Impotence (Erectile Dysfunction)

OVERVIEW:

This is defined as the inability to have penetrative sexual intercourse. The nerves for erection and orgasm are separate, and it is possible to have a satisfying sexual relationship without penetration. Impotence can be a sign of cardiovascular disease, and patient should be evaluated for underlying cardiac issues.

TREATMENT:

• Behavioral modification: Cessation of smoking, weight loss, and increased physical activity may be beneficial.
• Medications: Options include: Sildenafil (Viagra), Vardenafil (Levitra), and Tadalafil (Cialis). These medications do not independently induce erections and therefore require foreplay for success.
• Intra-cavernosal agents: Medications that are injected directly into the penis with a small needle before intercourse which allows for erection.
  Intraurethral suppositories (MUSE): Medications placed directly into distal urethra (urine tube) which leads to erection.
• Vacuum Erection Device (VED): Plastic suction cylinder placed over penis with manual or battery operated vacuum pump creates erection by drawing blood into penis and then elastic ring is placed at the base of the penis to prevent loss of erection.
• Surgical intervention with Penile Prosthesis: An outpatient procedure in which a permanent prosthesis is placed into the penis and allows for on demand sexual intercourse with excellent cosmetic results.

https://www.coloplast.us/surgical-urology/patient/men/erectile-dysfunction/