Kenneth Goldberg, M.D. Answers Questions On: Men's Health

Back when I worked at the Male Health Center in the pre-Viagra and other drugs days, ED was largely solved by penile injection. It was a huge practice, and it was all we had besides penile prosthesis, which is what I did. I got interested with that and was involved in clinical trials for Cialis and Muse and other ED nonsurgical techniques that came along. I also speak professionally regarding the area of ED and conduct continuing medical education courses on for physicians. So I’ve watched the industry evolve and advance, and I feel I have a great breadth of knowledge on the topic.

UT Southwestern was one of the sites for the clinical trials conducted on this particular procedure. Depending on the size of the prostate, the procedure consists of two to seven treatments, each merely nine seconds in duration, received in a single one- to two-hour office visit. So it’s quick, simple, and you do get results.

For the right patient—someone who isn’t satisfied with his symptom management or whose symptoms are progressing or who doesn’t want to take medication—this new procedure, performed on an outpatient basis, can truly improve quality of life.

The procedure works by inserting .5 cc of sterile water vapor (steam) into the prostate gland during the nine-second treatments. The therapy is targeted to a defined area because steam will travel only between cells until it encounters natural collagen barriers or the prostate capsule itself.

Well, treatments have advanced in so many ways—primarily, I’d say, in that there’s less open surgery and more laparoscopic and robotic techniques. You also have the less invasive treatments for the prostate. Certainly another advancement is lithotripsy—using shock waves to break up stones in the kidney, bladder, or ureter so they can pass out of the body in the urine. I was the second urologist in North Texas to do lithotripsy back in the early 80s when it came up. I just really saw that as a novel way to deal with stones without an incision. Another highly gratifying area in urology is the oral drugs we now have for ED.