A holistic approach to treating men with sexual dysfunction
UH Innovations in Urology - Fall 2018
ARAM LOEB, MD
Urologist, Department of Urology, University Hospitals
Aram Loeb, MD, brings unique expertise in men’s sexual dysfunction to the University Hospitals Urology Institute, where he’ll be seeing patients at various locations throughout the hospital system.
After attending the University of Wisconsin-Madison as an undergraduate, Dr. Loeb spent a year before medical school in sub-Saharan Africa, working at health clinics and traveling. Upon returning to the states, he completed his medical training at Wright State University in Dayton, Ohio. There, he met his wife, who is now a family medicine doctor at UH.
A thoughtful examination of his medical interests lead Dr. Loeb to a urology residency at Wayne State University in Detroit, Michigan, and ultimately to a Fellowship in Male Sexual Dysfunction at the University of South Florida in Tampa.
“My fellowship director was Rafael Carrion, MD, a pioneer in the field of prostatic urology,” Dr. Loeb says. “He is a thought leader in the field has been an excellent mentor to me. I gained expertise in male sexual dysfunction, which includes penile implants, artificial urinary sphincters, male infertility, Peyronie’s disease [penile curvature] and hypogonadism.”
Dr. Loeb’s wife grew up on the East Side of Cleveland, Ohio, and being a native Ohioan himself, he was happy to take the position at University Hospitals. He is the only physician at UH with his particular expertise, which offers him an exciting professional opportunity.
CHANGING MEN’S LIVES
Sexual dysfunction can affect every aspect of a man’s life, so treating these patients can be hugely rewarding.
“I really enjoy what I do,” Dr. Loeb says. “I really enjoy talking to patients and providing individualized medicine.”
As the old saying goes, if all you have is hammer, every problem is a nail. However, Dr. Loeb says, a one-size-fits-all approach doesn’t apply to his field. “It’s not so much what I know and what I can do, but where patients are coming from, their perspective and how I can help them get to where they want to be,” he explains. “Within this kind of subspecialty, there’s not one way to do everything.”
TREATING ERECTILE DYSFUNCTION
Erectile dysfunction (ED) is very common in men who’ve had bladder or prostate cancer surgery or who have chronic medical problems, such as diabetes or cardiovascular disease, Dr. Loeb says. There are nonsurgical ways to treat ED, of course – for example, medications such as phosphodiesterase type 5 inhibitors (PDE5Is) –but they don’t always work (more than 30 percent of ED patients taking PDE5Is fail therapy).
Inflatable penile prosthesis — penile implants — have become the gold standard for patients who don’t respond to other therapies. However, fewer than 5 percent of those eligible choose to undergo the surgery.
This provides a real opportunity for Dr. Loeb and his patients, particularly because satisfaction rates from penile implants tend to be very high. “I see men who haven’t been able to be intimate with their partner for years,” he says. “They go through surgery and come back to my office in tears because it brought intimacy back to their relationships. When we put penile implants in well, and they heal well, the patient satisfaction is one of the highest of the things urologists do.”
Penile implants are a specialty procedure and they are irreversible. Dr. Loeb notes, “They should really be done by someone who does a lot of them, someone who understands the nuances of the procedure — the pre-operative expectations as well as the postoperative trouble shooting. We offer all that here in my clinic.”
HOME FOR GOOD
Dr. Loeb is excited to bring his fellowship training in this specialty to an region where there is a great need, and to provide this service to the UH community and the UH Urology Institute. He’s also glad to be home.
“I’m from the Midwest,” he says. “I like being here. This is home for me. I enjoy talking to patients and working with them. And, I feel like patients enjoy coming to see me. I take a lot of pride in that.”
To make an appointment or discuss a patient case with Dr. Loeb, call UH St. John Urology at 440-887-9139.