What is erectile dysfunction?
Erectile dysfunction (ED), or impotence, refers to the inability of a man to attain and/or maintain an erection sufficient for intercourse. One of the most common sexual problems for men, ED can occur when there is reduced blood flow to the penis or when there is nerve damage - both of which can be triggered by a variety of factors. Although scientists once believed that ED was an emotional issue only, they now know physical factors are just as important as psychological triggers. In addition, several medications can also contribute to impotence.
How is ED diagnosed?
Failing to achieve and/or sustain an erection is the primary symptom of ED. But diagnosing the specific cause and prescribing appropriate treatment usually require a variety of tests, beginning with a complete history and physical examination. Your urologist may order additional laboratory tests to assess any conditions interfering with normal erectile function, particularly arterial flow to the penis. However, erectile function tests are the primary tools your doctor will use to determine how the blood vessels, nerves, muscles and other tissues of your penis and pelvic region are working.
How is ED treated?
The first method of treatment for men with uncomplicated ED is the use of oral medications known as phosphodiesterase-5 inhibitors (PDE-5). These medications are taken before beginning sexual activity, and they boost the natural signals generated during sex - improving and prolonging the erection itself. The side effects of PDE-5 inhibitors are mild and usually transient, decreasing in intensity with continued use. For men who do not respond to oral medications, another medication called alprostadil can be used. This drug is available in two forms: injection and a transurethral suppository. In addition, for men who cannot or do not wish to use drug therapy, an external vacuum device may be used. ED can also be treated with surgery, including penile prostheses, vascular surgery, penile arterial revascularization or venous ligation surgery.