Ronald Virag
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Ronald Virag (born December 7, 1938) is a French cardiovascular surgeon who specialises in
andrology Andrology (from , ''anēr'', genitive , ''andros'' 'man' and , ''-logy, -logia'') is a name for the medicine, medical specialty that deals with male health, particularly relating to the problems of the male reproductive system and urology, urologi ...
, the study of the male reproductive system. After training in general and cardiovascular surgery at
Paris University The University of Paris (), known metonymically as the Sorbonne (), was the leading university in Paris, France, from 1150 to 1970, except for 1793–1806 during the French Revolution. Emerging around 1150 as a corporation associated with the ca ...
, he shifted his focus to the study of
erectile dysfunction 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 Human penis, penile erection with sufficient rigidity and durat ...
, 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.


Biography

Ronald Virag was born in
Metz, France Metz ( , , , then ) is a city in northeast France located at the confluence of the Moselle and the Seille rivers. Metz is the prefecture of the Moselle department and the seat of the parliament of the Grand Est region. Located near the tripoi ...
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 France, secondary education is in two stages: * ''Collèges'' () cater for the first four years of secondary education from the ages of 11 to 14. * ''Lycées'' () provide a three-year course of further secondary education for students between ...
in Paris before entering the Faculty of Sciences and then the Faculty of Medicine at the
University of Paris The University of Paris (), known Metonymy, metonymically as the Sorbonne (), was the leading university in Paris, France, from 1150 to 1970, except for 1793–1806 during the French Revolution. Emerging around 1150 as a corporation associated wit ...
. 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 Papaverine (Latin '' papaver'', "poppy") is an opium alkaloid antispasmodic drug, used primarily in the treatment of visceral spasms and vasospasms (especially those involving the intestines, heart, or brain), occasionally in the treatment of ...
injected directly into the penis, could provoke a long-lasting erection. Thus, he developed the technique of
intracavernous injection An intracavernous (or intracavernosal) injection 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 (in, for example, a combined intrac ...
, which has been used worldwide since 1983 to treat erectile dysfunction. He was appointed as a consultant at
Harvard Medical School Harvard Medical School (HMS) is the medical school of Harvard University and is located in the Longwood Medical and Academic Area, Longwood Medical Area in Boston, Massachusetts. Founded in 1782, HMS is the third oldest medical school in the Un ...
and now teaches within various structures of French and foreign medical societies. He is a permanent member of the French National Academy of Surgery.


Impact on treatment of erectile dysfunction

Until the last third of the 20th century, medicine had little interest in treating
erectile dysfunction 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 Human penis, penile erection with sufficient rigidity and durat ...
. Busy urologists would simply prescribe men a quick cure of male hormones, then send them back to the psychiatrist; because of
Freud Sigmund Freud ( ; ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating pathologies seen as originating from conflicts in t ...
, erectile dysfunction was incorrectly thought to be caused by
neurosis Neurosis (: neuroses) is a term mainly used today by followers of Freudian thinking to describe mental disorders caused by past anxiety, often that has been repressed. In recent history, the term has been used to refer to anxiety-related con ...
. 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 The International Society for Sexual Medicine (ISSM) is a medical society devoted to the study of the medicine of human sexuality. It publishes four journals, ''The Journal of Sexual Medicine'', ''Sexual Medicine Open Access'', ''Sexual Medicine Re ...
(ISSM), with over a thousand members.


Intracavernousal injection of papaverine

The intracavernous injection of
papaverine Papaverine (Latin '' papaver'', "poppy") is an opium alkaloid antispasmodic drug, used primarily in the treatment of visceral spasms and vasospasms (especially those involving the intestines, heart, or brain), occasionally in the treatment of ...
was a turning point in the history of the treatment of erectile dysfunction. Ronald Virag, then an active member of one of the most renowned units of cardiovascular surgery in
Europe Europe is a continent located entirely in the Northern Hemisphere and mostly in the Eastern Hemisphere. It is bordered by the Arctic Ocean to the north, the Atlantic Ocean to the west, the Mediterranean Sea to the south, and Asia to the east ...
, 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 The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
as the “Virag’s procedure”. 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”. 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 Sildenafil, sold under the brand name Viagra among others, is a medication used to treat erectile dysfunction and pulmonary arterial hypertension. It is also sometimes used off-label for the treatment of certain symptoms in secondary Ray ...
, the intracavernous mini injection remains the most efficient and reliable medical treatment for erectile dysfunction.”


Viagra and Virag

When the American pharmaceutical company
Pfizer Pfizer Inc. ( ) is an American Multinational corporation, multinational Pharmaceutical industry, pharmaceutical and biotechnology corporation headquartered at The Spiral (New York City), The Spiral in Manhattan, New York City. Founded in 184 ...
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. He was also consulted that same year by the National Ethics Advisory Council.CCNE Rapport n°62 « Médicalisation de la sexualité : Le cas du Viagra. Réponse au secrétaire d’État à la Santé »


Prizes and awards

In 1985, the American Urology Association presented him the
John Lattimer John Kingsley Lattimer, MD (October 14, 1914, in Mount Clemens, Michigan – May 10, 2007, in Teaneck, New Jersey) was a urologist who did extensive research on the Abraham Lincoln and John F. Kennedy assassinations, becoming the first medical sp ...
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

*Papavérine et Impuissance (Les Editions du CERI) 1987 *L’Homme qui Marche (Table Ronde) 1990 *Le Sexe de l’Homme (Albin Michel et Poche) 1997, 2001 *La pilule de l’Erection et votre sexualité (Albin Michel) 1998 *Histoires de Pénis (Albin Michel) 2003 *Les Injections intracaverneuses (John Libbey-Eurotext) 2004 *Le Sexe de l’Homme nouvelle edition (Albin Michel) 2011
eBook An ebook (short for electronic book), also spelled as e-book or eBook, is a book publication made available in electronic form, consisting of text, images, or both, readable on the flat-panel display of computers or other electronic devices. A ...
s: * Erection, the user's guide (Editions Clément) May 2013


References

{{DEFAULTSORT:Virag, Ronald French surgeons Living people 1938 births