girth after the placement of a penile prosthesis, in most cases, it is possible to reconstruct the penis to restore or recover length and girth.  Dr. Valenzuela employs a series of techniques that can mediate these conditions. A small midline scrotal incision allows for the removal of the existing implant. He then uses a strategy call Tunica Expansion Procedure or TEP (term developed by Dr. Egydio). TEP allows for stretching of the corpora to recover the largest possible size and diameter of the penis. The length is limited to the maximum stretch of the nerves, vessels, and urethra. This procedure has been shown to restore up to 1.5” in length and girth.

FLOPPY GLANS (head of the penis)

Another complaint after surgery is hypermobility of the glans or head of the penis when the penis is erect. This can make penetration difficult and even painful. The tips of the cylinders can be palpated and often visible below the glans. This is easily identified by inflating the prosthesis to the maximum and tilting the head of the penis forward and back. Depending on the surgical approach this can result in 5-20% of patients. This condition may result from fibrosis of the cavernosum (tissue inside the penis) These patients tend to low levels of satisfaction with outcome.

CORRECTION OF FLOPPY GLANS

The post implant surgical correction of floppy glans depends on the extent of hypermobility and location of the cylinders. A simple procedure can relocate and fixated the glans directly over the cylinders and eliminate the hypermobility. This procedure can be performed in office under local anesthesia or in the operating room depending on the extent of hypermobility.

In cases where the cylinders may be too short, fixation of the glans decrease the length of the penis. As a result, we recommend a penile prosthesis exchange and re-sizing of the prosthesis.  At the time of the procedure the penile prosthesis is removed, the corpora are rechanneled to the level of the mid-glans and placement of a larger penile prosthesis. This will help restore penile length and improve esthetic outcome and function.

VISIBLE TUBING OR HIGH RIDING PUMP

Despite having a functional prosthesis, this condition can be very disturbing to the patients. Patient will often avoid sexual encounters due to feeling insecure and embarrassment. Relocation of tubing or pump to maximize esthetic results, can easily be achieved with an outpatient procedure.

Here are some examples of pump placement: 

The pump is high in the scrotum. This makes it more visible due to its location may interfere with sexual activity.

Pump located visible high in the scrotum and at the penoscrotal junction.

Pump low in the scrotum but midline and visible.

In the ideal location the pump should be low in the scrotum, should not interfere with sexual activity and maximize esthetics.

In this case the pump is low in the scrotum, behind the testicles and it is not visible regardless of the angle of the penis

GOALS OF PENILE PROSTHESIS REVISION OR EXCHANGE SURGERY

• Recover axial rigidity and give good penetrative ability.
• Restore girth and length with Tunica Expansion Procedure (TEP).
• Treat the fibrosis that may have appeared after the first surgery.
• Maximize function and esthetics.
• Use national and international protocols to minimize complications
• Rescue a healthy sex life.

Dr. Valenzuela utilizes a series of adjunct procedure to achieve these goals. The choice of prosthesis is made together with the patient, at the time of the consultation, based on a careful evaluation and the needs of the patient. Each case is treated individually, considering the medical condition, lifestyle, personal preference, and cost-effectiveness.

Benign prostatic hyperplasia, also known as BPH, describes an enlarged prostate gland in men. It is a condition many men will eventually experience, and it progresses as a man ages. Let’s discover the dangers of leaving BPH untreated.

Continue reading “The Dangers Of Leaving BPH Untreated” →

When is it time to consider a penile implant for erectile dysfunction? If you are tired of taking medications and waiting for them to work, frustrated that they limit your spontaneity, and you want something that is a more permanent solution to erectile dysfunction, you may have your answer. It might be now.

Continue reading “When Is It Time To Consider A Penile Implant For Erectile Dysfunction” →

Since the introduction of the little blue pill known as Viagra into the marketplace, erectile dysfunction (ED) has become a much more common topic. However, for those men who continue to have issues with ED, there are a number of penile implant types which may be an option. But the real question is, are you a candidate?

Continue reading “Penile Implant Types and How to Know If You Are a Candidate” →