BOOK AN APPOINTMENT
The initial consultation will last for about two hours in order to properly diagnose the condition and formulate a treatment recommendation.
WHAT IS ERECTILE DYSFUNCTION
Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It is also sometimes also referred to as impotence.Occasional ED is not uncommon. Many men experience it during times of stress. However, frequent ED can be a sign of health problems that need treatment. It can also be a sign of emotional or relationship difficulties that may need to be addressed by a professional.
Not all male sexual problems are caused by ED. Other types of male sexual dysfunction include:
Premature ejaculation
delayed or absent ejaculation
lack of interest in sex
HOW DOES A MAN GET AN ERECTION?
An erection is the result of increased blood flow into the penis. Blood flow is usually stimulated by either sexual thoughts or direct contact with the penis.
When a man becomes sexually excited, muscles in the penis relax. This relaxation allows for increased blood flow through the penile arteries. This blood fills two chambers inside the penis called the corpora cavernosa. As the chambers fill with blood, the penis grows rigid. Erection ends when the muscles contract and the accumulated blood can flow out through the penile veins.ED can occur because of problems at any stage of the erection process. For example, the penile arteries may be too damaged to open properly and allow blood in.
The potential causes of ED are numerous. They include:
cardiovascular disease diabetes damage from cancer or surgery injuries stress smoking
anxiety relationship problems drug use alcohol use
WHAT ARE THE TREATMENT OPTIONS
Intracavernous Pharmacotherapy
With the advent of phosphodiesterase type-5 inhibition as oral therapy, intracavernous injection of vasoactive agents has been relegated to second-line therapy for most patients with erectile dysfunction. However, the future of this category of agents remains bright as an ever-expanding number and combination of agents in use and under investigation will likely make intracavernous injection more appealing as greater efficacy, tolerability, and more rapid onset is attained.In this article, functional anatomy and physiology of human penile erection is reviewed, as are current clinical vasoactive agents including prostaglandin E-1, papaverine, and phentolamine. Emerging therapies discussed include guanylate cyclase activators, potassium channel openers, nitric oxide donors, vasoactive intestinal polypeptide, calcitonin gene-related peptide, selective alpha-1 receptor antagonists, and gene therapy.Ongoing research continues to define new roles for this effective and safe technique, which has withstood the test of time, restoring erectile function among patients with diverse ED etiologies and a variety of co-morbidities.
Oral Medications
Oral medications for ED have become very well known, and their convenience often makes them the first-line of treatment. While effective for many men, those who take nitrates for chest pain should not use oral medications given the potential for an unsafe drop in blood pressure. Other potential side effects include, but are not limited to, blurred vision, loss of hearing, and headaches.
Intra-Urethral Suppository (Muse)
MUSE contains a vasodilator known as Alprostadil (or Prostaglandine E1) prepared in the form of a pellet that is inserted into the urethra, via an applicator. The medicine is absorbed through the urethral wall into the erectile chambers known as the corpus cavernosa.
Penile Prosthesis
Penile implants are devices placed inside the penis to allow men with erectile dysfunction (ED) to get an erection. Penile implants are typically recommended after other treatments for ED fail. There are two main types of penile implants, semirigid and inflatable. Each type of penile implant works differently and has various pros and cons. The placement of penile implants requires surgery. Before choosing penile implants, make sure you understand what surgery involves, including possible risks, complications and follow-up care. Penile implant surgery is a major surgery that is usually invasive and expensive. Nonetheless, it can benefit men who do not respond to any other form of treatment.
Vacuum Suction Devices
A VSD is a battery or manually-operated cylindrical pump which fully encloses the penis. When activated, it creates a vacuum by sucking air out of the sealed chamber, which draws blood to the penis. A firm rubber ring is placed around the base of the penis to trap the blood in the erectile chamber, which keeps the penis firm.
Arterial And Venous Surgeries
Approximately 2% to 5% of patients are candidates for vascular reconstructive surgery, which includes arterial bypass and venous ligation. Risks include those related to other major surgical procedures.
Hormonal Replacement Therapy
Some men experience a condition called andropause, similar to menopause in women, which can be caused by low testosterone. Symptoms can include, but are not limited to, feelings of sluggishness, fatigue, poor sleeping habits, weight gain, low sex drive, or erectile dysfunction.
Sex Therapy
Sex therapy is often the treatment of choice for patients with psychological Erectile Dysfunction. It demands the cooperation of the sexual partner, multiple sessions, and an experienced sex therapist for the best results.
Intranasal Medications
Intranasal medications offer a non-traditional method of administering different combinations of vasodilators with the goal or improving blood flow.
APPOINTMENT STEPS
DIAGNOSIS & EVALUATION
The process begins with a thorough evaluation of your medical history, and may include up to 3-4 diagnostics tests, including blood work, blood flow and nerve supply analysis.
TREATMENT RECOMMENDATION
Erectile dysfunction may cause or exacerbate psychological problems such as poor motivation, feelings of inadequacy, frustration, denial and low self-esteem, and may ultimately lead to depression.
