Professor Vaibhav Modgil

It's a choice thing.

What's really important is that they're counseled appropriately so that they know what options exist.

And if a patient turns around to me, having read up about the options, the patient's been to my clinic a couple of times, says, I don't want that.

I don't want to inject my penis when I wish to be intimate.

Well, I think they're perfectly within their rights to make that decision, you know, so long as they know that injections exist.

Yeah.

So, you know, if you look at the satisfaction rates from penile implant surgery, they're pretty staggering.

I don't do another operation that gives that level of satisfaction to a patient.

Yeah, of course there can.

And, you know, that's...

That's for every patient.

And so when you go and see a clinician, you know, if a young man comes to see me, it's not a case of, oh, it's all in your head, mate, you know, and dismiss it.

That's the worst thing you can do.

Because first things first, you've got to acknowledge what it took for them to walk into your room, particularly for the younger patient.

I'm massively reassured if they walk in

with a parent or their partner or a friend because i think at least they've shared that burden because you can't underestimate the burden of something like that on a young man you know that young guys can get themselves in a really really deep hole and it's difficult to get out of that so the first thing i'd say to any young person or anyone who knows a young person who's listening is if you think that's going on please try and initiate some form of conversation you know and there's several different ways of doing that

Yeah, so it's not a big secret.

We have seen a sort of global deterioration in sperm parameters.

over the last 20 to 25 years and again that's multifactorial and it's for the same reasons that we see many of the other health problems that we see so you know substance use is obviously a part of that you know again take testosterone there'll be no sperm in your ejaculate you know depending on how long you do it but actually if you're a young guy just don't do it

just don't take testosterone.