Treating Erectile Dysfunction

Treatments for erectile dysfunction cover a wide range of options. Drugs, surgery, prosthetics and more are available. Which is right for a given individual can only be determined by a careful professional diagnosis.

Viagra is probably the first thing that pops into the minds of most. It is decidedly one effective treatment for a large percentage of ED sufferers. Approved in 1998 by the FDA, it is one of a class of PDE-5 inhibitors that includes Cialis and Levitra.

Each pill works in slightly different ways and carries a different dosage recommendation. But, at base, the function of the drug is to enhance blood flow to the penis.

The corpora cavernosa is a cylinder of spongy tissue containing smooth muscles, arteries and veins. During stimulation, nerve signals generate the release of hormones that produce nitric oxide. That has the effect of relaxing the smooth muscles, causing blood to flow into the tissue leading to stiffening and elongation.

Many conditions can interfere with that blood flow, but Viagra and others work directly on the symptom, not the underlying causes. They've been used safely by millions of men and many physicians will prescribe them after an examination.

Some drug treatments are more direct than ingesting a pill. Needle injection therapy, for example, works by injecting alprostadil (prostaglandin) into the penis. The needle used is very sharp and narrow in diameter, and hence causes little discomfort. Other drugs used in this method include papaverine hydrochloride and phentolamine. Since they're injected their action is generally stronger, but they do carry possible side effects.

In an alternate delivery method, a small pellet of alprostadil, is inserted up the urethra through the small hole in the penis. The method (marketed under the name MUSE - Medicated Urethral Suppository for Erection) can produce an excessively long or hard erection. It may also cause pain to the penis or testicles.

Several non-drug treatments are available and may be more appropriate for certain patients. Vacuum pumps, for example, are available that fit over the penis and stimulate blood flow. This is a much older method of treatment, but it's safe and has been in use for decades with good results for some.

Implants are a more extreme measure, but are called for in certain instances. There are two basic types: malleable and inflatable. Malleable prosthetics use a pair of rods that are surgically inserted into the corpora cavernosa. Inflatables consist of a tube implanted inside the penis along with a sac and pump that injects fluid into the container. The sac typically resides in the lower abdomen, the pump is placed in the scrotum. They allow the user to extend and stiffen the penis mechanically.

In a number of cases the situation calls for other measures, ones which attempt to treat the underlying problem. Blood vessel damage from diabetes may prevent erection. One counter-measure is to re-work the arteries and/or veins directly, in order to restore normal blood flow into and out of the penis.

Which, if any, method is best depends on individual circumstances. In some cases, simple changes to diet and exercise are enough to restore the ability to achieve and sustain erection.

To schedule a consultation with Dr. Shah, give our office a call.