Millions of Indian men are silent sufferers of male sexual health issues, and even fewer discuss these issues with their doctors. Furthermore, many of these men have no idea that they can get medical attention for their penile problems and see a solution for their fertility issues, painful and curved penis, and numerous sensitive and painful conditions that affect their quality of life for many months and years.
Understanding and addressing these conditions should never be ignored. A specialist and treatment can help resolve most of these issues. Dr. Vikas Singh is a highly qualified Urologist who has been resolving male sexual health issues of men in Indore and has been associated with Reform Clinic Indore for more than a decade.
Furthermore, your concerns, no matter how difficult or problematic they are, are in the safest of hands. You have a right to quality care of the highest standard. Don’t hesitate to seek help.
In a man’s life, male sexual health relates to the range of physical health issues, from the ability to partake in satisfying sexual relationships, to healthy emotional relationships, to the ability to father children. These can be issues of the vascular, structural, or hormonal system, and can even be issues of the brain, of the nervous system or of the psyche.
In India, male sexual health issues still remain taboo. Culturally, men are taught and conditioned to see and relate sexual health issues as a man’s weakness. As a result, many men can go for many years without seeking help, even though the realities are very different. The majority of male sexual health issues can be traced to a clear and defined biological cause, and a great many can be treated as well.
Across the world, erectile dysfunction is estimated to be present in 10% of the male population in their 40s, 20% in their 50s, and 30 to 40% in their 60s and older. Varicocele disease is present in 15% of the global male population, and in 40% of males in the infertility population. Pellagra disease is present in 5-10% of the global male population. Disease reporting is poor, however.
In Indore, men can have all the diagnostics for male sexual health issues and their treatments at Kokilaben Dhirubhai Ambani Hospital, and at the hands of a specialist.
Erectile dysfunction (ED) is the top sexual health issue for men in nearly all countries. It is defined as the inability, for a prolonged period, to attain and maintain firmness for a desired sexual function. Separated from many possible causes, investigations help to come up with solutions.
Psychotropic, Antihypertensive, and Other Drugs: Antidepressants, blood pressure medications, and several other drugs may cause ED as an unintended consequence.
Having ED is not just a sexual concern for men. The condition erodes one’s self-esteem and ultimately causes depression and negatively impacts other close and intimate relationships. If the condition is ignored, by default, it continuously worsens. If men are properly diagnosed and treated, in most cases, they are able to resume and maintain a satisfactory sexual function.
Peyronie’s Disease causes the penis to bend, shorten, and become all the more fibrous and tough when scar tissue (or plaque) builds up under the covering (tunic) of the penis. The curvature can be in any dimension and can take the form of hourglass-shaped or even hinge-like deformities.
In the acute phase, which lasts from 6 to 18 months, pain is felt in the developing curve and in the erection. in the chronic phase, the curve and pain become fixed, and the deformity is present. The deformity can create psychological distress, difficulties in relationships and even pain that makes intercourse impossible.
In the acute phase, treatment can occur through oral medications or intralesional injections, and in the chronic phase, when curvature is too acute for intercourse, other procedures can be taken to reconstruct the penis and implants.
A varicocele is found when the veins of the scrotum have an abnormal increase in size and can be found to be dilated. The veins are able to heat the testicles above normal, which can be found to be optimal for the production of sperm. Hence, the production of optimal sperm is impaired.
Infertility caused by varicocele can be found in 40% of men, and in 15% of all men. Varicocele can cause pain and heaviness of the scrotum and can decrease the production of testosterone. This makes the treatment of varicocele one of the most common causes of male infertility.
Microscopic varicocelectomy is the best treatment for symptomatic varicocele, as well as for those who want to retain their fertility. It is a precision surgical technique that is performed under an operating microscope and has significantly better outcomes than the surgical techniques that do not employ the microscope.
The frenulum is a connective band of tissue located on the ventral side of the penis. It spans between the glans and the inner foreskin. Frenulum breves are variants of the typical band of frenulum that are ultra-short, or even tight. The hyper-short respite frenulum is painful and limits movement. Complete tearing of the tissue, which obviously will happen repeatedly during sexual activity, is very distressing.
