What Is Erectile Dysfunction/Impotence?

Inability to achieve and maintain an erection sufficient for vaginal penetration to the mutual benefit for both partners.

Classifications of Male Sexual Dysfunction?

1. Sexual desire disorder
2. Erectile dysfunction
3. Male orgasmic disorder

Premature ejaculation

Early discharge or Premature Ejaculation is a complex problem. It can ruin your sex life and also destroy relationships. But it is curable.

Signs And Symptoms Of Erectile Dysfunction

Aside from difficulty getting and sustaining an erection, erectile dysfunction may be accompanied by other problems such as reduced sexual desire, low testosterone levels and premature or delayed ejaculation.

Erectile dysfunction also has an emotional impact, including:

1. Lack of intimacy
2. Low self-esteem
3. Difficulty getting your partner pregnant
4. Stress
5. Depression

Causes Of Erectile Dysfunction

Psychogenic Causes:

• Anxiety
• Depression
• Fatigue
• Guilt
• Stress
• Marital Discord
• Excessive alcohol consumption

Organic Causes

• Cardiovascular disease
• Diabetes mellitus
• Surgery on colon, bladder, prostate
• Neurologic causes (lumbar disc, MS, CVA)
• Priapism
• Hormonal deficiency

Neurologic Causes

• Hormone Deficiency
• End Organ Failure
• Blockage of Blood
• Vessels
• Venous Leak

Evaluation Of Men With Erectile Dysfunction (Ed):

1. Medical History
2. Cardiovascular history
3. Endocrine history
4. Sexual history/questionnaire

Investigations For Erectile Dysfunction:

• A medical history review and physical exam are typically enough for a urologist to diagnose erectile dysfunction. Sometimes, further tests are recommended:
• Blood Tests –Detect signs of diabetes, heart disease, hormonal imbalance, low testosterone and other health issues.
• Urinalysis –Detect sugar, testosterone and protein levels in the urine for possible signs of diabetes, hormonal imbalance and kidney problems.
• Ultrasound – Detect any anatomical or health issues that cause problems in the way blood flows in and out the penis and the testes.
• Psychosocial Assessment – Diagnose mental conditions like anxiety and depression.

Physical Examination:

1. Blood pressure
2. Examine penis (Peyronie’s disease)
3. Focused vascular exam/peripheral pulses
4. Focused neurologic exam

Treatment For Erectile Dysfunction

1. Lifestyle changes
2. Oral agents
3. Penile injection
4. Urethral suppositories
5. External vacuum devices
6. Topical cream
7. Surgical intervention

Penile Implants / Penile Prosthesis

• Penile Implants are artificial rods. These silicon rods can be placed inside the penis. These rods provide hardness to the penis.
• Penile Implants are also called as Penile Prosthesis. They provide completely natural feeling erections.

Indications:

1. Patients who have failed other therapies
2. Peyronie’s disease
3. Severe vasculogenic disease

Penile Prosthesis advantages :

1. Low-morbidity
2. Low-mortality surgery
3. Low complication rates
4. High success rates – 5% malfunction rate at 5 years
5. High satisfaction rate – 87%
6. High partner satisfaction rate
7. Good rigidity
8. Freedom from medications
9. Outpatient/24HR surgery
10. Resume sexual activity 4-6 weeks
11. No loss of ability to ejaculate or achieve orgasm

Penile Prosthesis Disadvantages :

1. Surgery
2. Expensive
3. Possible mechanical failure

Erectile dysfunction and Premature Ejaculation may be a distressing condition, but treatable ones.