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Erectile Dysfunction

Erectile dysfunction (ED), also known as impotence, is a condition where men may experience persistent difficulty obtaining and/or maintaining an erect penis during sexual intercourse.

Erectile Dysfunction Symptoms

Symptoms of erectile dysfunction include the inability to get an erection, struggling to maintain an erection for sexual intercourse, and being unable to ejaculate.

Consult your urologist if you are experiencing any of these symptoms. Although erectile dysfunction is often a benign condition, it can indicate a more serious underlying health condition, such as diabetes or progressive coronary disease.

Causes of Erectile Dysfunction

Common causes for erectile dysfunction are:

  • Psychological factors, such as stress, anxiety, depression, and low self-esteem.
  • Chronic illnesses, such as hypertension, diabetes, coronary artery disease, and multiple sclerosis, can damage the nerves and arteries to the penis.
  • Poor lifestyle, such as smoking, excessive alcohol intake, obesity, and sedentary lifestyle.
  • Surgery or radiation treatment for prostate cancer, which damages the cavernosal nerves.
  • Medications, such as anti-depressants, blood pressure drugs, antihistamines, and appetite suppressants.
  • Hormonal abnormalities, such as low testosterone levels.

Erectile Dysfunction Diagnosis

  • You will be asked to complete a questionnaire, such as the International Index of Erectile Function (IIEF) to assess the severity of erectile dysfunction.
  • Your urologist will perform a physical examination of the penis and a psychological examination. Unusual characteristics of the penis itself can suggest the source of the problem. For example, a penis that bends or curves when erect could indicate Peyronie’s disease.
  • Your hormone profile and state of penile flow may be further evaluated.
  • Blood tests and urine tests may be ordered to exclude other conditions.
  • An ultrasound may be performed to check the blood vessels that supply the penis.

Erectile Dysfunction Treatment Options

Treatment options for erectile dysfunction include:

  • Oral medication, such as a daily dose regime of PDE-5 inhibitors.
  • Intracavernosal injection is used when oral medications are not effective. Drugs, such as prostaglandin E1, papaverine hydrochloride, and phentolamine, are injected into the shaft of the penis to relax the smooth muscles of the corpora cavernosa, causing it to become engorged with blood.
  • Vacuum erection devices: A penis pump is a hollow tube with a hand-powered or battery-powered pump. The tube is placed over the penis, and the pump draws blood into the penis by creating a negative pressure around the penile shaft. This creates a vacuum pulling blood into the penis. Once there is an erection, a tension ring should slip around the base of the penis to hold in the blood keeping the penis firm. The vacuum device is then removed. This provides an erection sufficient for intercourse.
  • Low-intensity shockwave therapy (LIST) is an effective treatment for patients who are not responsive to oral medications. Focused shockwaves of low intensity are passed through the erectile tissue, restoring erectile function by clearing plaque out of blood vessels and stimulating the growth of new blood vessels. Treatment comprises six sessions lasting 15-20 minutes each, over three weeks.
  • Surgery to insert a prosthetic penile implant: This procedure involves inserting a malleable or inflatable implant device in the penile shaft, which creates an erection by fluid flowing into the device from a concealed reservoir placed beneath the skin. Once a man has a malleable or inflatable implant, he must use the device to have an erection.

Seek recommendations on suitable treatment options for Erectile Dysfunction with Colin Teo Urology. Contact us to book an appointment today.