Frenulum breve is frequently thought to be a label of phimosis by the layman, but the educated observer will see that the foreskin is indeed retractable, and it is the frenulum that restricts. The treatment of choice is a frenuloplasty, a minor surgical procedure that employs a local anaesthesia, whereby the frenulum is cut and then reconstructed to a more proper length and with greater mobility. The success rates are excellent and the procedure is quite minor with a recovery of about two to three weeks.
For men who have severe erectile dysfunction and have not responded to the more traditional means of erection aids (which include oral medications of the type sildenafil and tadalafil, intracavernosal injections, and vacuum devices) or are unable to use the more traditional means of erection aids because of severe medical contraindications, a penile implant is by far the best option and the most workable and the most effective option.
Consider a penile implant to have control over your erections. This implant contains a hydraulic system to increase the size of the penis. Other models allow your penis to remain stiff. These implants are completely removable and are not visible. 90% of test subjects and their partners of the inflatable implants were satisfied with their results. This makes this implant the most rewarding, long-term option for treatment-resistant ED.
Sexual health concerns are best tackled when they are detected and reported in their early stages. The main reason why most men take time before they consult a medical practitioner on their sexual problems is the discomfort they experience when they talk about such conditions. The following are a few medical concerns on men’s health that you should address before it’s too late:
Diagnosis forms the backbone of all therapies. At Kokilaben Dhirubhai Ambani Hospital, Indore, Dr. Vikas Singh employs an amalgamation of detailed evaluation of the clinical data with diagnostic work to ascertain the primary pathology rather than the symptom.
Every consultation begins with a Past Medical History evaluation that encompasses the nature and duration of the issue, relevant medical conditions (Diabetes, Hypertension, Cardiovascular diseases, Past Surgeries, Spinal or Neurological conditions), medications (self and prescribed), habits (smoking, alcohol, exercise), and mental wellness.
Physical Examination of male sexual health issues involves detailed examination of the genitals (Foreshore, Frenulum, Shaft of a Penis for the presence of Plaques or Deformity, Testes for size and consistency), examination of the scrotum for Varicocele (both standing and with Valsava Maneuver), examination of secondary sexual characteristics, and in some cases blood pressure and peripheral pulses to assess vascular health.
For those experiencing erectile dysfunction, a Penile Doppler Ultrasound is a quantitative assessment of blood flow behind the major vascular networks of the penis. It reflects both the arterial and venous supply to the penis, and assessment of both penogenic blood flow and tissue retention (i.e., venous occlusion) at rest and following the administration of a vasodilator is done. This is the only test able to differentiate between the arterial insufficiency, the venous leak, and the mixed vascular disease.
Also when it comes to the assessment of Peyronie’s disease, Penile Doppler is of great importance. It is able to assess the number, size, location, and even calcification of plaques, and also the degree of vascular changes, aiding to the planning of surgical correction.
Blood investigations for Male Sexual disorders report on assessment of hormonal and metabolic issues, as well as Total and Free Testosterone, LH and FSH (to differentiate primary and secondary hypogonadism), Prolactin and Thyroid levels (TSH, T3, T4), Blood Glucose with HbA1c (to determine Diabetes), Lipids and Blood report for overall health status (Complete Blood Count, Liver, and Kidney function).
In male fertility assessment, semen analysis is of great importance. A semen sample is expected to contain a number of sperm with assessment of the various aspects of the sperm, including the motility and morphology. Semen volume, sperm count, motility, shape, semen volume, semen pH, and WBC count are to be assessed after abstaining from ejaculation for 2-5 days. Varicocele and other male fertility issues (including severe sperm issues) are assessed using other tests, which include hormonal level assessment, scrotal Doppler ultrasounds, and testicular biopsies.
You could receive a range of services provided by Dr. Vikas Singh when it comes to dealing with male sexual health problems, including medication, surgically-based therapy, and penile surgery, all of which are offered in a step-wise fashion. Each treatment is based on the patient’s need, whether to manage a specific problem, meet a certain goal or a combination of both.
If a case of erectile dysfunction is particularly severe and has proven recalcitrant to all forms of treatment, a penile implant is the treatment of choice. Compared to the alternative treatment of oral or injectable pharmaceutical options, penile implants are proven to deliver a safe, satisfactory solution.
Men with the Three-Piece or Inflatable Penile Implants can expect the most sophisticated implant on the market. Each implant comes with a rigid cylinder and reservoir to support the fluid exchange, and a scrotal subcutaneous pump. Once the pump is activated, the fluid exchange between the reservoir and the cylinder carries a matched supply of fluid. To deflatten, the release valve is activated, and the implant will rapidly return to the normal state with the ellipsoid appearance of the cavernosum. An implant is designed to maintain a very natural appearance, and patient satisfaction, along with partner satisfaction, exceeds 90%.
