Erectile dysfunction (ED) is a medical term that describes the inability to achieve and maintain an adequate erection of the penis that allows you to perform the sexual act in a satisfactory manner. The prevalence of ED increases with age and this condition is one of the most common sexual problems among men.
Achieving a normal erection is a complex process involving psychological impulses from the brain, adequate levels of the male sex hormone i.e. testosterone, a functioning nervous system, and a healthy vascular tissue in the penis.
It is estimated that ED affects between 15 and 30 million men in the United States. The causes are many, including systemic diseases that affect the erection (hypertension, diabetes mellitus, hypercholesterolemia, etc.), smoking, previous pelvic surgery, concomitant medication, etc. Some patients suffer psychological issues that need a multidisciplinary approach (medical and psychological).
In our Lyx Centre for Urology in Madrid, we offer the following diagnostic and therapeutic alternatives:
- Comprehensive diagnosis, by means of clinical and sexual interview. Possibility of realising the following diagnostic tests:
- Penile Doppler ultrasound.
- Nocturnal erections registry-RigiScan.
- Cavernosography and cavernosometry.
- Intracavernosal injection test (IIC).
- Inter-specialist assessment to evaluate and treat possible underlying causes (cardiology, neurology, endocrinology, etc.).
- Etiological and symptomatic treatment:
There is a variety of alternative treatments, ranging from drugs to surgery. In VCUG we will talk about the options that might be suitable for you, as well as the risks and benefits.
- Oral Medications: There are numerous prescription drugs available that can improve the blood flow into the penis. When these medications are combined with sexual stimulation, you can produce an erection.
- Injections: in the therapy of injections, a small needle is used to inject medication directly into the penis. The medicine allows blood to flow into the penis and produce an erection.
- Intra-urethral suppositories: another option is a suppository that contains medication. A small pill (suppository) is inserted into the urethra.
- Shock wave treatment for ED
- Penile prosthesis: penile prostheses, which have been used for over 30 years, can offer an effective surgical option to men who are not satisfied with the results they obtain from other treatment options.
What are some of the causes of ED?
There are risk factors for the development of ED. As men age, the level of circulating testosterone decreases, which may interfere with normal erection. Although it is not common for a low level of testosterone in itself should ED, a low level of testosterone can contribute with other risk factors of ED among many men. The most important cause for the development of ED is the presence of diseases such as hypertension, diabetes mellitus, high levels of cholesterol and cardiovascular diseases. These processes, which act over time, can lead to the degeneration of the blood vessels in the penis, causing a restriction of blood through the arteries and also the loss of blood through the veins during erection.
Smoking, alcohol or drug abuse, particularly over an extended period of time, will compromise the blood vessels of the penis. Lack of exercise and sedentary lifestyle will contribute to the development of ED. The correction of these conditions will help to improve the general state of health and can in some individuals to correct the mild.
The treatment of many medical illnesses can interfere with normal erections. The drugs used to treat the risk factors listed above can also lead to or make it worse, if it already exists. Patients who are undergoing surgery or radiation treatment for prostate, bladder, colon or rectum cancer are at high risk of developing ED.
How is ED diagnosed?
For most patients, the diagnosis will require the preparation of a simple clinical history, physical examination, and a systematic analysis of blood. The choice of the tests and treatment will depend on the objectives of the individual. If the erection is restored with a simple treatment such as the administration of oral medication and the patient is satisfied, further diagnosis or treatment become unnecessary. If the response to initial treatment is inadequate or if the patient isn’t satisfied, then you can take the next step. In general, more invasive treatment options involve more complex studies.
What is the treatment process?
During the first visit to the urology centre, your urologist will present the different treatments for erectile dysfunctions and inform you which is best suited to your situation.
In our centre, we will only recommend a treatment if you need it. In addition, the team at the Urology Centre will inform you of all available payment facilities.
Application of the Treatment
The new treatment by application of low-intensity shock waves “creates new small blood vessels inside the penis”.
If you are a candidate this procedure and once you accept the budget, we will put you in touch with our nurse to arrange the days of treatment.
The treatment will take place 2 days a week during three consecutive weeks. Occasionally, the urologist may prescribe another periodicity. The sessions last 20-30 minutes, with the patient lying down and they don’t cause any type of discomfort.
The follow-up consultation
4 weeks after the end of treatment, visit the urologist to assess the results. Occasionally, he might prescribe 2 additional sessions.