How to Treat Erectile Dysfunction (Impotence)?

In the early 60-ies experts agreed that 90 percent of impotent men experience emotional difficulties. The senior practitioners prescribed such patients injections of testosterone, which apparently was useless. The younger and well-trained therapists looked upon this practice and turned patients to physiotherapy, which also did not help.

In the mid 70th the doctors began to identify more physical causes of impotence, but 10 years ago it was coped with such problems. Now experts are convinced that impotence has organic (i.e. non-psychological) causes. Some of these patients are treated by family doctors, the other fall into the urologist and andrologist hands.

All methods of impotence treatment are divided into conservative (invasive and noninvasive) and operative.

The conservative methods include oral drug treatment or vacuum constrictor device.

Impotence Drug Treatment

Until now Yohimbine used to be the drug of impotence treatment. The effectiveness of its use does not exceed 10 percent. The need for prolonged use (up to a year), low efficiency of treatment, and a large number of side effects make this method of treatment less acceptable.

Now the drug Viagra (Sildenafil) is successfully used for impotence treatment. The effectiveness is obvious, but it may cause a lot of side effects.

Modern new drugs (the so-called sexual dope) used in clinical practice, lead to higher efficiency of treatment, which reaches 70-80 percent. These drugs may have such side effects as headache, a sudden reddening of the face and neck, nasal hyperaemia, changes in chromatic sensitivity and visual acuity.

Vacuum constrictor device impotence treatment

This method is based on the creation of a negative pressure in the cavernous bodies of the penis with the help of a vacuum cylinder and pump, which causes blood flow and erection, restrained by the application of a special ring contraction on the base of the penis, restricting the venous outflow. Thus, it is possible to have intercourse, no longer than 30 minutes.

The effectiveness of the method is 40-50 percent. The disadvantages are the practical use of the device (impossible to hide from the partner, etc.), painful ejaculation due to a contraction ring, bleeding on the penis, numbness of the penis, and others.

The method of intracavernosal injection of vasoactive drugs

This method is based on microinjection of vasoactive drugs directly into the penis before sexual intercourse. The method of intracavernosal injection of vasoactive drugs has become the most common and most effective among conservative treatment of erectile dysfunction. Prostaglandin is used for treatment as monotherapy and in various combinations.

The combination of drugs is used to decrease the side effects of each by reducing the concentration and potentiation of pharmacological action. A complex policy approach lets to make the usage of this method effective and safe.

Intraurethral impotence therapy

The different drugs are used for intraurethral application such as alprostadil. From the urethra the drug is absorbed and enters the cavernous body with the blood flow, where the reaction occurs, causing an erection. This method is similar to the previous one, but avoids an injection into the penis.

Currently, this therapy is not widely used because of the high cost of drugs and side effects (burning sensation in the urethra), and the usage of condoms is obligatory.

Surgical impotence treatment

Surgical intervention is not often used because of the high efficiency of drug therapy. Surgical methods are used in extreme cases, when conservative treatment does not give the desired results.

The efficiency of this method is about 50%. However, it is still used in clinical practice as an additional method which allows to achieve high results.

The surgical treatment of arterial insufficiency of the penis is shown in the case of insufficient arterial blood flow to the cavernous tissue. A microvascular arterial shunting is carried out, the effectiveness of which varies from 30 to 50%. This operation shows the high efficiency only in young patients.

Prosthetic of the penis is currently the main method for recovery of the penis rigidity. The implantation of prosthesis is the final stage of impotence treatment if all previous methods of treatment have failed.

Psychotherapeutic methods

Some medical advice refers to the chapters of "The Kamasutra". The tree-stages of sensuality focusing is the most important. This method advises to pay more attention to the satisfaction of the partner.

The first stage is the mutual satisfaction without the contact with genitals. The second stage is the contact of the partners to the genitals and erogenous zone but do not have coitus. And only at the third stage there is coitus.

Some experts claim that it is enough to visit a psychotherapist for patients in 65% of cases. Often, a failure in bed is a big tragedy for a man, and as a result, there is uncertainty about the "male power".

Believe in yourself and you will make it!

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