A male patient in his mid-60s walks into his primary care physician’s office. He is nervous about his appointment because it might get embarrassing.
He tells the nurse his reason for being there is “personal” and then is seated in an exam room. His doctor walks in and asks, “So what seems to be the problem?” The patient responds, hesitating, “I can’t seem to get an erection anymore.”
The doctor replies, “It is probably just in your head, besides your getting up in age. You shouldn’t be concerned with the ability to have an erection.”
Dr. LeRoy A. Jones of Urology San Antonio is all too familiar with the above scenario.
“When you look at the field of sexual medicine, it was always thought that if a guy had trouble with erections that it was in his mind, and still a lot of people think that way,” says Jones, who specializes in erectile dysfunction (ED) and penile prosthetics.
According to the Urology San Antonio Web site, erectile dysfunction is often referred to as impotence. At some time or another, most men experience erection problems, but for some 30 million men in the United States, impotence is a chronic problem. It accounts for about 10 percent of the male population and 35 percent of men older than 60. And fewer than 5 percent of men with impotence have ever been treated.
Pre-Viagra, sexual medicine was even harder to get any scientific standing. Doctors of the practice were fighting a sexual taboo. “It is interesting that it is still something that patients are still hesitant to bring up. Even physicians are hesitant,” the urologist says.
Currently, since the conception of Viagra, Cialis and other such drugs, the media has shined a bright light on sexual medicine. Despite the light, Jones wants men who are experiencing ED or similar situations to know about options available to them.
Jones did his training at Baylor University College of Medicine working alongside Dr. F. Brantley Scott, a urologist who developed the penile prosthesis.
“Working with Dr. Scott piqued my interest and things just kind of took off from there,” he says. “There were not many options for guys with ED, so there weren’t a lot of choices for men; it wasn’t something very popular among urologists.”
Thus, Jones began specializing in ED and prosthetics. Over the last four years, he has completed more than 500 urological prosthetic procedures. This includes the inflatable penile prosthesis and artificial urinary sphincter procedures.
For those men who opt for a penile prosthetic it is a device that is surgically placed into the penis; 40 minute out-patient procedure. It consists of a pair of cylinders that are surgically inserted into the penis. The prosthesis is positioned up for intercourse or down for every day activities. The two-piece inflatable prosthesis consists of a fluid filled pair of cylinders implanted in the penis and a small pump implanted in the scrotum. To get an erection you simply squeeze and release the pump several times.
“One guy in particular that I remember he was a pretty young guy treated for prostate cancer, and he never thought he would [have problems with an erection],” Jones says.
When considering a prosthetic, many men have a lot of questions: Is it invasive? Is this something that I really want? How important is it to me? “Once done their quality of life changes pretty radically,” Jones says. “They come back saying, ‘Doc, it has changed my life!’ ”
Jones says getting treated helps with self-esteem and depression. For instance, federal law mandates that women who have had a mastectomy because of breast cancer receive reconstructive surgery, and insurance companies have to cover it.
The reason is based on the number of studies that have looked at women treated for breast cancer and depression based on body perception. It has been noted that patients, reconstructed after a mastectomy, have reduced levels of depression. Their self worth is increased, and they feel better about themselves.
Men with erectile dysfunction rarely want to talk to anybody about their problem let alone women, Jones says. They are embarrassed, so they avoid discussing it and become distant and depressed.
Regarding the patient who had prostate cancer and who has erectile dysfunction, he doesn’t want to stop being sexually active, Jones says. “Maybe he’s married maybe he’s not married; it doesn’t really matter. It is an important thing for him, so if I can restore how he feels about himself, it is a great feeling,” the urologist says.
Jones joined Urology San Antonio in 2004.
“We were able to coerce him to leave academics and come join our group in the private sector,” says Dr. Juan A. Reyna, president and CEO of Urology San Antonio. “Dr. Jones has a tremendous reputation for his area of expertise. He is a terrific urologist and a very knowledgeable physician.
“His expertise, I thought, would fit very nicely with a group our size because we could get him a significant number of referrals for what he does. Come to find out we have propelled him into a very prestigious physician in the area of prosthetic surgery. He is probably one of the top 5 surgeons in the world for prosthetics.” In 2006, Jones was No. 1 in the world.
Before going into private practice at Urology San Antonio, Jones taught at the University of New Mexico Health Sciences Center, the University of Texas Health Science Center, and at Baylor College of Medicine. He completed his medical degree at Washington University in St. Louis. His surgical and urology training were completed at Johns Hopkins Hospital in Baltimore and Baylor College of Medicine.
Jones is certified by the American Board of Urology, and he is a member of the American Urologic Association.