Malleable (Semi-Rigid) Penile Implant – Two flexible rods implanted inside the penis. The penis is always semi-rigid but can be positioned upward for intercourse and angled downward when not in use. Simpler mechanics, easier to use, and an excellent option for older patients or those with limited hand dexterity. Satisfaction rates are around 80 to 90%.
Penile implant surgery is a 1-2 day hospital procedure. The implant is internal, so there are no additional components or external appearance changes to the flaccid penis. Patients are not able to partake in sexual activity for 4-6 weeks while healing. Dr. Vikas Singh offers both pre-operative counseling and post-operative counseling so that both the patient and their partner are ready.
Microsurgery for Varicocele is the standard surgical treatment for Varicocele, and is the best option to improve the overall sperm quality and natural fertility. The procedure is done through the testis operating microscope and offers a 25 times the original view of the surgical area. The surgeon is then able to identify and correct the dilated Varicocele veins while preserving the testis artery, lymphatic vessels, and vas deferens.
A small incision of about 2 to 3 cm in length is made in the groin or directly below the groin. All dilated veins are ligated by the surgeon. The high magnification capabilities of the microscope reduce the two most important risks, the damage of the testis artery and Varicocele recurrence, due to the microsurgery, the surgeon is able to ligate the veins.
Study after study has demonstrated that post-surgical sperm analysis reveals an improvement in sperm count, motility, and morphology at a rate that is statistically significant and can be observed at a time between 3–6 months post-varicocelectomy. Natural conception occurs for about 40%–70% of men having a varicocele and seeking infertility, after a time period of 12–24 months post-varicocelectomy. Clinically, improved sperm subjects as noted, additionally optimize outcomes for all Assisted Reproductive Technologies (ARTs: IUI, IVF, ICSI). The varicocelectomy is an outpatient procedure and lasts approximately 60–90 minutes, after which most patients can return to their homes one (1) day after the procedure.
Treatment of Peyronie’s disease can and should be staged and will vary depending on the phasic state (acute vs. chronic) and degree of functional impairment dichotomies.
For the Acute Phase: Patients may try oral treatment with pentoxifylline. Local treatment of the plaques with direct adjunct medicines like collagenase (if available), verapamil, and interferon (to name a few) can attain the goals of plaque destruction and prevention.
For the Chronic Phase: The plaques become incised, and a graft is placed, which is the best option in the face of complex deformities and severe curvature. It can be more technically complex.
For men with both Peyronie’s disease and erectile dysfunction – a common combination – a penile implant with intraoperative manual modeling is often the best method, and the only one that can correct both concerns in one procedure.
Frenuloplasty is the procedure that resolves the short frenulum by offering an elongation of the frenulum, which effectively eliminates the pain, restriction, and risk of tearing of the short frenulum that is caused as the short frenulum gets more and more taut. A small incision is made across the surface of the frenulum and is closed by the Z-plasty method, thus efficiently elongating the frenulum and preserving the overall integrity of the frenulum.
The procedure is done in local anaesthesia and is of short duration (20 – 30 min), which allows for a walk-in check out after the operation. The stitches that are used are self-dissolving. The patients can undertake physical activity right after they are discharged. Sexual activity can be resumed within 3 – 4 weeks. The results are almost 100%. The pain and the restriction disappear, and complications and recurrences are extremely rare.
PDE5 Inhibitors (Sildenafil, Tadalafil, Vardenafil) – Considered the first line of pharmacological treatment for ED, PDE5 Inhibitors work by decreasing the contraction of arterial smooth muscle and allowing the arteries to dilate and fill with blood, given the right sexual stimulation, achieving an erection. These medications work for about 65 – 70% of males. Once the doctor has reviewed cardiovascular health and medications, prescribed treatment options, and given very specific contraindications, the doctor can then prescribe one of the PDE5 Inhibitors.
Low testosterone (hypogonadism) in men, testosterone can be given via injections or can be given via topical formulations (gels, patches) to improve libido, increase energy and improve overall mood and sexual function.
