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Shockwave Therapy For ED

User
Posted 17 Jul 2023 at 10:37

I know this treatment is relatively new, I was wondering if anyone else on here has heard of this treatment or been on it?

Thanks.

User
Posted 17 Jul 2023 at 10:37

I know this treatment is relatively new, I was wondering if anyone else on here has heard of this treatment or been on it?

Thanks.

User
Posted 17 Jul 2023 at 15:10

Thanks Andy for the response. I guess, the flip side is that there is not much to lose from trying and going on the trial if one has the chance. I just wonder how far we (in the UK) are behind the curve when it comes to advancements in Post PCa surgery and rehabilitation.

I will be seeing my andrologist this week after a 7mth hiatus, and I can pretty much guess how the consultation will go - fill out a form for their survey, check my little man, blood tests, and ask if erections have returned. That is the meeting over. I have had to improvise in the bedroom department, by utilising non-UK articles.

User
Posted 17 Jul 2023 at 15:29

I don't know how it varies by country, but it varies enormously in the UK.

Some centres have no support for andrology and not even an ED nurse, whereas a very few others feed all their patients through andrology as a matter of course. Even most of those that do have the appropriate department only feed in those patients who ask for the support. Most patients don't even know to ask, and wouldn't be that comfortable doing so even if they did, and don't find themselves in front of a clinician where they feel comfortable raising the subject.

Some recent research where clinicians were questioned about raising the issue with patients, even in urology departments, it often doesn't happen. For patients in oncology, most clinicians don't even think it's their job to raise this, but neither do they refer the patient anywhere else to get the appropriate support.

Clearly not all urologists or oncologists are going to be comfortable or competent dealing with the subject, but they should all know to refer the patient to someone who is.

Another complication is that some GP's won't prescribe the medications the consultants require for recovery.

User
Posted 17 Jul 2023 at 17:57

Andy, you are absolutely right. It is postcode lottery when it comes to PCa aftercare. I asked a friend of mine who also had PCa and he had never heard of andrology. Event though my appointments has been a hit and miss, I am still grateful nonetheless in view of your assessment! I have an appointment, this week, would be my 3rd since my surgery 18mths ago. 

User
Posted 17 Jul 2023 at 22:10

Originally Posted by: Online Community Member

Hi Andy 62,

I know that I'm preaching to the converted, but it baffles me that someone who has had a prostatectomy and has ongoing issues with E.D. and incontinence is then discharged by their Urologist.  Surely these adverse effects of the surgery are urological issues, and until they are resolved (or ameliorated as much as possible) the Urologist's work is not over?  I know the NHS is busy (and even overwhelmed) at present, but the Urologist could (should) refer on elsewhere and still keep a 'watching brief'.  

Sorry to bend your ear...

Best wishes,

JedSee.

JedSee,

To be fair, only one outcome after Prostate Cancer treatment is looked into, whether that is due to the pressures on the NHS or just what it is I don't know. In a simplistic view, the 3 outcomes are:

1. Cancer Cured or not

2. Incontinence

3. Erectile Dysfunction

The main priority is the cure or prolonging life. No 2 and 3 it seems are accepted collateral damage and par for the course! I don't the the QoL issues get the same level of attention...

 

 

User
Posted 17 Jul 2023 at 23:26
It depends on the ICB - some state that post-RP monitoring and care are urology's responsibility and others say that post-op is the responsibility of primary care (the GP). It doesn't just affect ED and incontinence care; anything from getting a district nurse visit to where you get your ongoing PSA tests is determined by the ICB
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

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User
Posted 17 Jul 2023 at 11:28

I've heard of it, and been to a couple of talks which have mentioned it.

The general feeling I've heard from urologists is there isn't yet any good evidence for it. One of the London hospitals (Guys and St Thomas's, I think) is running a trial for some patients who had prostatectomies there.

I love the bit of her promotional YouTube video where she says, "I provide the treatment, but I don't even promote it". Motivations for treatments are very different in the US.

