A 44-year-old Kenyan man lay on the operating table at Aga Khan University Hospital (AKUH), Nairobi. He was nervous and anxious, hoping to get what he had always longed for – enjoy sex like any other normal functioning person.
Dr Ahmed Youssef – a consultant urologist and the lead surgeon in what is now the first successful penile implant in Kenya – highlighted that tests conducted on the patient, including a penile doppler ultrasound had revealed that he was struggling with a “severe venous leakage”. That is why an implant was the ideal treatment.
Dr Youssef spoke to the Nation on how he and his team fixed the problem that is rarely discussed by menfolk not just in Kenya but around the world.
“Before we start talking about erectile dysfunction (ED), it is important that we know of a branch of science that deals with male sexual life, genitals as well as infertility. It is known as andrology.
ED is the inability to achieve or maintain an erection sufficient to have sexual intercourse or satisfaction for you and your partner.
This man had suffered for many years. We were determined to fix that.
There are many causes of ED, including diabetes, hypertension, treatment for hypertension, cardiac problems, renal failure and uremia, obesity and vascular illnesses.
Others are increased cholesterol and hyper lipedema as well as atherosclerosis
Ten to 15 percent of adults below 40 years have ED.
It goes up to 76 percent between the ages of 50 and 70.
25 percent of adults in all age groups have the problem.
It is, however, important to note that many men with this condition do not seek medical treatment.
They also rarely discuss it with family doctors, making the official percentage lower than the actual numbers.
When an ED patient comes for treatment, we start by a complete evaluation.
AKUH has a highly specialised clinic dealing with such cases.
Evaluation entails knowing the history of the patient.
He needs to say when the problem began. Next, we examine him.
We then conduct a series of tests to determine the cause of the condition.
Doctors then come up with a plan to manage the problem.
The programme starts with giving the person pills that are designed to improve his erection
The pills are suitable for men with mild to moderate ED.
We will then counsel the patient and find out if he and his partner are satisfied with the treatment.
If not, and he happens to have a moderate to severe ED, we go to the second level of treatment.
This involves using intra-uretheral pills or an injection to the penis that induce an erection. We again counsel the patient and gauge his satisfaction with this treatment.
If the man is not satisfied or has a severe erectile dysfunction, doctors will advise that he proceeds for penile prosthesis. A penile prosthesis is what we carries out.
The procedure actually takes less than an hour.
For our patient, we made a small incision that allowed us access the entire tissue of the penis.
We then did some dilatation in order to have space in the tissue.
Then we put the implant according to the size and girth of the penis. We closed the wound after that.
The implant is used to give the penis a very good degree of erection.
From what we have observed in this case, the satisfaction rate of the man reached 95 per cent.
After all the tests dome by the team, we can confirm that the man and his partner can successfully engage in sex any time.
It actually means there is no need for special preparation before coitus, like taking pills or that sort of thing.
The man can get his erection comfortably, have sex for as long as he wants, ejaculate, erect again and have more sex while satisfying himself and the partner.
Sexual pleasure, desire, sensation, orgasm and ejaculation are normal and not affected by the operation.
Recovery time after the surgery is around one week. The man can then comfortably resume his sex life.
He will not even notice the implant after four to six weeks as the body system adapts to it very fast.
The whole procedure costs between Sh800,000 to Sh1 million.
Compared to the blue pill, the implant is more beneficial and cost-effective.
In the long term, the implant is much cheaper than the pills, which a man will always have to buy before having sex.
There is ignorance and unawareness among Kenyan men when it comes to this “taboo” subject.
The men are at times shamed when they open up about ED and premature ejaculation.
Others think the condition is a normal process of aging.
There are multiple lines of ED treatment. The government should ensure the condition is covered by insurance as it directly affects the quality of life and lifestyles of men and women.
It should also be noted that pyeron’s disease and severe fibrotic penile curvature affect men.
These two are brought about by the stress related to work whose best mode of treatment is a penile implant.” BY DAILY NATION