Erectile dysfunction (ED) is a sexual dysfunction in men. It affects male sexuality at any age and also increases with age. Erectile Dysfunction is associated with the inability to get and sustain an erection for sexual intercourse. Studies show that every 1 man out of 10 is affected by ED. It is more common in men with diabetes, with 35-75% of men with diabetes suffering from this condition. (Source: National Institute of Diabetes and Digestive and Kidney Diseases). In most cases, erectile dysfunction can be a symptom of other underlying problems such as problems with orgasm/ejaculation or lack of desire for sexual intercourse.
Is Erectile Dysfunction common?
Every 1/10 males experience this dysfunction during their lifetime. Most men experience it occasionally because of various reasons including excessive drinking, relationship issues, stress, or fatigue.
When do you need to worry about ED?
- Less than 20% failure to get an erection is usual and doesn’t require evaluation and treatment.
- More than 50% of failure to erect is something serious that requires proper diagnosis and treatment.
What causes ED?
Several risk factors cause erectile dysfunction are
- Advanced age (rare)
- Vascular diseases
- Trauma
- Psychological States
- Neurological disorders
- Peyronie’s disease
- Colon cancer
- Chronic Illness
- Atherosclerosis
- Endocrinological conditions
- Substance abuse
- Certain Medicines
What are the effective ways to evaluate ED?
There are several causes of ED. Therefore, there are various methods to evaluate or diagnose Erectile dysfunction. To identify the risk factor of ED following primary care patient evaluation can be used. Evaluation of ED
Common and basic tests:
- Physical exam
- CBC tests (blood tests)
- Urinalysis (urine test)
- Ultrasound
- Psychological exam
- Liver and kidney function test
- Lipid profile
- Thyroid function test
- Blood hormone studies
Additionally, the most important and best tests for evaluation are
1. Duplex Ultrasound
2. Bulbocavernosus reflex
3. Nocturnal penile luminescence (NPT)
4. Penile biothesiometry
5. Vasoactive Injection
6. Dynamic Infusion Cavernosometry
7. Cavernosography
8. Arteriography
What is the most effective treatment for ED?
Erectile dysfunction can be treated in many different ways. Management of Erectile Dysfunction includes Surgical and Non-Surgical treatment.
Non-Surgical treatment of ED:
- Education
- Psychological therapy
- Oral medicines (especially phosphodiesterase type-5 inhibitors)
- Sex therapy
- Medical Aids / Vaccum Erection Device
- Penile Injection Therapy (intracavernosal injection therapy)
- Intraurethral therapy
- Testosterone therapy
- Hormone Replacement Therapy (HRT)
Surgical treatment of ED:
- Penile Vascular surgery (not for aging males)
- Penile prosthesis surgery (Penile Implants)
Types of Penile Implants:
1. Semi-rigid Implant (bendable)
2. Inflatable Implant