Finally, penile implants or surgery to bypass penile artery damage in younger men with a history of severe pelvic trauma may be performed.
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Physical reasons for ED range from heart disease and diabetes to high blood pressure and obesity. Damage to your nerves or arteries can cause problems with erections, too. Lack of exercise, drinking, and smoking can lead to problems.
Mayo Clinic: Erectile Dysfunction: Diagnosis and Treatment.UCSF Medical Center: Erectile Dysfunction Diagnosis.Urology Care Foundation: How is ED Diagnosed?National Institute of Diabetes and Digestive and Kidney Diseases (NIH): Diagnosis of Erectile Dysfunction.Cleveland Clinic: Erectile Dysfunction (ED): Diagnosing.
Surgery to repair arteries (penile arterial reconstructive surgery) can reduce impotence caused by obstructions that block the flow of blood to the penis. The best candidates for such surgery are young men with discrete blockage of an artery because of a physical injury to the pubic area or a fracture of the pelvis. The procedure is less successful in older men with widespread blockage of arteries.
To reduce your risk of erectile dysfunction, exercise and maintain a healthy weight, stop smoking, avoid alcohol and substance abuse, and keep your diabetes under control, if you have it.
Prostaglandin E1 (intraurethral alprostadil or MUSE) can be inserted in a pellet (suppository) form into the urethra to attain erections. It is available in four dosage strengths: 125 mcg, 250 mcg, 500 mcg, and 1,000 mcg. Most individuals need 500 mcg to 1,000 mcg for a satisfactory response.
MUSE offers an alternative route for administration of prostaglandin using a small pellet inserted using an applicator into the tip of the urethra (water pipe opening). Once massaged the prostaglandin is released and helps the blood to flow into the penis to gain an erection. Some men experience a mild burning sensation afterwards in the water pipe but this is a good alternative option for men who do not like the idea of using injection therapy.
Because of the relation between erectile dysfunction and heart disease the doctor generally does a cardiac risk evaluation as part of the diagnosis. Your doctor may refer you to a cardiologist for further evaluation and specific cardiac tests, such as a ‘stress test.’
While many cases of ED are caused by medical conditions that can’t be cured, various treatment options can help restore sexual function.
Aetna considers Xiaflex (collagenase clostridium histolyticum) for the treatment of Peyronie’s disease medically necessary when the following criteria are met: The member has stable Peyronie’s disease without clinical changes (e.g., worsening curvature) for at least three months; and The member has a palpable plaque and curvature deformity of at least 30 degrees and less than 90 degrees prior to initiating Xiaflex therapy; and The member has intact erectile function (with or without medication); and The member is 18 years of age or older; and The member will receive a maximum of one treatment course with a maximum of 8 injections total, including any injections the member has received for any previous treatment.
A doctor may ask for the following laboratory tests in the evaluation of erectile dysfunction:
A vacuum device (VED) is an external device (not a drug) that goes over the penis. When pumped, it pulls blood into the penis then a special ring is placed over the base of the penis to keep it erect.
Erectile dysfunction occurs when a man is not able to maintain or get an erection. It’s common in men of all ages. Facing erectile dysfunction once in 2-3 months is fine. But if it becomes an ongoing problem, it needs medical intervention in time.
There have been rare reports of priapism (prolonged and painful erections lasting more than six hours) with the use of PDE5 inhibitors such as sildenafil, vardenafil, and tadalafil. Patients with blood cell diseases such as sickle cell anemia, leukemia, and multiple myeloma have higher than normal risks of developing priapism. Untreated priapism can cause injury to the penis and lead to permanent impotence. Therefore, if your erection lasts four hours, you should seek emergency medical care.
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