Erectile Dysfunction, sexual impotence

WHAT IS ERECTILE DYSFUNCTION?

It is the inability to obtain a sufficiently intense and lasting erection to initiate, sustain and culminate sexual intercourse successfully. We consider sexual erectile dysfunction exists when one fails to have sexual intercourse in over 50 % of attempts.

How many types of erectile dysfunction exist?

· ‘Coeundi’ erectile dysfunction, better known as sexual erectile dysfunction (lack of erection).
· ‘Generandi’ erectile dysfunction, commonly known as infertility.

What are the causes of erectile dysfunction?

· Organic origin: Endocrine (diabetes), vascular (arteriosclerosis), neurological (brain or medullar injuries), urological (congenital penis injuries), pharmacological (drugs, alcohol, tobacco, certain medical drugs), traumatic (pelvis fracture).
· Psychical origin: Fear of failure, guilt, infidelity, previous premature ejaculation, insecurity, etc.
· Mixed origin: Combination of the above: a) & b).

What is the methodology of the study of erectile dysfunction?

As it is often caused by other illnesses, it is necessary to perform a multi-disciplinary study within a team of experts. An exhaustive clinical history is developed together with a psychological profile of the patient. Biochemical and hormonal studies are performed as well as radiological and vascular tests (Rigidometer). In our Centre, we are pioneers in the Rigidometry testing which is a fast, painless and reliable medical test that is able to objectively quantify axial rigidity and relative intracavernosal pressure in order to assess the patient’s degree of erectile dysfuntion. Rigidometry testing in carried out with the Rigidometer or erectile health monitor, a device which is able to register axial rigidity in grams in only a few seconds for diagnosis and treatment follow-up purposes. All of the above is complemented by a uro-andrological, cardio-circulatory and neurological physical study all of which eventually leads to a solid diagnosis.

What are the available treatments?

If the origin is psychological, a psycho-sexological therapy is prescribed. If the origin is organic, there is a choice between pharmacological treatments, stimuli and/or hormonal treatments, vacuum devices, vasoactive substances and in other cases, vascular surgery or penile prosthesis implants are required.

What are vacuum devices?

These devices provoke an erection through the suction created by emptying tube with which a positive flow is obtained throughout the vascular area of the penis and within the elastic structures. The blood flow has a high oxygen concentration which improves the metabolism of the tissues through a good cellular oxygenation, increasing the erectile capacity and thus penile rigidity.

What are vasoactive substances?

They are substances which are introduced through the urethra or injected directly into the cavernosal tissues of the penis. They produce an erection which allows sexual intercourse. They can be used once or twice a week. Before beginning the treatment it is important to make the necessary tests to predict the kind of response each patient will experience.

What are penile prothesis?

They are silicon (biocompatible material) cylinders with an anatomical structure, which are placed in the cavernosal tissues of the penis to produce the necessary rigidity for a good satisfactory erection. There are various sizes, shapes and mechanisms.

What does penile implant surgery consist of?

There are various techniques to implant a prosthesis. The surgery usually takes 45 minutes. An incision of 3 – 4 cm is made in the inferior part of the penis and in the root of the scrotum. This facilitates reaching the cavernosal tissue in which the two corresponding prosthesis will be placed, safely. All of the above is performed under local or regional anaesthesia.

How long should one stay in hospital?

As it is not a very aggressive surgery, post surgery care is simple, the patient can leave the hospital between 12 and 24 hours after surgery. The patient can resume normal sexual activity after 3 or 4 weeks of adaptation.

Is the prosthesis the best solution for erectile dysfunction?

Not necessarily for all patients, but in some cases it is the only method that will solve problems which had no prior solution. It is a new discovery of medical science which solves serious problems for the male and his partner.

How does one decide the treatment option?

The treatment will depend on a correct diagnosis.

If one thinks he is impotent, what should one do?

Since nowadays we have appropriate means of diagnosis, adequate therapeutics and effective medical and surgical treatments, it is important to go to the doctor as soon as possible and avoid wasting time with non-orthodox methods which only contribute to enhancing the problem