7
ESSM
Today
Interview with Ates Kadioglu
by Juan I. Martinez-Salamanca (JIMS)
PRoF. ATES KADIoGLU
is an internationally
known figure and world-class leader in the field
of sexual medicine and especially in Genitouri-
nary Reconstructive and Prosthetic Surgery. He
is the current Chairman of ESSM 2014 Congress
will be held in Istanbul and also a great human
being. He is an outstanding contributor to the
field of sexual medicine as a researcher, pa-
tient advocate, educator, innovator, author, and
international recognition as an expert in erectile
dysfunction, priapism, Peyronie´s Disease and
many aspects in Andrology. Having you here is
a real pleasure and honor not only for me but
also for all ESSM Members.
JIMS: Dear Ates, could you make us a brief
journey throughout your professional back-
ground?
I earned my medical degree at the Istanbul
Faculty of Medicine in 1983; served as Urol-
ogy Resident and clinical instructor until 1994.
I spent 7 months as an andrology observer
in UCSF and Baylor College of Medicine with
Dr. Lue and Dr. Lipshultz respectively. The time
of my associate professor and full-professor
degree is 1994 and 2000 respectively. Since
2002 I have the privilege of being chief instructor
of Andrology Division in our institution. Besides
my academic interests, I also work as an ad-
ministrator since 2002 as President of Turkish
Society of Andrology followed by my presidency
of Turkish Association of Urology at 2008. I’m still
carry the titles of Turkish Association of Urology
Vice President and Honorary President of Turk-
ish Society of Andrology. In addition I have been
in the position of Vice Dean in Istanbul Medical
Faculty since 2011.
dr. ates Kadioglu
Urology Department
Istanbul Tıp Fakültesi
Fatih/Çapa
Istanbul
34093 Turkey
dr. Juan i. Martínez-Salamanca
Hospital Universitario Puerta de
Hierro-Majadahonda Universidad
Autónoma de Madrid
Department of Urology
JIMS: During you dilated career, which has
led to the passage from “Andrology” to
“Sexual Medicine”, and what do you prefer
“Sexual Medicine” or “Men´s Health”?
In the 1980’s, andrology consisted of infertility,
male and female sexual medicine. After the ICSI
era, evidence base approach to male infertility
surgical treatment led to a decline in patient
population whereas surgical volume of sexual
medicine increased relatively. Until recently the
focus of an andrologist had been in a narrow
width of vision which led to the term sexual
medicine. However, today we know that man’s
sexuality is an inseparable part of his overall
physical and psychological health. Sexual dys-
functions, lower urinary symptoms are only pro-
jections of the same disease on different organs.
Furthermore these diseases are also accepted
as the forewarnings of ischemic heart disease
and other cardiovascular events. Instead of being
only sexual specialist, I like to consider myself
as a part of multi-disciplinary team (urologist,
cardiologist, endocrinologist and psychiatrist)
which is the initial inspector of my male patients
who probably meet and receive an examination
for the first time in their adult lives. As an male
health specialist I hope prevent and get the pa-
tient prepared for additional diseases in addition
to his sexual dysfunction.
JIMS: What do you think the role of the
urologist should be in the management of
Peyronie´s Disease? And what are our major
challenges?
There are three goals in the management of
Peyronie’s disease in my perspective. The con-
servative medical treatment of an early phase
PD patient (<1 year) and the surgical treatment
which is required for patient who present later
than 1 year. Despite the promising new con-
servative modalities such as collagenase and
interferon treatments, the mainstream treatment
for late presenting patients is still surgical treat-
ment. The third objective of an urologist should
be increasing the public awareness in order to
catch the patients at the early phases of PD and
administer the treatment. For the major chal-
lenges: Accompanying erectile dysfunction, hour
glass and complex deformities are on top of my
list. Although grafting procedures may increase
the ED rate, this outcome might be prevented
with careful patient selection. Furthermore ED
may be managed by synchronous penile pros-
thesis implantation or oral pharmacotherapies.
For challenging deformities, an expert andrologist
with sufficient experience might be required.
JIMS: Dr. Kadioglu, PDE5 Inhibitors (Tadalafil)
have been approved patients with ED & LUTS,
which do you consider being the ultimate
role of this drug in all treatment options of
this group of patients?
As the paradigms in male sexual health change,
daily tadalafil 5mg treatment became a major
candidate for the mainstream management mo-
dality of coexisting LUTS and ED. The already
established place of PDE 5 inhibitors for ED is
completed with their additional efficacy on LUTS.
We describe this concept with the phrase: ”Hit
two birds with one stone”.
JIMS: In the field of Priapism in which you
worked and contributed very hard, what
do you think are the main challenges to
achieve?
In my opinion 3 different types of the priapism
disease leads to their individual challenges: For
ischemic priapism the choice of shunting and
early penile prosthesis implantation surgery and
the timing of those are the most controversial
issue of today. The threshold of irreversible penile
necrosis and refractory status varies for different
authors changing between 36–72 hours. For the
choice of shunt surgery, T-shunt has proven its
superiority in my opinion.
