CS: I’m Christopher Springmann, and you’re listening to Life Love & Health: Special Edition. Erectile dysfunction or ED, the inability to either have or maintain an erection, is a source of embarrassment and frustration for many men and their partners . . and there are many reasons, including diabetes, prostate surgery, vascular disease and psychological causes. And those so-called male enhancement ads on TV and the Internet . . . a re NOT amusing to men who suffer with erectile dysfunction. Our next guest is most sympathetic to men with ED – he’s Dr. James Barada, a board certified urologist from Albany, New York who recommends treatments and devices for his patients that are both effective and safe.
CS: And I think our last show was on Peyronies Disease. But I must say, we have never done a program like this. And I think the biggest issue is, you know, I have never been persuaded that any of these products enjoy great efficacy or safety. And that’s probably the first question. You know, why would you as a physician prescribe a vacuum pump?
JB: Well, a treatment of erectile dysfunction as one of the sexual dysfunctions, I think, is very important in overall quality of life. And a good sexual relationship with a couple, I think, has tremendous health benefits. My job is basically to build better erections so that men have the opportunity to have intimacy with their partner. And I have a lot of different treatment options that are available to me that I try to direct to the patient themselves. Certainly we have the new “Viagra” era, treatment with pills. But pills are not necessarily the right treatment for every patient. For example, side effects, contra indications. Vacuum therapy has been around for a long period of time. Actually, it predates the Viagra era. And it has always been shown to be a very effective form of therapy. The down side to vacuum devices is that they’re basically cumbersome unto themselves and requiring the use of constriction bands to maintain the erection. But we’re moving into a new era, which is the idea of maintaining corporal health, or sexual health. And one of the ways of doing that is by use of a product called the Bathmate.
CS: Tell me, Doctor, what has your experience been with the Bathmate hydro pump?
JB: My experience with the Bathmate hydro pump is to use in patients to maintain corporal health. There are advantages to using expansion, whether it’s by a vacuum device, which is pretty much an older therapy, or the new approach using hydraulic pressure to create enlargement of the penis.
CS: Well, how is the Bathmate hydro pump different from the air pump in terms of safety, comfort and ease of use?
JB: The Bathmate hydro pump differs from the vacuum pumps or air pumps that have been around for a long period of time. They both incorporate a cylinder that flips over the penis. But the negative pressure is created differently for the Bathmate by using water instead of a negative air pressure. One of the advantages of the Bathmate is because it’s using warm water, it’s more comfortable for patients. The negative pressure that’s developed is less dramatic and so that there is less risk of having discomfort or pain, or development of black and blue marks from high negative pressures. And as a result the compliance for patients using the Bathmate is much higher than what we’ve seen with patients using standard vacuum devices.
One of the advantages of the Bathmate …it’s more comfortable for patients
CS: Compliance is an issue and I think people have to be patient. So let’s talk about compliance rates between the two strategies, the Bathmate hydro pump versus the air pump.
JB: Compliance for different treatments depend on the ease of use of the therapy that’s been prescribed. In my experience using a vacuum pump on a daily basis to maintain penile health -is difficult to have patients do because it’s somewhat cumbersome and there’s a lot of messiness because of the need for jellies and other things to maintain a seal. Whereas the Bathmate is used in the privacy of the bath or the shower. It involves warm water, which is much more comfortable. And some patients report to me it’s actually kind of fun. So it becomes part of their shower or bath routine. As most people that use showers or baths for daily hygiene, it’s pretty simply to incorporate that into a pattern, such that compliance rates are increased with the Bathmate rather than sort of setting aside a specific time to use a vacuum device.
CS: Well, tell me, Doctor, why does the Bathmate hydro pump work? What does it do?
