IMPOTENCE
What
is Impotence?
Impotence
or erectile dysfunction is a very common problem that affects 20 million
(approximately 1 out of 5) American Men. Erectile dysfunction is the
result of a single, or more commonly a combination of multiple factors.
At one time impotence was thought to be the result of
psychological problems but we now know that 90% of the cases are organic
in nature. Some of the many causes of impotence include, diabetes, high
blood pressure, heart and vascular disease, stress, hormone problems,
pelvic surgery, trauma, venous leak, and side effects of frequently
prescribed medications.
No
matter what the cause, most men have a secondary psychological reaction
that can worsen the situation. Feelings of performance anxiety, guilt,
and low self-esteem are common. For many years impotence was a
problem that was not talked about because of its personal nature.
Men suffering from this condition often do not know about the various
treatment options availible to them and do not seek help.
TREATMENT
Treatment options for erectile dysfunction can be
divided into four broad categories, pharmacological, mechanical,
surgical, and psychological.
Pharmacological treatment involves delivering
medication which can help restore erections. There are several different
types of medication and ways of administering them.In general, medical
therapy is the most appealing form of treatment and can be highly
successful.
| |
|
|
|
| MEDICATION |
ROUTE |
MECHANISM |
EFFECTIVENESS |
| Yohimbine (Yocon) |
Oral |
Alpha receptor agonist |
Poor |
| Testosterone |
Injection, Patch, Oral |
|
Good (only in men with
low testosterone levels) |
| Prostaglandin E1
(Caverject) |
Penile injection |
Dilates penile
arteries |
Very good |
| Papaverine/ regitine/
prostaglandin |
Penile injection |
Dilates penile
arteries |
Very good |
Prostaglandin E1
(MUSE) |
Intraurethral pellet |
Dilates penile
arteries |
Moderate |
| Sildenafil
(Viagra) |
Oral |
Increases penile blood
flow |
Research data
very good |
| Phentolamine |
Oral |
Increases penile blood
flow |
Research only (at this
time) |
Mechanical treatment involves the use of a vacuum
erection device or "pump" along with a constriction ring. The
penis is placed in a vacuum tube and the air is pumped out. This creates
negative pressure and allows blood to flow into the penis. Once the
penis becomes erect, a rubber ring is placed around the base of the
penis to prevent the blood from leaving. The vacuum tube is then
removed. This non-invasive mode of therapy is effective in treating
erectile problems form most causes although the device can be cumbersome
to use.
Surgical therapy is the most invasive form of
treatment for erectile dysfuction. The penile implant is a very good
option for those men who have failed medical therapy or have a severe
arterial or venous causes of impotence. Penile microsurgical
revascularization procedures are reserved for those men who have a
discrete identifiable penile arterial blockage. This surgery is
technically challenging and must be performed by an experienced
microvascular surgeon. The overall results are good in carefully
selected patients. Penile vein ligation surgery has met with some
controversy over its effectiveness but may yield fair results in
patients with a venous leak.
| |
|
|
| SURGICAL PROCEDURE |
CAUSE OF DYSFUNCTION |
EFFECTIVENESS |
| Penile implant |
|
|
|
Semi-rigid |
All |
Excellent
penis always in semi-rigid state |
|
Inflatable |
All |
Excellent
penis looks more natural |
| Arterial
Revascularization |
Discrete arterial
blockage |
Moderate to good |
| Penile Vein
Ligatation |
Discrete venous
leak |
Poor to moderate |
Psychological therapy is very useful in those cases of
erectile dysfunction which are a direct result of psychological causes.
These patients may also benefit from pharmacologic or combination
therapy.
The treatment of erectile dysfunction is rapidly
changing as our understanding of erectile physiology expands. Men are
becoming increasingly aware of the many different solutions availible
for this problem and are actively seeking help. Wives and partners are
becoming more involved in the treatment process. If you or a loved
one suffers from erectile dysfuntion, help is just a phone call away.
