Sexual Potency

When psychological factors or difficulties in the man’s relationship with his partner are considered an important cause for erectile dysfunction, a course of sex or couple’s therapy might be recommended. It is very useful in helping couples re-establish a sexual relationship when there has been a long period without sexual interaction because of erectile dysfunction. Sex therapy is sometimes advocated in combination with other forms of treatment.

Vacuum constriction devices

Several different designs of constriction devices are available. Essentially the device consists of a plastic cylinder connected to a pump, which may be either hand or battery driven, and one or more tension rings. The penis is inserted in to the cylinder and activation of the pump removes the air from within the cylinder so creating a vacuum. This results in blood being drawn into the penis, which immediately enlarges in a similar way to a natural erection. Once an adequate erection is produced, a tension band is slipped around the base of the penis to maintain the erection. The vacuum within the cylinder is then released and the cylinder removed from the penis. It is important that the tension ring is also removed within 30 minutes.  For medical suppliers click here or contact the Sexual Dysfunction Association Helpline.

Intracavernosal injection therapy

This is a highly effective form of treatment. The patient (or his partner) is taught to inject a drug directly into the shaft of the penis when he wants an erection. Erection usually follows within fifteen minutes of the injection. The procedure is easy to learn. Several different products are available.

Transurethral therapy

This is an effective needle-free form of treatment. A small pellet of drug is introduced into the urethra (the tube through which urine is passed) using a special disposable applicator. The drug is then absorbed through the wall of the urethra and passes into the erectile tissue, giving an erection within 5 to 10 minutes.

Oral Treatments

There are currently four oral drugs licensed for the treatment of erectile dysfunction. Three are tablets taken one hour before sexual activity, the other is a tablet taken sublingually (under the tongue) twenty minutes before sexual activity. All four drugs are effective and do not cause an erection unless the man is sexually stimulated.

Another oral treatment which is not licensed is yohimbine. It is derived from the bark of an African tree and several studies have suggested it has a beneficial effect in enhancing erectile function.

Hormone treatment

Only a small proportion of cases of erectile dysfunction are caused by hormone abnormalities. The most frequent hormone abnormality is a reduced level of testosterone (male sex hormone) which can be restored by appropriate testosterone replacement. It is unwise to take testosterone preparations unless laboratory investigations confirm deficiency.

Penile prosthesis

Essentially these are splints which are inserted surgically in to the penis. There are two main types: semi-rigid rods which maintain the penis in a state of rigidity all the time but which allow the penis to be bent downwards out of the way when not required. The second type is more sophisticated and involves insertion of a hydraulic device which causes stiffening of the penis when a pump (implanted in the scrotum) is activated. As implantation of penile prosthesis causes destruction of erectile tissue, they should never be considered until other forms of treatment have been tried.

Surgical treatments

A few cases of erectile dysfunction that are caused by abnormalities in blood-flow into and out of the penis can be treated by surgery.

Private or NHS?

Both NHS and Private clinic services can provide appropriate medical treatment. NHS services may sometimes be limited while some private clinics may offer a service but this may be at a relatively high price.

It is always important to ensure that anyone offering a service has appropriate qualifications. In many private clinics you may be seen by a physician or surgeon who also works within the NHS.

Posted in Erectile Dysfunction (ED)