DIAGNOSIS and TREATMENT PLANNING: WHAT TO EXPECT DURING YOUR OFFICE VISIT
You will be asked to complete a set of forms prior to your first visit. Some of these will cover necessary formalities such as demographic, contact and insurance information, certain legal notices, office policies, etc. The rest will obtain clinically relevant information from you, including certain questionnaires, scales or inventories that are meant to be filled out on your own in order to assist and guide the assessment process during your visit. Dr. Duzyurek's approach in both evaluation and treatment is painless and non-invasive, meaning that no puncturing, injecting, or cutting is involved.
During your visit, in full confidentiality and in a relaxed and unrushed, low-pressure, dignified, friendly and supportive private practice setting, a tailored subset, or all, of the following tasks will be covered by Dr. Duzyurek:
1.He will listen to your complaints, concerns, and story. 2.He will ask specific questions to obtain more detailed and targeted information. 3.He will evaluate the information you have provided in the pre-visit paperwork. 4.He will evaluate reports, tests or other medical record information from any previous clinician, when available. 5.He will check your vital signs, such as blood pressure, pulse, weight, and body mass index. 6.Depending on the nature of your presenting complaints or problems, he may perform a standard genital exam, e.g., a physical exam involving the penis, intrascrotal structures (such as the testes). This may also include checking certain key reflexes relevant to erectile and ejaculatory functioning. 7.On a case by case basis, he will perform other elements of a physical exam, e.g., checking the status of the lower body arterial pulses, or a focused neurological exam, if indicated by your history. 8.Depending on the nature of the problem, Dr. Duzyurek may also recommend in some cases the option of a more detailed functional diagnostics for gathering more specific, detailed and direct data points regarding key aspects of your sexual functioning in order to better guide the diagnosis and the choice of treatment options. This may include (a) an assessment of various aspects and parameters of erectile and/or ejaculatory physiology in response to audiovisual and/or vibrotactile stimulation under standard conditions with or without an erection enhancer/inducer medication (e.g., checking the timing, quality, and the magnitude of these responses, such as the measurement of the maximal axial penile rigidity attained during the functional exam procedure with the use of a digital axial rigidity gauge); (b) checking the tactile and temperature sensation, as well as a biothesiometric assessment of the vibro-sensitivity level of the shaft and the glans of your penis; (e) an assessment of the therapeutic potential of a specific treatment option, such as the Viberect; When an in-office medical procedure for a functional exam, therapeutic trial and/or instruction is recommended, Dr. Duzyurek will provide you with further information about the procedure, before you make your decision regarding taking advantage of that particular clinical option.
9. He will also screen for and evaluate psychological or psychiatric as well as relationship factors that may be involved.
10. He may also order certain other diagnostic tests, such as blood levels of total and free testosterone, thyroid stimulating hormone, DHEA-S, prolactin, and various other blood, urine or genomic tests.
11. He will then answer your questions and discuss his findings, clinical impression, and the therapeutic options he would recommend with you in order to co-construct a treatment plan toward the resolution of your difficulties, taking your input and preferences into account. Although it is often possible to take the first step toward treatment by the end of your initial office visit, at times, tasks needed for a full assessment may span more than one visit, and this may in some cases also include a coordination or consultation with another specialist or clinician.
12. Finally, your first follow-up session will be scheduled, as in most cases the achievement of treatment goals fully and in a sustained manner requires a step-wise and progressive treatment process involving monitoring of responses obtained at each step and additional assessments, as needed, along the course of treatment.
MALE SEXUAL FUNCTION HEALTH Practice
SINAN DUZYUREK, MD, PLLC - Washington, DC
A capacity to resist an axial pressure of at least 1 kg for 5 sec without buckling and maintaining this level of rigidity upon multiple measurements in an aroused state is an operational definition of full (grade 4 or 4+) potency.
An FDA-approved Device (Viberect) for reflexive activation of erectile and ejaculatory physiology in the clinic or physician's office, or for home use following tailored instructions by an MD.
The biothesiometer used at this practice for evaluation of sensory aspects of erectile and ejaculatory mechanisms
Another axial rigidometer
Another medical vibrotherapeutic device (Ferticare Personal) that may be utilized in some cases.
Further evaluation of penile vasculature via referral, if necessary
Various biophysical factors of penile rigidity to consider in erectile function assessments may include penis geometry and stretchability
Activation (and testing) of the bulbocavernosus reflex, for example prior to application of Viberect