User
Posted 17 Jul 2023 at 15:10

Thanks Andy for the response. I guess, the flip side is that there is not much to lose from trying and going on the trial if one has the chance. I just wonder how far we (in the UK) are behind the curve when it comes to advancements in Post PCa surgery and rehabilitation.

I will be seeing my andrologist this week after a 7mth hiatus, and I can pretty much guess how the consultation will go - fill out a form for their survey, check my little man, blood tests, and ask if erections have returned. That is the meeting over. I have had to improvise in the bedroom department, by utilising non-UK articles.

User
Posted 17 Jul 2023 at 15:29

I don't know how it varies by country, but it varies enormously in the UK.

Some centres have no support for andrology and not even an ED nurse, whereas a very few others feed all their patients through andrology as a matter of course. Even most of those that do have the appropriate department only feed in those patients who ask for the support. Most patients don't even know to ask, and wouldn't be that comfortable doing so even if they did, and don't find themselves in front of a clinician where they feel comfortable raising the subject.

Some recent research where clinicians were questioned about raising the issue with patients, even in urology departments, it often doesn't happen. For patients in oncology, most clinicians don't even think it's their job to raise this, but neither do they refer the patient anywhere else to get the appropriate support.

Clearly not all urologists or oncologists are going to be comfortable or competent dealing with the subject, but they should all know to refer the patient to someone who is.

Another complication is that some GP's won't prescribe the medications the consultants require for recovery.

User
Posted 17 Jul 2023 at 17:57

Andy, you are absolutely right. It is postcode lottery when it comes to PCa aftercare. I asked a friend of mine who also had PCa and he had never heard of andrology. Event though my appointments has been a hit and miss, I am still grateful nonetheless in view of your assessment! I have an appointment, this week, would be my 3rd since my surgery 18mths ago. 

User
Posted 17 Jul 2023 at 20:21

Hi Andy 62,

I know that I'm preaching to the converted, but it baffles me that someone who has had a prostatectomy and has ongoing issues with E.D. and incontinence is then discharged by their Urologist.  Surely these adverse effects of the surgery are urological issues, and until they are resolved (or ameliorated as much as possible) the Urologist's work is not over?  I know the NHS is busy (and even overwhelmed) at present, but the Urologist could (should) refer on elsewhere and still keep a 'watching brief'.  

Sorry to bend your ear...

Best wishes,

JedSee.

User
Posted 17 Jul 2023 at 22:10

Originally Posted by: Online Community Member

Hi Andy 62,

I know that I'm preaching to the converted, but it baffles me that someone who has had a prostatectomy and has ongoing issues with E.D. and incontinence is then discharged by their Urologist.  Surely these adverse effects of the surgery are urological issues, and until they are resolved (or ameliorated as much as possible) the Urologist's work is not over?  I know the NHS is busy (and even overwhelmed) at present, but the Urologist could (should) refer on elsewhere and still keep a 'watching brief'.  

Sorry to bend your ear...

Best wishes,

JedSee.

JedSee,

To be fair, only one outcome after Prostate Cancer treatment is looked into, whether that is due to the pressures on the NHS or just what it is I don't know. In a simplistic view, the 3 outcomes are:

1. Cancer Cured or not

2. Incontinence

3. Erectile Dysfunction

The main priority is the cure or prolonging life. No 2 and 3 it seems are accepted collateral damage and par for the course! I don't the the QoL issues get the same level of attention...

 

 

User
Posted 17 Jul 2023 at 23:26
It depends on the ICB - some state that post-RP monitoring and care are urology's responsibility and others say that post-op is the responsibility of primary care (the GP). It doesn't just affect ED and incontinence care; anything from getting a district nurse visit to where you get your ongoing PSA tests is determined by the ICB
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 18 Jul 2023 at 19:46

Thanks Lynn,

From a patient's perspective, it would seem to me that the "Integrated Care Board" (ICB) is a misnomer, since it doesn't facilitate integrated or holistic treatment; rather it encourages a fragmented service.  But thanks for your insight.

Best wishes,

JedSee.

User
Posted 18 Jul 2023 at 19:47

Thanks Gee Baba,

You're spot-on.

Best wishes,

JedSee.

 
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