If a patient has make a surgery of vericoseal grade2 before 4years ago but he is suffering from ED,PME, AND semen infection Epididymal cyst more than 9mm.

Dear Abhijeet,

Based on your concerns, consulting a urologist is the best option. A urologist specializes in both premature ejaculation (PE) and frequent urination and can provide the right diagnosis and treatment plan. Additionally, for drug addiction, a psychiatrist can help you with de-addiction therapy and mental health support.

Treatment for Premature Ejaculation (PE)

• Behavioral Therapy: Techniques like the start-stop method and squeeze technique can help delay ejaculation.
• Counseling & Therapy: Cognitive Behavioral Therapy (CBT) can help manage anxiety and stress related to sexual performance.
• Medical Treatment: After proper evaluation, a urologist may prescribe topical creams, selective serotonin reuptake inhibitors (SSRIs), or other medications. Do not take any medication without a doctor’s advice.
• Surgical Options: In rare cases, dorsal nerve desensitization surgery may be recommended for persistent PE that does not respond to other treatments.

Lifestyle Tips for Better Sexual Health

• Maintain a Healthy Diet: Include zinc- and magnesium-rich foods like nuts, spinach, and seafood to improve sexual health.
• Regular Exercise: Pelvic floor exercises (Kegels) can strengthen muscles and improve ejaculatory control.
• Stress Management: Practice meditation, yoga, and deep breathing techniques to reduce anxiety.
• Avoid Smoking & Alcohol: These can negatively impact sexual performance.
• Quality Sleep: Ensure 7-8 hours of restful sleep to maintain hormonal balance.

Hello Saifullah Khan Ji,

Thank you for reaching out.

Before proceeding further, could you please let me know if you have had any investigations done, such as a PSA test, ultrasound, or DRE (Digital Rectal Exam), to confirm whether you have an enlarged prostate?

For sexual problems, these can sometimes be linked to prostate issues, medications, or other factors like hormone levels, stress, or lifestyle. I recommend:

1. Consulting a urologist to assess both your prostate health and sexual function.

2. A hormonal evaluation to check for testosterone levels.

3. Exploring medications or therapies for erectile dysfunction if necessary.

4. Lifestyle modifications such as regular exercise, a healthy diet, and stress management.

Additionally, please do not take any medication without consulting your doctor, as certain medications may have side effects or interactions that need to be carefully managed.

Feel free to reach out for further assistance.

Wishing you good health!

Hello Ajaj Ji,

As per your sperm analysis report:

• Sperm Count: 10 million/mL (Oligospermia) → Lower than normal (≥ 15 million/mL).
• Motility: 15% (Asthenozoospermia) → Reduced from normal (≥ 32%).

This may impact natural conception.

Before suggesting treatment, I need to know:
✔️ Any history of testicular injury, infections, or surgeries?
✔️ Any chronic conditions like diabetes, thyroid issues, or varicocele?
✔️ Current medications or use of steroids, tobacco, or alcohol?
✔️ Any recent history of fever, stress, or excessive heat exposure?

Recommendations:

1. Lifestyle Modifications:

✅ Eat a high-antioxidant diet (nuts, berries, leafy greens).
✅ Avoid smoking, alcohol, junk food, and excessive caffeine.
✅ Exercise regularly but avoid overtraining.
✅ Reduce stress with meditation/yoga.
✅ Maintain a healthy BMI.

2. Medical Tests Recommended:

🩸 Hormonal Profile: FSH, LH, Testosterone, Prolactin
🩺 Scrotal Doppler Ultrasound: To check for varicocele
🦠 Semen Culture: To rule out infections

3. Treatment Plan (Based on Test Results):

💊 Antioxidants
💉 Hormonal therapy (if required)
⚕️ If varicocele is present → Surgery may be advised
🔬 Assisted Reproductive Techniques (IUI, IVF, ICSI) for severe cases and to help in conception

📅 Follow-up: After 3 months of lifestyle modifications, repeat semen analysis. Consult an Andrologist or Fertility Specialist for further evaluation.

Would you like assistance in scheduling a consultation?