Suggest Remedy For Erectile Dysfunction And Hypertension

Posted on Fri, 27 Mar 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 27 Mar 2015 Answered on

Fri, 24 Apr 2015 Last reviewed on

Question : Hi
i am a 38 year old man / 5ft 8" height/78 kgs suffering from Erectile Dysfunction from the last 1 year. Recently i did the variceole key hole surgery ( 25 Dec 2014)and has been on Siphene 50 /Sq-Forte/Linovo.
Besides thid i have Genetic hypertension and is on Olmesartan 20mg.
But now after surgery the ED has become very worse. Pre surgery the semen count was 5.5 million , but post surgery in March end (3 days abstinence) it has become 0.8 million.But the FSH has reduced from 19 to 15 and motility has increased to 14.
1. Are these readings normal after variceole surgery
2. Is Siphene 50mg safe for treating Male Infertility because i had read elsewhere abt Siphene-M which is prescribed at only 25 mg for men.
Looking forward to your response
Regards

Answered by Dr. Mahesh Koregol (46 minutes later)

Brief Answer:
Varicocelectomy does not improve sperm count

Detailed Answer:
Hi XXXXXXX

I understand your concerns about worsening sperm count after varicocelectomy.

There is no guarantee that varicocelectomy improves sperm count and unfortunately majority of times it does not improve sperm count.

Hence I don't think the sperm counts can improve in future.

ED could also be due to psychological reasons. Are you under stress in past 2 years ? If you were having normal libido all these years, ED can be due to stress related personal, professional, financial life.

Let me know the details so that I can help you further.

Regards
Dr. Mahesh Koregol
IVF and Infertility Specialist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (16 hours later)

Dear Dr. XXXXXXX
I am not experiencing any performance anxiety.
So it is not due to stress.
Before operation i could have proper erection , but now I cannot even have a proper erection.
In your experience have u ever seen semen count and testosterone improve after it has hit rock bottom.
Is it safe for me to have 50mg Siphene?

What are my options for the future?

Thanks
XXXX

Answered by Dr. Mahesh Koregol (4 hours later)

Brief Answer:
Go for ICSI

Detailed Answer:
Hi

Very rarely such low counts improve and majority of times no improvement.

If ED is post surgery , you should see a urologist to confirm if ED is due to nerve damage.

You can continue 50 mg of Diogenes for few more days but I don't see much improvement.

You should go ahead with ICSI ( Intracytoplasmic Sperm Injection) treatment for getting pregnancy.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Mahesh Koregol (7 hours later)

Hi Dr.

i did see a urologist.He did physically examine the testes.Is there a test for nerve damage or is it deduced through a physical exam.

Answered by Dr. Mahesh Koregol (33 minutes later)

Brief Answer:
PGF2 alpha injection

Detailed Answer:
Hi,

There is no test for nerve damage.

But there is a test to diagnose if erectile dysfunction is due to vascular insufficiency. This is done by injecting prostaglandin F2 alpha into penis and check if erection is due to vascular causes.

If you are in XXXXXXX you can visit me so that I can get this test done for you.

Let me know if you need anymore help.

Regards

Above answer was peer-reviewed by : Dr. Pradeep Vitta