Medical Treatments
1. Oral Medications There
are now three FDA approved medications for erectile dysfunction.
These medications are VIAGRA
- also known as SILDENAFIL, LEVITRA
- also known as VARDENAFIL, and CIALIS
- also known as TADALAFIL. Erection
occurs after arousal.
2. Utheral Inserts
Urethral Insert: Prostaglandin E-1/Alprostadil
(Muse) is a FDA approved intraurethral insert that provides an
erection.
The Muse is a tiny insert that fits into the urethral
opening of the penis. The Muse contains the drug Prostaglandin E-1.
The success rate is about 60-70%
3. Vacuum Devices
Vacuum Erection Device: an external device that
is used to get an erection.
PENILE PUMP
A penile pump is a vacuum erection device that is
manually operated by the patient. A pump creates a vacuum which
in turn makes a penis hard. A special constricting ring is then
placed at the base of the penis and this keeps it hard. These devices
may be useful in men with impotence of almost any cause. This device
has a success rate of 40 - 65%.
4. Penile Injections
Intracavernosal Pharmacologic Agents: a painless
self-injection into the penis of one or a combination of Papavarine,
Phentolamine, Prostaglandin E-1 just before an erection is desired.
5. Hormone Therapy
Hormone Therapy: topical patches or injectable treatment
for a hormonal condition.
Surgical Treatments
1. Penile Implants:
Penile Implant: an internal device that is permanent
and makes the penis hard enough for penetration. There are several
types with different features. With the currently available state-of-the-art
implants, a success rate of almost 95% may be expected.
PENILE IMPLANT SURGERY
This requires the placement of two implants in the
penis; one in the left erectile chamber and one in the right. The
implants and the pump which fills the implants are totally concealed
inside the body and give excellent cosmetic and functional results
in most patients.
The success rate is from 80 to 90% in terms of patient
and partner acceptance, and almost 95% in terms of patient satisfaction.
The implants are FDA approved.
There are two categories of implants: - the non-inflatable
rods which are bendable and can be manipulated to give an erection,
and inflatable implants which contain fluid to give a more natural
erection. This fluid is transferred within or to cylinders in the
penis to give hardness.
While less than 5% of patients choose this form of
treatment initially, the final choice of treatment is a penile implant
in 10% of patients. In U.S.A., approximately 20,000 implants are
performed each year.
2. Penile Arterialization: Rerouting
blood to the penis.
3. Venous Ligation: Tying off leaky
veins.
Treatment for Psychogenic
Dysfunction
Individuals and Couples
1.Marital and Family Therapy
2. Sex Therapy
3. Psychotherapy
4. Psychopharmacotherapy
5. Intraurethral Insert (Muse)
6. Prostaglandin E-1 (Caverject)
7. Sildenafil (Viagra), Vardenafil (Levitra),
and Tadalafil (Cialis)
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