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The erectile dysfunction treatment can be done by following methods:
• Treatment of the underlying cause
• Treatment with medicines
• Treatment with devices
• Treatment with surgery
This is the first strategy followed by the doctors for Erectile dysfunction Treatment. Your doctor would make sure that you are getting the right treatment for an underlying condition which is contributing or resulting into erectile dysfunction. This may consist of managing diabetes, blood pressure, high cholesterol and others.
The doctor would also change the medicine or alter the dose of the medicine which is found responsible for causing erectile dysfunction in you.
The doctor may refer you to a psychologist or psychiatrist to help you deal with your stress, mental and relationship issues. He would also provide reassurance to you and your partner and will teach how to deal better with the condition.
There are several drugs that can be used in Erectile dysfunction treatment:
• Oral medicines: these medicines are phosphodiesterase inhibitors which causes relaxation of the muscles of the penis. This in turn allows the blood to flow into muscles of the penis causing erection. These oral medicines has to be used as the first option to cause erection. These medicines are as follows:
• Sildenafil which is popularly known by the name of Viagra
The above mentioned medicines doesn’t not automatically result into an erection and needs sexual stimulation to induce such effect on penis. These medicines doesn’t enhances your sex drive or produces excitement and are not required in healthy people with normal erection.
These medicines have been found to effective in 60 to 75% of cases.
Precaution: it is important not to take these medicines with nitrates such as nitroglycerin which is generally taken for angina. The nitrates causes dilation of the blood vessels which when taken with these medicines can cause sudden drop in the blood pressure.
This should be also avoided if you low blood pressure, heart disease or heart failure or you take drugs called alpha blockers for treatment of enlarged prostate. If you wish to use any medicine or herbal supplement or drug if it always advisable to get an approval of your doctor.
Possible side effects that can be produced are nasal congestion, headache, backache, flushing, and others.
• Penile self injection or suppository: you can also use these medicines which tend to produce stronger and automatic erection of the penis without need of sexual stimulus. The medicine used is alprostadil which can be taken as an injection or a suppository.
Alprostadil injection is directly taken on the base or side of the penis. The medicine can be combined with other medicines such as papaverine and phentolamine to be more effective.The effect of the injection usually lasts for about an hour. Pain due to injection is not significant and you may experience minimal pain or discomfort. Side effects can be mild bleeding from the injection site, prolonged erection and rarely, development of a fibrous tissue at the injection site.
Alprostadil suppository can also be opted to develop and erection, however, it has been found to produce satisfactory erection in less men than with an injection ie, 60% vs 90% respectively. The pellet of the medicine is inserted about an inch into the urethra using a refilled applicator. This causes an erection in about 8 to 10 minutes which usually lasts for 30 to 60 minutes.Side effects may consist of a burning sensation in your penis, minimal bleeding in the urethra and development of fibrous tissue inside your penis.
• Testosterone replacement. Your doctor may prescribe you testosterone therapy if you have low levels of testosterone and is complicating erectile dysfunction. It has not been found useful in age-related or late-onset hypogonadism. Taking testosterone may cause side effects such as high RBC count and issues with passing urine. It can also affect how other medicines work which may lead to serious complications. You should always take testosterone only after consultation with your doctor.
If medicines aren’t helping or considered appropriate for you the doctor would suggest a vacuum device. The device works by using vacuum to pull the blood into penis causing erection. The device consists of three parts:
• Plastic tube, which surrounds your penis
• Pump, which pulls air out of the tube, developing vacuum inside the tube causing blood to fill in the penis
• Elastic ring, which is pulled from the end of the tube to the base of the penis while removing the tube. This holds the blood within the penis and thus maintains an erection. The elastic ring can be placed in position for upto 30 minutes. The ring has to be removed once the sexual intercourse is over. Remove the ring after that time to bring back normal circulation and to prevent skin irritation.
You may feel your penis has become cold or numb and has developed a purple color. You may also develop bruises on your penis which are usually painless. Vacuum devices may restrict ejaculation but mostly there is no not affect on experiencing an orgasm.
Surgery for the erectile dysfunction treatment should be considered as the last resort only when medicines and vacuum devices fail.
A specialist doctor called as urologist performs the surgery for the erectile dysfunction:
• He may implant a device to produce artificial erection or,
• Reconstruct arteries to increase penile blood flow
Penile implants: these are the devices that are placed inside your penis which acts like an erected penis to help you perform sexual activity. The implants are basically of two types:
• Inflatable implants: these are the implants that can be enlarged in size as and when required by using a pump which inflates them with fluid. The pump is placed inside the scrotum which is when pressed causes enlargement of the implant producing an erection.
• Malleable implants: these are semi rigid rods that are placed inside your penis which keeps your penis always erect. These devices are concealed by keeping them aligned towards the body and used for the sexual activity by bending them down away from the body. The recovery from the surgery doesn’t take much time and you would be discharged on the same day or next day after surgery. Once home you could start using the implant about 4 to 6 weeks after the surgery.
Complications of implant could be malfunction or infection which is rare (less than 5%) especially when done by an experienced surgeon.
Partner satisfaction: is found to be the highest amongst all options which is above 95%.
Artery reconstruction surgery: this surgery is done in men who have blockages in the arteries of penis. The surgery repairs these arteries treating erectile dysfunction. Younger men (less than 30 years) with arterial disease causing erectile dysfunction are the best candidates for this type of surgery.
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