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Suggest treatment for erectile dysfunction

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Posted on Tue, 17 May 2016
Question: My partner has had diabetes and hashad erectile dysfunction for the last 5 years. We have tried medicines and the pump but no luck. The urologist we went to has said it sounds like nerve damage to erectile nerve and ejaculation nerve (as he cannot ejaculate either). Is there anyway of pin pointing where the issue is and any treatments for replacing the nerves
doctor
Answered by Dr. P. T. Patil (48 minutes later)
Brief Answer:
Needs to evaluate further .

Detailed Answer:
Hello Thanks for your query,based on the facts that you have posted it appears that your husband who is known to be diabetic is facing problem of Erectile Dysfunction and anjaculation since five years .

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Is he diabetic since childhood (Juvenile Diabetes)?
2) Is diabetes well controlled ?

Erectile Dysfunction in a diabetic person is mostly due to Diabetic Neuritis and Diabetic Vasculitis.

Since he has poor response with Sildenafil (Viagra) and Cialis .I would suggest to consult qualified Urologist for clinical assessment and get Color Doppler Scan of the Penis done to confirm the Vasculogenic cause for his ED which could be either Arterial Insufficiency or Venous leak .

Further treatment will depend upon the result of this test .

He will get good erection with taking Intra Cavernosal Injection of Caverjet.

Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you .

Thanks and Regards.
Dr.Patil.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. P. T. Patil (1 hour later)
He is now 31 and has had it since 19. He did not control well as he used to drink a lot. It has been under control the last two years since I came along.
In relation to speaking to a urologist, he did no tests but suggested the injections. I am trying to determine whether or not nerve function can be restored (if it is the problem) or if there is another underlying problem or if any surgery can be done to replace the nerves I needed
doctor
Answered by Dr. P. T. Patil (9 hours later)
Brief Answer:
Read detail answer below .

Detailed Answer:
Hello
Thanks for follow up

Erection is a complex process that involves nervous system and vascular system .
The prime factor in erection process is filling up of blood in erectile tissue with large volume of blood (120 ml)by relaxation of the arterioles in erectile tissue.

There is no surgery that can correct the nerves that are involved in long standing Diabetes or any infective pathology .

Basically it is filling of the erectile tissue with blood is important aspect in achieving erection .

When one does not get erection with drugs like Viagra or Cialis we recommend to take Intra Cavernosal Injection (Caverjet )directly in to penis which helps to dilate arterioles to get filled with blood and there by achieve desired erection to have penetrative sex .

Thanks and Regards.
Dr.Patil.






Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. P. T. Patil (16 hours later)
So what would be the main cause of blood not getting to the penis for an erection? Is it still possible that my partner is still producing sperm and if so, how do we test
doctor
Answered by Dr. P. T. Patil (14 minutes later)
Brief Answer:
Vasculitis due to Diabetes is the cause for reduced blood flow to penis .

Detailed Answer:
Hello
Thanks for follow up .

Vasculitis and Neuritis due to Diabetes prevents relaxation of arterioles and there by incomplete filling of blood in erectile tissue is the prime cause for Ed in a person with Diabetes .

Erection ,ejaculation and production of sperm are three separate processes .

One can have normal sperm count even with ED or ejaculation problem .
.
Get his semen analysis done to confirm the sperm count ,sperm motility and morphology of sperms .

Thanks and Regards,
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10362 Questions

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Suggest treatment for erectile dysfunction

Brief Answer: Needs to evaluate further . Detailed Answer: Hello Thanks for your query,based on the facts that you have posted it appears that your husband who is known to be diabetic is facing problem of Erectile Dysfunction and anjaculation since five years . I shall be happy if you can post me few more details to help me in making comments on your problem. 1) Is he diabetic since childhood (Juvenile Diabetes)? 2) Is diabetes well controlled ? Erectile Dysfunction in a diabetic person is mostly due to Diabetic Neuritis and Diabetic Vasculitis. Since he has poor response with Sildenafil (Viagra) and Cialis .I would suggest to consult qualified Urologist for clinical assessment and get Color Doppler Scan of the Penis done to confirm the Vasculogenic cause for his ED which could be either Arterial Insufficiency or Venous leak . Further treatment will depend upon the result of this test . He will get good erection with taking Intra Cavernosal Injection of Caverjet. Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you . Thanks and Regards. Dr.Patil.