kalpesh kapadia

Consultant Urologist & Andrologist

[kalpesh kapadia @KALPESHKAPADIA3]

How is PRP for erectile dysfunction supposed to work?
Platelets carry growth factors. The theory is that injecting them into the erectile tissue encourages new blood vessels and nerve repair.
A theory is not yet a proven treatment.
#p-shotinahmedabad #pshotfored

[kalpesh kapadia @KALPESHKAPADIA3]

A semen report can say "normal" while the sperm carry damaged DNA.
Count, motility and shape tell you how sperm look and move. They tell you nothing about the genetic cargo inside.
That gap explains some of "unexplained" infertility.
#maleinfertility #spermDNAfragmentation #DFI

[kalpesh kapadia @KALPESHKAPADIA3]

A very firm grip, a fast rhythm, the same position for years.
The penis can get conditioned to a stimulus that intercourse cannot match.
Lighter pressure, slower pace, varied technique: this often needs retraining, not tablets.
#drkalpeshkapadiauroandrologist #anejaculation

[kalpesh kapadia @KALPESHKAPADIA3]

"Doctor, I reach orgasm but nothing comes out. Is it dangerous?"
A dry orgasm is usually retrograde ejaculation or anejaculation. Prostate medicines (tamsulosin, silodosin), prostate surgery and nerve damage are common causes.
Rarely harmful by itself. Important for fertility.

[kalpesh kapadia @KALPESHKAPADIA3]

Anejaculation is not the same as testicular failure.
In many of these men the testes make sperm. The delivery is what fails.
Vibratory stimulation, electroejaculation, sperm from urine or surgical retrieval can be options. Know this before a couple gives up.
#ejaculationproblems

[kalpesh kapadia @KALPESHKAPADIA3]

Normal ejaculation alone. Difficulty with a partner.
That pattern usually points away from nerves and hormones, and toward arousal, anxiety, technique or the relationship.
Reassuring, but only after a proper evaluation has ruled out the rest. #drkalpeshkapadiauroandrologist

[kalpesh kapadia @KALPESHKAPADIA3]

Why does the penis bend in Peyronie's disease?
The erectile chambers fill and lengthen evenly. A scarred segment cannot lengthen.
So one side stays short while the rest expands, and the erection pulls towards the scar. The curve is mechanical, not a nerve problem.
#peyronie's

[kalpesh kapadia @KALPESHKAPADIA3]

If you are prescribed a lidocaine-prilocaine spray or cream for premature ejaculation, know that it https://t.co/SdUMoTdmYy report genital numbness and reduced sensation from contact.
Apply it early and wipe the glans before penetration, or use a condom.
#prematureejaculation

[kalpesh kapadia @KALPESHKAPADIA3]

"Can't finish" is not one diagnosis.
Delayed ejaculation. Anejaculation. Anorgasmia. Retrograde ejaculation. Painful ejaculation.
Different mechanisms, different tests, different treatment. Naming the problem correctly comes first. #drkalpeshkapadiauroandrologist #anejaculation

[kalpesh kapadia @KALPESHKAPADIA3]

Penile implant replaces the erection. It does not replace sensation.
Skin feeling, orgasm and ejaculation run on nerves and pathways the device never touches.
Men fear they will feel nothing. Most feel exactly what they felt before, with rigidity added.
#penileimplantinahmedabad

[kalpesh kapadia @KALPESHKAPADIA3]

"Doctor, I reach orgasm but nothing comes out. Is it dangerous?"
A dry orgasm is usually retrograde ejaculation or anejaculation. Prostate medicines (tamsulosin, silodosin), prostate surgery and nerve damage are common causes.
Rarely harmful by itself. Important for fertility.

[kalpesh kapadia @KALPESHKAPADIA3]

Peyronie's disease + ED? This combo demands aggressive early intervention. The sooner you treat, the better outcomes. Don't delay. #UroandroLogy #PeyroniesdDisease #drkalpeshkapadiauroandrologist #penileimplantinahmedabad

[kalpesh kapadia @KALPESHKAPADIA3]

Orgasm and ejaculation are not the same event.
One is a sensation generated by brain and pelvic nerves. The other is semen leaving the body.
A man can have either without the other. That one fact clears up most of the confusion in this consultation.#drkalpeshkapadiauroandrologist

[kalpesh kapadia @KALPESHKAPADIA3]

A high intra-abdominal testis sometimes cannot reach the scrotum in one operation, for a simple mechanical reason: the testicular vessels are too short.
The staged Fowler-Stephens approach divides them first and lets collateral supply take over before the testis isbrought down.

[kalpesh kapadia @KALPESHKAPADIA3]

Premature ejaculation is not a stopwatch needs three things together: a 𝗰𝗼𝗻𝘀𝗶𝘀𝘁𝗲𝗻𝘁𝗹𝘆 short time to ejaculation, little or no control over when it happens, and 𝗿𝗲𝗮𝗹 𝗱𝗶𝘀𝘁𝗿𝗲𝘀𝘀 for the man or his partner.
#prematureejaculationtreatment

[kalpesh kapadia @KALPESHKAPADIA3]

Uroandrologists — when do you first raise the Penile implant option?
After maximum-dose oral therapy has properly failed, or only once injections have failed too?
It may be the biggest reason men reach a prosthesis clinic so late. Years passed before...
#penileimplantinahmedabad

[kalpesh kapadia @KALPESHKAPADIA3]

Penile implant is a machine, and machines have a working life. Many last a long time. Some fail earlier. Revision surgery exists because of this, not despite it. A device you might replace once is still worth having.Mechanical Failure is also possible.
#penileimplantinahmedabad

[kalpesh kapadia @KALPESHKAPADIA3]

Penile implants report some of the highest satisfaction scores in sexual medicine. Satisfaction tracks with expectations set before surgery, and with whether the partner was part of it.The counselling is the intervention.
#penileimplantinahmedabad

[kalpesh kapadia @KALPESHKAPADIA3]

Peyronie's disease with severe ED is its own situation.
Here the implant does two jobs: it restores rigidity, and placing it — sometimes with additional straightening manoeuvres — addresses the curvature in the same sitting.
One operation, two problems.
#penileimplantinahmedabad

[kalpesh kapadia @KALPESHKAPADIA3]

Not every man who fails tablets needs an implant.
A penile Doppler study separates arterial inflow disease from severe venous leak, and hormonal, drug and psychological causes still need excluding.
The implant discussion should follow the workup.
#penileimplantinahmedabad