Premature Ejaculation

Premature Ejaculation

Treatment:

1- Antidepressant as

Tofranil 25 mg - 50 mg tab. 1×3.

Toframin 25 mg tab. 1-2×3.

2- Local analgesic before intercourse as

Lidocaine cream.

Lignocaine cream.

3- Reassurance.

4- Drugs of psychogenic impotence may be used.

5- Squeeze technique as follows

Wife can squeeze penis shaft to induce erection, when erection wanes, she will repeat manual stimulation, and this is repeated several times till husband can learn to control his ejaculation.

Psychogenic Impotence

Psychogenic Impotence

Diagnosis:

Depending on exclusion of organic causes as DM and surgical or neurological causes.

Treatment:

1- reassurance.

2- drugs (one or combination of following drugs). As

Viagra tab. (sildenafil) 50 mg.

Yohimbex tab. (yohimbine 4.5 mg).

Sex forte tab.

Prostavasin syringe (amp) → intracavernosal injection at lowest dose that can produce erection.

Senile prostatic hyperplasia

Senile prostatic hyperplasia

Diagnosis:

Old age.

Micturition → Dysuria.

                 → Frequency.  

                 → Urgency.

                 → Nocturnal enuresis may be an early symptom.

Urine retention (acute or chronic).

Late → Renal failure.

Treatment:

Compination of many drugs may be used.

1- Alpha blockers.

         Cardura tab. 1 mg. - 4 mg.

         Dosin tab. 1 mg. – 4 mg.

- Start by 1 mg/day then increased to a maximum 8 mg/day.

2- Other alternatives.

        Tadenan cap. 25 – 50 mg.

        Prosta cap cap. 50 mg.

        Prostacure cap. 50 mg.

Or

        Proscar tab. 1×1.

        Prostat tab. 1×1.

        Prostec tab. 1×1.

        Prostalin supp.

        Decongestyl supp.

3- Anti androgen (lipido is maintained).

        Eulexin tab.

        Androcur tab.

        Diane tab.

NB. Surgery is indicated if:

- Severe increase in frequency and dysuria.

- Acute urine retention not relieved by catheter.

- Chronic renal retention.

- Complications as haematuria – diverticulum – cystitis – back pressure on kidney……

Chronic prostatitis

Chronic prostatitis

Diagosis:

Dysuria - ↑frequent micturition - impotence - urethral discharge - myositis - arthritis - urine analysis (pus culture is important).

PR → prostate is tender and enlarged.

Treatment:  1- antibiotic (quinolone).

                     2- symptomatic → analgesic.

                                               → increased frequency.

                     3- decongestyle supp 1×2.

NB. some times Chlamydia may be the causative organism.
Doxymycin cap. 1×2×4.