Erectile Dysfunction Surgery

Erectile Dysfunction

For most men, sexual health is a part of their self-image and self-confidence. Declining sexual performance can be devasting; erectile dysfunction is the most common sex problem men report to their doctor.

It’s estimated that 30 million American men suffer from erectile dysfunction. At Keck Medicine of USC, Dr. Patel helps patients with their erectile dysfunction.

What Is Erectile Dysfunction?

For successful intercourse, a man needs to have an erection that is firm enough, and he needs to be able to maintain that erection. Erectile dysfunction is defined as when a man cannot get or keep an erection adequate for intercourse. There’s no cut and dried reason one man many have ED and another does not. Erectile dysfunction can have physical or psychological causes, or it can be a combination. It is a common condition as men age, increasing with the passing years after the age of 40.

What Causes Erectile Dysfunction?

Just about any man over 40 has had at least an occasional problem with his erections. Stress or distractions at work. Relationship issues. Whatever. But when it becomes more routine, the situation needs to be examined. Erectile dysfunction can happen due to three main areas:

  • Blood flow in the penis is limited or nerves are harmed
  • Stress or emotional reasons are intervening
  • It is an early warning of a more serious health problem, such as heart disease

Getting an erection can seem like a straightforward process, but it’s actually a complicated mixture of physical components involving blood vessels, muscles, and nerves, coupled with complicated psychological function involving both the brain and various hormones.

As we age our vascular system weakens. That’s why older people get cold easier and often have cold feet and fingers. The blood’s simply not pumping as strongly as in their youth. That’s why men start to experience ED once they turn 40, or for sure after 50.

But erectile dysfunction can also be a side effect of sorts from other health problems, emotional issues, or a mix of both. These are some physical reasons behind ED:

  • Heart disease
  • Atherosclerosis
  • High cholesterol
  • High blood pressure
  • Obesity
  • Diabetes
  • Parkinson’s disease
  • Multiple sclerosis
  • Side effect of certain medications
  • Alcoholism
  • Substance abuse
  • Sleep disorders
  • Peyronie’s disease
  • Treatments for prostate cancer or enlargement
  • Natural result of aging

At What Age Does ED Commonly Begin?

For some men, erectile dysfunction can start with their 40th birthday, but more likely is occurrence in the late 40s and into the 50s. This is the time that correlates to decreasing strength in the blood vessels.

How Can Erectile Dysfunction Be Treated?

The most common treatment approach for ED is medication. We’ve all seen the commercials, and brand names such as Cialis and Viagra have become well known. These medications work to enhance the effects of nitric oxide, a natural chemical in your body that relaxes the muscles in the penis. When these muscles relax, blood flow increases, and you get and maintain an erection.

While these medications are very effective for most men, they aren’t an instant erection producer. Sexual stimulation is needed for the body to release nitric oxide from the nerves in the penis.

These are the four oral medications approved for treatment of ED:

  • Sildenafil (Viagra)
  • Tadalafil (Adcirca, Cialis)
  • Vardenafil (Levitra, Staxyn)
  • Avanafil (Stendra)

These medications can have these possible side effects: flushing, nasal congestion, headaches, visual changes, backaches, and upset stomach. They can’t be used if the patient is already taking nitrate drugs, has heart disease, or hypotension (very low blood pressure).

These are other treatment approaches for erectile dysfunction:

  • Testosterone therapy — It is not common, but in those cases where low levels of testosterone exist, testosterone therapy can be effective.
  • Vacuum erection device — A vacuum erection device is a plastic tube that slips over the penis, making a seal with the skin of the body. A pump at the other end of the tube creates a low-pressure vacuum that pulls blood into the penis, creating and erection. An elastic ring is then slipped onto the base of the penis, which maintains the erection for about 30 minutes.
  • Injection therapy — A drug called alprostadil can be injected into the penis with a very thin needle. These are done at home. This can be a good solution for men who do not respond to the oral medications described above. The most common side effect of these injections is a prolonged erection, which can be quite painful.

Surgical treatment

If the above treatments are unsuccessful, Dr. Patel may perform penile implant surgery. Penile implants are devices that are placed fully inside the patient’s body. These devices create an erection that then allows the patient to have normal sexual relations.

There are two types of penile implants Dr. Patel may use:

  • Semi-rigid implant — This implant is made from two easy-to-bend rods usually made of silicone. These rods give the man’s penis the firmness needed for sexual penetration. The implant can be bent downward for urination or upward for sex.
  • Inflatable implant — With this type of implant, Dr. Patel places fluid-filled cylinders lengthwise in the penis. Tubing joins these cylinders to a pump placed inside the scrotum. When the pump is engaged, pressure in the cylinders inflates the penis and makes it stiff. This implant option gives the patient the most control.

Is There Recovery After ED Treatment?

There isn’t any recovery involved with ED medication or injections. Of course, that’s not true after implant surgery. Most men will require prescription pain medication for one to two weeks after these procedures. Pain, bruising, and swelling can last for a few weeks.

For one month after surgery, patients need to limit their physical activity. Dr. Patel will discuss this with you during your consultation.

After about eight weeks most patients can begin to have sex.

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