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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Sexology Treatment of Impotence

Treatment of Impotence

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Treatment of male impotence or erectile dysfunction will depend on the cause of the erectile dysfunction. Most of the treatments work on a temporary basis as they will lead to an successful erection for intercourse but will not cure the underlying condition. Therefore these treatments are generally prescribed before the intercourse only. If someone is using these approved treatments he will be able to successfully maintain erection for the duration of the intercourse.

 

Testosterone supplements are offered frequently to the patients who have erectile dysfunction secondary to hormonal deficiency. Generally the main cause for the erectile dysfunction is the lack of adequate blood supply to penis as a result of damage to inner walls of blood vessels which leads to a faulty erection. As the age progresses the person is predisposed to this type of damage but it can also occur in some diseases like diabetes as vascular complications. Drugs are usually in form of oral medications, injections and penile suppositories. All the drugs will increase the efficacy of NO, which dilates the blood vessels of corpora cavernosa which ultimately results in erection. Penile injections are also offered to the patients after the failure of oral medications and penile suppositories but the injections may sometimes result in painful erections or Priaprism. In some cases refractory to medications external vacuum pump can be used to attain erection, with a separate compression ring fitted to the penis to maintain it. These are used as a treatment for the erectile dysfunction rather than to increase the penile size. Implants are very expensive. If the patient is having some vascular problem then a surgical treatment is offered to him. These treatments are based on the principles of hydraulics and simple mechanics and are reliable also but they may have certain side effects.

 

Oral treatment

PDE5 inhibitors like sildenafil or Viagra, vardenafil or levitra and tadalafil or cialis are prescribed orally. These drugs block the action of PDE5, which leads to cGMP degeneration. CGMP specific phosphodiesterase type 5 causes the smooth muscle relaxation of the arteries in the penis thus allowing the corpus cavernosum to fill with blood. These medications will work after sexual stimulation only and the time taken for the optimum erection will vary from few minutes to 1 hour, so it is advisable to take the medicine 45 minutes before intercourse.

Alprostadil

It is a Prostaglandin and is injected into the penis or inserted using a special applicator just before sexual intercourse. Now a day’s topical application preparation is also available.

Vacuum Therapy

In this procedure a vacuum cylinder device is placed in the penis. The device will apply negative pressure and will draw the blood. A tension ring is applied at the base of the penis to help maintain the erection. It is also known as penis pump and is available in various types.

Surgery

A prosthetic implant which may consist of rod may be placed in the penis if other measures are not working.

Counseling

It is used to manage the distress if doctor suspects that there is some psychological problem.

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