Intracavernosal injections to the erectile area of the penis with Alprostadil produce a very strong and reliable erection in a very short period of time (10 to 20 minutes) in the population of men who do not respond to oral medications. After some training, most men can perform the self-injection very easily.
A device that creates a vacuum around the penis causing an erection by pulling blood into the penis with a constriction ring. The treatment of ED with these devices is drug free and safe, particularly for men for whom a PDE5 Inhibitor has contraindications.
Huge improvements, sometimes even to the point of complete treatment of ED, can be reached by non-medication methods – the elimination of cigarettes, decreased alcohol, increased fitness, management of diseases such as diabetes and blood pressure, and sexual performance anxieties are some methods of improvement that can be achieved through therapies such as cognitive behavioral and performance anxiety management.
Choosing the right male sexual treatment requires consideration of the diagnosis, the stage or severity of the condition, the cause, and your personal preferences. Given that the final recommendations remain with Dr. Vikas Singh, the following is a basic guide:
Condition | Recommended Treatment Approach |
Mild to Moderate ED | Oral PDE5 inhibitors (sildenafil/tadalafil), lifestyle modification, testosterone therapy if low T confirmed |
Moderate ED – failed oral medications | Intracavernosal injections (alprostadil), vacuum erection device |
Severe ED – failed all non-surgical options | Penile implant (inflatable preferred; malleable for selected patients) |
Peyronie’s Disease – Acute Phase | Oral pentoxifylline, intralesional injections, regular monitoring |
Peyronie’s Disease – Chronic Phase | Penile plication or incision-grafting; penile implant if ED co-exists |
Varicocele – Infertility or Scrotal Pain | Microscopic varicocelectomy |
Frenulum Breve | Frenuloplasty – a day procedure under local anaesthesia |
Low Testosterone (Hypogonadism) | Testosterone replacement therapy (injections, gel, or patches) |
Dr. Vikas Singh provides exclusively safe and research-based techniques for addressing male sexual organ concerns. Given is a breakdown of possible outcomes:
There are multiple aspects to life after successful male sexual treatment. Along with the huge impact such treatment can have on overall quality of life, mental wellbeing, self-esteem and confidence, and improvement of personal relationships, the physical aspect should not be overlooked. This is your future after treatment:
Post Penile Implant Surgery, the expected outcomes are as follows. A hospital stay of 1 to 2 days is the norm. Expect a discomfort level of mild to moderate roughly for the first week, which can be managed with over-the-counter medications. A no-use period of 4-6 weeks to the device is expected. At the follow-up appointment, the device will be used for the first time. The majority of men return to their regular sexual activities by the 6th to 8th week, and can use the device with no restrictions henceforth.
In terms of a Microscopic Varicocelectomy, a majority of patients are able to leave the hospital the same day or do so within 24 hours. Expect mild swelling/inflammation to the scrotum for 7 to 10 days. Light work can resume as soon as 5 to 7 days. Activities requiring a higher level of physical restraint should be avoided for 3 to 4 weeks, and sexual activity also should be reserved for 2 to 3 weeks. Semen analysis should also be repeated at 3 and 6 months to demonstrate sperm improvement.
Post Peyronie’s Surgery, you can typically expect a hospital stay of 1 to 2 days. Sexual activity should also be reserved for 6 to 8 weeks, and there are regular examinations to assess the penile straightening and the healing process, as well. Changes to your sensitivity of the penis can be expected and are the norm. In the following months, these changes will subside.
After Frenuloplasty, you will be able to leave the hospital the same day. The discomfort level is expected to be very minimal, and you are able to return to your normal, light activity immediately. Sexual activity is also reserved for 3 to 4 weeks. A follow up appointment should be scheduled for 4 to 6 weeks to assess the healing process.
Dr. Vikas Singh urges patients to take a more balanced approach to sexual health after trauma, which encourages the acknowledgment of psychological aspects, tailoring the adjustment process to partners when necessary, and incorporating healthy habits for sustained sexual health.
Male Sexual health treatments are now available in one clinic with Dr. Vikas Singh. ED diagnosis and treatment, penile implant surgery, Peyronie’s disease treatment, frenuloplasty, management of varicocelectomy, and fertility evaluations are now available in Indore. There is no longer any reason to travel to Mumbai or Delhi.
Penile implant surgery goes beyond technical skill. Patient selection is essential, and guidelines dictate that patients will receive comprehensive counseling and post-op training. Dr. Vikas Singh offers comprehensive counseling and post-op training and is committed to ensuring that both patients and partners receive all resources.
