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Impotency And Erectile Dysfunction Facts And Information
Erectile Dysfunction And Impotency Treatments
Most physicians suggest cutting back on any drugs with harmful side effects. For example, drugs for high blood pressure work in different ways. If you think a particular drug is causing problems with erection, tell your doctor and ask whether you can try a different class of blood pressure medicine.
Psychotherapy and behavior modifications in selected patients are considered next if indicated, followed by oral or locally injected drugs, vacuum devices, and surgically implanted devices. In rare cases, surgery involving veins or arteries may be considered.
Sex Therapy
Psychological therapy is effective in conjunction with medical or surgical treatment. Sex therapists emphasize the need for men and their partners to be motivated and willing to adapt to psychological and behavioral modifications, including those that result from medical or surgical treatment. A significant number of men develop impotence from psychological causes that can be overcome. When a physiological cause is treated, subsequent self-esteem problems may continue to impair normal function and performance. Qualified therapists (e.g., sex counselors, psychotherapists) work with couples to reduce tension, improve sexual communication, and create realistic expectations for sex, all of which can improve erectile function.
Oral Medication
Oral medications used to treat erectile dysfunction include selective enzyme inhibitors e.g. sildenafil (Tradename Viagra), vardenafil HCl (Tradename- Levitra) and tadalafil (Tradename- Cialis).Selective enzyme inhibitors are available by prescription and may be taken up to once a day to treat ED. They improve partial erection.
Side effects of selective enzyme inhibitors include:
Headaches Reddening of the face and neck (flushing) Indigestion Nasal congestion Cialis may cause muscle aches and back pain, which usually resolve by themselves within 48 hours.
Ease of administration makes oral medication advantageous. Some drugs, however, are suitable for only a relatively small group of men, and in many cases, oral medications may by less effective than other treatments.
Other, more invasive treatments for Erectile Dysfunction are:
Self-Injection
Self-injection involves using a short needle to inject medication through the side of the penis directly into the corpus cavernosum, which produces an erection that lasts from 30 minutes to several hours. Prostaglandin (alprostadil, Caverject, Edex), and phentolamine (Regitine) produce results similar to Viagra but are localized in the penis after injection. They cause vascular dilation and a relaxation of smooth muscle. Prostaglandin is the only substance currently approved for erectile dysfunction treatment. Phentolamine is a heart medication with similar effects used by some physicians to treat impotence.
These drugs have been shown to produce erections in 80% of men who inject them. Some men claim that they produce erections that feel natural and improve sex. The injections are relatively painless and create an erection that begins about 5 to 15 minutes after the injection.
Side effects of self-injections:
Infection Bleeding Bruising at the injection site Dizziness Heart palpitations Flushing Repeated injection may cause scarring of erectile tissue, which can further impair erection
Self-injection, as the Erectile Dysfunction treatment, should be done no more than once every 4 to 7 days. There is a small risk for priapism (an erection that lasts for more than 6 hours and requires medical relief).
Urethral suppositories
These are alternatives to injections; these contain prostaglandin (aprostadil) for example Muse (Medicated Urethral System for Erections). Using a hand-held delivery device, a man inserts a prostaglandin pellet through the meatus (penis opening) into the urethra. Prostaglandin is absorbed through the urethral mucosa and into the surrounding erectile tissue. It is available with a prescription, is well tolerated, and may improve erections in 60% of men who use it.
A word of caution regarding urethral suppositories - in addition to the side effects associated with injecting aprostadil, pain in the penis and perineum (area between scrotum and rectum) may occur with suppository use.
Vacuum Devices
Vacuum devices (commonly known as "Swedish Pumps") work best in men who are able to achieve partial erections on their own. They are easy to use at home, require no other procedure, and typically improve erections regardless of the cause of impotence. Some men experience a numbing feeling afterwards. Since the penis is flaccid between the ring and the body, the erection may be somewhat floppy. Vacuum devices work by manually creating an erection.
Penile Implants
Surgery usually has one of three goals:
to implant a device that can cause the penis to become erect; to reconstruct arteries to increase flow of blood to the penis to block off veins that allow blood to leak from the penile tissues.
Implanted devices, known as prostheses, can restore erection in many men with ED. Malleable implants usually consist of paired rods, which are inserted surgically into the corpora cavernosa. The user manually adjusts the position of the penis and, therefore, the rods. Adjustment does not affect the width or length of the penis. Inflatable implants consist of paired cylinders, which are surgically inserted inside the penis and can be expanded using pressurized fluid. Inflatable implants can expand the length and width of the penis somewhat. They also leave the penis in a more natural state when not inflated.
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