JB: The Bathmate hydro-pump works because it increases the size of the penis by drawing blood into the penis and expanding the natural vascular channels that are found there. The natural state of the penis is flaccid 99 percent of the time. During that time that tissue builds up various, we can call them toxins or whatnot, that make it more difficult for an erection to occur when sexual stimulation is involved. By using the Bathmate you get a gradual expansion of those vascular channels. You wash out the toxins that have accumulated over say the course of a day, and you actually start to stretch the tissue around the vascular channels, increasing length and girth. So you get a lot of advantages by regular use of this device.
The Bathmate hydro-pump works because it increases the size of the penis by drawing blood into the penis and expanding the natural vascular channels that are found there.
CS: What has been your personal experience? Now is it fair to assume that you would not recommend a product to your patients that you have not tried yourself?
JB: That was the first thing that I performed. I try all therapies, non-invasive therapies for corporal health. In my experience, relatively straightforward to apply the device, to use the device. It was simple and straightforward. As a matter of fact, I have it on the shelf in my own shower. I’m a firm believer in maintaining corporal health to prevent erection problems from happening, rather than waiting until it is an issue requiring more involved treatment. I advocate for the Bathmate for people who are concerned about erection quality, to prevent progression of disease. And of course this should be involved, these patients should also be taking care of their general cardiovascular health. Regular exercise, management of sugar if they have diabetes, control of high blood pressure, good cholesterol awareness. All of those things are beneficial for overall cardiovascular health and are going to have a direct impact on sexual health as well.
[Using the device is] …simple and straightforward. As a matter of fact, I have it on the shelf in my own shower.
CS: It’s interesting that you should mention cardiovascular disease, because erectile dysfunction or ED is often an early warning sign of cardiac problems.
JB: ED is a marker for overall cardiovascular health and it’s not unusual for patients to present with erectile dysfunction only to uncover other cardiovascular issues. So maintenance of overall cardiovascular health of which penile health, or sexual health is one form of it, is very, very important for all men.
CS: Now I know I’m digressing by saying this, but I’m sure you’ve had a number of what are called doorknob conversations with men. And one of the great inherent dangers of acquiring erectile dysfunction drugs like Levitra, CIALIS and Viagra clandestinely or without a prescription is that you may miss an opportunity to evaluate your overall cardiovascular state. Is that true?
JB: It is true that patients acquiring medications to treat erectile dysfunction are a missed opportunity to have an overall general health evaluation. But, again, when you deal with issues of sexual health there’s a lot of embarrassment and concern. The idea of feeling alone and somehow broken. And so it is not unusual to have the internet prey on this vulnerable population, making access easier, but unfortunately it may not be in their best overall health interest.
CS: What has your patients’ experience been with the Bathmate hydro pump? How have they responded to this therapy?
JB: The experience of patients that I have given information on, easy to acquire, easy to use. Compliance has been high. The number one response that I’ve gotten is that they all have the perception of a larger penis when they do have sexual activity and a better or more satisfactory sexual experience.
CS: But perception is reality. And especially visual perception and the perception of a partner. Those are quite real.
JB: Not only perception is important, but many times fastidious patients actually do measurements before initiating therapy and then report those results back to me.
CS: And what sort of results have you heard?
JB: I have heard increases in overall size in terms of length and girth by their measurements. We don’t have an objective study to look at this, but that would be an interesting thing to do from a scientific standpoint as well.
…increases in overall size in terms of length and girth…
CS: As a urologist what are your thoughts about this? Are you pleased with what you’re seeing? And also are you happy to have another useful-I don’t want to use the word tool-therapy available to you to address your patients’ needs?
JB: The treatment of sexual health, I think, should move from treating erectile dysfunction to actually preventing erectile dysfunction. And I think that the idea of corporal health by regular expansion of the penis with the Bathmate may actually prevent ED from occurring. So my experience is to use this product in a proactive fashion before a real problem arises. In addition, it’s also another tool available to me for treatment. For example, I can combine it with oral medications, and it may improve the response to those medications. So I can prevent somebody having to go on to more invasive therapies. It’s really a win/win situation for the patient, for the benefit that they derive from the therapy, as well as the urologist who is looking after their sexual health in preventing progression of disease.
