Erectile Dysfunction Clinic
Approximately 1 in every 10 adult males will suffer from Erectile Dysfunction (ED) during their lifetime. Many men do experience occasional failure to achieve erection, which can happen due to several reasons such as high alcohol intake, stress, relationship issues, or from being extremely tired.
The failure to achieve an erection less than 2 out of 10 times is not unusual and typically does not require treatment. However, the failure to achieve an erection more than 5 out of 10 times generally means that there is a problem and treatment is required.
Causes of erectile dysfunction
ED can be caused by a number of factors, including:
Blood supply to the penis can become blocked or narrowed as a result of vascular diseases such as atherosclerosis (hardening of the arteries).
Neurological disorders (such as multiple sclerosis):
Nerves that send impulses to the penis can become damaged from conditions such as stroke, diabetes, or other causes.
These include stress, depression, lack of stimulus from the brain, and performance anxiety.
An injury could contribute to symptoms of ED.
Operations on the prostate, bladder, and colon cancer may also be contributing factors.
Chronic illness, certain medications, and a condition called Peyronie’s disease can also cause ED.
Medications which may cause erectile dysfunction
Erectile dysfunction (ED) is a common side effect of a number of prescription drugs. While these medications may treat a disease or condition, in doing so they can affect a man’s hormone levels, nerves or blood circulation resulting in ED or increasing the risk of ED.
If you experience ED and think that it may be a result of the medication you are taking, do not stop taking your medication, if the problem persists, contact your treating internal medicine physician and he or she may be able to prescribe a different medication. Common medications that may list ED as a potential side effect include:
2-Antihypertensives (high blood pressure medication)
5-Parkinson’s disease medication
6-Antiarrhythmics (medication for irregular heart beat)
9-Nonsteroidal anti-inflammatory medication(NSAIDs)
10-Histamine H2-receptor antagonists
13-Prostate cancer medication
Other substances or drugs that can cause or lead to ED include overconsumption of alcohol and recreational drugs.
Can ED be prevented?
ED does not have to be a part of getting older. While some older men may need more stimulation, they should never-the-less be able to achieve an erection and enjoy intercourse.
For people who are at risk of developing ED due to personal behavior, steps may be taken to try to prevent its occurrence, however, other causes may not be preventable. A number of studies now suggest a link between ED and obesity, high cholesterol, hypertension, diabetes, and heart disease.
The following recommendations may help prevent ED or improve the problem if it is already present:
-Eat a balanced, healthy diet.
-Reduce cholesterol levels.
-Maintain a healthy weight.
-Exercise regularly as regular exercise may reduce the risk of ED.
How do doctors treat erectile dysfunction?
The type of medical specialist who treats ED will depend on the cause of the problem. Based on your family’s medical history, as well as your own medical history and current health, your doctor may treat you with oral medications such as Viagra®, Levitra®, Cialis®.
If these options fail, at Bedaya Hospital our andrologists will assist with other non-surgical options such as the use of a vacuum device, injections or surgical treatment options. If needed, your doctor may also refer you to a psychologist specializing in sexual dysfunction.
Erectile dysfunction treatment
ED can be treated in many ways, including:
6-Surgery (penile implant)
The first step to treating ED is to find the underlying cause, and then the appropriate treatment can begin. There are a number of non-surgical and surgical options that can help a man regain normal sexual function.
Non-surgical treatment for ED
Education and communication
Education about sex, sexual behaviors, and sexual responses may help a man overcome his anxieties about sexual dysfunction.
Talking honestly with your partner about your needs and concerns may also help to overcome many barriers and lead to a healthy sex life.
Medications may help improve sexual function in men by increasing blood flow to the penis. It is important to note that men being treated for angina with medications such as nitroglycerines should not use medication to treat ED as the combination of nitrates and these specific medications can cause low blood pressure.
The most common side effects of ED medications include indigestion, nasal congestion, flushing, headaches, and a temporary visual disturbance.
Aids such as vacuum devices and penile constriction rings serve as erectile aids for some men.
The vacuum device can be safely used to treat most causes of erectile failure, however many people are not comfortable with the idea of this option.
Penile injection therapy (intracavernosal injection therapy)
Men are taught how to inject medications directly into the erection chambers of the penis in order to induce an erection. Injection therapy is effective in treating a wide variety of erection issues that are caused by blood vessel, nerve, and psychological conditions.
A painful erection that lasts longer than two to three hours is called priapism and may occur with injection therapy. This can be lessened with proper dosing and by following the treatment guidelines.
surgical treatment options
Penile prosthesis surgery
Inflatable penile prostheses can be implanted during a simple outpatient surgery. Once the prosthesis is part of a man’s body, it enables him to have an erection whenever he desires. The use of prosthesis preserves penile sensation, orgasm, and ejaculation for most men.
The most commonly used penile implant consists of a pair of inflatable cylinders that are surgically implanted into the erection chambers of the penis. The cylinders are connected through tubing to a reservoir of fluid under the lower abdominal muscles, and to a pump inside the scrotal sac.
To inflate the penile prosthesis, the man compresses the pump a number of times to transfer fluid from the reservoir to the cylinders and this causes the penis to become erect. When inflated, the prosthesis makes the penis stiff and thick, which is very similar to a natural erection.
A penile prosthesis does not change the sensation on the skin of the penis or a man’s ability to achieve orgasm or ejaculate. Pressing on a deflation valve attached to the pump returns the fluid to the reservoir, which returns the penis to a flaccid state.
The surgical procedure is performed through one or two small incisions that are generally well hidden. Other people will be unable to tell that a man has an inflatable penile prosthesis — most men would not be embarrassed in a locker room or public restroom. Complications following surgery are not common, but primarily include infection and mechanical device failure.
Approximately 95% of penile implant surgeries in Bedaya Hospital are successful in producing erections that enable men to have fully functioning sexual intercourse.