Ronald Virag

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Ronald Virag
Dr. Ronald Virag, working.jpg
Dr Ronald Virag (2010)
Born (1938-12-07) December 7, 1938 (age 85)
Metz, France
NationalityFrench
Education MD from Paris University, with a specialization in cardiovascular surgery.
Occupation Cardiovascular surgeon

Ronald Virag (born December 7, 1938) is a French cardiovascular surgeon who specialises in andrology, the study of the male reproductive system. After training in general and cardiovascular surgery at Paris University, [1] he shifted his focus to the study of erectile dysfunction, which has been his primary area of study since 1978. In 1981, he founded a private institute in France dedicated to the clinical study of erectile dysfunction and developed early programs using intracavernosal drugs to treat the condition.

Contents

Biography

Ronald Virag was born in Metz, France in 1938 to Hungarian parents who had become French citizens before his birth. His father, Edmond Weiskopf (1911-1996), was a former professional soccer player. Virag attended Ecole des Roches and Lycée Janson de Sailly in Paris before entering the Faculty of Sciences and then the Faculty of Medicine at the University of Paris.

After completing his medical training, Virag became an intern and resident at Paris Public Assistance Hospitals. Afterward, he was appointed Chief Resident at the Faculty and specialized in cardiovascular surgery. He created several cardiovascular surgery units in private institutions before taking an interest in male sexual dysfunction caused by vascular diseases.

Virag developed specific techniques to explore the penile blood flow dynamics and designed various original surgical interventions, such as the penis dorsal vein arterialization which was named after him. In 1982, he discovered, almost by chance, that an old medication, papaverine injected directly into the penis, could provoke a long-lasting erection. Thus, he developed the technique of intracavernous injection, which has been used worldwide since 1983 to treat erectile dysfunction.

He was appointed as a consultant at Harvard Medical School and now teaches within various structures of French and foreign medical societies. He is a permanent member of the French National Academy of Surgery. [2]

Impact on treatment of erectile dysfunction

Until the last third of the 20th century, medicine had little interest in treating erectile dysfunction. [3] Busy urologists would simply prescribe men a quick cure of male hormones, then send them back to the psychiatrist; because of Freud, erectile dysfunction was incorrectly thought to be caused by neurosis. It was not until the 1970s that a few pioneers developed surgical and medical techniques to help those suffering from erectile dysfunction. Ronald Virag was one of these pioneers. He was then a young chief resident at the Hospital Broussais, a Paris Public Assistance Hospital, and he took an interest in the erectile dysfunctions occurring in the patients affected by Leriche's syndrome. Urged by their despair, Virag became passionate about this problem and devoted most of his professional life to it. A small international group was formed, combining the Europeans, more focused on physiology, and the Americans, who developed the penile implant techniques. This group founded a new medical Society which today has become the International Society for Sexual Medicine (ISSM), [4] with over a thousand members.

Intracavernousal injection of papaverine

The intracavernous injection of papaverine was a turning point in the history of the treatment of erectile dysfunction. [5] Ronald Virag, then an active member of one of the most renowned units of cardiovascular surgery in Europe, had already developed a procedure aiming to improve the blood flow in the penis. His intervention called “dorsal vein arterialization” is known in the United States as the “Virag’s procedure”. [6] In 1981, during a surgical operation on the penis, he discovered that an old medication extracted from poppies, and used since the late 19th century to dilate blood vessels, could induce an erection when injected into the penis. After a year of observing the effects of papaverine on volunteers, himself being one of them, the discovery was published in the famous medical journal “Lancet”. [7] Patients rapidly saw benefits and the intracavernous injection became the standard means of triggering an erection. Since then the technique was improved for the comfort of patients, who may now use an automatic injector. Even after the rise in popularity of Viagra , the intracavernous mini injection remains the most efficient and reliable medical treatment for erectile dysfunction.” [8]

Viagra and Virag

When the American pharmaceutical company Pfizer realized that a molecule tested against heart failure had positive effects on erection, Ronald Virag was immediately consulted for a first assessment, which launched research on the topic. Afterward, with a Norwegian colleague, he led the first European preliminary study of the medicine. In 1999, he was part of the task force appointed by the French Ministry of Health. [9] He was also consulted that same year by the National Ethics Advisory Council. [10]

Prizes and awards

In 1985, the American Urology Association presented him the John Lattimer prize (a unique fact for a doctor nonspecialized in urology and non-American), awarding a discovery that changed the course of the specialty. The association then lauded his discovery of the intracavernous injection as one of the most important discoveries of the century in the urology and andrology fields. In 1997, he was honored by the European Society for Sexual Medicine for the entirety of his works. Brazilian, Portuguese, Spanish, and Greek medical societies honored him as well. He was elected associate member, then a permanent member of the French National Surgery Academy (2012).

