Hair loss Treatment Center

PARTICIPANTS J. François Eid, MD Private Practice, NYC

J. FRANÇOIS EID, MD: Good evening. Thank you, David.

DAVID R. MARKS, MD: We also have two of his patients, named John and Jim, who last joined us about 18 months ago, just a few weeks after they had their implants, and they are off camera. We're happy to have them. And we have John's partner with us, so thank you all for joining us again.

Now, Dr. Eid, when people think of sexual dysfunction, they think of Viagra. That's been in all the news stories, but it doesn't really work for everyone, does it?

J. FRANÇOIS EID, MD: No, and many don't know that Viagra works in about two thirds of patients, so we have about one third of the population of men who suffer from erectile dysfunction who do not respond to Viagra. That's approximately 10 million men.

DAVID R. MARKS, MD: Why doesn't it work?

J. FRANÇOIS EID, MD: These patients have a severe end stage erectile dysfunction. Many of them have had cancer surgery or have diabetes or advanced disease of the blood vessels of the penis. The penis is irreparably damaged, so the medical treatment is ineffective.

DAVID R. MARKS, MD: There are a couple of new drugs in the pipeline that'll be out in the near future. Does this offer hope for some of these patients?

J. FRANÇOIS EID, MD: Well, we always want to think that there is hope down the tunnel. However, these new drugs work very much similarly to Viagra. They use the same enzyme system, so it is unlikely for a patient who does not respond to Viagra to respond to these new drugs. If a patient cannot use Viagra because of a side effect, then these drugs may have fewer side effects or different side effects, and therefore that would be an option for that patient. But most of the patients will not respond to the new drugs.

DAVID R. MARKS, MD: So these people are going to have to look for other options, and there are a number of them out there. There's injections and there's the vacuum. Tell us about those.

J. FRANÇOIS EID, MD: Yes, these are all decent options. The vacuum is probably the least preferred option. It is easy to do but very unnatural. The injections work in 90% of patients regardless of the cause of the erectile dysfunction, but to have to do an injection each time one needs to make love is a very hard thing to ask a man to ask of a man who suffers from erectile dysfunction. So most patients who really start penile injection therapy eventually drop out.

The urethral medicated system for erection is something that we were hoping would replace penile injection.

DAVID R. MARKS, MD: What is that? Tell us what that is.

J. FRANÇOIS EID, MD: It's the same medication that is delivered to the penis with a needle. Instead, it's placed in the meatus, in the hole through which urine flows out from the penis. It is applied with a little applicator, approximately two and a half inches inside the penis.

DAVID R. MARKS, MD: So that leaves implants.

J. FRANÇOIS EID, MD: Exactly.

DAVID R. MARKS, MD: When either people decide not to have these other options or they're not candidates. What type of patient actually looks into getting an implant and decides that it's for them?

J. FRANÇOIS EID, MD: That's a great question. I think the most important thing is to make sure, first of all, that Viagra doesn't work, that an oral medication doesn't work. That's really our number one criterion for considering somebody for a prosthesis. So if a patient has tried Viagra and tried it diligently and does not respond to it, then automatically that puts the patient in the category of severe erectile dysfunction. We then will offer the other options, but we know that the other options are only temporary at best, and therefore we always want to make sure that the patient is educated in knowing what an implant looks like and what it can offer the patient.

DAVID R. MARKS, MD: Let's talk to some of the patients who have actually had it done. Now, John, we last spoke to you a while ago, a year and a half ago, and you had just had the implant. What made you decide to even look into this option?

JOHN: I was in the hospital getting followup treatment to my operation, and I was questioning the fact that I was not getting my erection back that I was hoping for.

DAVID R. MARKS, MD: Your operation for what?

JOHN: Prostate cancer. And my concern was that I was not returning to where I had been, and my operation was, I think, a very fortunate one that was very successful, and very few of the nerves were affected.

DAVID R. MARKS, MD: When you say not returning to where you had been, what do you really mean?

JOHN: My erection was next to nothing, and then I was advised or prescribed to try the oral medication of Viagra, and that was working, but it was not working to any satisfaction, at least to myself, from what I had seen in the past, and I was becoming very concerned, and I was being told by the doctors -- and justifiably -- and I was also reading that it might take a year to come back fully. You know, you can't give up until a year.

DAVID R. MARKS, MD: That must have been frustrating.

JOHN: It was very frustrating, and I was talking like eight months, and I was active.

DAVID R. MARKS, MD: Now, Jim, you also went through this process of learning about the different options. What kind of fears did you have, or concerns?

JIM: Well, I had a very similar situation. I had prostate cancer. I had an operation. However, I wasn't as fortunate after the operation. They didn't spare that many nerves. So we tried the Viagra, and it didn't work at all. I was a young man, 53 years old, so at a meeting at Sloan Dr. Eid spoke, and he had one of his patients up there, and there was no way I was going to fool around with the injection. The operation, he explained it, and I made an appointment to go see him, and right away I had complete confidence in Dr. Eid and I decided to have the operation as soon as possible. I had no doubts at all.

DAVID R. MARKS, MD: No doubts?

JIM: None at all.

DAVID R. MARKS, MD: No fears?

JIM: None at all.

DAVID R. MARKS, MD: You're a brave man.

JIM: None at all.

DAVID R. MARKS, MD: Let's see if John's partner was as brave. Did you have any concerns at all about this process?

JOHN'S PARTNER: None whatsoever. When I first started dating John, the procedure was already set up. The appointment was made, so I basically learned along with John at that point and just supported John. It was John's decision. It's his body.

DAVID R. MARKS, MD: Are these typical reactions from patients?

J. FRANÇOIS EID, MD: In some respects, yes, but I think what I try to explain to patients is that when they have a penile implant, the penile prosthesis or the pump, they're going to feel like themselves again. They're going to feel normal again. If a doctor is not willing to say that to the patient, then the patient doesn't see the possibility for them of recovery potency the way it used to be. So you almost have to paint a picture of what's possible and describe it in a lot of detail.

For example, many of the patients that I see assume that when they get a penile implant they're not going to have any sensation, that it's something that one gets to satisfy one's partner, and when you tell them, "You are going to feel like a regular erection. You're going to have an orgasm and so forth," then they say, "Hm, that's interesting. Then maybe I'll do it."

Speaking to another man who went to the same experience is very helpful, very, very helpful and very encouraging. John and Jim can say things to patients that I can't. They can talk about their experience, and that is extremely helpful and reassuring for patients.

DAVID R. MARKS, MD: How important is it to get the partner involved in making this decision?

J. FRANÇOIS EID, MD: I think it's very important, because the partner can be an enabler. I think it's very important for men to realize it when they're getting this device, it is a gift for themselves. They're doing it for themselves. Now, the partner will of course benefit from the patient feeling complete and like himself again, but the real reason that the patient is getting it is for himself, and I think the distinction is important, because then the partner doesn't feel guilty that the patient is actually doing something and having a procedure for her.

DAVID R. MARKS, MD: John and Jim, John's partner, do you have any final comments?

JOHN: I'd just like to say that both Jim and I, I believe, have volunteered to be on the list to talk to other prospective patients, and the message I would give them and do give them, and so does Jim, and to anybody listening to this telecast is don't hesitate. If you have any concerns, go get looked at, get checked, and take care of it.

DAVID R. MARKS, MD: Thank you for being here.

J. FRANÇOIS EID, MD: Thank you, David.

DAVID R. MARKS, MD: And thank all of you for being here once again. I appreciate it. Thanks for joining the webcast. I'm Dr. David Marks. Goodbye.