Dr. Vikas Singh uses an operating microscope to perform Varicocele surgery to ensure that they are minimally invasive. Microscopic Varicocele surgery has not been performed before in Indore. Dr. Vikas Singh is committed to ensuring that his patients receive the best services available.
Dr. Vikas Singh prides himself on ensuring his patients receive highly sensitive consultations. Judgements and embarrassing comments will not be made. There will be complete confidentiality.
During his training, Dr. Vikas Singh has performed numerous intricate surgeries during his postgraduate training as he trained at PGI Chandigarh, Max Super-Speciality Hospital in New Delhi, and SMS Medical College in Jaipur.
Dr. Vikas Singh has performed numerous intricate surgeries at Kokilaben Hospital in Indore. At Kokilaben Dhirubhai Ambani Hospital in Nipania, Indore, Dr. Singh has advanced surgical theatres, penile dopplers, an andrology and fertility laboratory, and a supportive staff team.
In aging populations, you might see some diminished sexual function, perhaps a delay in an erection, but it is a delay, not a dysfunction. Furthermore, if an erection delay gets worse, it is not a part of normal aging. It is a patient’s condition. It is treatable. It is clearly a medical issue. Most patients with delays and dysfunction (not only in the ED) can expect large improvements in terms of their medical condition with the right treatment.
Not at all. There is an insertion, but it is not something you or your partner can see. There is also no evidence of your device in the flaccid state of your penis. Neither your partner, nor your friends will be able to tell if your erection is caused by a non-personal reason or a medical device. Many of your friends (your partner is also your friend) will tell you that their sexual satisfaction has improved. The device that allows them to have an erection any time is very reliable.
The entire spermatogenesis process can take 72 to 90 days. When we talk about the treatment of ED and infertility of patients, we are also able to measure the success at the 3, 9, and 12-month mark of the surgery. If you will not be able to conceive naturally within that time, we are also able to measure the infertility treatment attempts. We discontinue attempts to conceive. Dr. Vikas Singh will help you with the necessary recommendations of timing and infertility attempts.
For the large majority of the population, as well as men with heart conditions, PDE5 inhibitors like the ED medications have proven to be largely safe with one major exception, which are men with heart conditions that use the nitrate type drugs (nitroglycerin spray or isosorbide mononitrate) are at risk of suffering a significant drop in blood pressure due to a dangerous drug interaction. Before prescribing, Dr. Vikas Singh thoroughly checks his patient’s cardiac history along with their medications.
Not at all, your age is not associated with any surgical contraindications. It is not at all unusual for men in their 60s, 70s, or even older than 80 to go through with a penile implant, all of which have had astounding results. Your surgical fitness is what will determine whether or not you are safe to have surgery, not your age. Dr. Vikas Singh will determine that surgery is safe, appropriate, and qualifies for the particular circumstance in which the patient is in with a comprehensive procedure assessment.
A varicocele is a scrotal vein dilation that makes the scrotum feel like a large mass of worms. A hernia results from a disruption in the integrity of the abdominal wall that allows the abdominal tissue, including visceral tissue, to protrude through the abdominal wall, creating a noticeable bulge in the abdominal wall. A hernia and a varicocele are two conditions that are not related at all, therefore they have different treatments. A scrotal ultrasound can identify the two with certainty.
Peyronie’s disease likely develops in those of a genetic disposition after there is repetitive micro-trauma to the erect penis after there is vigorous sexual activity. However, many men cannot identify a specific injury. It is not a sexually transmitted condition. Also, it is not the patient’s “fault.” Because of this, seeking treatment early is always the best option.
No, absolutely not. There is a very high occurrence of counterfeit medications online. They may contain incorrect doses or may contain substances that are harmful. More importantly, ED can mean that there is a serious cardiovascular or hormonal condition that is underlying and so managing it means that the client will miss treatment and diagnosis. Therefore, they must consult Dr. Vikas Singh prior to starting any form of treatment.
It is dependent on what the problem is derived from. For the short term problems like medication side effects, obesity, or anxiety, it can result in permanent resolution. For the permanent problems that are adverse like vascular damage or nerve injury, it can manage the issue, but will not resolve it. A penile implant can offer the most efficient long term and permanent solution. Most devices will function well up to 10-15 years.
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