Bibliography

eBooks:

Related Research Articles

Erectile dysfunction (ED), also referred to as impotence, is a form of sexual dysfunction in males characterized by the persistent or recurring inability to achieve or maintain a penile erection with sufficient rigidity and duration for satisfactory sexual activity. It is the most common sexual problem in males and can cause psychological distress due to its impact on self-image and sexual relationships. Majority of ED cases are attributed to physical risk factors and predictive factors. These factors can be categorized as vascular, neurological, local penile, hormonal, and drug-induced. Notable predictors of ED include aging, cardiovascular disease, diabetes mellitus, high blood pressure, obesity, abnormal lipid levels in the blood, hypogonadism, smoking, depression, and medication use. Approximately 10% of cases are linked to psychosocial factors, encompassing conditions like depression, stress, and problems within relationships.

<span class="mw-page-title-main">Priapism</span> Medical condition where an erection lasts excessively long

Priapism is a condition in which a penis remains erect for hours in the absence of stimulation or after stimulation has ended. There are three types: ischemic (low-flow), nonischemic (high-flow), and recurrent ischemic (intermittent). Most cases are ischemic. Ischemic priapism is generally painful while nonischemic priapism is not. In ischemic priapism, most of the penis is hard; however, the glans penis is not. In nonischemic priapism, the entire penis is only somewhat hard. Very rarely, clitoral priapism occurs in women.

<span class="mw-page-title-main">Peyronie's disease</span> Medical condition

Peyronie's disease is a connective tissue disorder involving the growth of fibrous plaques in the soft tissue of the penis. Specifically, scar tissue forms in the tunica albuginea, the thick sheath of tissue surrounding the corpora cavernosa, causing pain, abnormal curvature, erectile dysfunction, indentation, loss of girth and shortening.

<span class="mw-page-title-main">Penis enlargement</span> Technique aimed to increase the size of a human penis

Penis enlargement, or male enhancement, is any technique aimed to increase the size of a human penis. Some methods aim to increase total length, others the shaft's girth, and yet others the glans size. Techniques include surgery, supplements, ointments, patches, and physical methods like pumping, jelqing, and traction.

Sexual dysfunction is difficulty experienced by an individual or partners during any stage of normal sexual activity, including physical pleasure, desire, preference, arousal, or orgasm. The World Health Organization defines sexual dysfunction as a "person's inability to participate in a sexual relationship as they would wish". This definition is broad and is subject to many interpretations. A diagnosis of sexual dysfunction under the DSM-5 requires a person to feel extreme distress and interpersonal strain for a minimum of six months. Sexual dysfunction can have a profound impact on an individual's perceived quality of sexual life. The term sexual disorder may not only refer to physical sexual dysfunction, but to paraphilias as well; this is sometimes termed disorder of sexual preference.

<span class="mw-page-title-main">Phentolamine</span> An α-adrenergic antagonist medication

Phentolamine, sold under the brand name Regitine among others, is a reversible nonselective α-adrenergic antagonist.

Prostaglandin E<sub>1</sub> Erectile dysfunction medication

Prostaglandin E1 (PGE1) is a naturally occurring prostaglandin and is also used as a medication (alprostadil).

Nocturnal penile tumescence (NPT) is a spontaneous erection of the penis during sleep or when waking up. Along with nocturnal clitoral tumescence, it is also known as sleep-related erection. Men without physiological erectile dysfunction or severe depression experience nocturnal penile tumescence, usually three to five times during a period of sleep, typically during rapid eye movement sleep. Nocturnal penile tumescence is believed to contribute to penile health.

Venous leak, also called venogenic erectile dysfunction and penile venous insufficiency, is one category of vasculogenic impotence — a cause of erectile dysfunction in males. It affects all ages, being particularly awkward in young men. Much about venous leaks has not reached a consensus among the medical community, and many aspects of the condition, particularly its treatment strategies, are controversial. The prevalence of the condition is still unknown, although some sources claim it to be a common cause of erectile dysfunction.

