Helping to restore virility

Dr Peter Lim, senior consultant urologist at the Andrology, Urology & Continence Centre. Photo: DR PETER LIM

Scenario: You meet an attractive woman in a bar. How would you explain what you do and your chosen speciality?

I would say that I specialise in men's health, which covers areas such as andrology, urology and continence.

In layman's speak, I deal with diseases of the kidney, the waterworks, sexual function and fertility, particularly in men. Examples include overactive bladder and erectile dysfunction (ED).

So you deal with the male plumbing. What's the most fascinating bit of the system for you?

The sexual and fertility parts of the human system.

I am sure it is fascinating to everyone else too. A male's virility is key to his existence and this has been true since the start of mankind.

Men seem to be very concerned about performing in bed. Do you see a lot of that in your practice?

I think it is more important to address potential men's health issues when discussing this topic.

But it is a fact that most men are more concerned about their performance; in fact, I see that in plenty of my male patients.

Are men shy when it comes to their nether region?

Perhaps 20 to 30 years ago, but they certainly are not today. People are open-minded and very knowledgeable in this modern age. So, I don't think men are that shy any more.

Why do you think being virile is so important?

A male's virility is crucial to his ego. It is psychologically the epitome of being male - being the dominant, the powerful, the strong and the mighty protector in the partnership.

Is ED psychological or physical?

Both.

The physical part is more important. Today, we have uncovered the causes of ED such as heart disease, high cholesterol, high blood pressure, diabetes and obesity.

The psychological aspect sets in when the physical inadequacy presents itself and enhances the overall failure of the sexual function. We must never neglect the impact of either one of the factors.

How then has treatment of ED changed?

At first, it relied heavily on psychological counselling, when the physical causes were not clear.

When physical causes were uncovered, surgery became the mainstay of treatment.

Then after 1999, the Viagra revolution occurred. Today, we have shock wave therapy of the penis to treat ED.

Viagra has also continued to innovate itself through its new orodispersible tablets, which dissolve in the mouth and gets it going within minutes.

Any side effects to ED medication?

Yes. Some oral meds are not suitable in heart patients, especially those on nitrates.

Otherwise, it carries the usual side effects such as headache, nose blocks, and gastritis; or muscle aches and pains in some men.

What's the craziest or weirdest thing you have come across or experienced in your job?

I've seen bottles stuck in the anus, safety pins in the urethra, and rings around the shaft that cannot be removed.

Any perks of the job?

As a doctor, it is very satisfying when my treatment is successful or in situations where ED causes infertility, the treatment successfully results in a baby. Whenever I see my patients successfully treated, it is definitely something special and extraordinary for me.

Downside?

It is very disheartening to see the failures of treatment in some very bad and severe cases, especially those involving juvenile Type 1 diabetics.


This article was first published on June 28, 2015.
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