Yes we are doing penile prosthesis implant surgery at our hospital. So far we have done about 150 implant surgeries. It is the only hospital in Kerala where large number of penile implant operations done . The cost is much low compared to foreign countries. It is a life long remedy for erectile dysfunction. Only side effect is the size of the penis in case of a non inflatable implant. The size will remain as the size of a fully erected penis. You can bend it and conceal easily. If it is an inflatable one it can be deflaed to reduce the size to flaccid level. We have to find out whether you require an implant surgery and whther there is sufficient indications. Only after our evaluation including all the relevant investigations we will be able to give an opinion.

Yes we do have AMS and we do penile prosthesis implant surgery. With out evaluating the need for the surgery  there is no point in discussing these matters. First thing required is the assessment of the patient. In our practice we do full evaluation and give a course of medication. If the medication is not effective and there is sufficient indication for the surgery then we discuss about different types of implants, its cost and may proceed to surgery if the patient is willing. We don t perform any surgery just because somebody demanded. The treating doctors must get convinced about its indications.

You have multiple problems. I would consider the first one as a vaginismus. Your wife may be having vaginismus that why you are unable to insert the penis fully into the vagina. Even the IUI and trans vaginal scanning  appears to be painful. She may experience pain or burning sensation during sexual intercourse. You wrote that she had to suffer a lot. This suffering is due to vaginsmus a condition in which muscles surrounding the outer portion of vagina will contract or close due to fear of pain. I have treated many such ladies. This condition needs treatment, otherwise it may continue for life long. But many of the gynecologists are either not aware of this or ignore it.

Second problem is infertility due to severe oligospermia. You are likely to have a varicocele which needs intervention. If you don t investigate in to the cause of low sperm count and treat it urgently you are likely to become ifertile for life long. Your condition needs urgent medical intervention. Consult an experienced andrologist immediately. Don t consult any gynecologist for your problem. Unfortunately many men consult male gynecologists for their problems. Many gynecologists give treatment also. This is not the correct practice. By the virtue of their training Gynecologists learn about womans health, woman s reproductive system, woman s fertility and infertility, delivary etc. They don t learn much about male reproductive system, male fertility and infertility. Only an andrologist is trained, qualified and experienced to deal with male fertility problems. So you consult an andrologist immediately.

Always planning is a good idea. If both of you are very young there may not be any harm in postponing pregnancy. Before taking the final decision to postpone the pregnancy it is advisable to undergo an andrological evaluation for the husband and gynecological evaluation for wife to rule out problems if any that can lead to infertility. If any such chances are there you have to try for an early pregnancy. Use of condoms is one of the best and harmless methods of contraception. The only risk is breakage or slippage of condoms. You can be careful.  It doesn t cause any health problems. Another method is observe the safe period. But it need not be safe always. After marriage you can consult a gynecologist and take an opinion.

Diabetes mellitus can cause smooth muscle dysfunction which leads to ED. It has to be investigated to find out extent of the problem. Depending on the test findings treatment can be planned. In certain cases medicnes are effective. In some other cases medicines may not be effective. In such patients a new treatment method called ESWT is available. It is new method. We have this treatment facility in our Institute and it is the first and only equipment in Kerala. If all these methods are not effective penile prosthesis implant operation is the best and life long  solution. We have done this operation for more than 150 people, most of them are elderly persons with diabetes. Don t worry, there is complete soluton for your problem. An andrologist can help you. Please consult a doctor experienced in dealing with such cases.

As per WHO, homosexual orientation is not considered as a disease, it is a style of life. Homosexuals are considered as a sexual minority. Only those with ego dystonic homosexuality can be treated. Ego dystonic homosexuality means that one s homosexual behaviour becomes a problem for him and cause a lot of personal distress. Individual feels that "Due to some reason I happened to be a homosexual, I want to get rid of this." Since it causes personal agony and guilt feelings the individual strongly desires to change his homosexual behaviour. Only such individuals can be treated and will be benefited from the treatment. This has to be evaluated prior to making any plans for treatment. If you have genuine motivation to change this habit, treatment will be effective. Otherwise no treatment can help you. You can consult at our hospital when come to Kerala next time.

It appears that you are suffering from an orgasmic dysfunction. There is some reasons behind it. Example: Inadequte desire, inadequate erection, tiredness, anxiety, feeling of sadness, depression, obsessive personality traits, presence of any illness etc. There is treatment for this problem 

False claims of  cures for HIV and AIDS have been around since the syndrome emerged in the early 1980s. In all cases, they have only served to worsen the suffering by exploiting the ignorance of the public.

So far no medicine is found out to cure HIV or AIDS. How ever the antiretroviral therapy can suppress or delay the progress of HIV infection leading to AIDS. It can  delay the illness for many years, but it cannot eradicate the virus completely. Several researches are going in this line to find out a cure. Progress of research to develop a vaccine is highly promising. But remember prevention is better than cure.

Varicocele causes progressive and duration dependent damage to the testis. As a result sperm motility will be reduced first followed by count. Over the years testis become atrophied and the production of male hormone (testosterone) will reduce. It will cause loss of sexual desire and erection. In other words you may develop an early andropause.

If there is a varicocele in an unmarried man one must undergo microsurgical varicocelectomy. This is the latest scientific view and standard teaching on this matter. How ever in most of the places varicocele is usually operated using laparoscopic surgery or conventional surgery.

The most common complications of conventional varicocele operations are hydrocele, varicocele recurrence, and injury to testicular artery, spermatic cords etc. This may the reason why your Gynecologist advised against the surgery and advised for ICSI. A person having varicocele should undergo microsurgical varicocelectomy before going for IUI, IVF or ICSI to improve the sperm quality. It will reduce or nullify the adverse effect of ROS (reactive oxygen species) on the sperms. Presence of varicocele will reduce the percentage of success when going for artificial reproduction techniques.

In microsurgery the use of the operating microscope allows for reliable identification of spermatic cord, lymphatics, internal spermatic veins and venous collaterals, and the testicular artery or other arteries. So that chances for these complications are almost reduced to less than 1 percent. Repair of varicocele results in greater improvement in sperm motility and count.

Microsurgical varicocelectomy provides a safe and effective approach to varicocele repair with preservation of testicular function, improvements in semen quality, and improvements in pregnancy rates. So in your case the best solution is bilateral microsurgical varicocelectomy.

We cannot give an opinion without clinical examinations/investigation. You may consult a nearby doctor.If not satisfied you may visit our hospital