<span class="mw-page-title-main">Penile implant</span> Medical device

A penile implant is an implanted device intended for the treatment of erectile dysfunction, Peyronie's disease, ischemic priapism, deformity and any traumatic injury of the penis, and for phalloplasty or metoidioplasty, including in gender-affirming surgery. Men also opt for penile implants for aesthetic purposes. Men's satisfaction and sexual function is influenced by discomfort over genital size which leads to seek surgical and non-surgical solutions for penis alteration. Although there are many distinct types of implants, most fall into one of two categories: malleable and inflatable transplants.

Trimix is a prescription combination drug containing alprostadil, papaverine, and phentolamine. It is used to treat erectile dysfunction.

<span class="mw-page-title-main">Erection</span> Physiological phenomenon involving the hardening and enlargement of the penis

An erection is a physiological phenomenon in which the penis becomes firm, engorged, and enlarged. Penile erection is the result of a complex interaction of psychological, neural, vascular, and endocrine factors, and is often associated with sexual arousal, sexual attraction or libido, although erections can also be spontaneous. The shape, angle, and direction of an erection vary considerably between humans.

Boston Medical Group is a network of medical offices sharing research information and treatment methods for erectile dysfunction and premature ejaculation.

An intracavernousinjection is an injection into the base of the penis. This injection site is often used to administer medications to check for or treat erectile dysfunction in adult men. The more common medications administered in this manner include Caverject, Trimix, Bimix, and Quadmix. These medications are all types of vasodilators and cause tumescence within 15 minutes. Common side effects include priapism, bruising, fibrosis, Peyronie's disease, and pain.

<span class="mw-page-title-main">Clitoral erection</span> Physiological phenomenon involving the engorgement of the clitoris

Clitoral erection is a physiological phenomenon where the clitoris becomes enlarged and firm.

Combined intracavernous injection and stimulation test or CIS test is the most commonly performed office diagnostic procedure for erectile dysfunction. It consists of an intracavernosal injection, visual or manual sexual stimulation, and a rating of the subsequent erection. Neurogenic and hormonal influences are thus bypassed as the status of the blood vessels of the penis is assessed directly and objectively. A rigid erection of more than 10 minutes indicates normal function of veins. The same conclusion cannot be made for the function of arteries as some men with mild arterial problems can also have the same response.

<span class="mw-page-title-main">Michael Perelman (psychologist)</span>

Michael A. Perelman is an American psychologist. He is a Clinical Professor Emeritus of Psychology in Psychiatry and former Clinical Professor of Reproductive Medicine, and Urology at Weill Cornell Medicine. Perelman is the co-director of the Human Sexuality Program, Payne Whitney Clinic of the NewYork–Presbyterian Hospital.

Culley Clyde Carson III is an American retired urologist who specializes in Peyronie's disease, penile implants and erectile dysfunction. After serving two years as a flight surgeon with the United States Air Force, he took on a urology residency at the Mayo Clinic and then taught at the Duke University Medical Center as an assistant professor, subsequently gaining full professorship.

Penile implants may be employed to treat erectile dysfunction or urinary troubles after a spinal cord injury.

<span class="mw-page-title-main">Glans insufficiency syndrome</span> Medical condition

Glans insufficiency syndrome, also known as the soft glans, cold glans, or glans insufficiency, is a medical condition that affects male individuals. This condition is characterized by the persistent inability of the glans penis to achieve and maintain an erect or turgid state during sexual arousal, remaining soft and cold. This condition can have an impact on a person's sexual function, including decreased sensitivity, difficulty in maintaining an erection, and overall quality of life.

References

  1. ↑ "Ronald Virag, MD (1938 – ) - Didusch Museum". urologichistory.museum. Retrieved 2023-01-02.
  2. ↑ "Home". academie-chirurgie.fr.
  3. ↑ G. Zwang Histoires des Peines de Sexe, Maloine éditeur 1994
  4. ↑ "Home". issm.info.
  5. ↑ D. Schulteiss, S Musitelli, CG Stief, U.Jonas Classical writings on Erectile Dysfunction ABW Wissenschaftsverlag
  6. ↑ A.H.Bennett Impotence Saunders (v. dédicace de l’ouvrage et page 209)
  7. ↑ R.Virag Intracavnous Injection for erectile failure Lancet 1982 2: 938
  8. ↑ The ESSM Syllabus of Sexual medicine Medix publishers
  9. ↑ A. Giami et R Pietri Les Traitements de l’Impuissance La documentation Française
  10. ↑ CCNE Rapport n°62 « Médicalisation de la sexualité : Le cas du Viagra. Réponse au secrétaire d’État à la Santé »
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