Dale, I have tolerated quietly your Urological mumbo jumbo for the past 7 months only because I have assumed that you are a good will
Urologist with a limited experience with MUSE and that with time you would have more data and come out with a more opinion.Unfortunately this has not occurred and here you are continuing to spout forth PERSONAL, SUBJECTIVE, UNSUBSTAMTIATED OPINIONS that you are parleying as facts and are asking that investors follow these uninformed opinions.If you were an Academician in good standing ( which you are not as far as I know ) I might listen to you longer, but under these circumstances I am not . Here is a list of your pseudo-scientific
expounding ( lifted in toot from your own writings) for which this pseudo-thread and the real Vivus 1997/1998 thread want some REAL answers :
-"In my practice ": How big IS your practice Dale? 15 patients?
-"In my practice there is almost zero interest in MUSE at this time. It doesn't look like that will change until Viagra is on the market a while and patients have had a chance to try it themselves. ": WHAT in
creation does THIS mean Dale? Are you taking anti depressants or is this just bad English?
-"The attractiveness of a pill over a urethral suppository seems to be overwhelming." : REALLY!!!!!!Is this your new insight into life Dale or did you read this somewhere? Most of us are not aware that Americans prefer a pill to surgery or even a suppository.Any little help you can give us in understanding the human mind is appreciated.
-"but my experience suggests ": not to belabor the point: WHAT IS your experience Dale: How many patients? Have you run a similar study
as the NEJM? You are just shy and want to keep this incognito? If so I would urge to please publish your data ( at least in this thread if you are afraid they are so garbled they won't pass peer review).
-"Those long VVUS underestimate the degree of dissatisfaction patients have with MUSE. ": WHERE is the data Dale? Your practice again?
If you are too lazy Dale to review the literature and become an informed physician ( maybe that is why your patients don't do too well with MUSE: You have not spent enough time educating them on it's use ), here is what Tom Lue senior investigator of both MUSE and Viagra has to say about MUSE as recently as Feb 98; ( for thread readers, Dr Lue is reviewing a recent book by DrDePalma ) :
The Journal of
UROLOGY
Volume 159 February 1998 Number 2,Page 612
Vascular Surgery for Impotence: A Review
By R.G.DE PALMA, University of Nevada School of Medicine, Department of Veterans Affairs, Reno, Nevada Int. J. Impotence Res., 9: 61-67, 1997
Dr Lue's review:
Progress in treatment of impotence in the past two decades has resulted in impressive advances. While most men respond to medical therapy including prostaglandin El injection or the more recent use of urethral alprostadil, 6-7% of men fail to respond to these treatments or vacuum devices. This review considers current and past results of vascular surgery in this group of men. Guidelines for case selection for vascular interventions as well as reporting criteria are suggested. Vascular surgery as a logical first step in selected patients may offer an advantage in men failing conservative therapy and for those not desiring prosthetic implantation.
Dr.Lue's Editorial Comment: Presently, vascular surgery is indicated only in younger patients whose impotence is a result of localized arterial occlusion secondary to pelvic or perineal trauma. Many patients older than 55 years have generalized atherosclerosis and the results of vascular surgery have been disappointing. In addition to arterial insufficiency, long-term vascular disease often causes smooth muscle atrophy, fibrosis and endothelial dysfunction and results in penile venous leakage. External vacuum devices, intracavernous injection or penile prosthesis has been the standard treatment for these patients. Researchers should take advantage of molecular biology techniques to investigate and develop better strategies for the prevention and treatment of vascular disease. If these measures can prevent restenosis of blood vessels, then vascular surgery may become a useful therapy in all patients with vasculogenic impotence.
Tom F. Lue, M.D.,Editor.
( PS note that DrLue hasn't said a word about Viagra here ).
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Bottom line Dale if you want me to read your posts, next time you post on "your practice',"your patients", please ADD, how many patients, what was the etiology fo their impotence, what was their comorbidity, what other drugs were they on, age, what dose of MUSE did you try, did they get the needle or did they refuse that too; also TELL us how well were they being cared for by your medical team, ( a LOUSY support medical team that doesn't control your patients' diabetes, hypertension, emhysema, congestive heart failure, coronary artery disese, etc etc ): in one of your posts 8 months ago you said something about working ?in a removed aerea. If you don't have an expert MEDICAL support team to take care of comorbidity ( other diseses in addittion to ED ), then it is unlikely that the patient's ED will respond well to MUSE.Maybe you should move to a more centrally located aerea with better medical support.
TA |
