Considering that advertising for a host of medications like Viagra, Levitra, Cialis, and Staxyn have brought the problem of erectile dysfunction (ED) into our living rooms, many men still find it difficult to talk about in their doctor’s office. Yet it is an issue that 30 million men in America – including half of those 40 to 70 years of age- will experience. Nearly one in every four men over the age of the 65 will experience some degree of erectile dysfunction.
The fact is, it is very important for a man to tell his doctor if and when he has ED, not just because he’ll be happier to be able to have normal intercourse, but because ED can be a symptom of a serious underlying medical condition, such as cardiovascular disease.
For many men, the new medications work and are very helpful. But what about those who don’t see any improvement, the more than 30% of patients who fail to respond? In their case, there are several other approaches that have proven successful in dealing with ED.
The least invasive treatment is the penile vacuum erection device. This is a vacuum cylinder that’s placed over the penis and a pump creates a vacuum that draws blood into the penis, causing it to become erect. A constrictive band is placed at the base of the shaft to maintain the erection. Studies find that, after 12 months, there is a 60% satisfaction rate for both patient and partner, although the erection is limited to 30 minutes. If this doesn’t sound very spontaneous, it isn’t. In my practice, I have mainly seen this be successful when the couples are in a long-term relationship.
There is new line of therapeutic options involving synthetic Prostaglandin EI Or Alprostadil. These relax the muscles of the blood vessels, allowing more blood flow to the penis. The medication can be administered by a urethral suppository, or by an injection into the side of the penile shaft. With both methods, an erection occurs within five and 20 minutes and lasts from 30 to 60 minutes.
A highly effective option is the penile implant – achieving patient and partner satisfaction rates upwards of 98 percent. There are two basic types of penile prostheses – both of which are implanted during a routine outpatient procedure – the inflatable and the flexible rod. For most of my patients, I recommend the inflatable implant that is carefully concealed and produces a controlled, more “natural” erection, complete with orgasm and ejaculation. The inflatable prosthesis uses hydraulic technology with a pump filling to cylinders in the penis from a fluid reservoir. It is easy to initiate, effective to operate, and simple to deflate.
Determining the causes of ED can be challenging, since most men will have multiple factors that contribute to their disease. Today, for the vast majority of men with ED, and their partners, there are treatments that can lead to a more fulfilling intimate experience.
It is important for men who experience erectile dysfunction to seek medical advice including a thorough examination and tests. The Urology Division at Premier Medical Group includes eleven highly experienced, and knowledgeable physicians who maintain offices in eight locations, in Dutchess, Ulster, and Orange, counties. For appointments, call 845-437-5000.