…the Bathmate may actually prevent ED…
CS: When you write a prescription, in effect metaphorically, for use of the Bathmate hydro pump, how often do you recommend that men use this product and for what duration?
JB: The Bathmate does not require a prescription. It can be purchased by the individual without a prescription. I’m not sure about coverage by insurance companies and things like that, but it’s not a prescription dispensed device. Use of the Bathmate, I don’t think you can use it too often. I like the idea of incorporating it into their regular shower or bath hygiene, you know, because that’s a fixed period of time. Use of it daily is fine. Application five to ten minutes- not much more than that is necessary. You just want to get full expansion, a period of maintenance and then removal of the device. So it really doesn’t take too much time either. So basically they’re going to be using it on a daily or every other day basis, and that’s where they get the benefits of the therapy.
JB: Why not?
CS: Why not? Are these results permanent?
JB: We don’t have data to say that they’re permanent, much like your Kegel exercises. If you stop doing them you have the benefit fade over a period of time. However, if you get a benefit, and you want to maintain it, and it’s simple to do, I imagine they would use it indefinitely. Certainly it would take a study to say benefit is derived, therapy is discontinued and benefit is lost. But in terms of corporal health, certainly no harm is going to be done with long-term use. And I would anticipate that the benefit gained will be maintained, although you may have to do it less frequently.
CS: You know, I am shocked by the commercials that I see on TV, which on one hand are amusing, but frankly appalling, selling nautics [phonetic] with no proven efficacy or safety. The whole male enhancement business seems to me-and this is just my personal opinion-like Snake Oil 101. You must have some observations about this. In fact, I would suspect that your patients frequently ask you about male enhancement products. Is that true?
JB: I am asked about male enhancement products ad nauseam. I believe that they are preying on a vulnerable population. Any benefit derived of various nutra-ceuticals for enhancement are primarily a placebo effect. But if somebody derives benefit, that’s a beneficial placebo effect. It’s just a question if it’s worth the cost that they’re spending for it. At the same time, the Bathmate is an application or an application of negative pressure therapy, which has a longstanding, scientific record. It’s just a different way of approaching the problem.
Bathmate is an application …which has a longstanding, scientific record.
The use of negative pressure to create erections, to derive a benefit for treatment or prevention of erectile dysfunction has a long scientific history, predating that of the Viagra era. The Bathmate hydro pump is the same principle using a different mechanism. Using water as the negative pressure source rather than air. Therefore the benefits of it should be the same as seen with the vacuum pump devices. So, again, it’s an effective therapy. It probably maintains corporal health, which subsequently improves sexual functioning or subsequent sexual experiences. It’s safe. It’s relatively inexpensive. It’s durable. And it’s easily incorporated into somebody’s lifestyle. Treatment of erectile dysfunction as one of the sexual dysfunctions, I think, is very important in overall quality of life. And a good sexual relationship with a couple, I think, has tremendous health benefits.
It’s safe. It’s relatively inexpensive. It’s durable. And it’s easily incorporated into somebody’s lifestyle.
My job is basically to build better erections so that men have the opportunity to have intimacy with their partner. And I have a lot of different treatment options that are available to me that I try to direct to the patient themselves. Certainly we have the new “Viagra” era, treatment with pills. But pills are not necessarily the right treatment for every patient. For example, side effects, contra indications.
…pills are not necessarily the right treatment for every patient…
Vacuum therapy has been around for a long period of time. Actually, it predates the Viagra era. And it_has always been shown to be a very effective form of therapy. The down side to vacuum devices is that they’re basically cumbersome unto themselves and requiring the use of constriction bands to maintain the erection. But we’re moving into a new era, which is the idea of maintaining corporal health, or sexual health. And one of the ways of doing that is by use of a product called the Bathmate.
…we’re moving into a new era…the idea of maintaining…sexual health. And one of the ways of doing that is by [using]…Bathmate