Tobias S. Kohler, MD, MPH, discusses the epidemiology and associated dangers of steroid abuse. Specifically, he explains steroid-related risk of testicular atrophy, gynecomastia, infertility, and sudden cardiac death. Through an anecdote, he illustrates the psychological and sociological causes of steroid abuse.
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Tobias S. Kohler MD, MPH, discuss the current AUA guidelines regarding priapism, covering proper diagnosis, sympathomimetic injections, phenylephrine use, shunt techniques, and oral medications. He then suggests changes to these guidelines, such as including proper patient counseling, minimizing proximal shunts, and early penile prosthesis. Furthermore, he proposes a new algorithm for the management of this condition.
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Tobias S. Kohler, MD, MPH, demonstrates the correlation between cardiac pathology and erectile function, other sexual function, testosterone levels, and lower urinary tract symptoms (LUTS). To illustrate this, he describes the methodology and results of his Cardio-Urologic Pathology/Prevalence Interplay Determination (CUPID) study. He also discusses ED risk factors, sex hormone binding globulin (SHBD), and the connection between testosterone levels and benign prostatic hyperplasia (BPH).
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Tobias S. Kohler MD, MPH, discusses the corollary relationship between vascular disease and its treatment and erectile dysfunction (ED) and the literature supporting this relationship. He then reviews ED management approaches through a cardiovascular standpoint, including counseling patients on lifestyle modification and pudendal artery stenting.
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Tobias S. Kohler, MD, MPH, discusses limitations and biases in literature regarding inflatable penile prosthesis (IPP), and how they led to the development of the Prospective Registry of Outcomes With Penile Prosthesis (PROPPER) study and the upcoming Erectile Restoration Outcomes Study (EROS). He describes best practices when performing penile implant surgery, such as infection control, reservoir replacement, wound closure, and patient selection.
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