Erectile Dysfunction

It is not uncommon to find young men worried about their penile size, emission of seminal fluid during sleep and about their concern on masturbation and loss of semen over the years. None of the above factors are cause for concern. Unfortunately the ‘Quack Professionals’ create suspicion in the minds of the gullible young men and exploit huge amount of money in instalments – in other words Male Sexual dysfunction – Erectile and Ejaculatory disturbances have been the concern of most of the married men and also for those intending to get married. When counselled these men come out with a variety of medical problems from head to toe which does not form any symptom complex of known organic disease. It is to be understood that Erectile dysfunction is more often functional (Psychogenic) and largely curable. Current Andrological research has established that there could be problems in erection related to arterial, venogenic or nervous problems.

ARTERIOGENIC : where the arteries supplying blood to the penis do not bring enough blood to cause an erection. This occurs in elderly, diabetics or those with injury to genitalia like pelvic fracture or vehicular accident.

VENOGENIC : In normal men during full erection the veins close down almost completely preventing to outflow from penis. This allows blood to accumulate in the sinusoids of penis, raising pressure and develop rigidity and hardness.

NEUROGENIC : Intact nerve supply and proper conduction of impulses is necessary for initiation and maintenance of penile erection. Injuries on spinal cord, operations on rectum or urinary bladder could affect the nerve supply. The most common cause is Diabetes Mellitus.

ENDOCRINE ( Hormonal): Generally hormonal changes affect the sex drive. During recent years ‘ANDROPAUSE’ in men has been recognized analogous to ‘Menopause’ in women . ‘Andorpause’ may occur at different ages in the elderly.

Current Treatment options for Erectile Dysfunction
Invariably erectile dysfunction remains concealed by the husband, who in the pretext of saving his Masculine ego tend to offer excuses viz work exhaustion – stress and many others. Male sexual dysfunction by itself has been the sole cause for barren marriages. It is not uncommon to find ‘Unconsummated marriages’ even after several years of their marital life. Indian women in general have learnt to suffer in silence and when confronted with the problem of erection and ejaculation as the factor, serious consequences follow which may even lead to legal suits and divorce. Gone are the days when counseling alone was the option for the treating physicians. Oral medications like SILDENAFIL (VIAGRA) are adjuncts widely used along with counseling – for these oral drugs to be effective there is need for perfect harmony and understanding among the couple. Sexual counseling is a time taking exercise but worth a fortune if they could succeed in preserving the matrimonial intent and effect to produce children.

Various other forms of treatment like ‘External Vaccum Devices’ Penile Injections with Papavarine , Phentolamine, Prostoglandin etc., ‘Self injections’ are successful in selected cases. “Priapism’ is a painful, purposeless, prolonged erection which has been reported following use of ‘Self Injections’ – if and when it occurs urgent medical intervention is mandatory. Penile prosthesis – Rigid and Inflatable are used only in cases refractory to any of the above methods of treatment. In the modern era with better understanding of Erectile function and Dysfunction, Male Impotence is largely curable.