Prime Time - Jane Fonda [94]
Self-administered intraurethral therapy (Muse). This treatment involves using a disposable applicator to insert a tiny suppository, about half the size of a grain of rice, into the tip of the penis. (A flashlight will help you see exactly what you are doing! Try holding a small one in your mouth during the insertion to light your way.) The suppository, placed about two inches into the urethra, is absorbed by erectile tissue in the penis, increasing the blood flow and causing an erection within approximately three minutes. Absorption is helped by rolling the penis between the palms of the hands for a minute or longer. The erection should last from forty-five minutes to an hour. Side effects may include pain, burning, minor bleeding in the urethra, dizziness, and formation of fibrous tissue in the urethra. In fact, 10 to 20 percent of men experience pain or burning with Muse or injections. If your urologist prescribes Muse, be sure that both you and your partner go on the website to get all the instructions. Doctors don’t always explain everything, but you can ask. For instance, it was only on the website that I learned that you should hold the penis upright before and during insertion of the pill and then, after rolling the penis between your palms, as previously described, walk around for a few minutes, holding the penis upright, to increase the blood flow.
If the sexual pharmaceuticals, injections, vacuum pumps, and suppositories have not worked for a man, the next thing to consider is the penile pump.
The penile pump consists of two or three devices. The pump is inserted through a small incision in the scrotum and placed invisibly within a fatty deposit between the testicles. A reservoir cylinder is placed next to the bladder, in the lower abdomen, and another soft cylinder goes into the penile shaft. None of the penile nerves are cut or damaged. When the pump is squeezed, a saline solution is pumped from the reservoir into the cylinder in the penis to create an erection for as long as is desired. When sex is over, the solution is pumped back into the reservoir.
When flaccid, the penis looks entirely normal—locker room safe. No one can tell that a device has been implanted. I am told it looks and feels so natural that some men never let on, and their partners don’t know. I think that if a man is in a committed relationship, there should be full disclosure and the implant and pump should become part of foreplay in the same way that putting on a condom can become a sexy act. The pump, after all, is evidence that the man is truly committed to giving as well as receiving pleasure.
Because the penis itself has not been damaged, the man has the same feelings as he did during intercourse prior to the procedure, and he can still have an orgasm and father children. For men suffering from Peyronie’s disease, which causes pain or bending of the penis during erection, the pump may be the best solution. For healthy men, infection rates are low; men with diabetes are at higher risk of infection. The insertion currently involves a forty-minute procedure requiring a twenty-four-hour hospital stay; as of this writing, costs run between $12,000 and $20,000, depending on the hospital. Coverage of this procedure by medical insurance depends on one’s insurance policy. Medicare now covers it completely, except for the co-pay. Other insurers will cover it if it is in the man’s contract and depending on the cause of the ED.
The device needs to be replaced, on average, every ten years. I am told that, according to many doctors treating sexual dysfunction, the penile pump has a 99 percent satisfaction rate. Dr. Tom Lue, an internationally recognized expert in the treatment of male sexual dysfunction at the University of California, San Francisco, says, “The reason for the high satisfaction rate is that, first of all, you look like a normal person. No one sees any difference. But you can pump it