In patients who either fail to respond to first or second-line therapy, or are not interested in the conservative therapies, penile prosthesis implantation is available. Malleable and rigid implants were available for many years, but in 1973 the world of penile prosthetics took a giant leap forward with the advent of the inflatable penile implant. Most implants done nowadays are of the inflatable variety. Adverse events including malfunction and infection are rare, and patient satisfaction is very high.45
Your doctor will take a medical history to understand your general state of health. As part of the medical history your doctor will ask about any other conditions you may have. If you take any medication If you smoke When and how much you drink If you drink much coffee or alcohol If you use recreational drugs on a regular basis If you ever had pelvic surgery If you have any heart and/or vascular problems If you have hormonal disorders If you have any psychological problems
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This problem affects men of all ages, but as men get older, there is a greater chance of developing erection problems. Population studies show that nearly 20% of men over age 20 and about 50% of men over the age of 50 have ED. The primary cause of ED is poor circulation to the penis. Just as poor circulation to the heart may result in a heart attack, so too in ED, the penis often suffers from lack of adequate circulation which results in poor erections. Age High Blood Pressure Diabetes Smoking High cholesterol Cardiovascular disease such as previous heart attacks or strokes
An accurate diagnosis is important because it helps doctors identify the most effective treatment for you.
Other than strengthening the pelvic floor, the most effective workout is aerobic. Aerobic exercise of moderate-to-vigorous intensity can help improve function and reduce other conditions that can contribute to ED such as high blood pressure and excess weight. Even a regular routine of gentle walking can contribute to penis health.
Harvard Health. 2021. Benefits of exercise for the prostate and erectile dysfunction help – Harvard Health. [online] Available at:
Reduction of “bad” cholesterol (low-density lipoprotein or LDL) levels in the blood, as well as the total level of cholesterolReduction in body weight (obesity is associated with cardiovascular disease) Increase in insulin sensitivity (exercise increases the body’s ability to control glucose levels in the blood)Increase in “good” cholesterol (high-density lipoproteins)
Vardenafil is effective in men of all ages, different nationalities, and in men with such medical conditions as diabetes mellitus and erectile dysfunction after prostate surgery.
When other treatment options are not successful, penile implant surgery can provide excellent patient and partner satisfaction. Both malleable (bendable) and inflatable devices can be implanted to allow penile rigidity and satisfactory sexual intercourse.
Gerbild recommends giving up smoking, drinking less, and following a healthier diet in combination with exercise.
The causes of erectile dysfunction are many, including physical problems like diabetes, heart disease, obesity, high blood pressure, high cholesterol, and even sleep disorders. Medication taken for health conditions can result in erectile dysfunction, as can alcohol and smoking.
It is estimated that ED occurs in 10% of healthy men without any apparent physical cause. This is known as idiopathic ED. the blood supply to the penis, hormonal abnormalities, interruption of normal nerve supply, certain medications, psychogenic factors weak or tight pelvic floor muscles.
Improvements in your lifestyle, such as a eating healthy diet, reducing alcohol intake, losing weight and increasing your exercise can dramatically improve erectile dysfunction. More specific treatment usually involves: weight loss and increased exercise (this may reduced the risk of erectile dysfunction by up to 70%) treatment of any hormone abnormality (testosterone treatment is only indicated if your testosterone levels are low and may be harmful if your the levels are normal); lifestyle modification (e.g. reduce stress, stop smoking, reduce alcohol consumption & stop illicit drugs); treatment of any anatomical abnormality if present (e.g. circumcision, frenuloplasty, penile straightening); psychological support if necessary.
The stress of erectile dysfunction and its toll on self-confidence and/or a relationship can be hard to deal with. Speaking to a psychologist or counselor about how to cope emotionally can be of great benefit to some people.
When possible, “nerve-sparing” methods are used in radical prostatectomy, radical cystectomy, AP resection, or TME. In nerve-sparing surgery, doctors carefully try to avoid these nerves. When the size and location of a tumor allow for nerve-sparing surgery, more men recover erections than with other techniques. But even if the surgeon is able to spare these nerves, they might still be injured during the operation and need time to heal.
AntidepressantsBlood pressure medicines (especially beta-blockers)Heart medicines, such as digoxinSleeping pillsSome peptic ulcer medicines
Certain feelings can interfere with normal sexual function, including feeling nervous about or self-conscious about sex, feeling stressed either at home or at work, or feeling troubled in your current sexual relationship. In these cases, treatment incorporating psychological counseling with you and your sexual partner may be successful. One episode of failure, regardless of cause, may propagate further psychological distress, leading to further erectile failure. Los of desire or interest in sexual activity can be psychological or due to low testosterone levels.